SARS-CoV-2 and COVID-19 (17)

Això és la continuació del tema SARS-CoV-2 and COVID-19 (16).

En/na SARS-CoV-2 and COVID-19 (18) ha continuat aquest tema.

ConversesPro and Con

Afegeix-te a LibraryThing per participar.

SARS-CoV-2 and COVID-19 (17)

1margd
gen. 5, 11:06am

"...the mutations that most reduce antibody binding usually occur at just a few sites in the (receptor-binding domain) RBD's receptor binding motif. The most important site is E484, where neutralization by some sera is reduced more than 10-fold by several mutations, including one in emerging viral lineages in South Africa and Brazil..."

Allison J Greaney et al. 2021. Comprehensive mapping of mutations to the SARS-CoV-2 receptor-binding domain that affect recognition by polyclonal human serum antibodies. BioRxiv (Jan 4, 2021) doi: https://doi.org/10.1101/2020.12.31.425021 https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1

This article is a preprint and has not been certified by peer review

Abstract

The evolution of SARS-CoV-2 could impair recognition of the virus by human antibody-mediated immunity. To facilitate prospective surveillance for such evolution, we map how convalescent serum antibodies are impacted by all mutations to the spike's receptor-binding domain (RBD), the main target of serum neutralizing activity. Binding by polyclonal serum antibodies is affected by mutations in three main epitopes in the RBD, but there is substantial variation in the impact of mutations both among individuals and within the same individual over time. Despite this inter- and intra-person heterogeneity, the mutations that most reduce antibody binding usually occur at just a few sites in the RBD's receptor binding motif. The most important site is E484, where neutralization by some sera is reduced more than 10-fold by several mutations, including one in emerging viral lineages in South Africa and Brazil. Going forward, these serum escape maps can inform surveillance of SARS-CoV-2 evolution.

2margd
gen. 6, 4:27am

"I think it's important that we name these new variants appropriately and we don't call these the South African or UK variant.
We need to use the names (B.1.351, B.1.1.7), because we don't want to stigmatize where the variants have been identified,"
-@WHO's @mvankerkhove

Image- portrait photo ( https://twitter.com/GHS/status/1346540850109706241/photo/1 )

- Global Health Strategies GHS | 2:35 PM · Jan 5, 2021

3margd
gen. 6, 5:02am

More efficient syringes could extend Pfizer supply by 1/6, if only government would order them...
(Geez guys, we're in a race against new strains--treat this like the war it is!)

Warning of Shortages, Researchers Look to Stretch Vaccine Supply
Sheryl Gay Stolberg and Sharon LaFraniere | Jan. 5, 2021

...Officials are also rushing to find supplies of more efficient syringes that could extract an additional dose from vials of the Pfizer-BioNTech vaccine. That could bolster the Pfizer supply by 20 percent.

...With the proper syringes, federal officials hope to extract an extra dose from Pfizer’s vials that were initially believed to contain only five doses, stretching Pfizer’s vaccine further. But the government has yet to sign contracts to supply enough of those syringes, according to two experts familiar with the vaccine distribution system...

https://nytimes.com/2021/01/05/us/politics/coronavirus-vaccine-supply.html

4margd
Editat: gen. 6, 6:16am

South African Covid variant appears to ‘obviate’ antibody drugs, Dr. Scott Gottlieb says
Emily DeCiccio | Jan 5 2021

“The South Africa variant is very concerning right now because it does appear that it may obviate some of our medical countermeasures, particularly the antibody drugs,” Dr. Scott Gottlieb (former FDA chief) said.

The South African variant is also known as 501.V2, and in mid-December officials reported that 501.V2 had been largely replacing other strains of the coronavirus as early as November.

More than 17 million Covid doses have been distributed to states, but only 4.8 million Americans have received their first shot according to the Centers for Disease Control and Prevention.

...in mid-December officials reported that 501.V2 had been largely replacing other strains of the coronavirus as early as November. South Africa has already sustained the more than 1.1 million COVID-19 cases and more than 30,000 deaths, the most on the African continent.

...501.V2 does appear to partially escape prior immunity. It means that some of the antibodies people produce when they get infected with Covid, as well as the antibody drugs, may not be quite as effective.

“The new variant has mutated a part of the spike protein that our antibodies bind to, to try to clear the virus itself, so this is concerning,” Gottlieb said. “Now, the vaccine can become a backstop against these variants really getting more of a foothold here in the United States, but we need to quicken the pace of vaccination.”

...work... through prioritized categories of people more quickly, expand... the number of vaccination sites, and stockpile... a smaller percentage of dosages in order to vaccinate more Americans.

“It really is a race against time trying to get more vaccine into people’s arms before these new variants become more prevalent here in the United States,” said Gottlieb.

https://www.cnbc.com/2021/01/05/south-africa-covid-variant-appears-to-obviate-an...

5margd
gen. 6, 5:35am

Eric Topol (cardiologist, author) @EricTopol | 5:01 PM · Jan 5, 2021:
If we wanted to get serious vs B.1.1.7
—get N95/K95 masks to all and enforce their use
—get rapid home testing big supply to each household for daily use
—amp up digital, mobility, genomic and wastewater surveillance 100X
—vaccinate 24/7 like it's an emergency. Because it is.

6margd
gen. 6, 6:12am

Viral mutations may cause another ‘very, very bad’ COVID-19 wave, scientists warn
Kai Kupferschmidt | Jan. 5, 2021

...In southeastern England, where the B.1.1.7 variant first caught scientists’ attention last month, it has quickly replaced other variants, and it may be the harbinger of a new, particularly perilous phase of the pandemic.

...“I really hope that this time we can recognize that this is our early alarm bell, and this is our chance to get ahead of this variant.”

...evidence has rapidly increased that B.1.1.7’s many mutations, including eight in the crucial spike protein, do enhance spread...

...Increased transmissibility of a virus is much more treacherous than increased pathogenicity ...

If the U.K. estimates of a 50% to 75% increase in the virus’ reproduction number, or R, hold true, “keeping the virus from spreading has become a lot harder,” says Viola Priesemann, a physicist at the Max Planck Institute for Dynamics and Self-Organization who has been modeling the pandemic and the effects of nonpharmaceutical interventions, such as physical distancing and school closures.

Isolating patients and tracing, quarantining, and testing their contacts is one part of any attempt at doing so; those measures alone can reduce R from about 2 to about 1, Priesemann has shown for Germany. But that effect breaks down when case numbers reach a critical threshold and public health authorities are overwhelmed, which means tougher measures now can help contain the spread of the new variant later. “It’s yet another reason to go for very low numbers,” says Priesemann, who co-authored a December 2020 letter to the The Lancet calling for Europe to adopt a joint strategy to bring down infections fast. Hodcroft agrees. “The case has never been stronger,” she says. “What’s the worst-case scenario here? We overshoot and we get cases so low that we can get rid of a lot of restrictions.”

Curtailing infections sharply has the added benefit of reducing the chances for the virus to evolve even further. Already other variants have emerged, notably one called 501Y.V2 in South Africa, that are just as worrying as B.1.1.7, Farrar adds. “It is essentially a numbers game: The more virus is circulating, the more chance mutants have to appear,” he says. In the long term, mutations could arise that threaten the efficacy of vaccines.

It’s dispiriting to feel like the world is back where it was in early 2020, says epidemiologist William Hanage of the Harvard T.H. Chan School of Public Health. “But we have to stop this virus. … Fatalism is not a nonpharmaceutical intervention.”

https://www.sciencemag.org/news/2021/01/viral-mutations-may-cause-another-very-v...

7margd
gen. 6, 7:09am

Oxygen...Egypt...LA...USNS Mercy in drydock...

Eric Feigl-Ding @DrEricDing | 6:27 AM · Jan 6, 2021:
Shocking videos from Egypt show chaos inside two hospitals as oxygen supplies allegedly ran out,
sending people into a panic and leaving at least 6 patients dead.

2:20 ( https://twitter.com/DrEricDing/status/1346780542323351552 )
( https://middleeasteye.net/video/everyone-died-shocking-video-shows-panic-egypt-h... )

Two investigations underway. Verified by AP & Al-Jazeera.

_________________________________________________

Amid ‘viral tsunami,’ Army Corps of Engineers will aid L.A. hospitals facing oxygen problems
Marisa Gerber, Rong-Gong Lin II | Jan. 1, 2021

...some respite finally arrived Friday: The Army Corps of Engineers was planning to send specialized crews to the region to update oxygen-delivery systems at a handful of aging hospitals.

Days earlier, several hospitals declared internal disasters and temporarily turned away all ambulance traffic because their internal oxygen systems began to buckle beneath the high demand of air flow needed by patients whose lungs had been ravaged by the coronavirus.

...older hospitals are being reconfigured to house far more patients than they ever anticipated holding, leading to the oxygen issues.

Dr. Christina Ghaly, L.A. County health services director, said that the demand is so great for a high flow of oxygen and the buildings pipes are so old, they can’t maintain sufficient pressure and, at times, started to freeze. In a scramble, Ghaly said, some hospitals were forced to move patients to lower floors, because it’s easier to deliver oxygen there without needing pressure to push it up to higher floors.

Another oxygen-related problem — the chronic shortage of portable tanks — has also hampered hospitals abilities in recent days, county officials said. To discharge recovering patients as quickly as possible and free up space for other, sicker patients, hospitals often send patients home with oxygen tanks.

The team of design and construction experts from the Corps will evaluate six hospitals — Adventist Health White Memorial in Boyle Heights, Beverly Community Hospital in Montebello, Emanate Health Queen of the Valley Hospital in West Covina, Lakewood Regional Medical Center, Mission Community Hospital in Panorama City and PIH Health Hospital in Downey — and then oversee upgrades where they’re deemed necessary...

https://www.latimes.com/california/story/2021-01-01/army-corps-of-engineers-to-a...

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USNS Mercy won’t be deploying for COVID-19 relief anytime soon
Erika I. Ritchie (Orange County Register) | January 5, 2021

The USNS Mercy, a (1,000-bed) Navy hospital ship that in March took aboard non-COVID-19 patients to help with a surge of patients in Los Angeles area hospitals, is not likely to be deployed to help again anytime soon, Navy officials said on Tuesday.

“There is no plan to deploy USNS Mercy at this time, or any time in the near future,” said Sarah Burford, a spokesperson for the ship’s command. “The ship is in the shipyard for an extended maintenance period for the next few months. It’s pretty much impossible to get it underway. We aren’t sure how long the maintenance will take.”

Last week, Los Angeles County Supervisor Janice Hahn requested that Gov. Gavin Newsom appeal to the federal government to bring the ship and its medical personnel back to the Port of Los Angeles as the region prepares for the anticipated coronavirus post-holiday “surge upon a surge.”

On Tuesday, Jan. 5, Newsom’s office said in a statement it was informed the ship was in dry dock and unavailable for service. The Navy had not received an official request for the ship from the federal government.

Instead, Newsom and the California Office of Emergency Services have asked the Federal Emergency Management Agency and United States Department of Defense to acquire and immediately deploy to additional hospitals in Southern California, medical personnel equivalent to the staff that would have been on the USNS Mercy, and then some...360 military medical personnel, 135 U.S. Health and Human Services Disaster Medical Assistance Team personnel and an additional 50 FEMA personnel, bringing the current federal augmentation request to more than 500 people...

https://www.ocregister.com/2021/01/05/usns-mercy-wont-be-deploying-for-covid-19-...

8margd
gen. 6, 10:26am

Short. Worth the read.

For mRNA vaccines, we should stick to the schedule
Angela Rasmussen* and Ilan Schwartz* | Jan 6, 2020

Vaccines are our best hope for controlling Covid-19. But they should be delivered in ways that we know are effective...

https://www.theguardian.com/commentisfree/2021/jan/06/mrna-vaccines-schedule-cov...

* Angela Rasmussen is a virologist at the Georgetown Center for Global Health Science and Security. Ilan Schwartz is an infectious diseases doctor at the University of Alberta, Canada

9margd
gen. 6, 11:30am

Jennifer M. Dan et al. 2020. Immunological memory to SARS-CoV-2 assessed for up to 8 months after infection. Science 06 Jan 2021: eabf4063 DOI: 10.1126/science.abf4063 https://science.sciencemag.org/content/early/2021/01/05/science.abf4063

Abstract
Understanding immune memory to SARS-CoV-2 is critical for improving diagnostics and vaccines, and for assessing the likely future course of the COVID-19 pandemic. We analyzed multiple compartments of circulating immune memory to SARS-CoV-2 in 254 samples from 188 COVID-19 cases, including 43 samples at 6 months or more post-infection. IgG to the Spike protein was relatively stable over 6+ months. Spike-specific memory B cells were more abundant at 6 months than at 1 month post symptom onset. 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.

...Concluding remarks
...Individual case reports show that reinfections with SARS-CoV-2 are occurring ... However, a 2,800 person study found no symptomatic re-infections over a ~118 day window ..., and a 1,246 person study observed no symptomatic re-infections over 6 months .... We observed heterogeneity in the magnitude of adaptive immune responses to SARS-CoV-2 persisting into the immune memory phase. It is therefore possible that a fraction of the SARS-CoV-2-infected population with low immune memory would become susceptible to re-infection relatively soon. While gender and disease severity both contribute some to the heterogeneity of immune memory reported here, the source of much of the heterogeneity in immune memory to SARS-CoV-2 is unknown and worth further examination. Perhaps heterogeneity derives from low cumulative viral load or a small initial inoculum in some individuals. Nevertheless, our data show immune memory in at least three immunological compartments was measurable in ~95% of subjects 5 to 8 months PSO, indicating that durable immunity against secondary COVID-19 disease is a possibility in most individuals....

10margd
gen. 6, 12:42pm

Good thing undocumented workers won't spread the virus?

Gov. Ricketts (R-NE) says undocumented workers at meatpacking plants will not be eligible to receive the COVID vaccine.
That’s at least 14% of Nebraska’s meatpacking workers, according to @MigrationPolicy

0:10 ( https://twitter.com/therecount/status/1346525695879614467 )
NE Gov: Undocumented Workers Will Not Get Vaccine

- The Recount @therecount | 1:35 PM · Jan 5, 2021

11John5918
gen. 7, 6:21am

12margd
gen. 7, 6:35am

13margd
gen. 7, 9:00am

CDC says severe allergic reactions to the Covid vaccine run 10 times reactions to the flu shot but they’re still rare
Noah Higgins-Dunn | Jan 6 2021

A new CDC study* published Wednesday found that people receiving Covid-19 vaccines experience anaphylaxis at a rate 10 times higher compared with the flu vaccine.

...The severe allergic reactions among Covid vaccine recipients are still thought to be rare and the drugs are safe for people to use, a top CDC official told reporters before the study was published...

https://www.cnbc.com/2021/01/06/cdc-says-severe-allergic-reactions-to-covid-vacc...

* Allergic Reactions Including Anaphylaxis After Receipt of the First Dose of Pfizer-BioNTech COVID-19 Vaccine — United States, December 14–23, 2020. MMWR Morb Mortal Wkly Rep. ePub: 6 January 2021. DOI: http://dx.doi.org/10.15585/mmwr.mm7002e1 https://www.cdc.gov/mmwr/volumes/70/wr/mm7002e1.htm?s_cid=mm7002e1_w

Summary
What is already known about this topic?
Anaphylaxis is a severe, life-threatening allergic reaction that occurs rarely after vaccination.

What is added by this report?
During December 14–23, 2020, monitoring by the Vaccine Adverse Event Reporting System detected 21 cases of anaphylaxis after administration of a reported 1,893,360 first doses of the Pfizer-BioNTech COVID-19 vaccine (11.1 cases per million doses); 71% of these occurred within 15 minutes of vaccination.

What are the implications for public health practice?
Locations administering COVID-19 vaccines should adhere to CDC guidance for use of COVID-19 vaccines, including screening recipients for contraindications and precautions, having the necessary supplies available to manage anaphylaxis, implementing the recommended postvaccination observation periods, and immediately treating suspected cases of anaphylaxis with intramuscular injection of epinephrine....

14margd
gen. 7, 11:41am

Quotes in online article putting Chinese success in terms of competition are kind of jarring. Never mind primary considerations of equity, it's important for all of us that this virus doesn't have opportunities to spread and mutate!

A Second Chinese Coronavirus Vaccine Is Said to Be Effective
Sui-Lee Wee | Jan. 7, 2021

Officials in the state of São Paulo, where a prominent medical research institute carried out a large study of the vaccine made by the Beijing-based Sinovac, said the inoculation had an efficacy rate of 78 percent.

The vaccine prevented all participants from developing serious and mild complications from the virus, officials said, calling it a highly effective preventive tool.

In anticipation of approval, the vaccine, called CoronaVac, has already been shipped around the world as countries prepare for mass inoculation campaigns. Sinovac has sold more than 300 million doses, mostly to low- and middle-income countries, accounting for about half of the total doses that China says vaccine makers were capable of producing in 2020...

...Even without the regulatory greenlight, China has embarked on an aggressive vaccination drive at home, with the goal of inoculating 50 million people by the middle of next month. Beijing has also developed an overseas distribution plan for exports, directing airlines to stock up on refrigerators and dry ice.

...The results in Brazil are closely watched by regulators in other countries that are conducting trials for the Sinovac vaccine because it had the biggest number of volunteers, at 12,476. Turkey announced on Dec. 24 that the vaccine had an efficacy rate of 91.25 percent but it was based on preliminary results from a small clinical trial. The scientists who ran the trial discussed the results at a news conference, but they did not provide the data online in written form.

The Chinese government said on Dec. 31 that it had approved another coronavirus vaccine made by the state-owned company Sinopharm, which had announced that its Phase 3 trials showed that its vaccine had an efficacy rate of 79.34 percent, but it did not provide any further data from their trial, making it impossible for outside experts to evaluate the claim.

Like the Sinopharm vaccine, CoronaVac is made with a traditional technology that uses an inactivated virus to provoke the body’s immune system to produce antibodies.

https://www.nytimes.com/2021/01/07/business/china-coronavirus-vaccine-sinovac.ht...

15margd
gen. 7, 4:24pm

COVID-19 vaccine allergic reactions: Experts offer reassurance
Timothy Huzar on January 5, 2021

...Vaccine allergies?

The allergists point out that, in general, vaccines are incredibly safe, with only around 1.3 anaphylactic reactions per 1 million vaccine doses administered.

When allergic reactions occur, they are typically in response to the inactive ingredients that accompany the vaccine’s active ingredients.

These inactive ingredients perform a range of functions, including preventing bacterial contamination, stabilizing the vaccine during transportation and storage, and ensuring a stronger immune response.

Both the Pfizer-BioNTech and Moderna vaccines use the inactive ingredient polyethylene glycol (PEG) to stabilize the active components. Drug manufacturers use PEG in many approved over-the-counter pharmaceuticals.

The authors of the present article note that while there is some evidence that a person’s immune system may react to PEG, anaphylactic reactions are rare.

Nonetheless, they note that many allergists hypothesize that a preexisting PEG allergy may account for the small number of reported cases of allergic reactions to the COVID-19 vaccines.

At the time of publication, the authors note that of the 2 million doses of the Pfizer-BioNTech vaccine administered in the U.S., there have been at least 10 reports of allergic reactions. All of them occurred during observation immediately after the person received the vaccine, but the participants quickly received treatment that completely resolved their symptoms.
Guidance

The authors highlight that the FDA recommend people with a history of severe allergic reactions to any component of the Pfizer-BioNTech vaccines should not receive the vaccine.

They also state that the Centers for Disease Control and Prevention (CDC) recommend that clinical staff monitor people for 15 minutes after they receive a COVID-19 vaccination. For people with a history of allergic reactions to vaccines, clinicians should monitor them for 30 minutes after vaccination.

The authors also explain that the CDC recommend that staff administering the vaccine receive training to respond to anaphylaxis.

Supplementing these guidelines, the allergists have developed a screening questionnaire that they say can quickly and safely determine if a person with allergies should receive the vaccine, and if so, under what conditions.

The questionnaire asks if the person has had a severe allergic reaction to:

injectable medications
a vaccine
other allergens
PEG

A response of “no” to all the questions means the person is lower-risk and can receive the vaccinations under the usual conditions.

A person is considered medium-risk if they answer “yes” to questions 1, 2, or 3. In this case, clinicians would observe them for 30 minutes, rather than 15.

A person is considered higher-risk if they answer “yes” to question 4. In this case, an allergist should evaluate the individual with a skin test.

If an individual reports an allergic reaction to the first dose of the vaccine, the authors suggest that allergists confirm this by using a skin test. Depending on the severity of the reaction, the allergist and the individual may decide it is safer to avoid the second vaccine dose.

Reassurance

For the authors of the article, the key message is that COVID-19 vaccines are generally very safe, and that even people with histories of allergic reactions can, in most circumstances, receive the vaccine.

For Dr. Aleena Banerji, clinical director of the Allergy and Clinical Immunology Unit at Massachusetts General Hospital, associate professor at Harvard Medical School, and the corresponding author of the article, “as allergists, we want to encourage vaccination by reassuring the public that both FDA-approved COVID-19 vaccines are safe.” She continues:

“Our guidelines are built upon the recommendations of U.S. regulatory agencies and provide clear steps to the medical community on how to safely administer both doses of the vaccine in individuals with allergic histories.”

https://www.medicalnewstoday.com/articles/covid-19-vaccine-allergic-reactions-ex...

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Paige G.Wickner et al. 2020. mRNA Vaccines to Prevent COVID-19 Disease and Reported Allergic Reactions: Current Evidence and Approach. The Journal of Allergy and Clinical Immunology: In Practice. Available online 31 December 2020
In Press, Journal Pre-proof. https://doi.org/10.1016/j.jaip.2020.12.047 https://www.sciencedirect.com/science/article/pii/S2213219820314112?via%3Dihub

Abstract
The recent Food and Drug Administration (FDA) approval of two highly effective COVID-19 vaccines from Pfizer-BioNtech and Moderna has brought hope to millions of American in the midst of an ongoing global pandemic. The FDA Emergency Use Authorization guidance for both vaccines is to not administer the vaccine to individuals with known history of a severe allergic reaction (e.g., anaphylaxis) to any component of the COVID-19 vaccine. The Centers for Diseases Control and Prevention (CDC) advises that all patients should be observed for 15 minutes after COVID-19 vaccination and staff must be able to identify and manage anaphylaxis. Post-FDA approval, despite very strong safety signals in both phase 3 trials, reports of possible allergic reactions have raised public concern. To provide reassurance and support during widespread vaccination across America, allergists must offer clear guidance to patients based on the best information available, but also in accordance with the broader recommendations of our US regulatory agencies. This review summarizes vaccine allergy epidemiology and proposes risk stratification schema: (1) for individuals with different allergy histories to safely receive their first COVID-19 vaccine and (2) for individuals who develop a reaction to their first dose of COVID-19 vaccine...

16margd
gen. 7, 5:10pm

Earlier in this/previous thread a spray was proposed to depress potential viral activity (I'll look later for link).
Image--benefits of reducing infectious period from 9.5 to 6 days ( https://twitter.com/EricTopol/status/1347293499943645184/photo/1 )

Bruce Y. Lee et al. 2020. The value of decreasing the duration of the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection. PLOS Computational Biology (January 7, 2021) https://doi.org/10.1371/journal.pcbi.1008470

Abstract
Finding medications or vaccines that may decrease the infectious period of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could potentially reduce transmission in the broader population. We developed a computational model of the U.S. simulating the spread of SARS-CoV-2 and the potential clinical and economic impact of reducing the infectious period duration. Simulation experiments found that reducing the average infectious period duration could avert a median of 442,852 {treating 25% of symptomatic cases, reducing by 0.5 days, reproductive number (R0) 3.5, and starting treatment when 15% of the population has been exposed} to 44.4 million SARS-CoV-2 cases (treating 75% of all infected cases, reducing by 3.5 days, R0 2.0). With R0 2.5, reducing the average infectious period duration by 0.5 days for 25% of symptomatic cases averted 1.4 million cases and 99,398 hospitalizations; increasing to 75% of symptomatic cases averted 2.8 million cases. At $500/person, treating 25% of symptomatic cases saved $209.5 billion (societal perspective). Further reducing the average infectious period duration by 3.5 days averted 7.4 million cases (treating 25% of symptomatic cases). Expanding treatment to 75% of all infected cases, including asymptomatic infections (R0 2.5), averted 35.9 million cases and 4 million hospitalizations, saving $48.8 billion (societal perspective and starting treatment after 5% of the population has been exposed). Our study quantifies the potential effects of reducing the SARS-CoV-2 infectious period duration.

17margd
Editat: gen. 8, 10:10am

Pfizer vaccine seems effective against transmissibility mutation (N501Y, UK and S Africa).
Similar tests planned for another mutation of concern (E484K, S Africa)--keep an eye on this one.
If needed, Pfizer vaccine could be tweaked in as little as six weeks.

Pfizer/BioNTech vaccine appears effective against mutation in new coronavirus variants -study
Michael Erman (Reuters) | 8 January 2021
https://news.trust.org/item/20210108022715-m5obt

18margd
gen. 8, 5:49am

Eric Feigl-Ding @DrEricDing | 12:41 PM · Jan 7, 2021
POTENTIALLY WORST MASS SPREADER EVENT—This #CapitolRiots could be worse than Sturgis—indoors, almost no masks, no distance, lot of shouting—worst of all scenarios.

I dread the #COVID epidemic curves in 2-3 weeks after these MAGA rioters return home.

0:40 ( https://twitter.com/DrEricDing/status/1347237031815086082 )
From Cleavon MD

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Roshan Rinaldi @Roshan_Rinaldi | 8:27 PM · Jan 7, 2021:
Yesterday during the mob takeover of Congress,... members of the House and Senate were evacuated into a shared space, where many asshole Republicans (at least 50) refused to wear a mask.

Inevitably, there's going to be a covid outbreak in Congress.
Image ( https://twitter.com/Roshan_Rinaldi/status/1347354098929119236/photo/1 )

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Eric Feigl-Ding @DrEricDing | 9:10 PM · Jan 7, 2021
Worried—Freshman GOP Kansas Congressman Jake LaTurner tests #COVID19 positive. Is 11th House member of 117th Congress—all of the same party.

But what worries me is MOCs were all holed up together yesterday during the siege. Many maskless. He was likely infectious.

19margd
gen. 8, 10:12am

London Mayor declares major incident over COVID hospital pressure
Reuters Staff | January 8, 2021

Mayor of London Sadiq Khan...“The situation in London is now critical with the spread of the virus out of control,” Khan said. “One in 30 Londoners now has COVID-19. If we do not take immediate action now, our NHS (National Health Service) could be overwhelmed and more people will die...We are declaring a major incident because the threat this virus poses to our city is at crisis point...Londoners continue to make huge sacrifices and I am today imploring them to please stay at home unless it is absolutely necessary for you to leave.”

The number of COVID-19 cases in London is now more than 1,000 per 100,000 people, and between Dec. 30 and Jan. 6, the total number of hospital patients in the capital rose by 27%. In the last three days there were 477 deaths of patients who had tested positive for the virus.

The number of people in hospital is 35% higher than during the peak of the pandemic on April, and there are concerns admissions will continue to rise.

A major incident is defined as being “beyond the scope of business-as-usual operations, and is likely to involve serious harm, damage, disruption or risk to human life or welfare, essential services, the environment or national security”.

The last major incident in London was declared following the Grenfell Tower fire in 2017 when 72 people died in Britain’s worst blaze in a residential building since World War Two.

https://www.reuters.com/article/us-health-coronavirus-britain-london/london-mayo...

20Limelite
gen. 8, 10:50pm

Possible New "US Variant" or True Covid-19 Hoax

Contrary reports coming from CDC and or White House adding to America's pandemic chaos. The stories are not a hoax, but the existence of a US Variant ARE FALSE.

False Reports of a New ‘U.S. Variant’ Came from White House Task Force

Reports of a highly contagious new variant, published on Friday by multiple news outlets, were based on speculative statements made by Dr. Deborah Birx.
The erroneous report originated at a recent meeting where Dr. Birx. . .presented graphs of the escalating cases in the country. She suggested to other members of the task force that a new, more transmissible variant originating in the U.S. might explain the surge, as another variant did in Britain.
This was in no way an announcement of fact by Dr. Birx. She was hypothesizing in the way scientists do when trying to explain phenomena that are outside the parameters of known norms. Unfortunately, her "out loud thinking"
made it into a weekly report sent to state governors. “This fall/winter surge has been at nearly twice the rate of rise of cases as the spring and summer surges. This acceleration suggests there may be a USA variant that has evolved here, in addition to the UK variant that is already spreading in our communities and may be 50% more transmissible,” the report read. “Aggressive mitigation must be used to match a more aggressive virus.”
Unfortunately, it appears that whoever wrote, edited, and issued the report failed to understand the "scientific method" of talking that Dr. Birx employed, and jumped over all the steps in the scientific method to conclusions.
. . .the C.D.C. tried to have the speculative statements removed, but were unsuccessful, according to three people familiar with the events.

C.D.C. officials did not agree with her assessment and asked to remove it but were told no.
It is not clear if Dr. Birx insisted her speculations be included in the report. She could not be reached.

21margd
gen. 9, 3:13am

Interesting to me that researchers measured "6-min walking distance". I had mild COVID (if indeed that's what I had back in Feb 2020), followed by months of distance and speed being curtailed in my daily walk. I persevered (gently), improving bit by bit until previous distance (~2.7 mile) achieved and speed, almost?

Covid symptoms can linger at least 6 months, Wuhan study finds
Erika Edwards | Jan 8, 2021

...Roughly three-quarters of the patients reported lingering symptoms six months after their initial diagnosis. Sixty-three percent said they still had fatigue or muscle weakness, 23 percent cited anxiety or depression, and 26 percent reported trouble sleeping...

https://www.nbcnews.com/health/health-news/covid-symptoms-can-linger-least-6-mon...
--------------------------------------------------​

Chaolin Huang et al. 2020. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet (January 08, 2021) DOI:https://doi.org/10.1016/S0140-6736(20)32656-8 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32656-8/fulltext

...Added value of this study
To our knowledge, this study is the largest cohort study (n=1733) with the longest follow-up duration for the consequences of adult patients discharged from hospital recovering from COVID-19. Our findings showed that 76% of patients reported at least one symptom at 6 months after symptom onset, and the proportion was higher in women. The most common symptoms were fatigue or muscle weakness and sleep difficulties. Additionally, 23% of patients reported anxiety or depression at follow-up. The percentage of patients with pulmonary diffusion abnormality during follow-up is higher in patients with more severe disease at acute phase. These patients also have a higher CT score at follow-up. Ground glass opacity* and irregular lines are the most common pattern at follow-up. In multivariable analysis, women and participants with severity scale** 5–6 have a higher risk of lung diffusion impairment, anxiety or depression, and fatigue or muscle weakness. The seropositivity of the neutralising antibodies, N-IgM, RBD-IgM, and S-IgM, N-IgA, RBD-IgA, and S-IgA antibodies, and RBD-IgG, and neutralising antibody titres at follow-up were significantly lower compared with at acute phase....

* Ground-glass opacities are abnormal findings on a CT scan of the lungs. They are hazy areas that do not obscure the underlying structures of the lung, such as the bronchial airways and blood vessels. They are found in people with various lung conditions and have been seen in people with COVID-19. (WebMD)

** The disease severity was characterised by the highest seven-category scale during the hospital stay (termed the severity scale),...which consisted of the following categories:
1, not admitted to hospital with resumption of normal activities;
2, not admitted to hospital, but unable to resume normal activities;
3, admitted to hospital but not requiring supplemental oxygen;
4, admitted to hospital but requiring supplemental oxygen;
5, admitted to hospital requiring high-flow nasal cannula (HFNC), non-invasive mechanical ventilation (NIV), or both;
6, admitted to hospital requiring extracorporeal membrane oxygenation, invasive mechanical ventilation (IMV), or both; and 7, death.

22margd
gen. 9, 3:20am

An argument for cheap, at-home (paper) tests--as well as masks, etc.:
“at least 50% of new SARS-CoV-2 infections was estimated to have originated from exposure to individuals with infection but without symptoms.”

Michael A. Johansson et al. 2020. SARS-CoV-2 Transmission From People Without COVID-19 Symptoms. JAMA Netw Open. January 7, 2021;4(1):e2035057. doi:10.1001/jamanetworkopen.2020.35057 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707

...Abstract
...Results The baseline assumptions for the model were that peak infectiousness occurred at the median of symptom onset and that 30% of individuals with infection never develop symptoms and are 75% as infectious as those who do develop symptoms. Combined, these baseline assumptions imply that persons with infection who never develop symptoms may account for approximately 24% of all transmission. In this base case, 59% of all transmission came from asymptomatic transmission, comprising 35% from presymptomatic individuals and 24% from individuals who never develop symptoms. Under a broad range of values for each of these assumptions, at least 50% of new SARS-CoV-2 infections was estimated to have originated from exposure to individuals with infection but without symptoms.

Conclusions and Relevance In this decision analytical model of multiple scenarios of proportions of asymptomatic individuals with COVID-19 and infectious periods, transmission from asymptomatic individuals was estimated to account for more than half of all transmissions. In addition to identification and isolation of persons with symptomatic COVID-19, effective control of spread will require reducing the risk of transmission from people with infection who do not have symptoms. These findings suggest that measures such as wearing masks, hand hygiene, social distancing, and strategic testing of people who are not ill will be foundational to slowing the spread of COVID-19 until safe and effective vaccines are available and widely used...

23rastaphrog
gen. 9, 9:38am

From XKCD


24margd
gen. 9, 7:23pm

Graph: 7-day rolling average of cases in Ireland, N Ireland, England, UK, US, Scotland
https://twitter.com/DrEricDing/status/1348060175517806592/photo/1

Health officials in Ireland, where a more infectious variant of the coronavirus first discovered in England has been surging, said on Saturday they believe three cases of another new variant found in South Africa had been contained.
Reuters staff \ Jan 9, 2021

Ireland is grappling with a COVID-19 surge that has exceeded last year’s first wave. It confirmed the first cases of the more infectious variant found in South Africa on Friday in people who had travelled to Ireland from South Africa over the Christmas holidays.

Ireland this week reported an increasing presence of the variant first found in England. It was detected in 25% of positive cases that underwent further testing in the week to Jan. 3, up from just 9% two weeks earlier.

...The number of patients in Irish hospitals with COVID-19 rose by 12% in the space of 24 hours on Saturday to 1,285, having in recent days exceeded the peak of 881 set during the first wave of infections.

...the total number receiving critical care (rose) to 119 and left just 27 of the 284 ICU beds in the country’s public hospitals empty.

Those hospitals can increase ICU capacity safely to 375, the head of Ireland Health Service Executive (HSE) said this week. The HSE has also reached an agreement to take over private hospital ICU beds for COVID-19 admissions.

https://www.reuters.com/article/us-health-coronavirus-ireland-idUSKBN29E0J1

25margd
gen. 10, 4:47pm

At Elite Medical Centers, Even Workers Who Don’t Qualify Are Vaccinated
Apoorva Mandavilli | Jan. 10, 2021

...hospitals affiliated with Columbia University, New York University, Harvard and Vanderbilt...

The Centers for Disease Control and Prevention has issued recommendations intended to ensure that the nation’s vaccines first reach those at highest risk: health care workers who interact with Covid-19 patients, and residents and staff members at nursing homes, followed by people age 75 and older and certain essential workers.

Each state has established its own version of the guidelines, but with the rollout proceeding at a glacial pace, pressure has been growing for a more flexible approach. Officials at the C.D.C. and the Food and Drug Administration have recently suggested that it might be wiser to simply to loosen the criteria and distribute the vaccine as widely as possible.

Still, those officials did not envision that the vaccines would be given to healthy people in their 20s and 30s ahead of older people, essential workers or others at high risk. States should still prioritize groups that “make sense,” Dr. Stephen Hahn, the F.D.A. commissioner, told reporters on Friday...

https://www.nytimes.com/2021/01/10/health/coronavirus-hospitals-vaccinations.htm...

26margd
gen. 11, 6:57am

YIKES... The way it is spreading in UK and Ireland, B117 will be final nail for US...

Eric Feigl-Ding @DrEricDing | 8:32 PM · Jan 9, 2021:
FOLKS—if you think #COVID19 cases is really bad in the US, it is even more epically surging in the UK & Ireland .
I made a short video... and highlighted the simultaneous rise in the more contagious b117 variant.
Denmark CDC thinks B117 will become dominant strain by Feb.

0:33 ( https://twitter.com/DrEricDing/status/1348080234265006082 )

27margd
gen. 11, 8:57am

JAPAN via BRAZIL: yet another worrisome strain?

BREAKING—A new #SARSCoV2 variant (aka B.1.1.248) identified by Japan
in Airplane pax from Brazil. This new one has both the more infectious N501Y mutation (not affect vaccine), as well as the disruptive E484K mutation that escapes neutralizing antibodies.

Image ( https://twitter.com/DrEricDing/status/1348606324901359619/photo/1 )

https://bloomberg.com/news/articles/2021-01-10/japan-says-it-found-new-coronavir...

- Eric Feigl-Ding @DrEricDing | 7:22 AM · Jan 11, 2021

--------------------------------------------------​
Japan Says It Found New Coronavirus Variant Similar to U.K. Strain
Shoko Oda | January 10, 2021, 6:30 AM EST Updated on January 10, 2021, 7:04 AM EST

New variant has similarities to U.K., South Africa strains
Japan’s authorities investigating infectiousness of new strain

Japan’s National Institute of Infectious Diseases said authorities have found a new strain of the coronavirus in four passengers arriving from Brazil.

The new variant has similarities to strains found in the U.K. and South Africa, the NIID said in a statement on Sunday. The information about the new variant is limited to its genetic make-up, and it’s difficult to immediately determine how infectious the strain is or the effectiveness of current vaccines against it, the institute said.

In a separate statement, Japan’s Ministry of Health said the four passengers who arrived at Japan’s Haneda airport from Brazil on Jan. 2 were later diagnosed with a variant of the virus. One male in his 40s, who was asymptomatic upon arrival, was hospitalized as his respiratory system worsened.

The NIID has informed the World Health Organization of the new strain, the Yomiuri Shimbun newspaper reported, adding the institute is investigating if the variant causes more severe cases.

https://www.bloomberg.com/news/articles/2021-01-10/japan-says-it-found-new-coron...

28bnielsen
gen. 11, 9:39am

>26 margd: Yes, we think it is a wise move to get out most vulnerable citizens vaccinated before that happens!

I think >25 margd: is a recipe to disaster. Might save a few otherwise healthy people in their 20s and 30s, but crowding hospitals and ICUs will certainly cost some of them too.

29margd
Editat: gen. 11, 9:55am

>28 bnielsen: Hopefully, some good news this week from Israel's vaccination program (plus new US prez next week) will spur more intense effort!

Eran Segal (scientist, Weisman Institute) @segal_eran | 12:15 PM · Jan 10, 2021:
Israel:
1.8 million vaccinated (~21% pop.)
~72% of all 60+ years old
~80% of all 70+ years old

This week we expect to see the effect of the vaccines, by a drop in the relative number of 60+ years old out of the critically ill patients. Our projection is the blue dashed line

Image ( https://twitter.com/segal_eran/status/1348317646790524933/photo/1 )

30margd
gen. 11, 6:00pm

For once, for one person, a COVID silver lining??

Sarah Challenor and David Tucker. 2020. SARS‐CoV‐2‐induced remission of Hodgkin lymphoma. British college of Haemotology (02 January 2021) https://doi.org/10.1111/bjh.17116 https://onlinelibrary.wiley.com/doi/full/10.1111/bjh.17116

A 61‐year‐old man was referred to the haematology department with progressive lymphadenopathy and weight loss. He was receiving haemodialysis for end‐stage renal failure secondary to IgA nephropathy. He had been off immunosuppressive therapy for three years after a failed renal transplant. Needle‐core biopsy of a supraclavicular node demonstrated Epstein–Barr virus (EBV)‐positive classical Hodgkin lymphoma ... Fluorodeoxyglucose‐positron emission tomography/computed tomography (FDG‐PET/CT) revealed avid stage IIIs disease (left image, PET scan, and supplementary image PET/CT). Shortly after diagnosis he was admitted with breathlessness and wheeze and was diagnosed with PCR‐positive SARS‐CoV‐2 pneumonia. After 11 days of best supportive ward‐based care he was discharged to convalesce at home. No corticosteroid or immunochemotherapy was administered.

Four months later, palpable lymphadenopathy had reduced and an interim PET/CT scan revealed widespread resolution of the lymphadenopathy and reduced metabolic uptake throughout (right image and supplementary image). The EBV viral PCR had also fallen to 413 copies/ml (log10 2·62)...

We hypothesise that the SARS‐CoV‐2 infection triggered an anti‐tumour immune response, as has been described with other infections in the context of high‐grade non‐Hodgkin lymphoma.1 The putative mechanisms of action include cross‐reactivity of pathogen‐specific T cells with tumour antigens and natural killer cell activation by inflammatory cytokines produced in response to infection.

31Limelite
Editat: gen. 11, 9:33pm

Gorillas at San Diego Zoo Test Positive for COVID-19

At least two gorillas at California's San Diego Zoo have caught the coronavirus, the first known instance of natural transmission to great apes, officials said Monday.

Two primates began coughing last week and have since tested positive for Covid-19, while a third is showing symptoms, Governor Gavin Newsom said.

They are thought to have contracted the virus from an asymptomatic zoo worker, though this has yet to be confirmed.
(SNIP)
The San Diego Zoo Safari Park, where the gorillas are kept, has been closed to visitors since early December as record cases began surging through Southern California.

Workers are all required to wear personal protective equipment such as masks when near the gorillas, the zoo said.

32margd
gen. 12, 5:01pm

Alex Moe @AlexNBCNews | 4:25 PM · Jan 12, 2021:
JUST IN: Fines for members not wearing masks on House floor will be included in rule tonight per senior Dem aide. $500 fine for first offense. $2,500 for second office. Fines will be deducted from Member pay so cannot use campaign funds or MRA for fines

Also, the House Office Building Commission will be immediately considering the implementation of a similar fine system for non-compliance in the House Office Buildings and house side of the U.S. Capitol Building

This news comes after at least 3 House Dems* have tested positive for COVID after sheltering in a secure room Wednesday with members refusing to wear masks

*Congressmembers Brad Schneider (IL-10), Pramila Jayapal (WA-07), and Rep. Bonnie Watson Coleman
(NJ-12)---70s, black, cancer survivor...

33bohemima
gen. 12, 5:34pm

Yes. Finally.

34margd
gen. 13, 2:28am

Vaccine escape? E484K mutation seen in S Africa and Brazil variants:

Scientists are monitoring a coronavirus mutation that could affect the strength of vaccines
Andrew Joseph @DrewQJoseph | January 7, 2021

As scientists try to track the spread of a new, more infectious coronavirus variant around the world — finding more cases in the United States and elsewhere this week — they are also keeping an eye on a different mutation with potentially greater implications for how well Covid-19 vaccines work.

The mutation, identified in a variant first seen in South Africa and separately seen in another variant in Brazil, changes a part of the virus that your immune system’s antibodies get trained to recognize after you’ve been infected or vaccinated. Lab studies show that the change could make people’s antibodies less effective at neutralizing the virus. The mutation seems to help the virus disguise part of its signature appearance, so the pathogen might have an easier time slipping past immune protection.

It’s not that the mutation will render existing vaccines useless, scientists stress. The vaccines authorized so far and those in development produce what’s called a polyclonal response, generating numerous antibodies that home in on different parts of the virus. Changes to any of those target sites raise the possibility that the vaccines would be less effective, not that they won’t work at all.

...Jesse Bloom, an evolutionary virologist at Fred Hutchinson Cancer Research Center,...believe(s) the virus would have to pick up multiple mutations — and particular mutations in specific spots, not just any alterations — to have a serious effect on vaccine efficacy, which will likely take some time.

...Scientists do think the coronavirus could eventually change so much that the immunity provided by vaccines will be threatened, a process that will pick up as the number of people protected from the virus — either through vaccination or infection — grows and evolutionary pressure in turn increases. But they still anticipate it could take years, and that when it does occur, vaccine makers can tweak their designs to match the newer variant, a process some companies have said would only take weeks.

https://www.statnews.com/2021/01/07/coronavirus-mutation-vaccine-strength/

--------------------------------------------------​

Allison J. Greaney et al. 2020. Comprehensive mapping of mutations to the SARS-CoV-2 receptor-bindingdomain that affect recognition by polyclonal human serum antibodies​. BioRxiv (Jan 4, 2020) https://doi.org/10.1101/2020.12.31.425021 https://www.biorxiv.org/content/10.1101/2020.12.31.425021v1.full.pdf

Preprint. Not yet peer-reviewed.

Abstract
The evolution of SARS-CoV-2 could impair recognition of the virus by human antibody-mediated immunity. To facilitate prospective surveillance for such evolution, we map how convalescent serum antibodies are impacted by all mutations to the spike’s receptor-binding domain (RBD), the main target of serum neutralizing activity. Binding by polyclonal serum antibodies is affected by mutations in three main epitopes in the RBD, but there is substantial variation in the impact of mutations both among individuals and within the same individual over time. Despite this inter- and intra-person heterogeneity,the mutations that most reduce antibody binding usually occur at just a few sites in the RBD’s receptor binding motif. The most important site is E484, where neutralization by some sera is reduced >10 margd:-foldby several mutations, including one in emerging viral lineages in South Africa and Brazil. Going forward, these serum escape maps can inform surveillance of SARS-CoV-2 evolution.

35margd
Editat: gen. 13, 3:14am

CDC: Looking back to August, U.S. counties w/ large colleges/universities that had remote learning had a 18% DECREASE in COVID19 incidence while those w/in-person instruction had a 56% INCREASE. Study compared 21-day periods before & after classes started.

- Dr. Ali Nouri @AliNouriPhD4:24 PM · Jan 12, 2021

--------------------------------------------------​

Leidner AJ, Barry V, Bowen VB, et al. Opening of Large Institutions of Higher Education and County-Level COVID-19 Incidence — United States, July 6–September 17, 2020. MMWR Morb Mortal Wkly Rep 2021;70:14–19. DOI: http://dx.doi.org/10.15585/mmwr.mm7001a4 https://www.cdc.gov/mmwr/volumes/70/wr/mm7001a4.htm

Summary
What is already known about this topic?...

What is added by this report?
U.S. counties with large colleges or universities with remote instruction (n = 22) experienced a 17.9% decrease in incidence and university counties with in-person instruction (n = 79) experienced a 56% increase in incidence, comparing the 21-day periods before and after classes started. Counties without large colleges or universities (n = 3,009) experienced a 6% decrease in incidence during similar time frames.

What are the implications for public health practice?
Additional implementation of effective mitigation activities at colleges and universities with in-person instruction could minimize on-campus COVID-19 transmission and reduce county-level incidence.

36John5918
gen. 13, 11:05pm

Africa secures 270m Covid-19 vaccine doses (BBC)

A provisional 270 million doses of Covid-19 vaccines have been secured by the African Union (AU) for distribution across the continent... This is on top of 600 million doses already promised but is still not enough to vaccinate the whole region. There are fears that poorer countries globally will wait far longer than richer nations to be inoculated...


For a population of around 1.3 billion, which is slightly larger than Europe and north America combined.

372wonderY
gen. 14, 7:36am

Not sure this treatment trial has been reported already, but it sounds exciting. Inhalation of the protein interferon beta, prompting an immune system response; 80% protection.

Covid: Large trial of new treatment begins in UK https://www.bbc.co.uk/news/health-55639096.

38margd
Editat: gen. 14, 9:29am

>37 2wonderY: Cool! I don't recall this one, but some discussion of nasal-spray that one could use after exposure--to stop viral replication in nose and throat, before it heads to lungs and gut. Maybe the idea now has legs!

39margd
Editat: gen. 14, 4:20pm

Might be better to take paracetamol/acetaminophen/Tylenol, rather than NSAIDs/ibuprofen/meloxicam for any aches and pains after COVID vaccination: NSAID treatment may dampen the inflammatory response and production of protective antibodies, possibly altering one's immune response to SARS-CoV-2 vaccination.

Eric Topol (cardiologist, author) @EricTopol | 12:40 PM · Jan 14, 2021
https://twitter.com/EricTopol/status/1349773488580554754
I had wondered about the impact of taking NSAIDs for the side-effects of vaccines (like headache, muscle aches, etc).
That's especially why this work is particularly important

Quote Tweet
Prof. Akiko Iwasaki (Yale viologist) @VirusesImmunity · 3h
https://twitter.com/VirusesImmunity/status/1349771805360336898
This work by @WilenLab @chennifer_jen @StephanieEisen shows
non-steroidal anti-inflammatory drugs (NSAIDs) dampen antibody response to #SARSCoV2 in mice.
Important implications.
https://jvi.asm.org/content/early/2021/01/12/JVI.00014-21*
_________________________________________________

* Jennifer S. Chen et al. 2020. Non-steroidal anti-inflammatory drugs dampen the cytokine and antibody response to SARS-CoV-2 infection. J of Virology. DOI: 10.1128/JVI.00014-21 https://jvi.asm.org/content/early/2021/01/12/JVI.00014-21

Abstract
Identifying drugs that regulate severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and its symptoms has been a pressing area of investigation during the coronavirus disease 2019 (COVID-19) pandemic. Nonsteroidal anti-inflammatory drugs (NSAIDs), which are frequently used for the relief of pain and inflammation, could modulate both SARS-CoV-2 infection and the host response to the virus. NSAIDs inhibit the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), which mediate the production of prostaglandins (PGs). As PGs play diverse biological roles in homeostasis and inflammatory responses, inhibiting PG production with NSAIDs could affect COVID-19 pathogenesis in multiple ways, including: (1) altering susceptibility to infection by modifying expression of angiotensin-converting enzyme 2 (ACE2), the cell entry receptor for SARS-CoV-2; (2) regulating replication of SARS-CoV-2 in host cells; and (3) modulating the immune response to SARS-CoV-2. Here, we investigate these potential roles. We demonstrate that SARS-CoV-2 infection upregulates COX-2 in diverse human cell culture and mouse systems. However, suppression of COX-2 by two commonly used NSAIDs, ibuprofen and meloxicam, had no effect on ACE2 expression, viral entry, or viral replication. In contrast, in a mouse model of SARS-CoV-2 infection, NSAID treatment reduced production of pro-inflammatory cytokines and impaired the humoral immune response to SARS-CoV-2 as demonstrated by reduced neutralizing antibody titers. Our findings indicate that NSAID treatment may influence COVID-19 outcomes by dampening the inflammatory response and production of protective antibodies rather than modifying susceptibility to infection or viral replication.

Importance
Public health officials have raised concerns about the use of nonsteroidal anti-inflammatory drugs (NSAIDs) for treating symptoms of coronavirus disease 2019 (COVID-19). NSAIDs inhibit the enzymes cyclooxygenase-1 (COX-1) and cyclooxygenase-2 (COX-2), which are critical for the generation of prostaglandins – lipid molecules with diverse roles in homeostasis and inflammation. Inhibition of prostaglandin production by NSAIDs could therefore have multiple effects on COVID-19 pathogenesis. Here, we demonstrate that NSAID treatment reduced both the antibody and pro-inflammatory cytokine response to SARS-CoV-2 infection. The ability of NSAIDs to modulate the immune response to SARS-CoV-2 infection has important implications for COVID-19 pathogenesis in patients. Whether this occurs in humans and whether it is beneficial or detrimental to the host remains an important area of future investigation. This also raises the possibility that NSAIDs may alter the immune response to SARS-CoV-2 vaccination.

40margd
Editat: gen. 15, 1:09pm

I know five people now who have received first dose of (Pfizer?) vaccine: two Canadians in healthcare biz, plus three elderly Americans, one with health issues. The latter has two severe food allergies, so I was pleased to hear that she handled the vaccine with no problems. The Americans at least were advised to use Tylenol (acetaminophen) for any vaccine-related aches and pains.

Vaccine reserve was already exhausted when Trump administration vowed to release it, dashing hopes of expanded access
States were anticipating a windfall after federal officials said they would stop holding back second doses. But the approach had already changed, and no stockpile exists.
Isaac Stanley-Becker and Lena H. Sun | Jan. 15, 2021 at 12:20 p.m. EST

When Health and Human Services Secretary Alex Azar announced this week that the federal government would begin releasing coronavirus vaccine doses held in reserve for second shots, no such reserve existed, according to state and federal officials briefed on distribution plans. The Trump administration had already begun shipping out what was available beginning at the end of December, taking second doses directly off the manufacturing line.

Now, health officials across the country who had anticipated their extremely limited vaccine supply as much as doubling beginning next week are confronting the reality that their allocations will not immediately increase, dashing hopes of dramatically expanding access for millions of elderly people and those with high-risk medical conditions. Health officials in some cities and states were informed in recent days about the reality of the situation, while others are still in the dark...

https://www.washingtonpost.com/health/2021/01/15/trump-vaccine-reserve-used-up/

41margd
gen. 15, 1:40pm

20C-US, COH.20G/501Y... Sounds like SARS-CoV-2 mutations for infectiousness and ability to evade antibodies are being selected for, thus new strains are emerging independently throughout the world.* None of us is safe until all of us are safe...

New COVID-19 strain discovered in the US even more contagious - research
SARAH CHEMLA | JANUARY 15, 2021

A new variant of the coronavirus was discovered in the United States, and seems to be even more contagious than both the South African and British strain previously discovered, two studies revealed.

In the first study, scientists from Southern Illinois University identified a third US variant of COVID-19, that may be the most contagious strain yet, researchers said Thursday, adding it is believed to be responsible for up to 50% of all US cases.

...Keith Gagnon, an associate professor of biochemistry at SIU Carbondale who discovered the new variant, referred to as 20C-US.
“It’s definitely home-grown and widespread, and we’re the first to characterize it,” Gagnon said, adding that its impact on vaccines is uncertain....hitting mostly the Midwest, researchers said in a press release, revealing that they traced back the strain to Texas, where it apparently first appeared in May. “We have identified a new variant of the SARS-CoV-2 virus that emerged in the United States early in the coronavirus disease pandemic and has become one of the most prevalent US variants...It might be more easily transmissible than other variants, and its impact on vaccines is uncertain”...

(A day earlier) scientists from the Ohio State University Wexner Medical Center and College of Medicine discovered the new variant of SARS-Cov-2, identical to the UK strain, but likely arising in a virus strain already present in the United States.
The researchers also reported the evolution of another US strain, 20C-US, that acquired three other gene mutations not previously seen together in SARS-CoV2. “The big question is whether these mutations will render vaccines and current therapeutic approaches less effective,” said Peter Mohler, a co-author of the study and chief scientific officer at the Ohio State Wexner Medical Center and vice dean for research at the College of Medicine. “At this point, we have no data to believe that these mutations will have any impact on the effectiveness of vaccines now in use...It’s important that we don’t overreact to this new variant until we obtain additional data...We need to understand the impact of mutations on transmission of the virus, the prevalence of the strain in the population and whether it has a more significant impact on human health...Further, it is critical that we continue to monitor the evolution of the virus, so we can understand the impact of the mutant forms on the design of both diagnostics and therapeutics. It is critical that we make decisions based on the best science.”

The scientists said that discovery of the Columbus variant, COH.20G/501Y, suggests that the same mutation may be occurring independently in multiple parts of the world during the past few months. “Viruses naturally mutate and evolve over time, but the changes seen in the last two months have been more prominent than in the first months of the pandemic”...

https://www.jpost.com/health-science/new-covid-19-strain-discovered-in-the-us-ev...

--------------------------------------------------​

* What Is Convergent Evolution?
Charlie Wood | November 01, 2019
https://www.livescience.com/convergent-evolution.html

** Adrian A Pater...Keith T Gagnon. 2020. Emergence and Evolution of a Prevalent New SARS-CoV-2 Variant in the United States. BioRxiv (Jan 13, 2021) doi: https://doi.org/10.1101/2021.01.11.426287 https://www.biorxiv.org/content/10.1101/2021.01.11.426287v1

This article is a preprint and has not been certified by peer review.

Abstract
Genomic virus surveillance can lead to early identification of new variants and inform proper response during a pandemic. Using this approach, we have identified a new variant of the SARS-CoV-2 virus that emerged in the United States (U.S.) early in the coronavirus disease (COVID-19) pandemic and has become one of the most prevalent U.S variants. This new variant within the B.1.2 lineage referred to here as 20C-US, has not yet spread widely to other countries. The earliest 20C-US genomes can be traced to the southern U.S. in late May of 2020. A major early event was the rapid acquisition of five non-synonymous mutations. The changes carried by 20C-US now include mutations to genes involved in virus particle maturation and release, processing of viral proteins, and RNA genome integrity and translation genes, all important for efficient and accurate virus production. In addition, 20C-US has since acquired two new non-synonymous mutations that highlight its ongoing evolution, one of which is a Q677H mutation in the spike protein adjacent to the furin cleavage site. We predict that 20C-US may already be the most dominant variant of SARS-CoV-2 in the U.S. The ongoing evolution of 20C-US, as well as other dominant region-specific variants emerging around the world, should continue to be monitored with genomic, epidemiologic, and experimental studies to understand viral evolution and predict future outcomes of the pandemic.

***
https://wexnermedical.osu.edu/mediaroom/pressreleaselisting/new-sars-cov2-varian...

42margd
gen. 15, 1:43pm

"We also project a 0.87-y reduction in life expectancy at age 65 y. The Black and Latino populations are estimated to experience declines in life expectancy at birth of 2.10 and 3.05 y, respectively, both of which are several times the 0.68-y reduction for Whites. These projections imply an increase of nearly 40% in the Black−White life expectancy gap, from 3.6 y to over 5 y, thereby eliminating progress made in reducing this differential since 2006. Latinos, who have consistently experienced lower mortality than Whites (a phenomenon known as the Latino or Hispanic paradox), would see their more than 3-y survival advantage reduced to less than 1 y."

Theresa Andrasfay and Noreen Goldman. 2021. Reductions in 2020 US life expectancy due to COVID-19 and the disproportionate impact on the Black and Latino populations. PNAS February 2, 2021 118 (5) e2014746118; https://doi.org/10.1073/pnas.2014746118 https://www.pnas.org/content/118/5/e2014746118

Significance
COVID-19 has generated a huge mortality toll in the United States, with a disproportionate number of deaths occurring among the Black and Latino populations. Measures of life expectancy quantify these disparities in an easily interpretable way. We project that COVID-19 will reduce US life expectancy in 2020 by 1.13 y. Estimated reductions for the Black and Latino populations are 3 to 4 times that for Whites. Consequently, COVID-19 is expected to reverse over 10 y of progress made in closing the Black−White gap in life expectancy and reduce the previous Latino mortality advantage by over 70%. Some reduction in life expectancy may persist beyond 2020 because of continued COVID-19 mortality and long-term health, social, and economic impacts of the pandemic.

Abstract
COVID-19 has resulted in a staggering death toll in the United States: over 215,000 by mid-October 2020, according to the Centers for Disease Control and Prevention. Black and Latino Americans have experienced a disproportionate burden of COVID-19 morbidity and mortality, reflecting persistent structural inequalities that increase risk of exposure to COVID-19 and mortality risk for those infected. We estimate life expectancy at birth and at age 65 y for 2020, for the total US population and by race and ethnicity, using four scenarios of deaths—one in which the COVID-19 pandemic had not occurred and three including COVID-19 mortality projections produced by the Institute for Health Metrics and Evaluation. Our medium estimate indicates a reduction in US life expectancy at birth of 1.13 y to 77.48 y, lower than any year since 2003. We also project a 0.87-y reduction in life expectancy at age 65 y. The Black and Latino populations are estimated to experience declines in life expectancy at birth of 2.10 and 3.05 y, respectively, both of which are several times the 0.68-y reduction for Whites. These projections imply an increase of nearly 40% in the Black−White life expectancy gap, from 3.6 y to over 5 y, thereby eliminating progress made in reducing this differential since 2006. Latinos, who have consistently experienced lower mortality than Whites (a phenomenon known as the Latino or Hispanic paradox), would see their more than 3-y survival advantage reduced to less than 1 y.

43margd
gen. 15, 2:02pm

!

As of now, Publix is only offering vaccine in Florida counties won by Republicans
Jim Turner | Jan 14, 2021

DeSantis said the initial rollout has focused on areas where hospital systems might need assistance and where there are large senior populations...

https://www.cltampa.com/news-views/florida-news/article/21148001/as-of-now-publi...

44margd
gen. 15, 2:29pm

>39 margd: While Tylenol appears to be the better choice for any aches and pains associated with COVID vaccine* (and maybe initial fever stage of disease COVID?), this isn't to say NSAIDs and aspirin may not have a role in treating COVID, the disease (cytokine storm, clots, etc.). Check with your MD, if the question of which painkiller to use (and WHEN) arises, as it's a fast-moving area of study, e.g.,

NSAIDs

April 2020. “At present there is no evidence of severe adverse events, acute health care utilization, long-term survival, or quality of life in patients with COVID-19, as a result of the use of NSAIDs.” https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-...(nsaids)-in-patients-with-covid-19

Oct 2020: "In the outpatient setting, SARS-CoV-2-positive, new users of indomethacin, a non-steroidal anti-inflammatory drug (NSAID) that targets PGES-2, were less likely than matched new users of celecoxib, an NSAID that does not target PGES-2, to require hospitalization or inpatient services." https://www.worldpharmanews.com/research/5431-scientists-identify-common-vulnera...

*Jan 2021. “The ability of NSAIDs to modulate the immune response to SARS-CoV-2 infection has important implications for COVID-19 pathogenesis in patients. Whether this occurs in humans and whether it is beneficial or detrimental to the host remains an important area of future investigation. This also raises the possibility that NSAIDs may alter the immune response to SARS-CoV-2 vaccination.” https://jvi.asm.org/content/early/2021/01/12/JVI.00014-21

ASPIRIN

April 2020. ...the early use of aspirin in covid-19 patients, which has the effects of inhibiting virus replication, anti-platelet aggregation, anti-inflammatory and anti-lung injury, is expected to reduce the incidence of severe and critical patients, shorten the length of hospital duration and reduce the incidence of cardiovascular complications... https://clinicaltrials.gov/ct2/show/NCT04365309 ;

April 2020. At present there is no evidence of severe adverse events, acute health care utilization, long-term survival, or quality of life in patients with COVID-19, as a result of the use of NSAIDs. https://www.who.int/news-room/commentaries/detail/the-use-of-non-steroidal-anti-...(nsaids)-in-patients-with-covid-19

Sept 2020 ACTIV-4-Antithrombotics Outpatient will investigate whether anticoagulants or antithrombotic therapy can reduce life-threatening cardiovascular or pulmonary complications in newly diagnosed COVID-19 patients who do not require hospital admission. Researchers will also collect patient data and blood samples to help identify new drug targets and biomarkers that may help identify a patient’s risk of developing complications related to COVID-19. Participants will be assigned to take either a placebo, aspirin or a low or therapeutic dose of the blood thinner apixaban. https://www.nih.gov/news-events/news-releases/nih-activ-initiative-launches-adap...

Oct 2020 Following PCR-confirmation of the President’s diagnosis, as a precautionary measure he received a single 8 gram dose of Regeneron’s polyclonal antibody cocktail. He completed the infusion without incident. In addition to the polyclonal antibodies, the President has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin. https://www.cnn.com/politics/live-news/trump-coronavirus-positive/h_16a6e0e1d4f9... ;

Nov 2020...promising drugs...in development...Imperial College London: Aspirin... https://graphics.reuters.com/HEALTH-CORONAVIRUS/yxmvjqywprz/index.html ; 6.

45margd
gen. 16, 10:44am

1. Of consumer-grade masks, "a 2-layer woven nylon mask with ear loops that was tested with an optional aluminum nose bridge and nonwoven filter insert in place", i.e. black NYLON Easy Masks https://easymasks.com/, had FFE (fitted filtration efficiency) against NaCL aerosol--up to 79% after washing!

2. For medical procedure masks (Cardinal Health https://www.cardinalhealth.com ), modifications that enhanced the fit between the mask and the wearer’s face improved FFE. Simply tying the ear loops and tucking the corners of the mask against the wearer’s cheeks visibly improved mask fit and increased FFE from 38.5% to 60.3%

3. Sounds like Hanes 3-layer white cotton which I bought earlier may have FFE of only 26.5%...

Fit is important, so for easymasks.com measure ear-to-ear over upper lip. While we both measured 10.5", M/L fit me best, while XL best fitted DH.
__________________________________________________​
Phillip W. Clapp et al. 2020. Evaluation of Cloth Masks and Modified Procedure Masks as Personal Protective Equipment for the Public During the COVID-19 Pandemic. JAMA Intern Med. Published online December 10, 2020. doi:10.1001/jamainternmed.2020.8168 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2774266

Key Points
Question What are the fitted filtration efficiencies (FFEs) of consumer-grade masks, improvised face coverings, and modified procedure masks commonly used during the coronavirus disease 2019 (COVID-19) pandemic?

Findings In this comparative study of face covering FFEs, we observed that consumer-grade masks and improvised face coverings varied widely, ranging from 26.5% to 79.0% FFE. Modifications intended to enhance the fit of medical procedure masks improved FFE measurements from 38.5% (unmodified mask) to as much as 80.2%.

Meaning Simple modifications can improve the fit and filtration efficiency of medical procedure masks; however, the practical effectiveness of consumer-grade masks available to the public is, in many cases, comparable with or better than their non-N95 respirator medical mask counterparts.

Abstract
Importance During the coronavirus disease 2019 (COVID-19) pandemic, the general public has been advised to wear masks or improvised face coverings to limit transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). However, there has been considerable confusion and disagreement regarding the degree to which masks protect the wearer from airborne particles.

Objectives To evaluate the fitted filtration efficiency (FFE) of various consumer-grade and improvised face masks, as well as several popular modifications of medical procedure masks that are intended to improve mask fit or comfort.

Design, Setting, and Participants For this study conducted in a research laboratory between June and August 2020, 7 consumer-grade masks and 5 medical procedure mask modifications were fitted on an adult male volunteer, and FFE measurements were collected during a series of repeated movements of the torso, head, and facial muscles as outlined by the US Occupational Safety and Health Administration Quantitative Fit Testing Protocol. The consumer-grade masks tested included (1) a 2-layer woven nylon mask with ear loops that was tested with an optional aluminum nose bridge and nonwoven filter insert in place, (2) a cotton bandana folded diagonally once (ie, “bandit” style) or in a (3) multilayer rectangle according to the instructions presented by the US Surgeon General, (4) a single-layer woven polyester/nylon mask with ties, (5) a nonwoven polypropylene mask with fixed ear loops, (6) a single-layer woven polyester gaiter/neck cover balaclava bandana, and (7) a 3-layer woven cotton mask with ear loops. Medical procedure mask modifications included (1) tying the mask’s ear loops and tucking in the side pleats, (2) fastening ear loops behind the head with 3-dimensional–printed ear guards, (3) fastening ear loops behind the head with a claw-type hair clip, (4) enhancing the mask/face seal with rubber bands over the mask, and (5) enhancing the mask/face seal with a band of nylon hosiery over the fitted mask.

Main Outcomes and Measures The primary study outcome was the measured FFE of common consumer-grade and improvised face masks, as well as several popular modifications of medical procedure masks.

Results The mean (SD) FFE of consumer grade masks tested on 1 adult male with no beard ranged from 79.0% (4.3%) to 26.5% (10.5%), with the 2-layer woven nylon mask having the highest FFE. Unmodified medical procedure masks with ear loops had a mean (SD) FFE of 38.5% (11.2%). All modifications evaluated in this study increased procedure mask FFE...(up) to 80.2%..., with a nylon hosiery sleeve placed over the procedure mask producing the greatest improvement.

Conclusions and Relevance While modifications to improve medical procedure mask fit can enhance the filtering capability and reduce inhalation of airborne particles, this study demonstrates that the FFEs of consumer-grade masks available to the public are, in many cases, nearly equivalent to or better than their non-N95 respirator medical mask counterparts.

...Discussion
In this study, consumer-grade masks and medical procedure mask modifications were tested as personal protective equipment (protection for the wearer) against a test aerosol of 0.05-μm NaCl particles. Although the FFE of consumer-grade masks and face coverings was variable, the FFE of some consumer-grade products exceeded that of medical-grade procedure masks. For example, the 2-layer woven nylon mask with ear loops was tested under various conditions, including with and without an aluminum nose bridge, with and without a commercially available nonwoven insert, and after 1 wash cycle in a standard household washing machine (air-dried on a drying rack). The unwashed nylon mask without a nose bridge or insert had an FFE of 44.7%. The addition of a nose bridge reduced visible gaps around the nose and increased FFE to 56.3%. Adding a nonwoven filter insert to the mask with the nose bridge in place resulted in a further increase in FFE to 74.4% (Figure 3C). Interestingly, the FFE of the nylon mask (with the nose bridge but without the filter insert) improved slightly to 79.0% after washing. It is unclear why washing alone improved the FFE from 56.3% to 79.0%. It may be that the washing/drying process unraveled some of the fibers to increase the overall filtration surface, and thus filtration efficiency, of the medium, or perhaps it modified the mask shape or size in a way that improved fit, or both. The washing/drying test was not repeated with additional nylon masks. Further investigation to assess the association of single and multiple washing with mask integrity and material disposition would be necessary to validate any improvement in FFE.

The woven cotton mask, which comprises 3 layers and has a thin, flexible metal nose bridge, had the lowest FFE in this study (26.5%). The relatively loose weave of the cotton layers, while providing improved breathability and comfort, may reduce filtration efficiency. Additionally, we evaluated the FFE of improvised face coverings, including a standard cotton bandana and a neck gaiter balaclava bandana. The cotton bandana, when folded either bandit style or according to the US Surgeon General’s instructions, achieved approximately 50% FFE, which is better than the ear loop procedure mask we tested. Neck gaiter balaclava bandanas have also emerged as a popular face covering, particularly among athletes and young adults. As tested in this study, the single-layer gaiter, which was made of 92% polyester and 8% spandex and fits tightly to the wearer’s nose and mouth, had an FFE of 37.8%. While this face covering appeared to fit the wearer well, with no visible gaps in the seal, it may be that the relatively low FFE can be attributed to the low filtering efficiency of a single thin layer of woven material with large porosity.

For medical procedure masks, modifications that enhanced the fit between the mask and the wearer’s face improved FFE. Simply tying the ear loops and tucking the corners of the mask against the wearer’s cheeks visibly improved mask fit and increased FFE from 38.5% to 60.3% (Figure 3, A and B). The most effective modification tested was the use of a nylon hosiery sleeve placed over the procedure mask. This modification, which held the mask tight to the wearer’s face, eliminated all visible gaps and increased FFE from 38.5% to 80.2%. However, donning the nylon sleeve over the procedure mask was cumbersome and limited the wearer’s ability to adjust the procedure mask. Generally, improvements in procedure mask FFE appeared to be associated with the integrity of the seal of the edges of the mask to the wearer’s face, demonstrating the importance of mask fit to maximizing filtration. While all of the modifications described in the Table enhanced protection against airborne particles for the wearer, not all were comfortable or practical for extended use. For example, the 3–rubber band “fix-the-mask” modification created considerable pressure on the wearer’s ears (visible in Figure 2E), making it uncomfortable after only minutes of wear and raising questions about its adoption by the general public. While the modifications shown in this article can improve mask fit and provide increased filtration of airborne particles, it is important to choose a modification in which discomfort is not a deterrent from wearing the mask for prolonged periods.

Limitations
The data presented in this article provide information on the use of masks and face coverings as personal protective equipment, which is defined in this study as protection for the wearer against exposure to an aerosol composed of small (0.05-μm) particles. However, we acknowledge that there are limitations to these findings. First, all FFE tests were performed on a single individual to ensure consistency and allow for a controlled comparison between test products. Interperson heterogeneity in facial geometries may result in variability of mask fit and differences in FFE. Second, the size of the NaCl particles used in this study (0.05 μm) may not reflect the most penetrating particle size for all of the mask materials tested. The most penetrating particle size for nonelectret filter media (filters that collect particles by aerodynamic rather than electrostatic mechanisms) can range from 0.2 μm to 0.5 μm.12 As a result, the reported FFE values at 0.05 μm may slightly overestimate the FFE of particles in the most penetrating size range. However, based on the mechanisms of particle deposition that govern filtration (ie, diffusion, impaction, interception, and sedimentation), it is clear that protection against aerosols of 0.05-μm particles would also confer similar or better protection against much larger aerosols or droplets,13 which are currently believed to be the predominant source for COVID-19 transmission.

Conclusions
Masks serve a dual purpose to protect the wearer and others. These analyses were designed to quantify the protection that masks offer to the wearer when exposed to others who may be infected. The exact FFE required to prevent respiratory virus transmission is not precisely known. However, evidence from previous studies suggests that even face masks with an FFE less than 95% (eg, surgical masks) are effective in preventing the acquisition of epidemic coronaviruses (SARS-CoV-1, SARS-CoV-2) by health care clinicians, except possibly during aerosol-generating procedures.6-8 For prevention of an associated coronavirus, SARS-CoV-1, N95 respirators had no increased prevention benefit over surgical masks.

46margd
gen. 17, 8:58am

Everything We Know Now About Schools, Kids, and Covid-19
Researchers are finally getting good data on how severely SARS-CoV-2 affects children and how they transmit it. What does it mean for reopening classrooms?
Megan Molteni | 01.15.2021

...In the US, kids are between four and nine times less likely than adults to be hospitalized with Covid-19, and between nine and 16 times less likely to die, according to CDC data.

...Kids might be less likely to suffer the worst ravages of the disease. But when tens of millions of Americans are contracting Covid-19, even a low incidence of bad outcomes quickly starts to add up.

...Newborns and infants have consistently been found to be at the highest risk, along with kids with underlying health conditions. Then, as kids transform into teenagers, their bodies become more like adults and their social networks expand, putting them more at risk than elementary and middle school students. A pivotal shift appears to happen around the start of puberty.

...Black, Latino, and American Indian kids also suffer severe Covid-19 disease and death at higher rates than white children...Black and Latino children have also disproportionately come down with a constellation of serious heart, gastrointestinal, and kidney complications following bouts with Covid-19. Known as multisystem inflammatory syndrome, or MIS-C, this still-mysterious ailment, while rare, has struck more than 1,600 kids by the CDC’s most recent count.

...People who had the virus spread it to half of their household companions...And it didn’t matter whether it was a kid or an adult who brought SARS-CoV-2 home, they transmitted it to their family at similar rates. Within households, kids also got infected just as often as adults. But they tended to get less sick than the grown-ups, avoiding fevers and a cough most of the time...symptomatic kids can spread the coronavirus just as easily as symptomatic adults...To understand (spread by asymptomatic kids) we’ll have to wait a little bit longer.

...there HAVE been some super-spreading events at schools and other places where children congregate. The common threads uniting those incidents is that now-rote protective measures like social distancing, mask wearing, and improving ventilation weren’t rigorously enforced. And they happened in places where the virus was already circulating at very high rates.

...the loss of in-person instruction (damages) kids’ mental and physical well-being, as well as their education...severed millions of kids from regular meals they depend on...upended systems designed to protect students from child abuse...teens are experiencing anxiety and depression in shocking numbers. One troubling analysis performed by pediatricians and public health researchers at the University of Washington found that school closures in 2020 could be cutting the life expectancy of each child in primary school by an average of three months. And all of that is worse for Black, Latino, and American Indian kids, who disproportionately don’t have access to reliable internet connections and working computers.

...So, to recap: Kids can catch the coronavirus, like anyone else, although nobody has managed to put a pin in exactly how susceptible they are compared to adults or to younger teenagers, who seem to occupy a middle ground. But they’re less likely to show symptoms, and way less likely to get seriously ill. If they don’t have symptoms, they’re (probably) not going to spread it to a bunch of other people. And kids under 10 are about half as likely to transmit the virus as adults. SARS-CoV-2 can and will spread through schools, but they seem to only become super-spreading hot spots when precautions like masks, distancing, and ventilation are ignored. Schools are always going to be a risk, but one that can be managed—and not being in school is also really bad for kids, for their parents, and for society as a whole. Which is perhaps why the CDC is now recommending that K-12 schools should be both “the last settings to close” and “the first to reopen,” when they can do so safely.

Does the arrival of new, more contagious virus strains change this calculus? (Muge Cevik, an infectious disease researcher at the University of Saint Andrews in Scotland, who is advising the British government on its Covid-19 response) cautiously says no—decisions should still be driven by the local prevalence of Covid-19 cases, and the same mitigation measures should be adequate, if strictly followed.

Initial analyses tracking the UK variant, known as B.1.1.7, through the British populace suggested that it was spreading faster among young people than adults. But Cevik says that was effectively a glitch in the data. The mutation emerged in November while the country was on lockdown but secondary schools were open. “It just had more of a chance to circulate among teenagers than anyone else,” she says. It’s still early, but all evidence so far suggests the UK variant increases transmission—by about 30 to 50 percent—equally across all age groups. So while schools might be a lot riskier, so is everywhere else people congregate indoors.

Because of that, the new variant has caused a frightening escalation of infections in the UK that are threatening to collapse the nation’s hospital systems. England’s prime minister, Boris Johnson, had pledged last year to keep schools open as long as possible. But kids went back to primary school for exactly one day in January before his government reversed course and closed them again amid the latest surge.

For places where the variant has not yet taken over, preemptively closing schools out of fear isn’t the answer, says Cevik, especially if there aren’t ways to financially help parents and other caregivers shelter at home. “Sometimes school closures are seen as an exit strategy for controlling infections, because it’s easier to close schools than to provide isolation support or housing to low-paid employees,” says Cevik. “But that won’t be an effective solution if we’re not doing enough to address the structural factors that are actually driving the pandemic.”...

https://www.wired.com/story/everything-we-know-now-about-schools-kids-and-covid-...

--------------------------------------------------​

Lindsay A. Thompson and Sonja A. Rasmussen. 2020. One Year Later, How Does COVID-19 Affect Children?
JAMA Pediatr. Published online December 28, 2020. doi:10.1001/jamapediatrics.2020.5817 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2773981

47margd
gen. 17, 4:30pm

Norway Raises Concern Over Vaccine Jabs for the Elderly
Lars Erik Taraldsen | January 16, 2021,

Norway expressed increasing concern about the safety of the Pfizer Inc. vaccine on elderly people with serious underlying health conditions after raising an estimate of the number who died after receiving inoculations to 29.

The latest figure adds six to the number of known fatalities in Norway, and lowers the age group thought to be affected to 75 from 80. While it’s unclear exactly when the deaths occurred, Norway has given at least one dose to about 42,000 people and focused on those considered most at risk if they contract the virus, including the elderly.

...“There are 13 deaths that have been assessed, and we are aware of another 16 deaths that are currently being assessed,” the agency said. All the reported deaths related to “elderly people with serious basic disorders,” it said. “Most people have experienced the expected side effects of the vaccine, such as nausea and vomiting, fever, local reactions at the injection site, and worsening of their underlying condition.”

Official reports of allergic reactions have been rare as governments rush to roll out vaccines to try to contain the global pandemic. U.S. authorities reported 21 cases of severe allergic reactions from Dec. 14-23 after administration of about 1.9 million initial doses of the Pfizer vaccine. The first Europe-wide safety report on the Pfizer-BioNTech vaccine is due to be published at the end of January.

...Norway’s experience doesn’t mean that younger, healthier people should avoid being vaccinated. But it’s an early indication of what to watch as countries begin to issue safety monitoring reports on the vaccines. Emer Cooke, the new head of the European Medicines Agency, has said tracking the safety of Covid vaccines, especially those relying on novel technologies such as messenger RNA, would be one of the biggest challenges once shots are rolled out widely.

...The findings have prompted Norway to suggest that Covid-19 vaccines may be too risky for the very old and terminally ill, the most cautious statement yet from a European health authority...“for those with the most severe frailty, even relatively mild vaccine side effects can have serious consequences. For those who have a very short remaining life span anyway, the benefit of the vaccine may be marginal or irrelevant.”

...“The Norwegian Medicines Agency has communicated, prior to the vaccination, that when vaccinating the oldest and sickest, it is expected that deaths will occur in a time-related context with vaccination. This does not mean that there is a causal link between vaccination and death. We have also, in connection with the reported deaths, conveyed that it is possible that common and known side effects of the vaccines may have been a contributing factor to a serious course or fatal outcome,” the agency said.

https://www.bloomberg.com/news/articles/2021-01-16/norway-vaccine-fatalities-amo...

48stellarexplorer
Editat: gen. 18, 2:16am

>47 margd: It’s concerning that more context was not provided by Norwegian authorities, and I suspect this will be addressed in the coming days. Primarily what was missing from their reporting was a sense that this is not surprising. First, the deaths may have been unrelated to the vaccine, and part of the 400 or so deaths of debilitated people in Norwegian nursing homes weekly - the answer to this is not yet known - and second the deceased were extremely ill and frail, many terminally ill. This could have been expressed in a much more circumspect, careful way so as not to have seemed like a revelation, or a bombshell no less.

While there well may turn out to be relevant and important information in these reports, and we need to take this seriously and study the matter, if the result is to contribute to people dying of Covid-19 who would have survived if only they had accepted a vaccine, people will not have been well served. No one needs a reminder at this moment about how susceptible people can be to coming to the wrong conclusions in response to reports that cater to preexisting biases, or to forming false beliefs based on manipulated information. It’s hard to imagine that some people already opposed to vaccines would not misuse reports like these. Concerning.

49stellarexplorer
gen. 18, 2:31am

In just a few minutes of looking I’m already seeing “The carnage from this vaccine will be way worse than the virus”, and “it’s obviously a euthanasia shot, pure and simple”. Another non-surprising thing. Whatever problems are uncovered about vaccines will be distorted and amplified. Sigh. Life in 2021.

50margd
Editat: gen. 18, 3:54am

>48 stellarexplorer: Until this report, it seemed that the very old were tolerating Pfizer vaccine just fine. Curious to hear what, if anything, was different about these folks. Was the vaccine cause or just association when given to population already suffering higher than normal mortality?

Having spent hour or so today listening to my dearest anti-vaxxer, I am sure any subsequent nuance from Norway will be lost on her. (My hand had dents from clenching phone!) Happy, though, that a vaccine-hesitant person in our circle checked in with me before her vaccination. Her sister also. For people like them, I think important to address such scary, if preliminary, reports now that they are out there. My sense is that the vaccine-hesitant are hungry for information they can trust--not pablum, but accessible as possible for smart people without background in jargon, stats, etc. While my dearest anti-vaxxer, influential in her area, may not reverse herself, she does seem to be feeling pressure from the pushback this pandemic has engendered, if our chat today is any indication...

51margd
gen. 18, 4:06am

>47 margd: More info needed, but if Norway's experience was due to vaccine alone, it would not go un-noticed with the millions of people vaccinated worldwide, a good portion of whom receive Pfizer vaccine, I assume:

More Than 42.2 Million Shots Given: Covid-19 Vaccine Tracker
The U.S. has administered 14.3 million doses; Europe’s rollout begins
Updated: January 17, 2021

The biggest vaccination campaign in history has begun. More than 42.2 million doses in 51 countries have been administered, according to data collected by Bloomberg. The latest rate was roughly 2.43 million doses a day, on average.

Vaccinations in the U.S. began Dec. 14 with health-care workers, and so far 14.3 million shots have been given, according to a state-by-state tally by Bloomberg and data from the Centers for Disease Control and Prevention. In the last week, an average of 898,410 doses per day were administered...

https://www.bloomberg.com/graphics/covid-vaccine-tracker-global-distribution/

52margd
Editat: gen. 19, 5:32pm

ETA: I read that the allergic reactions from this lot were seen at one location only.

Study underway, but hopefully just a cluster, or patchiness.
http://www.umass.edu/landeco/research/fragstats/documents/Conceptual%20Backgroun...

CA calls for pausing distribution on one lot of Moderna vaccine after allergic reactions reported
ABC7.com staff | 1/18/2021

California health officials are recommending a temporary halt to distribution of a particular lot of Moderna's COVID-19 vaccine out of concern over allergic reactions.

More than 330,000 doses of the particular lot were distributed to 287 health-care providers across California earlier this month.

One particular community vaccination clinic reported up to 10 allergic reactions to the vaccine within a 24-hour period, considered an unusually high number. State officials say the expected rate of reaction to similiar vaccines is normally around 1 in 100,000.

The name and location of the clinic was not released, but the facility switched to a different lot of Moderna vaccines after closing for several hours. No other cluster of allergic reactions has been reported.

State officials are investigating what happened at the clinic and in the meantime State Epidemiologist Dr. Erica S. Pan recommends that doses from Moderna lot 41L20A not be distributed for now.

"Out of an extreme abundance of caution and also recognizing the extremely limited supply of vaccine, we are recommending that providers use other available vaccine inventory and pause the administration of vaccines from Moderna Lot 041L20A until the investigation by the CDC, FDA, Moderna and the state is complete," Pan said Sunday. "We will provide an update as we learn more."

https://abc7.com/health/california-calls-for-pause-to-distributing-some-moderna-...

53margd
gen. 18, 5:41am

Black Americans are getting vaccinated at lower rates than white Americans
About 3 percent of Americans have received at least one dose of a coronavirus vaccine so far.
Hannah Recht and Lauren Weber

...About 3 percent of Americans have received at least one dose of a coronavirus vaccine so far. But in 16 states that released data by race, white residents are being vaccinated at significantly higher rates than Black residents, according to the analysis — in many cases two to three times higher.

In the most dramatic case, 1.2 percent of white Pennsylvanians had been vaccinated as of Jan. 14, compared with 0.3 percent of Black Pennsylvanians.

The vast majority of the initial round of vaccines has gone to health care workers and staffers on the front lines of the pandemic — a workforce that’s typically racially diverse made up of physicians, hospital cafeteria workers, nurses and janitorial staffers...

A failure of federal response...
Speed v. Equity...
Historical hesitation...

https://www.nbcnews.com/health/health-news/black-americans-are-getting-vaccinate...

54margd
Editat: gen. 18, 6:41am

Aquest missatge ha estat suprimit pel seu autor.

55John5918
gen. 18, 5:55am

>54 margd:

Interesting video, but did you intend to post it in this particular thread on COVID-19, or was it supposed to be in one of the many threads about the storming of the US Capitol?

56margd
Editat: gen. 18, 6:43am

>55 John5918: There it is! Thx. I'll delete here, as I also posted 7 minute ITV video in Traitor Trump thread. (#148, https://www.librarything.com/topic/328472#n7390835 )

57davidgn
gen. 18, 7:14pm

Well shit. Did anybody else miss this?

https://www.state.gov/fact-sheet-activity-at-the-wuhan-institute-of-virology/

For more than a year, the Chinese Communist Party (CCP) has systematically prevented a transparent and thorough investigation of the COVID-19 pandemic’s origin, choosing instead to devote enormous resources to deceit and disinformation. Nearly two million people have died. Their families deserve to know the truth. Only through transparency can we learn what caused this pandemic and how to prevent the next one.

The U.S. government does not know exactly where, when, or how the COVID-19 virus—known as SARS-CoV-2—was transmitted initially to humans. We have not determined whether the outbreak began through contact with infected animals or was the result of an accident at a laboratory in Wuhan, China.

The virus could have emerged naturally from human contact with infected animals, spreading in a pattern consistent with a natural epidemic. Alternatively, a laboratory accident could resemble a natural outbreak if the initial exposure included only a few individuals and was compounded by asymptomatic infection. Scientists in China have researched animal-derived coronaviruses under conditions that increased the risk for accidental and potentially unwitting exposure.

The CCP’s deadly obsession with secrecy and control comes at the expense of public health in China and around the world. The previously undisclosed information in this fact sheet, combined with open-source reporting, highlights three elements about COVID-19’s origin that deserve greater scrutiny

58John5918
gen. 18, 10:34pm

Covid vaccine: WHO warns of 'catastrophic moral failure' (BBC)

The world faces a "catastrophic moral failure" because of unequal Covid vaccine policies, the head of the World Health Organization (WHO) has warned. Tedros Adhanom Ghebreyesus said it was not fair for younger, healthy people in richer nations to get injections before vulnerable people in poorer states. He said over 39 million vaccine doses had been given in 49 richer states - but one poor nation had only 25 doses...

59margd
gen. 19, 4:56am

Your smartwatch could detect Covid-19 (7-9 d) before you do
Axel Metz | 1/18/2021

Smartwatches including the Apple Watch may be able to detect the signs of Covid-19 before you know you're sick, a recent study has found.

In a study titled “Warrior Watch”, researchers at the Mount Sinai medical center found that the Apple Watch is able to detect small changes to a user’s heartbeat which may indicate they’ve contracted Covid-19 up to seven days before they develop visible symptoms.

Specifically, the study analyzed a metric called heart rate variability (HRV) — the variation in time between each heartbeat — which is also a measure of how well a person's immune system is working. The participants wore Apple Watches equipped with special apps that measured changes in their HRV.

"We already knew that heart rate variability markers change as inflammation develops in the body, and Covid is an incredibly inflammatory event," Dr. Robert Hirten, assistant professor at the Icahn School of Medicine in New York City and author of the study, told CBS. "It allows us to predict that people are infected before they know it."
A similar study conducted by Stanford University found that 81% of Covid-19-positive participants wearing a variety of smartwatches — from Apple, Fitbit, Garmin and others — were informed of an irregularity in their HRV up to nine days prior to the onset of major symptoms...

https://www.techradar.com/news/your-smartwatch-could-detect-covid-19-before-you-...

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Mount Sinai Researchers Use Apple Watch to Predict COVID-19
Mount Sinai | Dec 2, 2020
https://health.mountsinai.org/blog/mount-sinai-reseachers-use-apple-watch-to-pre...

Robert P. Hirten et al. 2020. Longitudinal Physiological Data from a Wearable Device Identifies SARS-CoV-2 Infection and Symptoms and Predicts COVID-19 Diagnosis. medRxiv (November 7, 2020). 26 p. https://doi.org/10.1101/2020.11.06.20226803 https://www.medrxiv.org/content/10.1101/2020.11.06.20226803v1.full.pdf

Preprint. Not peer-reviewed.

ABSTRACT:
...Interpretation: Longitudinally collected HRV (heart rate variability) metrics from a commonly worn commercial wearable device (Apple Watch) can identify the diagnosis of COVID-19 and COVID-19 related symptoms. Prior to the diagnosis of COVID-19 by nasal PCR, significant changes in HRV were observed demonstrating its predictive ability to identify COVID-19 infection.

60margd
gen. 19, 5:18am

"Within households, children and adolescents were less susceptible to SARS-CoV-2 infection but were more infectious than older individuals. Presymptomatic cases were more infectious and individuals with asymptomatic infection less infectious than symptomatic cases. These findings have implications for devising interventions for blocking household transmission of SARS-CoV-2, such as timely vaccination of eligible children once resources become available."

Fang Li et al. 2021. Household transmission of SARS-CoV-2 and risk factors for susceptibility and infectivity in Wuhan: a retrospective observational study. The Lancet Infectious Diseases. Published: January 18, 2021 DOI:https://doi.org/10.1016/S1473-3099(20)30981-6 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30981-6/fulltext

Summary
...Findings
27 101 households with 29 578 primary cases and 57 581 household contacts were identified. The secondary attack rate estimated with the transmission model was 15·6% ..., assuming a mean incubation period of 5 days and a maximum infectious period of 22 days. Individuals aged 60 years or older were at a higher risk of infection with SARS-CoV-2 than all other age groups. Infants aged 0–1 years were significantly more likely to be infected than children aged 2–5 years ... and children aged 6–12 years .... Given the same exposure time, children and adolescents younger than 20 years of age were more likely to infect others than were adults aged 60 years or older ... Asymptomatic individuals were much less likely to infect others than were symptomatic cases .... Symptomatic cases were more likely to infect others before symptom onset than after ... After mass isolation of cases, quarantine of household contacts, and restriction of movement policies were implemented, household reproductive numbers declined by 52% among primary cases ... and by 63% among secondary cases ...

61margd
gen. 19, 9:46am

The Economist's infographic of Huang et al. 2021* study on long COVID:
https://twitter.com/EricTopol/status/1351310034563522563/photo/1

*Chaolin Huang et al. 2021. 6-month consequences of COVID-19 in patients discharged from hospital: a cohort study. The Lancet Volume 397, ISSUE 10270, P220-232, January 16, 2021. https://doi.org/10.1016/S0140-6736(20)32656-8 https://www.thelancet.com/journals/lancet/article/PIIS0140-67362032656-8/fulltex...

62margd
gen. 19, 10:28am

Good news, for once. Survival rates in ICUs may not hold with new strains if they overload hospitals, though. Another reason to be careful until vaccines and/or summer take hold!

Eric Topol @EricTopol | 5:28 PM · Jan 18, 2021:
Improved survival (~50%) of the critically ill with covid, as the pandemic wore on, in a large academic health system
https://acpjournals.org/doi/10.7326/M20-5327
Image- graph ( https://twitter.com/EricTopol/status/1351295491351298049/photo/1 )
--------------------------------------------------​

George L. Anesi et al. 2021. Characteristics, Outcomes, and Trends of Patients With COVID-19–Related Critical Illness at a Learning Health System in the United States. Annals of Internal Medicine 9 Jan 19, 2021) https://doi.org/10.7326/M20-5327 https://www.acpjournals.org/doi/10.7326/M20-5327

Abstract
Design:
Single–health system, multihospital retrospective cohort study.

Setting:
5 hospitals within the University of Pennsylvania Health System.

Patients:
Adults with COVID-19–related critical illness who were admitted to an intensive care unit (ICU) with acute respiratory failure or shock during the initial surge of the pandemic.

Measurements:
The primary exposure for outcomes and care delivery trend analyses was longitudinal time during the pandemic. The primary outcome was all-cause 28-day in-hospital mortality. Secondary outcomes were all-cause death at any time, receipt of mechanical ventilation (MV), and readmissions.

Results:
Among 468 patients with COVID-19–related critical illness, 319 (68.2%) were treated with MV and 121 (25.9%) with vasopressors. Outcomes were notable for an all-cause 28-day in-hospital mortality rate of 29.9%, a median ICU stay of 8 days (interquartile range IQR, 3 to 17 days), a median hospital stay of 13 days (IQR, 7 to 25 days), and an all-cause 30-day readmission rate (among nonhospice survivors) of 10.8%. Mortality decreased over time, from 43.5% (95% CI, 31.3% to 53.8%) to 19.2% (CI, 11.6% to 26.7%) between the first and last 15-day periods in the core adjusted model, whereas patient acuity and other factors did not change.

Limitation:
Single–health system study; use of, or highly dynamic trends in, other clinical interventions were not evaluated, nor were complications.

Conclusion:
Among patients with COVID-19–related critical illness admitted to ICUs of a learning health system in the United States, mortality seemed to decrease over time despite stable patient characteristics. Further studies are necessary to confirm this result and to investigate causal mechanisms.

63margd
gen. 19, 11:28am

L452R was first detected in Denmark in March and appeared in California in May...

As the U.S. surpasses 24 million cases, Los Angeles confronts a more contagious variant.
Lucy Tompkins and Carl Zimmer | Jan. 17, 2021

(1. B117)...The state is among many dealing with the arrival of a more contagious viral variant, first discovered in Britain; the first confirmed case in Los Angeles was reported on Saturday. It is believed to be potentially 50 percent more transmissible than the initial version of the virus.

Officials said they thought the variant, which has caused infections to soar in London and southeast England, has been spreading through Los Angeles for some time. While more contagious, the variant does not appear to cause more severe illness.

(2. L452R )...On Sunday night, the California Department of Public Health reported another variant that had grown more common across the state since December. Known as L452R, it was first detected in Denmark in March and appeared in California in May. In December, researchers at the University of California, San Francisco, sequenced genomes of coronavirus gathered around the state and found that the variant was present in just 3.8 percent of their samples. By January, it had jumped to 25.2 percent.

Charles Chiu, who led the sequencing, cautioned that he and his colleagues worked with a small sample size, so they have not yet proven that this variant is more contagious. “But there are worrisome signs that this variant may be highly transmissible,” he said.

Dr. Chiu and his colleagues are now looking more carefully for this variant across the state and are trying to understand how its mutations have altered it. They want to see if the variant can escape from monoclonal antibodies and perhaps even make vaccines less effective. “These are critical studies that need to be done,” Dr. Chiu said.

After weeks under a stay-at-home order, the county’s positivity rate is starting to taper. Dr. George Rutherford, an epidemiologist at the University of California, San Francisco, said the state and Los Angeles seemed to be “in the process of sort of gradually turning a corner here.”

He cautioned against panicking about the more transmissible variant, noting the same cautious behavior will help keep it at bay: stay home, wear a mask, physically distance.

https://nytimes.com/live/2021/01/17/world/covid-19-coronavirus/los-angeles-crush...

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Charles Chiu @cychiu98 | 8:56 PM · Jan 17, 2021:
Hi all, we & other labs in CA identified a L452R spike mutation SARS-CoV-2 variant 3.8%->25 margd:.2% cases mid-Nov-early Jan.
Assoc with several high attack rate outbreaks in Santa Clara County. Epi/lab studies pending

Image-Increasing rates of L452R variant cases in CA, 11/22/2020- 1/3/2021 ( https://twitter.com/cychiu98/status/1350985418628587520/photo/1 )

COVID-19 Variant First Found in Other Countries and States Now Seen More Frequently in California
L452R Variant is Linked to Multiple Outbreaks in Santa Clara County and Being Studied by California Genomic Sequencing Experts
Date: January 17, 2021
Number: NR21-020
Contact: CDPHpress@cdph.ca.gov
https://www.cdph.ca.gov/Programs/OPA/Pages/NR21-020.aspx
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Eric Topol (cardiologist, author) @EricTopol | 11:16 PM · Jan 17, 2021:
A 4th variant (L432R) uncovered that was 3.8% of California genomes and 25.2% in January;
much still to learn but that, in itself, is concerning w/ @cychiu98 @UCSF

If L452R is shown to significantly promote transmission (not confirmed yet), it might help demystify the California vs Florida divergence that has yet to be explained
Image--graph, 7d rolling average confirmed cases in CA v FL ( https://twitter.com/EricTopol/status/1351026883299782656/photo/1 )
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Dr Emma Hodcroft (U Bern viologist) @firefoxx66 | 12:47 PM · Jan 18, 2021
https://twitter.com/firefoxx66/status/1351224782176579584
https://threadreaderapp.com/thread/1351224782176579584.html

A #SARSCoV2 variant with a combination of mutations in Spike (S13I, W152C, L452R) has been making headlines & twitter rounds today, so - a fresh-from-the-oven S:L452R focal build is now up - let's take a look: (10-tweet thread)

...we *don't yet know* if this variant is being pulled along with a general rise in cases, or some other environmental or behavioural change - or whether the mutations change the behaviour of the virus, like transmissibility.

...most sequences & the earliest sequences are from California, then the variant spread across the USA, e.g., NY, NM, WY...

...The variant has also been introduced outside of the US:
- Europe (yellow) in Denmark (1) & the UK (1)
- Asia (turquoise) in Singapore (1) & Israel (1)
- Oceania (blue) in Australia (7) & New Zealand (4)

...remember: we don't know this variant causes a difference in transmission - don't panic - wait for more info!

As sequencing picks up & more people become interested in tracking the virus' variation (which is normal life as a virus), we'll see more variants!

The hard question is figuring out which have mutations that actually change the virus. Most probably don't!

64margd
gen. 19, 5:33pm

>47 margd:>48 thru >51 margd:

Too soon to say whether 23 Norwegians died because of the covid-19 vaccine

Av Eva Akerbæk, Øyvind Bye Skille, Silje S. Skiphamn og Morten Langfeldt Dahlback
18. januar 2021

The Norwegian Medicines Agency is investigating 23 deaths among elderly who have received the coronavirus vaccine. The reports made people think they all died from the vaccine, but that is not clear.

1. Did 23 Norwegians die after receiving the coronavirus vaccine?

Yes. But that does not mean that they died of the vaccine...

2. Is it correct to say that they died of the vaccine?
No, it is not concluded that the deaths were caused by the vaccine. But it can not be excluded in some of the cases...

3. Who are the deceased?

The Norwegian Medicines Agency writes that the 13 deaths that have been assessed occurred in nursing homes. They were all above 80 years of age, and some of them were above 90. They had serious underlying conditions and "severe frailty"...

4. Were deaths among the vaccinated expected?

Yes. Each week, an average of 300-400 people die in Norwegian nursing homes...

5. Is the vaccine still considered safe?

Norwegian Minister of Health, Bent Høie, has previously said to Faktisk.no there is always risk involved when taking medicines, but a vaccine will only be approved if the benefits outweigh the risks.

The Norwegian Institute of Public Health writes that "for most of those who are old and who are living with frailty, potential side effects of the vaccine are more than outweighed by the reduced risk of becoming seriously ill from covid-19"...

https://www.faktisk.no/artikler/1wY/too-soon-to-say-whether-23-norwegians-died-b...

65margd
Editat: gen. 21, 11:54am

Time to develop vaccines that target more than just the spike? Opening post and a meaningful-to-me comment from virologists' thread on whether new variants might escape current vaccines
( https://twitter.com/LauringLab/status/1352024675916931072 ):

Lauring Lab (U Michigan) @LauringLab | 5:46 PM · Jan 20, 2021:
Spent the day looking at papers with post-vax titers and variants. What I am seeing doesn't match some of what I see on twitter. Here's three preprints looking at neutralization. Differences for sure, but changes are modest. Key unknown is neut titer cut-off for vax protection.
Image-3 preprints' figures on neutralization ( https://twitter.com/LauringLab/status/1352024675916931072/photo/1 )

Dan (PhD student pulmonary diseases) @BecauseIAmDAN | 7:53 AM · Jan 21, 2021:
Less concerned with immune escape from current variants than the implications of a future mutation, particularly given the massive caseload globally and the fact that functional mutations are clearly not out of the question for this virus in a (relatively) short time scale
__________________________________________________​

ETA:
Emerging Coronavirus Variants May Pose Challenges to Vaccines
Laboratory studies of mutations circulating in South Africa suggest they may dodge some of the body’s immune responses.
Apoorva Mandavilli | Jan. 20, 2021

...two small new studies (below), posted online Tuesday (Jan 19) night, suggest that some variants may pose unexpected challenges to the immune system, even in those who have been vaccinated — a development that most scientists had not anticipated seeing for months, even years.

...experts who reviewed the papers agreed that the findings raised two disturbing possibilities. People who had survived mild infections with the coronavirus may still be vulnerable to infection with a new variant; and more worryingly, the vaccines may be less effective against the variants.

...The studies published on Tuesday night show that the variant identified in South Africa is less susceptible to the antibodies created by natural infection and by vaccines made by Pfizer-BioNTech and Moderna.

Neither the South African variant nor a similar mutant virus in Brazil has yet been detected in the United States. (The more contagious variant that has blazed through Britain does not contain these mutations and seems to be susceptible to vaccines.)

...Even if antibody effectiveness were reduced tenfold, the vaccines would still be quite effective against the virus...

And while neutralizing antibodies are essential for preventing infection, the vaccines — and natural infection — also lead to production of thousands of other types of antibodies, not to mention various immune cells that retain a memory of the virus and can be roused to action when the body encounters it again.

...Vaccine trials being conducted in South Africa by Novavax and Johnson & Johnson will provide more real-world data on how the vaccines perform against the new variant there. Those results are expected within the next few weeks.

...The mRNA technology on which the Pfizer and Moderna vaccines rely can be altered in a matter of weeks, and far more easily than the process used to produce flu vaccines. But it would be wise to prepare for this eventuality now and think through not just the technical aspects of updating the vaccines, but the testing, approval and rollout of those vaccines...

Still, the best path forward is to prevent the emergence of new mutations and variants altogether (social distancing, masks, travel restrictions, etc. plus vaccines)...

https://www.nytimes.com/2021/01/20/health/coronavirus-variants-immunity.html

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Constantinos Kurt Wibmer et al. 2021. SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma
BioRxiv (Jan 19, 2021) doi: https://doi.org/10.1101/2021.01.18.427166 https://www.biorxiv.org/content/10.1101/2021.01.18.427166v1

This article is a preprint and has not been certified by peer review.

Abstract
SARS-CoV-2 501Y.V2, a novel lineage of the coronavirus causing COVID-19, contains multiple mutations within two immunodominant domains of the spike protein. Here we show that this lineage exhibits complete escape from three classes of therapeutically relevant monoclonal antibodies. Furthermore 501Y.V2 shows substantial or complete escape from neutralizing antibodies in COVID-19 convalescent plasma. These data highlight the prospect of reinfection with antigenically distinct variants and may foreshadow reduced efficacy of current spike-based vaccines.

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Zijun Wang et al. 2021. mRNA vaccine-elicited antibodies to SARS-CoV-2 and circulating variants. BioRxiv (Jan 19, 2021)
doi: https://doi.org/10.1101/2021.01.15.426911 https://www.biorxiv.org/content/10.1101/2021.01.15.426911v1

This article is a preprint and has not been certified by peer review.

Abstract
To date severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) has infected nearly 100 million individuals resulting in over two million deaths. Many vaccines are being deployed to prevent coronavirus disease-2019 (COVID-19) including two novel mRNA-based vaccines. These vaccines elicit neutralizing antibodies and appear to be safe and effective, but the precise nature of the elicited antibodies is not known. Here we report on the antibody and memory B cell responses in a cohort of 20 volunteers who received either the Moderna (mRNA-1273) or Pfizer-BioNTech (BNT162b2) vaccines. Consistent with prior reports, 8 weeks after the second vaccine injection volunteers showed high levels of IgM, and IgG anti-SARS-CoV-2 spike protein (S), receptor binding domain (RBD) binding titers. Moreover, the plasma neutralizing activity, and the relative numbers of RBD-specific memory B cells were equivalent to individuals who recovered from natural infection. However, activity against SARS-CoV-2 variants encoding E484K or N501Y or the K417N:E484K:N501Y combination was reduced by a small but significant margin. Consistent with these findings, vaccine-elicited monoclonal antibodies (mAbs) potently neutralize SARS-CoV-2, targeting a number of different RBD epitopes epitopes in common with mAbs isolated from infected donors. Structural analyses of mAbs complexed with S trimer suggest that vaccine- and virus-encoded S adopts similar conformations to induce equivalent anti-RBD antibodies. However, neutralization by 14 of the 17 most potent mAbs tested was reduced or abolished by either K417N, or E484K, or N501Y mutations. Notably, the same mutations were selected when recombinant vesicular stomatitis virus (rVSV)/SARS-CoV-2 S was cultured in the presence of the vaccine elicited mAbs. Taken together the results suggest that the monoclonal antibodies in clinical use should be tested against newly arising variants, and that mRNA vaccines may need to be updated periodically to avoid potential loss of clinical efficacy.

66margd
gen. 21, 10:38am

Europe’s growing mask ask: Ditch the cloth ones for medical-grade coverings
Loveday Morris and Rick Noack | Jan. 20, 2021

BERLIN ­— Faced with new, more contagious, strains of the coronavirus and a winter surge in cases, European nations have begun to tighten mask regulations in the hope that they can slow the spread of the virus.

Germany on Tuesday night made it mandatory for people riding on public transport or in supermarkets to wear medical style masks: either N95s, the Chinese or European equivalent KN95 or FFP2s, or a surgical mask.

...Meanwhile in France, the country’s health advisory council on Monday discouraged the wearing of inefficient cloth and homemade masks, also arguing they may not offer sufficient protection against the more highly transmissible coronavirus variants...

https://www.washingtonpost.com/world/europe/europe-coronavirus-masks-regulations...

67margd
gen. 21, 11:18am

Joe Biden’s Covid-19 Vaccine Plan: How He Intends to Speed Up Distribution
WSJ (open paywall) | Jan. 16, 2021

President-elect would add community vaccination sites, deploy mobile units and enlist pharmacies to achieve his pledge that 100 million doses will be administered in U.S. during his first 100 days in office

Joe Biden would spend $20 billion on the national vaccination program....

https://www.wsj.com/articles/joe-bidens-covid-19-vaccine-plan-how-he-intends-to-...

68margd
gen. 21, 12:15pm

Interesting. The crisper vision I was enjoying with saffron (for ARMD, https://www.ncbi.nlm.nih.gov/pmc/articles/PMC5342880/ ) disappeared for a while after bout of what I think was COVID in February, but has since returned. :) Benefit of saffron was retinal, though.

Maria Casagrande et al. 2021. Presence of SARS-CoV-2 RNA in the Cornea of Viremic Patients With COVID-19.
JAMA Ophthalmol (January 21, 2021). doi:10.1001/jamaophthalmol.2020.6339 https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2775161

Abstract
Importance Current recommendations are to avoid tissue for corneal transplant from donors with coronavirus disease 2019 (COVID-19) or those who were recently exposed to COVID-19 owing to the lack of knowledge about the presence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in corneal tissues. Evidence of SARS-CoV-2 in corneal tissue would seem to have clinical relevance for corneal transplant.

Objectives To investigate the presence of viral SARS-CoV-2 RNA in corneal discs of deceased patients with confirmed COVID-19 and assess viral genomic and subgenomic RNA load, possible infectivity, and histologic abnormalities.

Design, Setting, and Participants A case series was conducted of 11 deceased patients with COVID-19 who underwent autopsy between March 20 and May 14, 2020. Eleven corneal discs (1 corneal disc per patient) were harvested for molecular detection of viral genomic and subgenomic RNA, virus isolation, and immunohistochemistry. The SARS-CoV-2 RNA loads were compared with RNA loads in the conjunctival and throat swab samples and aqueous humor, vitreous humor, and blood samples.

Main Outcomes and Measures Evidence of SARS-CoV-2 RNA in human corneas.

Results This study comprised 11 patients (6 women (55%); mean age, 68.5 .... years). In 6 of 11 eyes (55%), SARS-CoV-2 genomic RNA was detected in the cornea; subgenomic RNA was present in 4 of these 6 eyes (67%). Infectivity or the presence of viral structural proteins could not be confirmed in any eye. However, patients whose corneal disc was positive for SARS-CoV-2 RNA also had positive results for SARS-CoV-2 RNA in 4 of 6 conjunctival swab samples, 1 of 3 aqueous humor samples, 3 of 5 vitreous humor samples, and 4 of 5 blood samples. Overall, conjunctival swab samples had positive results for SARS-CoV-2 RNA in 5 of 11 cases. Postmortem SARS-CoV-2 viremia was detected in 5 of 9 patients.

Conclusions and Relevance Viral genomic and subgenomic RNA of SARS-CoV-2 was detected in the cornea of patients with COVID-19 viremia. The risk of COVID-19 infection via corneal transplant is low even in donors with SARS-CoV-2 viremia, but further research is necessary to assess the rate of SARS-CoV-2 transmission via corneal transplant.

69Limelite
Editat: gen. 21, 4:32pm

Dr. Fauci During WH Press Conference: South African Variant Inhibits Level of Efficacy in Present Vaccines

Citing pre-prints, Dr. Fauci warns that while the two British variants of SARS-CoV-2 do not exhibit resistance to current vaccine dosage while being twice as infectious to the "wild" or original virus, that is not the case with the South African variant, about which we know little.

The British variant(s) have been detected in 20 US states. No evidence of the S. Af. strain being present exists yet. However, the US genomic analysis of viruses harvested from infected patients lags most of the rest of the world's efforts. Dr. Fauci said genomic testing in this country will be ramped up.

The study regarding the S. Af. variant indicates that the mutation of its binding site makes it more difficult for monoclonal antibodies that the vaccines stimulate in vivo to attach and prevent the virus from entering cells and producing disease symptoms. The impact on monoclonal antibody therapies in use is possibly more at risk for being rendered less effective when used in cases of the S Af. variant since they are specifically formulated to existing viral binding sites not the new ones.

However, since the vaccines in use are so highly effective (nearly 100%) a diminution in their effectiveness remains high, if reduced. Monoclonal antibody therapies will continue to be as effective as now in cases of wild SARS-CoV-2. The importance of genomic analysis becomes apparent and imperative.

The question most worrying to scientists is: Will this new S. Af. variant become the dominant strain, out-competing both the wild and British variants? That's an important one, because if the answer is "yes," that means the impact on our health care system will definitely reduce it to emergency levels and lead to potentially drastic changes to care options for infected patients.
___________________________________
No discussion of the Brazilian variant took place.

70margd
gen. 21, 4:38pm

>52 margd:
Pause lifted on batch of Moderna COVID-19 vaccines, health officials say
KCRA Updated: 10:37 AM PST Jan 21, 2021

...State epidemiologist Dr. Erica Pan said ..."We had further discussions with the County of San Diego Department of Public Health, the FDA, CDC and manufacturer, and found no scientific basis to continue the pause. Providers that paused vaccine administration from Moderna Lot 41L20A can immediately resume...These findings should continue to give Californians confidence that vaccines are safe and effective, and that the systems put in place to ensure vaccine safety are rigorous and science-based," Pan said, adding that some of her family members had received it...

https://www.kcra.com/article/pause-could-be-lifted-batch-of-moderna-covid-19-vac...

71margd
gen. 22, 5:06am

Pfizer and BioNTech (Astrazeneca, Johnson & Johnson) to Supply WHO's COVID-19 Vaccine Program
Cory Renauer | Jan 21, 2021

...Pfizer...and BioNTech...have agreed to supply a program co-led by the World Health Organization (WHO) with their COVID-19 vaccine. (number of doses, price per dose still unclear)

The COVAX program is a group effort coordinated by the WHO, the Coalition for Epidemic Preparedness Innovations (CEPI), and Gavi, the Vaccine Alliance. The program aims to secure 2 billion doses by the end of this year to protect vulnerable people and frontline healthcare workers in participating countries. All countries are eligible to participate, but the program plans to deliver about 1.3 billion doses to 92 low- and middle-income countries.

...In December, the COVAX program entered an advance purchase agreement with AstraZeneca...for 170 million doses of a coronavirus candidate that has been authorized for use in the U.K. and India.

Johnson & Johnson...also has an agreement with the program to supply 500 million doses of its single-dose vaccine candidate, which is expected to produce late-stage clinical trial data any day now.

https://www.fool.com/investing/2021/01/21/pfizer-and-biontech-to-supply-whos-cov...

72margd
gen. 22, 6:01am

Probability of dying of COVID-19 in the hospital doubles in L.A. County
Rong-Gong Lin II, Luke Money | Jan. 21, 2021

...the chance someone will die from the disease while hospitalized increased from about 1 in 8 in September and October to roughly 1 in 4 since early November...

https://www.latimes.com/california/story/2021-01-21/chance-of-dying-for-covid-19...

--------------------------------------------------​

Projections of Hospital-based Healthcare Demand due to COVID-19 in Los Angeles County
January 20, 2021 Update
11 p PPT
http://file.lacounty.gov/SDSInter/dhs/1101745_COVID-19ProjectionPublicUpdateLewi...

...about 1 in 130 (between 1 in 200 and 1 in 90) Los Angeles County residents are currently infectious to others. One week ago, this estimate was 1 in 115.

Approximately 1 in 3 persons in Los Angeles County has been infected with COVID-19 since the beginning of the pandemic.

...Hospitalized COVID Patients are Increasingly Ill
...each COVID patient admitted to the hospital requires (more days in the hospital, in the ICU, on mechanical ventilation, and has doubled chance of dying from 1 in 8 to 1 in 4)...These changes—despite improvements in treatments—suggest a substantial increase in the severity of illness among hospitalized patients

73margd
gen. 22, 3:04pm

"Among the 299 residents in the prevention group, there were 4 deaths attributed to COVID-19 at the time of death, and all occurred in the placebo arm. There were no COVID-19 attributed deaths in the (Lilly neutralizing antibody) bamlanivimab arm.

"Among the 41 residents in the treatment group, there were 4 deaths, and all occurred in the placebo arm with none in the bamlanivimab arm.

"Over the entire trial, there were a total of 16 deaths reported, including deaths not related to COVID-19, and all deaths were residents (11 deaths in placebo arm and 5 in bamlanivimab arm)."

--------------------------------------------------​
Lilly's neutralizing antibody bamlanivimab (LY-CoV555) prevented COVID-19 at nursing homes in the BLAZE-2 trial,
reducing risk by up to 80 percent for residents
Lilly Press Release | January 21, 2021

The Phase 3 BLAZE-2 COVID-19 prevention trial ... enrolled residents and staff at skilled nursing and assisted living facilities, commonly referred to as nursing homes, across the U.S.

The 965 participants who tested negative for the SARS-CoV-2 virus at baseline (299 residents and 666 staff) were included in the analysis of primary and key secondary endpoints for assessing prevention, while the 132 participants (41 residents and 91 staff) who tested positive for the virus at baseline were included in exploratory analyses for assessing treatment, adding to the growing body of evidence for treatment with bamlanivimab. All participants were randomized to receive either 4,200 mg of bamlanivimab or placebo.

After all participants reached 8 weeks of follow-up, there was a significantly lower frequency of symptomatic COVID-19 (the primary endpoint) in the bamlanivimab treatment arm versus placebo.... Results for all key secondary endpoints also reached statistical significance in both the overall and resident populations.

For the pre-specified subgroup of nursing home residents, there was also a significantly lower frequency of symptomatic COVID-19 in those treated with bamlanivimab versus placebo in this important population .... These results suggest that residents randomized to bamlanivimab have up to an 80 percent lower risk of contracting COVID-19 versus residents in the same facility randomized to placebo.

...Among the 299 residents in the prevention group, there were 4 deaths attributed to COVID-19 at the time of death, and all occurred in the placebo arm. There were no COVID-19 attributed deaths in the bamlanivimab arm. Among the 41 residents in the treatment group, there were 4 deaths, and all occurred in the placebo arm with none in the bamlanivimab arm. Over the entire trial, there were a total of 16 deaths reported, including deaths not related to COVID-19, and all deaths were residents (11 deaths in placebo arm and 5 in bamlanivimab arm)...

https://investor.lilly.com/news-releases/news-release-details/lillys-neutralizin...

74margd
gen. 22, 3:27pm

Boris Johnson says some evidence new Covid variant in the UK may be more deadly
Matt Clinch | Jan 22 2021

...all the evidence suggests the vaccines from Pfizer-BioNTech and AstraZeneca-Oxford University, the two currently being used in the U.K., remain effective against both the old and new (B.1.1.7 )variants of the virus.

Speaking alongside (UK PM Boris) Johnson on Friday, the U.K.’s chief scientific advisor, Patrick Vallance, said there is now early evidence that there’s an increased risk for those who have the new variant, compared with the old virus (as well as being more contagious). “If you took ... a man in their 60s, the average risk is that for 1,000 people who got infected, roughly 10 would be expected to unfortunately die with the virus. With the new variant, for 1,000 people infected roughly 13 or 14 people might be expected to die”

He described the data as not being strong yet, and highlighted more concern regarding other Covid variants found in Brazil and South Africa...

https://www.cnbc.com/2021/01/22/boris-johnson-evidence-new-covid-variant-associa...

75davidgn
gen. 23, 5:25pm

WHO advisor: COVID-19 pandemic likely started via lab leak
Calls wet market origin story a lie
https://torontosun.com/news/world/who-advisor-covid-19-pandemic-started-via-a-la...

One year after the pandemic started, World Health Organization advisor Jamie Metzl wants China to come clean about the origins of the COVID-19 virus.

The Kansas City-born, New York-based Metzl, who served as Deputy Staff Director of the Foreign Relations Committee under then Senator Joe Biden (2001-2003) and before that on the National Security Council (1997-99) and the State Department (1999-01) under President Bill Clinton), theorizes it was most likely an accidental lab leak in Wuhan.

“There’s no irrefutable evidence,” said Metzl, who was appointed to the WHO’s expert advisory committee on human genome editing in 2019 and is also the author of Hacking Darwin.

“There’s just more evidence and as more evidence arrives, the case for accidental lab leak, in my view, increases.”

We caught up with Metzl down the line from San Miguel de Allende:

76librorumamans
gen. 23, 6:04pm

There's an interesting discussion of research into boredom during the pandemic with surprising (to me) political implications. It's available on the CBC's science program Quirks and Quarks for January 6.

77John5918
Editat: gen. 24, 12:09am

Pontifical Academy for Life: No to 'vaccine nationalism', immunisation is a common good (Vatican News)

The Pontifical Academy for Life stresses the importance of overcoming "vaccine nationalism" so that everyone can have the opportunity of being vaccinated and nobody is left behind in the fight against Covid-19...


Mourn Gary Matthews and recognise that Covid conspiracies endanger life (Guardian)

One man’s tragic tale reveals much about the reach and harm of anti-science propaganda...

78margd
Editat: gen. 25, 2:24am

Explainer on COVID19 vaccination, fertility and pregnancy (3 p)
Victoria Male, Lecturer in Reproductive Immunology at Imperial College London
v.male@imperial.ac.uk
@VikiLovesFACS
Updated 24 Jan 2021
https://drive.google.com/file/d/1_wHIYX-tGkGBPwuax7N8BxZPR4PTTCDm/view
--------------------------------------------------​

I have updated my explainer on #COVID19 #vaccination #fertility #pregnancy and #breastfeeding to include a trial-by-trial breakdown of what happened to the people who became accidentally pregnant during the vaccine trials...

- Viki Male @VikiLovesFACS | 5:56 AM · Jan 24, 2021

79margd
gen. 24, 1:55pm

Virtually all residents and staff were positive for COVID in a Barrie, Ont home, 6 of 6 testing positive for the B117 strain first detected in UK... (My brother lives just outside Barrie, and our dad spent his last years in a retirement home in Barrie...)

U.K. variant confirmed in COVID-19 outbreak at Barrie long-term care home
Ryan Rocca | January 23, 2021

...Dr. Charles Gardner, Simcoe Muskoka’s medical officer, said ...it’s believed all residents who have tested positive have the variant...

https://globalnews.ca/news/7595436/uk-coronavirus-variant-barrie-long-term-care-...
__________________________________________________​

Even before B117 arrived...

The pandemic has exposed a crisis in Canada’s care homes
The Economist | Jan 23, 2021.

Too many old people are crammed into substandard institutions...deaths in Canadian long-term care homes were 25% higher than the average among 17 members of the OECD as a share of their populations...

https://www.economist.com/the-americas/2021/01/23/the-pandemic-has-exposed-a-cri...

80margd
gen. 24, 2:15pm

Colchichine? (I'll look for a reference.)

Pierre Zalloua (geneticist) @PZalloua | 11:33 AM · Jan 23, 2021:
Colchicine may be effective against Covid -19, a new trial just showed. This is a medication used in (Familial Mediterranean Fever -- FMF). A negative correlation between patients... under Colchicine and COVID-19 hospitalization would be a quick study to conduct in Lebanon where FMF is common.

Hanane @HananeT · 22h
The question is: is Colchicine effective on Covid patients who have been taking it for a long time (FMF...) or is it effective on Covid patients who start taking it with the beginning of the symptoms?

81stellarexplorer
gen. 24, 10:56pm

>77 John5918: very sad story

82margd
gen. 25, 3:45am

>80 margd: Colchichine, contd. Sounds like we're still waiting for publication, but people taking colchichine (for gout, Familial Mediterranean Fever) MIGHT be in for good news (or not?).

A gout drug shows promise for Covid-19, but skeptics worry about trusting science by press release
Matthew Herper @matthewherper | January 23, 2021

...In the release* which was issued late Friday, the Montreal Heart Institute said that the rate of hospitalization or death was 21% lower among patients in its COLCORONA study who received colchicine compared to those who were randomly assigned to placebo.

But here’s a caveat: the press release said these results were not statistically significant, although the numbers are close. When the researchers excluded 329 patients who were diagnosed with Covid-19 based on family contacts or clinical symptoms, but who did not have positive PCR tests, there was a 25% reduction in hospitalization, and substantial reductions in the need for mechanical ventilation and deaths.

Outside experts view those results as less trustworthy because the trial did not meet its main goal. They also agreed that the number of patients who needed mechanical ventilation or who died is likely to be small, making it difficult to draw firm conclusions. The press release does not include absolute numbers on the number of people who became hospitalized, needed to be put on ventilators, or died.

...The story of seemingly promising drugs that did not pan out, including, most famously, the malaria drug hydroxychloroquine, has left many researchers wary.

...In 2019, the same Montreal Heart Institute researchers published a study showing that colchicine, which is thought to quell inflammation and the immune response, may benefit patients who have had heart attacks, in part by preventing return hospital visits. Those results were published in the New England Journal of Medicine. The researchers began their Covid-19 study of colchicine in March, just as the pandemic was beginning to hit North America hard.

Jean-Claude Tardif, the lead investigator of both the 2019 study and the current one, said his team felt it was important to disseminate the results quickly, but that they would be publishing them in a medical journal and also thought it was important to leave the bulk of the data out of the press release...

https://www.statnews.com/2021/01/23/colchicine-gout-drug-shows-promise-for-covid...

--------------------------------------------------​

* Colchicine reduces the risk of COVID-19-related complications
MONTREAL HEART INSTITUTE, January 22, 2021

Positive results from COLCORONA trial show that colchicine is the only effective oral medication for treating non-hospitalized patients...

...analysis of the 4159 patients in whom the diagnosis of COVID-19 was proven by a naso-pharyngeal PCR test has shown that the use of colchicine was associated with statistically significant reductions in the risk of death or hospitalization compared to placebo. In these patients with a proven diagnosis of COVID-19, colchicine reduced hospitalizations by 25%, the need for mechanical ventilation by 50%, and deaths by 44%. This major scientific discovery makes colchicine the world’s first oral drug that could be used to treat non-hospitalized patients with COVID-19.

...Treating patients at risk of complications with colchicine as soon as the diagnosis of COVID-19 is confirmed by PCR reduces their risk of developing a severe form of the disease and, consequently, reduces the number of hospitalizations.

...Founded in 1954, the Montreal Heart Institute constantly aims for the highest standards of excellence in the cardiovascular field through its leadership in clinical and basic research, ultra-specialized care, professional training, and prevention. It houses the largest research center in Canada, the largest cardiovascular prevention center in the country, and the largest cardiovascular genetics center in Canada. The Institute is affiliated with the Université de Montréal and has more than 2,000 employees, including 245 doctors and more than 85 researchers. icm-mhi.org...

https://app.cyberimpact.com/newsletter-view-online?ct=guhsMu_jogsWK5zuKuZWMiFdWX...

83margd
Editat: gen. 27, 4:54am

Internet problems here, but if you care to search for it, a top virologist has posted a (44 tweet) tweetorial on variants, vaccines and antibodies based on currently available information:
Twitter.com
Florian Krammer
@florian_krammer
10:02 pm Jan. 25, 2021.

ETA: https://threadreaderapp.com/thread/1353900984209182720.html

ETA: He ends thusly:
35)...incubation time is relatively long. So that could help as well. In my opinion the worst case scenario is that the effectiveness of the mRNA vaccines will suffer a little but not too much. In the best case scenario there is not much of an effect.

36) However, it is important that high antibody titers are induced and not all vaccine candidates do that. The lower the initial titers, the higher the impact of these variants might be and I do find that worrisome. Now, what can be done? First, we need to do what every....

37)...good scientist is praying for a year now: We need to cut down on virus circulation. The more the virus replicates, the more infections there are the higher are the chances for new variants to arise. Also, we need to try and contain B.1.351 and B.1.1.248/P.1 as much....

38)...as possible. And then of course we need to prepare for making amendments to the vaccines if needed. Now, you hear from many that this is easy and can be done within weeks. It is not that easy. The devil is in the details. Yes, you can just change the vaccine, but....

39)...it is not the case that a new variant just takes over within a day and the old/wild type variants are gone. So, first you have to make sure that the new variant in the new vaccine also protects against the old variants. This experiment has not been done and it is likely....

40)...that there will be a mismatch in the other direction as well. If that is the case you need a bivalent vaccine. Or two different ones. The bivalent vaccine likely needs extended clinical trials again and that takes time. And who would want four shots if it is two....

41)...different vaccines? I actually like the idea of Moderna to give the first shot with the old variant and the second shot with the new variant. That might work, but will also need evaluation in clinical trials. Just to summarize: In general, I don't think there is a need to..

42)..panic. I think the mRNA vaccines and other vaccines that give high titers (Novavax etc.) will still work nicely. But this is a wake-up call! And I do worry about global vaccine supply since many vaccines for the global market induce lower neutralization titers.

43) And remember: Everybody can contribute to avoid the emergence of variants by not getting infected and by not passing on the virus to other. Now I'll finish my Blaufränkisch. (Marg: he's Austrian and seems to enjoy this wine ;) Have a good night.

84margd
gen. 27, 3:59am

Eric Topol (cardiologist) @EricTopol | 11:50 PM · Jan 26, 2021
When covid came on the scene a year ago there were no treatments that reduced major outcomes.
Now there are 3:
—Dexamethasone, 17% mortality reduction
—IL-6 blockers, 24% mortality reduction on top of dexamethasone
—Monoclonal antibodies, 70% reduced death or hospitalization*

*1st Phase 3 trial results on #SARSCoV2 monoclonal antibody combination with very positive results
1035 patients: 11 (2%) v (7%) for death or hospitalization and 0 vs 10 deaths in high-risk patients, given early
Coincides w/ EUA criteria.

News Release
New data show treatment with Lilly's neutralizing antibodies bamlanivimab (LY-CoV555) and etesevimab (LY-CoV016) together reduced risk of COVID-19 hospitalizations and death by 70 percent
January 26, 2021
https://investor.lilly.com/news-releases/news-release-details/new-data-show-trea...

85margd
gen. 27, 4:13am

Great to see others' manufacturing capability utilized in producing Pfizer vaccine. Hopefully first of many!

Sanofi to produce 100 million Pfizer/BioNTech vaccine doses, CEO says
Reuters Staff | January 26, 202112:24 PMUpdated 16 hours ago

PARIS, Jan 26 (Reuters) - French pharma giant Sanofi will produce more than 100 million doses of the COVID-19 vaccine developed by its competitors Pfizer and BioNTech by the end of the year, CEO Paul Hudson told Le Figaro newspaper in an interview published on Tuesday.

As Sanofi and its British partner GlaxoSmithKline have delayed the launch of their shot to late 2021, the French company decided to approach Pfizer “in order to be helpful as of now”, Hudson said, adding that an agreement with the U.S. company had been reached.

https://www.reuters.com/article/health-coronavirus-vaccines-sanofi/sanofi-to-pro...

86margd
gen. 27, 9:23am

01/26/2021 09:35 GMT — Is the AstraZeneca vaccine only 8% effective in over 65s?

According to some media outlets, German officials were concerned that the AstraZeneca vaccine will not be approved by the European Union because it is only 8% effective in adults over 65. However, this seems to be an error.

For instance, Prof. Stephen Evans, from the London School of Hygiene & Tropical Medicine, in the United Kingdom, says, “The randomized data on immunogenicity does not suggest that there will be notably lower efficacy at older ages for the Oxford/Astra Zeneca vaccine...If, however, these reports are based on the preliminary randomized trial data from The Lancet paper, (the authors state that), as older age groups were recruited later than younger age groups, there has been less time for cases to accrue and, as a result, efficacy data in these cohorts are currently limited by the small number of cases, but additional data will be available in future analyses.”

In agreement, Prof. Adam Finn, from the University of Bristol, in the U.K., says, “Elderly people were recruited to the U.K. phase 3 study relatively late and were relatively well shielded, so there were few cases of COVID-19 that had occurred at the time of submission of data to the Medicines and Healthcare products Regulatory Agency for approval"...he has “no idea where the 8% figure comes from."

There is no basis for the claims of very low efficacy of the Oxford-AstraZeneca vaccine which have been circulating in the media,” explains a spokesperson from the University of Oxford...“The results of the clinical trials have already been published transparently in five peer-reviewed scientific publications showing similar immune responses in younger and older adults, and a good safety profile, and high efficacy in younger adults. Furthermore, the preliminary efficacy data in older adults supports the importance of this vaccine for use in this population.”

https://www.medicalnewstoday.com/articles/covid-19-vaccine-live-updates

87margd
gen. 27, 10:32am

Where to find an N95 or high-filtration mask for Biden's 100-day challenge
Megan Cerullo | January 27, 2021

...Mask-wearing (most) effective when the face coverings fit properly and efficiently filter aerosol particles...

(1) The N95 — king of all masks...
...Because N95-approved masks remain in short supply, ...experts still recommend that they only be used by health care providers.

...Proper fit...is difficult for the layperson to achieve....

...A box of 50 respirators costs $199 at protectivehealthgear.com.

(2) Elastomeric masks...
...The elastomeric mask shell is sold separately from the filter. (Dr. Sricharan Chalikonda, the study's lead author) recommends pairing the masks with a P95 filter, as opposed to a P100 filter, for easier breathability. Another plus to elastomeric masks: They are relatively easy to find. A 3M version is available for $15 on Amazon, as are P95 particulate filters — sold separately.

(3) KN95s from China
...the quality of KN95 masks is wildly inconsistent...

...The Food and Drug Administration does however provide a list of KN95 masks it authorizes for emergency use by health care professionals.

Among them are KN95 masks from Chengde Technology, which cost $15 for a pack of 10. They're available ( https://rgpergo.com/products/kn95-respirator ).

Powecom KN95 masks are also FDA-approved for emergency use. Office Depot sells a 10-pack for $10.

(4) KF94s from South Korea

KF94 masks, which meet standards set by the South Korean government, are generally seen as more consistent in quality than the KN95's from China...

Korean cosmetics company Be Healthy ( https://behealthyusa.net/collections/dr-puri-brand ) sells KF94 masks imported from South Korea from a variety of different manufacturers. All of the products sold by the online company must meet South Korean standards, and some are also approved for use in Europe...

A study** from the National Center for Biotechnology Information, comparing the effectiveness of surgical N95 and KF94 masks, found both types of masks to be equally effective...

https://www.cbsnews.com/news/n95-mask-availability-where-to-buy/

--------------------------------------------------​

* Reusable elastomeric masks provide a more durable, less costly, longer-term option for health care workers’ protection than N95 masks, study finds (News Release)
American College of Surgeons | June 12, 2020
https://www.facs.org/media/press-releases/2020/reusable-masks-061220

** Min-Chul Kim et al. 2020. Effectiveness of surgical, KF94, and N95 respirator masks in blocking SARS-CoV-2: a controlled comparison in 7 patients. Infect Dis (Lond). Nov-Dec 2020;52(12):908-912. Epub 2020 Aug 26.
doi: 10.1080/23744235.2020.1810858. https://pubmed.ncbi.nlm.nih.gov/32845196/

88margd
gen. 27, 12:07pm

COVID-19 May Hide in Brains and Cause Relapses
Carolyn Crist | Jan. 25, 2021

The coronavirus may remain in people’s brains after infection and trigger relapses in patients who thought they had recovered, according to a new study*...

In the study, mice that were infected with the virus through their nasal passages developed severe illnesses due to brain infections, even after the virus left their lungs. In humans, this could explain why patients who appear to be over COVID-19 sometimes relapse and die.

...The research team found that the virus was located in the brains of mice at a level that was 1,000 times higher than in any other part of the body. Viral loads in the lungs began to drop after three days but remained high in the brain on the fifth and sixth days after infection, which is when the disease became more severe...

https://www.webmd.com/lung/news/20210125/covid-19-may-hide-in-brains-and-cause-r...

--------------------------------------------------​

* Pratima Kumari et al. 2021. Neuroinvasion and Encephalitis Following Intranasal Inoculation of SARS-CoV-2 in K18-hACE2 Mice. Viruses Jan 19, 2021, 13(1), 132; https://doi.org/10.3390/v13010132

Abstract
Severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) infection can cause neurological disease in humans, but little is known about the pathogenesis of SARS-CoV-2 infection in the central nervous system (CNS). Herein, using K18-hACE2 mice, we demonstrate that SARS-CoV-2 neuroinvasion and encephalitis is associated with mortality in these mice. Intranasal infection of K18-hACE2 mice with 105 plaque-forming units of SARS-CoV-2 resulted in 100% mortality by day 6 after infection. The highest virus titers in the lungs were observed on day 3 and declined on days 5 and 6 after infection. By contrast, very high levels of infectious virus were uniformly detected in the brains of all the animals on days 5 and 6. Onset of severe disease in infected mice correlated with peak viral levels in the brain. SARS-CoV-2-infected mice exhibited encephalitis hallmarks characterized by production of cytokines and chemokines, leukocyte infiltration, hemorrhage and neuronal cell death. SARS-CoV-2 was also found to productively infect cells within the nasal turbinate, eye and olfactory bulb, suggesting SARS-CoV-2 entry into the brain by this route after intranasal infection. Our data indicate that direct infection of CNS cells together with the induced inflammatory response in the brain resulted in the severe disease observed in SARS-CoV-2-infected K18-hACE2 mice.

__________________________________________________​

Eric Feigl-Ding (epidemiologist economist) @DrEricDing | 12:50 PM · Jan 26, 2021:

7) also worrisome study*—cognitive decline in recovered #COVID19 patients was found across severity level—largest among those hospitalized (& also among those not hospitalized). How big decline in hospitalized patients? Equal to -8.5 IQ point drop, or 10 years of aging decline.

Image-Global Cognitive Performance by COVID-19 Symptom Severity ( https://twitter.com/DrEricDing/status/1354124547058970624/photo/1 )

8) Decline was more pronounced for tests that assessed problem solving & visual attention. Study controlled for age, gender, education, income, racial-ethnic group & pre-existing conditions.

* Adam Hampshire et al. 2020. Cognitive deficits in people who have recovered from COVID-19 relative to controls: An N=84,285 online study. MedRxiv Oct 21, 2020. doi: https://doi.org/10.1101/2020.10.20.20215863 . https://www.medrxiv.org/content/10.1101/2020.10.20.20215863v1

This article is a preprint and has not been peer-reviewed

Abstract
Case studies have revealed neurological problems in severely affected COVID-19 patients. However, there is little information regarding the nature and broader prevalence of cognitive problems post-infection or across the full spread of severity. We analysed cognitive test data from 84,285 Great British Intelligence Test participants who completed a questionnaire regarding suspected and biologically confirmed COVID-19 infection. People who had recovered, including those no longer reporting symptoms, exhibited significant cognitive deficits when controlling for age, gender, education level, income, racial-ethnic group and pre-existing medical disorders. They were of substantial effect size for people who had been hospitalised, but also for mild but biologically confirmed cases who reported no breathing difficulty. Finer grained analyses of performance support the hypothesis that COVID-19 has a multi-system impact on human cognition.

Significance statement
There is evidence that COVID-19 may cause long term health changes past acute symptoms, termed ‘long COVID’. Our analyses of detailed cognitive assessment and questionnaire data from tens thousands of datasets, collected in collaboration with BBC2 Horizon, align with the view that there are chronic cognitive consequences of having COVID-19. Individuals who recovered from suspected or confirmed COVID-19 perform worse on cognitive tests in multiple domains than would be expected given their detailed age and demographic profiles. This deficit scales with symptom severity and is evident amongst those without hospital treatment. These results should act as a clarion call for more detailed research investigating the basis of cognitive deficits in people who have survived SARS-COV-2 infection.

https://www.medrxiv.org/content/10.1101/2020.10.20.20215863v1

89margd
Editat: gen. 27, 2:53pm

>82 margd: contd. Some early data on colchicine. Because drug is already available, I assume, if data survives peer review, MDs will dispense pills to non-hospitalized patients soon after diagnosis. Almost halves odds of death!

Eric Topol (cardiologist) @EricTopol | 1:40 PM · Jan 27, 2021:
The large colchicine RCT for covid is preprint published.
It shows some consistent directional benefit for major outcomes
https://medrxiv.org/content/10.1101/2021.01.26.21250494v1.full.pdf *

Since this is a pill, it's safe, cheap & an early intervention (as tested here, before hospital)
these findings are very encouraging

Image-Table 2. Rates and Odds Ratio for Major Clinical Outcomes
( https://twitter.com/EricTopol/status/1354499539370004481/photo/1 )

--------------------------------------------------​

* Jean-Claude Tardif et al. 2021. Efficacy of Colchicine in Non-Hospitalized Patients with COVID-19. MedRxiv January 27, 2021. 22 p; https://doi.org/10.1101/2021.01.26.21250494 https://medrxiv.org/content/10.1101/2021.01.26.21250494v1.full.pdf ( Unreviewed preprint )

ABSTRACT
Background
Evidence suggests the role of an inflammatory storm in COVID-19 complications. Colchicine is an orally administered, anti-inflammatory medication beneficial in gout, pericarditis and coronary disease.

Methods
We performed a randomized, double-blind trial involving non-hospitalized patients with COVID-19 diagnosed by polymerase chain reaction (PCR) testing or clinical criteria. The patients were randomly assigned to receive colchicine (0.5 mg twice daily for 3 days and once daily thereafter) or placebo for 30 days. The primary efficacy endpoint was the composite of death or hospitalization for COVID-19.

Results
A total of 4488 patients were enrolled. The primary endpoint occurred in 4.7% of the patients in the colchicine group and 5.8% of those in the placebo group (odds ratio, 0.79; 95.1% confidence interval (CI), 0.61 to 1.03; P=0.08). Among the 4159 patients with PCR-confirmed COVID-19, the primary endpoint occurred in 4.6% and 6.0% of patients in the colchicine and placebo groups, respectively... In these patients with PCR-confirmed COVID-19, the odds ratios were 0.75...for hospitalization due to COVID-19, 0.50...for mechanical ventilation, and 0.56...for death. Serious adverse events were reported in 4.9% and 6.3% in the colchicine and placebo groups ...; pneumonia occurred in 2.9% and 4.1% of patients ... Diarrhea was reported in 13.7% and 7.3% in the colchicine and placebo groups...

Conclusion
Among non-hospitalized patients with COVID-19, colchicine reduces the composite rate of death or hospitalization...

90margd
gen. 28, 4:34am

One death soon after a vaccination might be expected given the millions of doses dispensed so far. However the deceased had tested positive for the novel coronavirus in late December 2020, and died Jan. 21, a few hours after vaccination. CDC recommends that a person wait 90 days before receiving the vaccine, if treated for COVID-19 symptoms with monoclonal antibodies or convalescent plasma. In quick look, I saw no guidance on how long to wait after having had the disease, but not convalescent plasma or antibodies. Wonder if guidance will be forthcoming?

An anecdotal report on Twitter suggested that prior COVID-19 determined whether one had more severe side effects with first or second dose. (Prior COVID-19 was associated with side effects after first dose, according to this anecdotal report, whereas others had more severe side effects after second dose.)

-------------------------------------------------

Did a Californian Die Hours After Receiving COVID-19 Vaccine?
Authorities are investigating, but say it is too soon to tell if the death was causally related to the coronavirus immunization.
Madison Dapcevich | 27 January 2021

...It is currently unknown whether the individual’s death was caused by the COVID-19 vaccine.

Authorities are investigating the death of a California resident who died within hours of receiving the COVID-19 vaccine (Jan 21. 2021, not clear whether Pfizer or Moderna)
...

According to a Facebook post shared by the sheriff’s office, the individual had tested positive for the novel coronavirus in late December 2020...

https://www.snopes.com/fact-check/californian-die-covid-19-vaccine/

91margd
gen. 28, 7:49am

>83 margd: contd. (Efficacy of vaccines against new mutations)

"More encouraging news. This study looks at blood sera from patients vaccinated with the Pfizer vaccine, and finds neutralizing activity comparable to that against wildtype for combinations of key mutations in the UK and SA (South African) strains."

Image-Supplementary Fig 4 Ratios of Neutralization against Mutant v Wild Type Viruses
( https://twitter.com/CT_Bergstrom/status/1354638508908929047/photo/1 )

- Carl T. Bergstrom (biology prof U Washington) @CT_Bergstrom | 10:52 PM · Jan 27, 2021
--------------------------------------------------​

Xuping Xie et al. 2021. Neutralization of spike 69/70 deletion, E484K, and N501Y SARS-CoV-2 by BNT162b2 vaccine-elicited sera. BioRxiv Jan 27, 2021 doi: https://doi.org/10.1101/2021.01.27.427998 https://www.biorxiv.org/content/10.1101/2021.01.27.427998v1

This article is a preprint and has not been certified by peer review

Abstract

We engineered three SARS-CoV-2 viruses containing key spike mutations from the newly emerged United Kingdom (UK) and South African (SA) variants: N501Y from UK and SA; 69/70-deletion+N501Y+D614G from UK; and E484K+N501Y+D614G from SA. Neutralization geometric mean titers (GMTs) of twenty BTN162b2 vaccine-elicited human sera against the three mutant viruses were 0.81- to 1.46-fold of the GMTs against parental virus, indicating small effects of these mutations on neutralization by sera elicited by two BNT162b2 doses.

92margd
gen. 28, 8:15am

>88 margd: contd. ( Cognitive Deficits ) "our study provides clear demonstration that neurons can become a target of SARS-CoV-2 infection, with devastating consequences of localized ischemia in the brain and cell death" :(

Eric Song et al. 2021. Neuroinvasion of SARS-CoV-2 in human and mouse brain. J Exp Med. 2021 Mar 1; 218(3): e20202135.
Published online 2021 Jan 12. doi: 10.1084/jem.20202135 https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7808299/

Abstract
Although COVID-19 is considered to be primarily a respiratory disease, SARS-CoV-2 affects multiple organ systems including the central nervous system (CNS). Yet, there is no consensus on the consequences of CNS infections. Here, we used three independent approaches to probe the capacity of SARS-CoV-2 to infect the brain. First, using human brain organoids, we observed clear evidence of infection with accompanying metabolic changes in infected and neighboring neurons. However, no evidence for type I interferon responses was detected. We demonstrate that neuronal infection can be prevented by blocking ACE2 with antibodies or by administering cerebrospinal fluid from a COVID-19 patient. Second, using mice overexpressing human ACE2, we demonstrate SARS-CoV-2 neuroinvasion in vivo. Finally, in autopsies from patients who died of COVID-19, we detect SARS-CoV-2 in cortical neurons and note pathological features associated with infection with minimal immune cell infiltrates. These results provide evidence for the neuroinvasive capacity of SARS-CoV-2 and an unexpected consequence of direct infection of neurons by SARS-CoV-2.

...Discussion
We examined the potential for SARS-CoV-2 to infect neural tissues of both mice and human origin and demonstrate potential consequences of its neuroinvasion. Our results suggest that neurological symptoms associated with COVID-19 may be related to consequences of direct viral invasion of the CNS (Central Nervous System). Specifically, our work experimentally demonstrates that the brain is a site for high replicative potential for SARS-CoV-2. We further show that SARS-CoV-2 causes significant neuronal death in human brain organoids. Using electron microscopy, we identified viral particles budding from the ER (Endoplasmic Reticulum https://www.britannica.com/science/endoplasmic-reticulum ), indicating the virus’s ability to use the neuron cell machinery to replicate. Similar to neuronal loss observed in patient autopsies (Solomon et al., 2020), we noticed large numbers of cells dying in the organoid; however, this neuronal death did not colocalize directly with virus infection. Single-cell RNA-seq of the infected organoids showed metabolic changes in neurons without IFN (Interferon) or IFN-stimulated gene signatures, indicating that the neuroinvasive consequence of SARS-CoV-2 is unique compared with other neurotropic viruses such as ZIKV (Zika Virus). Closer examination showed diverging metabolic changes in infected versus neighboring cells, suggesting that the infected cells can cause local changes to their microenvironment, affecting survival of nearby cells. It is possible that viral infection induces locally hypoxic regions, which aids in lowering the threshold for tissue damage in the context of an already oxygen-deprived state.

While ACE2 expression levels in the human brain are still being investigated, we showed that ACE2 is expressed at the protein level and is functionally required for SARS-CoV-2 infection in human brain organoids. Further, we detected robust antiviral antibody presence in the CSF (Cerebrospinal Fluid) of a COVID-19 patient who presented with acute neurological symptoms. This finding suggests that, at least in some patients with COVID-19 and neurological symptoms, there is robust antibody response against the virus within the CSF. In the in vivo setting of the CNS with vasculature and immune cells, neuronal death could have cascading downstream effects in causing and amplifying CNS inflammation.

Although our rodent model does not use endogenous ACE2 expression, it has been previously reported that even mouse-adapted SARS-CoV is still neurotropic in wild-type mice, and SARS-CoV-2 is neurotropic in mice with hACE2 expression from the endogenous locus (Roberts et al., 2007; Sun et al., 2020). Using mouse models, we demonstrate for the first time that SARS-CoV-2 neuroinvasion in mice can have significant remodeling of brain vasculature, providing a potential link between the hypoxia and what we see in both the human organoid and the patient brains.

Similar to previous reports of acute hypoxic ischemic damage without microthrombi in postmortem brain of COVID-19 patients (Solomon et al., 2020), we also found presence of ischemic damage and microinfarcts in postmortem brain samples of COVID-19 patients. In our study, we observed evidence of SARS-CoV-2 infection within the regions of micro–ischemic infarcts (clots in arteries), suggesting the possibility of neuroinvasion-associated ischemia and vascular anomalies, consistent with what we observed in mice. However, a limitation of our study is that autopsy samples from only a small number of patients were examined, providing a snapshot of case reports from several patients rather than a generalizable phenomenon. Future studies are needed to examine whether there are other cases of neuroinvasion in the CNS, and the predisposition for such infection. Although we are unable to determine the exact relationship between neuroinvasion and ischemic infarcts, we pose a possible hypothesis from our findings in the patients, mice, and infections of human brain organoids: that SARS-CoV-2 neuroinvasion may cause locally hypoxic regions and disturbance of vasculature, and the disruption of brain vasculature can make vulnerable ischemic infarcts and regions more susceptible to viral invasion (Fig. 8 E). Our findings expand the utility of human brain organoids, beyond modeling fetal brains, and highlight the importance of using a variety of approaches to best model physiology of the human brain.

In future studies, identifying the route of SARS-CoV-2 invasion into the brain, in addition to determining the sequence of infection in different cell types in the CNS, will help validate the temporal relationship between SARS-CoV-2 and ischemic infarcts in patients. It may be through the nasal cavity–to-CNS connection through the cribriform plate, olfactory epithelium and nerve, or viremia, but regardless, the brain should be considered a SARS-CoV-2–susceptible organ system upon respiratory exposure (Baig and Sanders, 2020; Coolen et al., 2020).

Altogether, our study provides clear demonstration that neurons can become a target of SARS-CoV-2 infection, with devastating consequences of localized ischemia in the brain and cell death, highlighting SARS-CoV-2 neurotropism and guiding rational approaches to treatment of patients with neuronal disorders.

93margd
gen. 28, 10:23am

The New Virus Strains Make the Next 6 Weeks Crucial
Ezra Klein | Jan 28, 2021

...The B.1.1.7 variant of coronavirus, first seen in Britain, and now spreading throughout Europe, appears to be 30 to 70 percent more contagious, and it may be more lethal, too.

...“What we need to do right now is to plan for the worst case scenario,” Michael Osterholm, director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told me. “And when I say ‘worst case,’ I’m potentially talking about the most likely case. Let’s not wait until we wrap the car around the tree to start pumping the brakes.”

...Paul Romer, the Nobel laureate economist...modeling suggests that if we continue on our current path, delivering one million vaccinations a day and growing fatigued of lockdowns and masks, more than 300,000 could die in the coming months.

...One (tool to avoid total lockdown) is (cheap) rapid, at-home testing...Used widely, they’d let all of us check, daily, if we were potentially infected, so we could then isolate and avoid infecting others...the Food and Drug Administration (has) been disastrously slow in approving these tests and have held them to a standard more appropriate to doctor’s offices than home testing.

...Biden has proposed spending $50 billion on testing, and a chunk of that money will go to genomic sequencing. This is crucial, because the virus is mutating, and we need to know how, and where, and we need to know it quickly.

...Better masking would also make a difference...we should have stronger guidance on choosing the most effective masks. “I want to see very direct guidance from the C.D.C. of masks people should be wearing in different contexts,” (Ashish Jha, dean of the Brown University School of Public Health ) said that with the new strains, he won’t go into a grocery store unless he’s double-masked, or wearing an N95, or the South Korean equivalent, a KF94.

...Romer’s calculations suggest that two million vaccinations a day could keep us ahead of the new strains, and blunt their impact almost entirely.

...The new strains spread quickly. The speed of our countermeasures will decide our fate. What feel like reasonable delays in our normal experience of time — a few weeks here for Congress to debate a bill, a few weeks there for the F.D.A. to hold meetings — could lead to the kind of explosive infections that overwhelm our hospitals and fill our morgues.

https://www.nytimes.com/2021/01/28/opinion/new-covid-strain.html

94margd
gen. 28, 10:57am

See Covid-19 Risk in Your County and a Guide for Daily Life Near You
Eleanor Lutz, Aliza Aufrichtig, Charlie Smart, Albert Sun, Rich Harris and Gabriel Gianordoli | Jan. 26, 2021
https://www.nytimes.com/interactive/2021/us/covid-risk-map.html

95margd
Editat: gen. 30, 2:54am

Joseph Allen (Harvard Chan SPH) @j_g_allen | 5:16 PM · Jan 27, 2021:
My 'cheat sheet' on masks:

1. N95 (if you can find)
2. KF94 (S. Korea)
3. KN95s (*only* if manufacturer holds a 'NIOSH Certificate')
4. double-mask (cloth mask on top of surgical)
5. surgical mask
6. cloth mask that fits well

Important details here

Opinion | Everyone should be wearing N95 masks now
With better masks, essential workers could have hospital-grade protections. What's stopping us?
Jan 26, 2021
https://www.washingtonpost.com/opinions/2021/01/26/n95-masks-safest-next-best-op...

96John5918
gen. 28, 2:01pm

Coronavirus vaccines: Boost for Africa in race for jabs (BBC)

The African Union (AU) has secured an additional 400 million doses of coronavirus vaccines for the continent. Together with doses the AU has already reserved and those to be made available via the World Health Organization-backed Covax scheme, this brings the total for Africa to 1.27 billion. Africa needs about 1.5 billion doses to immunise 60% of inhabitants, the threshold for herd immunity. Most nations have not started vaccinating, lacking funds to do so. Initiatives to help them have struggled to put in orders as wealthier countries are accused of bulk-buying vaccines. Earlier this week, South Africa's leading coronavirus expert Salim Abdool Karim told the BBC that such behaviour was "unconscionable", warning "no-one is safe until everyone is safe"...


Still no news of when we might get vaccines here in Kenya.

97margd
Editat: gen. 28, 4:30pm

>96 John5918: Well, one can be #1 per capita in doses ordered, but 20th in doses administered...
(At least it's summer in your neck of the woods!)

Canada falls to 20th in the world for vaccine doses administered
John Paul Tasker · CBC News · Posted: Jan 28, 2021

..According to data collated by the University of Oxford-based Our World in Data, Canada now ranks 20th globally, well behind allies like the United States and the United Kingdom but also middle-income countries like Poland and Serbia.

Canada's vaccination effort has also been outpaced so far by those in Bahrain, Denmark, Germany, Israel, Italy, Malta, Portugal, Romania, Slovenia, Spain and the United Arab Emirates, among others.

While a laggard compared to many other wealthy nations, Canada has administered more shots per capita than G7 partners like France and Japan.

Japan, with a population of 126 million people and just 5,400 COVID-19-related deaths, hasn't yet started its vaccination campaign. Unlike Canada, Japan is planning to produce 90 million shots of the AstraZeneca vaccine domestically.

Some observers have blamed France's "technocratic" system with its maze of red tape — a patient needs to consult with a doctor before they get a shot — for the slow rollout there.

...Even when accounting for population size, the U.S. has vaccinated 3 times more people per capita than Canada...

The U.K., a world leader so far, has administered at least one dose to 11.3 per cent of its people, nearly five times more per capita than Canada.

That country's vaccination efforts have been helped by an early approval of the product from Swedish-British pharmaceutical giant AstraZeneca. Health Canada regulators are still reviewing the company's promising vaccine for safety and efficacy.

Canada was among one of the first countries in the world to authorize the Pfizer and Moderna vaccines for use but other nations have since caught up, as Canada contends with shortages because of a plant shutdown in Belgium...to...upgrade...A Belgian newspaper reported Thursday those upgrades are now complete, but a spokesperson for Pfizer confirmed Canada's deliveries won't return to a more normal level until next month.

...a government planning document released to the provinces Wednesday caused confusion as the delivery charts indicate Canada would only receive 3.5 million Pfizer doses by the end of March, 500,000 less than anticipated.

The confusion stems from just how many doses are included in each vial shipped. Amid manufacturing delays, Pfizer is pushing the government to recognize that six doses can be extracted from each vial, but the current Health Canada standard is only five...

https://www.cbc.ca/news/politics/canada-20-world-vaccine-doses-administered-1.58...

98John5918
gen. 28, 11:02pm

Sharing Covid vaccines is in UK's best interests, say scientists (Guardian)

Delivering doses to other countries will reduce chance of virus coming back in new forms, say experts...

99margd
gen. 29, 6:43am

"Here, we described an engineered antibody that neutralizes SARS-CoV-2 with a potency that rivals current lead SARS-CoV-2 clinical nAbs (neutralizing antibodies), but also broadly neutralizes other clade* 1 sarbecoviruses**... and provides significant protection against SARS and COVID-19 disease in mouse models...ADG-2 (the engineered antibody) represents a promising candidate for the prevention and treatment of not only COVID-19, but also future respiratory diseases caused by pre-emergent*** SARS-related CoVs. Furthermore, epitope**** represents an Achilles’ heel for clade 1 sarbecoviruses and hence is an attractive target for the rational design of “pan-SARS” vaccines that aim to elicit similar broadly protective antibodies."

* sarbecoviruses—the viral subgenus containing SARS-CoV and SARS-CoV-2
https://www.nature.com/articles/s41564-020-0771-4

**A clade is a term for a group of organisms that all originate from a common ancestor, and is widely used in biology. Using phylogeny, which is the evolutionary history of a group of organisms, the development of changes in a set of descendant organisms can be tracked. | In virology, a clade describes groups of similar viruses based on their genetic sequences, and changes in those viruses can also be tracked using phylogeny. Rapid genome sequencing is the method by which developments in a virus’s genomic makeup can be tracked. | SARS-CoV-2 is itself a clade within the family coronaviridae and the genus betacoronavirus. Generally, the genetic variations of a virus are grouped into clades, which can also be called subtypes, genotypes, or groups.
https://www.news-medical.net/health/Viral-Clades-of-SARS-CoV-2.aspx

*** pre-emergent SARS-related CoVs --a coronavirus related to SARS and COVID-19 that has not yet jumped from bats to humans(?)

**** epitope--the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells (wikipedia)

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C. Garrett Rappazzo et al. 2021. Broad and potent activity against SARS-like viruses by an engineered human monoclonal antibody.
Science 25 Jan 2021:eabf4830 DOI: 10.1126/science.abf4830 https://science.sciencemag.org/content/early/2021/01/22/science.abf4830

Abstract
The recurrent zoonotic spillover of coronaviruses (CoVs) into the human population underscores the need for broadly active countermeasures. We employed a directed evolution approach to engineer three SARS-CoV-2 antibodies for enhanced neutralization breadth and potency. One of the affinity-matured variants, ADG-2, displays strong binding activity to a large panel of sarbecovirus* receptor binding domains (RBDs) and neutralizes representative epidemic sarbecoviruses with high potency. Structural and biochemical studies demonstrate that ADG-2 employs a distinct angle of approach to recognize a highly conserved epitope overlapping the receptor binding site. In immunocompetent mouse models of SARS and COVID-19, prophylactic administration of ADG-2 provided complete protection against respiratory burden, viral replication in the lungs, and lung pathology. Altogether, ADG-2 represents a promising broad-spectrum therapeutic candidate against clade** 1 sarbecoviruses.

...Discussion
Since the beginning of the COVID-19 pandemic, a plethora of potently neutralizing SARS-CoV-2 antibodies have been isolated and some have rapidly advanced into clinical trials... However, the epitopes recognized by most of these nAbs are highly variable among other clade 1 sarbecoviruses, hence limiting their neutralization breadth and increasing their susceptibility to antibody escape mutations... Here, we described an engineered antibody that neutralizes SARS-CoV-2 with a potency that rivals current lead SARS-CoV-2 clinical nAbs, but also broadly neutralizes other clade 1 sarbecoviruses, potently triggers Fc-mediated effector functions, and provides significant protection against SARS and COVID-19 disease in mouse models. Thus, ADG-2 represents a promising candidate for the prevention and treatment of not only COVID-19, but also future respiratory diseases caused by pre-emergent SARS-related CoVs. Furthermore, our fine epitope mapping and structural studies demonstrate that ADG-2 employs a distinct angle of approach to recognize a highly conserved epitope overlapping the receptor binding site. This epitope represents an Achilles’ heel for clade 1 sarbecoviruses and hence is an attractive target for the rational design of “pan-SARS” vaccines that aim to elicit similar broadly protective antibodies.

100margd
Editat: gen. 30, 3:01am

Medical myths: 13 COVID-19 vaccine myths
Tim Newman on January 29, 2021

1. The vaccines are not safe, because they were developed so fast
2. The vaccine will alter my DNA
3. COVID-19 vaccines can give you COVID-19
4. The vaccine contains a microchip
5. COVID-19 vaccines can make you infertile
6. The COVID-19 vaccine contains fetal tissue
7. People who have had COVID-19 do not need the vaccine
8. After receiving the vaccine, you cannot transmit the virus
9. Once I have been vaccinated, I can resume a normal life
10. The vaccine will protect against COVID-19 for life
11. People with preexisting conditions cannot take the vaccine
12. People with compromised immune systems cannot have the vaccine
13. Older adults cannot have the vaccine

https://www.medicalnewstoday.com/articles/medical-myths-13-covid-19-vaccine-myth...

101margd
gen. 29, 12:20pm

Novavax vaccine shows efficacy of
95.6% against the original COVID-19 strain
85.6% against the UK variant strain (B117)
("The company initiated a rolling submission to the United Kingdom’s regulatory agency, the MHRA, in mid-January.")

60% against the triple mutant variant virus first reported in S Africa, and just reported in S Carolina.
("Novavax initiated development of new constructs against the emerging strains in early January and expects to select ideal candidates for a booster and/or combination bivalent vaccine for the new strains in the coming days. The company plans to initiate clinical testing of these new vaccines in the second quarter of this year.")

Two doses are required but can be stored in existing refrigerators.

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01/29/2021 09:08 GMT — Novavax vaccine shows 89.3% efficacy

Novavax have announced that, according to an interim analysis of Phase 3 clinical trials, their vaccine candidate demonstrates 89.3% efficacy. The analysis included 62 cases of COVID-19, 56 of which occurred in the placebo group, and six in the vaccine group.*

The study involved more than 15,000 participants, 27% of whom were 65 or older. The United Kingdom, where the trials took place, has already purchased 60 million doses.

Novavax also ran trials in South Africa. Here, most cases involved the variant first identified in the region, and in people without an HIV infection, the vaccine demonstrated 60% efficacy.

If Novavax offering is approved for emergency use by the Medicines and Healthcare products Regulatory Agency, it will be the U.K.’s fourth vaccine.

According to Prof. Paul Heath, chief investigator of the U.K. Novavax vaccine trial, “These are enormously exciting findings and show that this is a highly effective and safe COVID-19 vaccine — importantly, it also shows that this is a vaccine that is effective against the U.K. variant that has spread so quickly.”

However, Prof. Peter Openshaw from Imperial College London in the U.K. adds a note of caution:

“The rather lower level of protection ... seen in South Africa is a concern, given that the triple mutant variant virus … was widely circulating at that time. The press release hints that prior infection with earlier variants of SARS-CoV-2 may not completely protect against subsequent infection by the variant of concern, but that vaccination with (Novavax vaccine candidate) did provide some protection.”

https://www.medicalnewstoday.com/articles/covid-19-vaccine-live-updates
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* Novavax COVID-19 Vaccine Demonstrates 89.3% Efficacy in UK Phase 3 Trial (Press Release)
Novavax | Jan 28, 2021

...The interim analysis included a preliminary review of the safety database, which showed that severe, serious, and medically attended adverse events occurred at low levels and were balanced between vaccine and placebo groups.

...“The 60% reduced risk against COVID-19 illness in vaccinated individuals in South Africans underscores the value of this vaccine to prevent illness from the highly worrisome variant currently circulating in South Africa, and which is spreading globally. This is the first COVID-19 vaccine for which we now have objective evidence that it protects against the variant dominating in South Africa,” says Professor Shabir Maddi, Executive Director of the Vaccines and Infectious Diseases Analytics Research Unit (VIDA) at Wits, and principal investigator in the Novavax COVID-19 vaccine trial in South Africa. “I am encouraged to see that Novavax plans to immediately begin clinical development on a vaccine specifically targeted to the variant, which together with the current vaccine is likely to form the cornerstone of the fight against COVID-19.”

Novavax initiated development of new constructs against the emerging strains in early January and expects to select ideal candidates for a booster and/or combination bivalent vaccine for the new strains in the coming days. The company plans to initiate clinical testing of these new vaccines in the second quarter of this year.

“A primary benefit of our adjuvanted platform is that it uses a very small amount of antigen, enabling the rapid creation and large-scale production of combination vaccine candidates that could potentially address multiple circulating strains of COVID-19,” said Gregory M. Glenn, M.D., President of Research and Development, Novavax. “Combined with the safety profile that has been observed in our studies to-date with our COVID-19 vaccine, as well as prior studies in influenza, we are optimistic about our ability to rapidly adapt to evolving conditions.”

https://ir.novavax.com/news-releases/news-release-details/novavax-covid-19-vacci...
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Novavax says its candidate, NVX-CoV2373, can be stored at refrigerated temperatures, "allowing for successful cold chain management with existing infrastructure."
https://ir.novavax.com/news-releases/news-release-details/novavax-covid-19-vacci...

102margd
gen. 29, 4:22pm

Johnson & Johnson’s Vaccine Offers Strong Protection but Fuels Concern About Variants
Carl Zimmer, Noah Weiland and Sharon LaFraniere | Jan. 29, 2021

Johnson & Johnson, the only major drug maker developing a single-dose vaccine for Covid, announced on Friday that its shot provided strong protection against Covid-19...The vaccine’s efficacy rate dropped from 72 percent in the United States to 57 percent in South Africa, where a highly contagious variant is driving most cases.

Studies suggest that this variant also blunts the effectiveness of Covid vaccines made by Pfizer-BioNTech, Moderna and Novavax. The variant has spread to at least 31 countries, including the United States, where two cases were documented this week.

Johnson & Johnson became the fifth company supported by the U.S. government to develop an effective Covid vaccine in less than a year, and the only one that doesn’t need two doses...

The Johnson & Johnson (adenovirus) vaccine was extremely effective in preventing severe cases of Covid — including serious illness caused by the variant, the company said. Though less effective than the Moderna and Pfizer vaccines now authorized in the United States, Johnson & Johnson’s is still considered a strong vaccine by scientists. Annual flu vaccines, for example, are typically 40 to 60 percent effective...

Johnson & Johnson said that it planned to apply for emergency authorization of the vaccine from the Food and Drug Administration as soon as next week, putting it on track to receive clearance later in February...may only have about seven million doses ready when the F.D.A. decides whether to authorize it...and about 30 million doses by early April...(but) the variant from South Africa, known as B.1.351,...by April it could make up a large fraction of infections in the United States.

The fact that at least four vaccines backed by the federal government seem to be less effective against the B.1.351 variant has unsettled federal officials and vaccine experts alike. Facing this uncertainty, many researchers said it was imperative to get as many people vaccinated as possible — quickly. Lowering the rate of infection could thwart the contagious variants while they are still rare, and prevent other viruses from gaining new mutations that could cause more trouble.

...Federal regulators are also still waiting on data from Johnson & Johnson’s new manufacturing facility in Baltimore that prove it can mass-produce the vaccine. The company is counting on that factory to help reach its contractual pledge to the federal government of 100 million doses by the end of June.

If Johnson & Johnson can deliver vaccines quickly enough to the United States, it might be able to help drive down cases before variants make things worse. Since the vaccine requires only a single shot — unlike the Moderna and Pfizer-BioNTech vaccines, which require two — that delivery would translate into full coverage for 100 million people.

Johnson & Johnson’s vaccine has another advantage that might help speed up the rollout. It can stay viable in a refrigerator for three months, while the two authorized vaccines have to be kept frozen. That gives the company an edge not just in reaching more isolated parts of the United States, but in getting the vaccine to remote areas of the world that could otherwise seed more aggressive mutants.

https://www.nytimes.com/2021/01/29/health/covid-vaccine-johnson-and-johnson-vari...

103margd
Editat: gen. 30, 3:22am

U. study: Pregnant women with severe COVID-19 symptoms at higher risk for complications, death
Carter Williams, KSL.com | Jan. 29, 2021

SALT LAKE CITY — Pregnant women who developed severe symptoms of COVID-19 were at higher risk of pregnancy complications and even death compared to women who experienced no symptoms, or mild or moderate symptoms, according to a new study led by a University of Utah researcher.*

The good news, according to the study, is that most pregnant women who were studied didn't experience severe or critical effects of COVID-19; however, Dr. Torri Metz, an associate professor and maternal-fetal medicine subspecialist at University of Utah Health, and the study's lead author, said it's still difficult to know why some pregnant women developed severe symptoms while others didn't.

"(Adverse effects) do seem to be predominately(sic) limited to that severe and critical group but we don't have control over who ends up being in that severe and critical group," she said, in a briefing with media Friday. "And since that was 12% of our population, I think we have to take that into context to know that if pregnant women do develop COVID-19, they are at risk for developing severe and critical illness. And if they do, they are at risk for adverse pregnancy outcomes."

The study was released Friday in time to be presented at the Society for Maternal-Fetal Medicine's annual meeting. Researchers analyzed data from more than 1,200 pregnant women at 33 hospitals across 14 states from March 1 through July 31, 2020.

In all, nearly half were asymptomatic, while 27% reported mild symptoms and 14% experienced moderate symptoms. Another 8% experienced severe symptoms and 4% experienced critical symptoms.

Those who tended to experience worse symptoms were older, had higher body mass index, and were more likely to have underlying health conditions like asthma, diabetes or high blood pressure, researchers discovered. The women more likely to suffer severe outcomes from the coronavirus were more likely to die or have serious complications like preterm birth, postpartum hemorrhage or heavy bleeding after childbirth, high blood pressure during pregnancy, or have a cesarean delivery.

The death rate from the study of COVID-19 in women was also 0.3%, which would equate to 3 deaths per 1,000 or 300 per 100,000. The last known rate of 17.4 deaths per 100,000 in pregnant women without COVID-19, according to the Centers for Disease Control and Prevention.

"This is much higher than would be expected at baseline and it's certainly concerning," Metz said. "In pregnancy, we're seeing the same thing that we're seeing in non-pregnant people in that there are increased death rates over this time period."

The data on higher deaths tied to COVID-19 is something that Metz's University of Utah Health colleagues mentioned during a briefing Thursday. During that briefing, experts said COVID-19 was the third-leading cause of death in Utah during 2020 behind heart disease and cancer. It even outpaced heart disease and cancer at points during the end of the year.

The researchers were "in some ways" surprised by the findings. Metz explained that they weren't sure if there were adverse pregnancy outcomes with COVID-19 when they began the study. They also didn't know if those would be influenced by the severity of the disease.

There were some limitations to the study as well. She added a "vast majority" of the patients studied were in the third trimester of their pregnancy. Researchers still don't know if infection in the first trimester would cause birth defects.

Metz said the study could be viewed as reassuring for women who experience mild or moderate COVID-19 symptoms, which was the majority of those who experienced any symptoms. That said, since there is no way of knowing someone's outcome in advance, she advised that pregnant women wear a mask, practice social distancing and follow all other public health measures aimed at reducing the risk of contracting COVID-19.

Advice for COVID-19 vaccination during pregnancy

Pregnant women weren't included during the initial COVID-19 vaccine trials. Pfizer is currently in the process of studying the vaccine in pregnant women but those trials aren't yet completed. At this point in the vaccine rollout, pregnant medical professionals, emergency response or teachers would be among the individuals who would have to make the decision about vaccination.

The CDC's official stance on the matter is that those who are pregnant should consult their health care provider since there are no data on the subject. It added there are no indications of risk from mRNA vaccine studies.

"When making a decision, pregnant people and their health care providers should consider the level of COVID-19 community transmission, the patient's personal risk of contracting COVID-19, the risks of COVID-19 to the patient and potential risks to the fetus, the efficacy of the vaccine, the side effects of the vaccine, and the lack of data about the vaccine during pregnancy," the CDC advises.

While the study didn't address vaccines, Metz said knowing the risks of COVID-19 illness is something that women have to weigh in the decision over having a child during the pandemic, and if they want to get a COVID-19 vaccine.

https://www.ksl.com/article/50097463/u-study-pregnant-women-with-severe-covid-19...

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* Late-Breaking Research Presentations Session 1

LB02 - Maternal and neonatal outcomes of pregnant patients with coronavirus disease 2019 (COVID-19): A multistate cohort
Thursday, January 28, 2021
12:45 PM – 1:00 PM EST
Objective: To describe COVID-19 disease course in a multistate cohort of pregnant patients and evaluate whether more severe disease is associated with worse maternal and neonatal outcomes.

Study Design: Cohort of all pregnant patients with a singleton gestation and positive SARS-CoV-2 nucleic acid or antigen test (either in- or out-patient), who delivered at one of 33 U.S. hospitals from March 1 to July 31, 2020. Disease severity was classified by NIH criteria. Perinatal outcomes included death, cesarean delivery (CD), postpartum hemorrhage (PPH), hypertensive disorders of pregnancy (HDP), and preterm birth

104margd
gen. 30, 3:35am

Pregnant Women May Receive Covid Vaccines Safely, W.H.O. Says
Apoorva Mandavilli | Jan. 29, 2021
https://www.nytimes.com/2021/01/29/health/covid-vaccine-pregnancy.html

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The Moderna COVID-19 (mRNA-1273) vaccine: what you need to know
WHO | 26 January 2021

...Should pregnant women be vaccinated?

While pregnancy puts women at higher risk of severe COVID-19, very little data are available to assess vaccine safety in pregnancy.

Nevertheless, based on what we know about this kind of vaccine, we don’t have any specific reason to believe there will be specific risks that would outweigh the benefits of vaccination for pregnant women.

For this reason, those pregnant women at high risk of exposure to SARS-CoV-2 (e.g. health workers) or who have comorbidities which add to their risk of severe disease, may be vaccinated in consultation with their health care provider...

https://www.who.int/news-room/feature-stories/detail/the-moderna-covid-19-mrna-1...

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Vaccination Considerations for People who are Pregnant or Breastfeeding
CDC Updated Jan. 7, 2021

COVID-19 Vaccination Considerations for People Who Are Pregnant

Pregnant people are at increased risk for severe illness from COVID-19...
There are limited data about the safety of COVID-19 vaccines for people who are pregnant...
Because supplies are currently limited, CDC recommends certain groups receive the first supply of COVID-19 vaccines...
Getting vaccinated is a personal choice for people who are pregnant...
Vaccine side effects...
Routine testing and pregnancy...
COVID-19 vaccination considerations for people who are breastfeeding...

https://www.cdc.gov/coronavirus/2019-ncov/vaccines/recommendations/pregnancy.htm...

105margd
gen. 30, 4:05am

Viral Posts Distort WHO Guidance on COVID-19 Tests
Angelo Fichera | January 29, 2021

Quick Take
Dubious websites and viral posts falsely claim that the World Health Organization changed COVID-19 testing protocols for political reasons following Joe Biden’s inauguration and admitted that false-positive cases had been inflating the case count. The WHO’s guidance merely reminded labs to follow instructions provided by each test’s manufacturer.

Full Story
A recent memo from the World Health Organization designed for lab professionals became a major focus of misinformation — with unreliable websites and social media users claiming the agency had changed a testing protocol and admitted that COVID-19 cases have been wildly inflated.

But neither of those claims is accurate...

https://www.factcheck.org/2021/01/scicheck-viral-posts-distort-who-guidance-on-c...

106margd
gen. 30, 5:07am

A new study shows occupations with the highest Covid death rates
Michelle Cheng | January 26, 2021

It’s been well documented that essential workers face heightened risks of contracting Covid-19. Now, research from the University of California, San Francisco, suggests they’re also more likely to die from it.

A new study from UCSF’s Institute for Global Health Sciences found that death rates for working-age adults in California were 22% higher than what would have been expected had there been no pandemic. The so-called excess mortality rate was highest among food and agriculture workers (39%), transportation and logistics workers (28%), facilities workers (27%), and manufacturing workers (23%).

...Why are those in food and agriculture at such high risk? It comes down to more than just the availability or quality of PPE in the workplace or being able to social distance. Part of the difference also can be explained by socioeconomic factors. According to a study by the Kaiser Family Foundation, food production workers are more likely than the average US worker to subsist below the federal poverty level, be uninsured, and live in non-metro area.

“Especially in certain parts of the state of California, people who are poor are likely to be living in crowded living units, where the virus can quickly be transmitted,” says Yea-Hung Chen, an epidemiologist at UCSF and a co-author of the study.

Many of the highest risk workers are also low-wage earners. Quitting a job out of safety concerns, with no financial safety net, is often impossible for them...

The researchers also looked at mortality through the lens of race and ethnicity. Latino and Black Californians, who also face the highest jobless rates, have had relatively higher increases in mortality during the pandemic, at 59% and 28%, respectively. Overall, the risk ratios are highest for Latino workers in food or agriculture workers, Asian workers in health or emergency, Black workers in retail, and white workers in food or agriculture.

...vaccine prioritization for essential workers will be essential for lowering on-the-job health risks. And that can be complimented with workplace safety measures and access to PPE and testing...

https://qz.com/1962493/a-new-study-shows-occupations-with-the-highest-covid-deat...
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Yea-Hung Chen et al. 2021. Excess mortality associated with the COVID-19 pandemic among Californians 18–65 years of age, by occupational sector and occupation: March through October 2020. MedRxiv (Jan 22, 2021) doi: https://doi.org/10.1101/2021.01.21.21250266 https://www.medrxiv.org/content/10.1101/2021.01.21.21250266v1

This article is a preprint and has not been peer-reviewed

Abstract
Background
Though SARS-CoV-2 outbreaks have been documented in occupational settings and though there is speculation that essential workers face heightened risks for COVID-19, occupational differences in excess mortality have, to date, not been examined. Such information could point to opportunities for intervention, such as workplace modifications and prioritization of vaccine distribution.

Methods and findings
Using death records from the California Department of Public Health, we estimated excess mortality among Californians 18–65 years of age by occupational sector and occupation, with additional stratification of the sector analysis by race/ethnicity. During the COVID-19 pandemic, working age adults experienced a 22% increase in mortality compared to historical periods. Relative excess mortality was highest in food/agriculture workers (39% increase), transportation/logistics workers (28% increase), facilities (27%) and manufacturing workers (23% increase). Latino Californians experienced a 36% increase in mortality, with a 59% increase among Latino food/agriculture workers. Black Californians experienced a 28% increase in mortality, with a 36% increase for Black retail workers. Asian Californians experienced an 18% increase, with a 40% increase among Asian healthcare workers. Excess mortality among White working-age Californians increased by 6%, with a 16% increase among White food/agriculture workers.

Conclusions
Certain occupational sectors have been associated with high excess mortality during the pandemic, particularly among racial and ethnic groups also disproportionately affected by COVID-19. In-person essential work is a likely venue of transmission of coronavirus infection and must be addressed through strict enforcement of health orders in workplace settings and protection of in-person workers. Vaccine distribution prioritizing in-person essential workers will be important for reducing excess COVID mortality.

107margd
gen. 30, 9:18am

Fact Check: Did the American Journal of Medicine Recommend Hydroxychloroquine For COVID?
Lauren Giella | 1/29/21

The Claim
A new article published in this month's edition of The American Journal of Medicine (AJM) circulated on social media this week led many people to believe the journal is now endorsing the use of HCQ to treat COVID-19 as a political move after Trump left office.

The Facts
Dr. Joseph S. Alpert, editor-in-chief of the AJM, said the journal does not endorse HCQ treatment for COVID-19. "This article does not mean the journal recommended this therapy...The authors recommended it just as others recommend other interventions. We just publish their findings and recommendations...We have also published articles from other authorities that said don't use it (HCQ treatment)...This is still controversial with two sides saying different things. Often we have editorials that dispute the article's recommendations. We are a scientific journal and do not push or recommend any specific thing. The authors do that."

The article was put together last spring and was published online in August, all when Trump was still in office. When the article was submitted to the journal, Alpert said the data was controversial but not unreasonable at the time.

The article presents data from the time showing that in a test tube lab, the drugs interfered with the normal reproduction of the coronavirus. Therefore, the authors advocate for more testing into the effect of HCQ and other agents on COVID-19.

...Subsequent studies came out that showed the drug did not work on patients who were already sick. Alpert said the drug may be useful as a preventative measure but those studies have not been widely done.

"We need more data, it's a new virus and we don't have all the answers right now," Alpert said. "Science is a constantly evolving entity. What is true today can be false tomorrow with new studies and new observations."...

https://www.newsweek.com/fact-check-did-american-journal-medicine-recommend-hydr...

108margd
gen. 31, 8:59am

Anti-vaxxers actually blocked entrance to a clinic in Dodger Stadium, not only inconveniencing those seeking COVID vax, but, had anti-vaxxers persisted, potentially blocking use of vaccines past expiry period! Amazing behavior considering that COVID vaccines appear incredibly safe in absolute as well as relative terms.

Globally and in the US, # vaccinations just surpassed # cases. While confirmed deaths from COVID soar there have been NONE for vaccinations. Some vax-associated deaths, of course, are being investigated for cause, and some can be expected given the tens and hundreds of millions being vaccinated (~ populations of NYC, Canada, UK), including the most frail among us. Allergic reactions have been documented, but so far all have resolved. Time, I think for a hard shove back against anti-vaxxers who would block access:

World
COVID: 103 million cases | 2.22 million confirmed deaths
Vaccinations: 100+ million | 0 confirmed deaths

US
COVID: 26.1 million cases | 0.44 million confirmed deaths
Vaccinations: 29.5 milliion | 0 confirmed deaths

1092wonderY
gen. 31, 9:50am

>108 margd: What are they afraid of? Nobody is forcing them to take a shot. Who cares if the rest of the world is transformed to Bill Gates zombies?

110margd
gen. 31, 4:09pm

Eric Topol (cardiologist) @EricTopol | 3:23 PM · Jan 31, 2021·Twitter Web App
Just to show how fast things are moving
On the same day this was published

SARSCoV2 evolution and vaccines: cause for concern? @LancetRespirMed
https://thelancet.com/journals/lanres/article/PIIS2213-2600(21)00075-8/fulltext*

The ? was answered, w/ a drop-off in vaccine efficacy (89%->49 stellarexplorer:%) for B.1.351, (96%->86 margd:%) for B.1.1.7

While there's been a lot of attention to the B.1.351 (SA) variant immune escape and efficacy drop-off, @novavax results also point to partial resistance (albeit less) for B.1.1.7, which is troubling, as it clearly has enhanced transmission
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*Thomas C Williams and Wendy A Burgers. 2021. SARS-CoV-2 evolution and vaccines: cause for concern? (Comment)
The Lancet Respiratory Medicine ( | January 29, 2021) DOI:https://doi.org/10.1016/S2213-2600(21)00075-8 https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00075-8/fulltext

In little more than a year, the COVID-19 pandemic has reached every continent, causing 98 million confirmed cases and over 2 million deaths (as of Jan 25, 2021). Equally rapid has been the progress in vaccine development, with clinical trials commencing just months after the initial release of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genome on Jan 10, 2020. At present, a number of vaccines are already licenced or progressing through phase 3 trials. Most use a recombinant spike glycoprotein: either mRNA based (the Moderna and Pfizer–BioNTech vaccines), via an adenovirus vector (the Oxford–AstraZeneca, CanSino, and Johnson & Johnson vaccines), or via injection of the protein itself (the Novavax vaccine). In tandem with rapid vaccine development, widespread whole genome sequencing (WGS) efforts have provided more than 360 000 SARS-CoV-2 sequences on the Global Initiative on Sharing All Influenza Data platform. This sequencing has allowed researchers to track the spread of different lineages globally. Some mutations in the virus appear to provide fitness advantages and facilitate quicker spread of particular lineages, such as the globally dispersed variant with a Asp614Gly spike substitution...and the recently described variant of concern 202012/01 (B.1.1.7) lineage in the UK...

A number of studies have yielded insight into the relationship between SARS-CoV-2 genomic variability and the host immune response; in this Comment, we discuss whether such variability has the potential to affect the efficacy of recently developed vaccines...

So is there cause for concern? Clearly, variability in the spike glycoprotein can affect the efficiency of antibody neutralisation. The role of spike protein variability in T cell immunity is likely to be elucidated in experimental studies in the next few months; a priori, the enhanced repertoire of T cell epitopes makes the loss of cytotoxic activity or recognition improbable. But only ongoing clinical trials will show whether vaccinated individuals recognise SARS-CoV-2 variants differently, and whether mutations decrease vaccine protection in some vaccinated individuals. The ongoing phase 3 trial of an adenovirus-vectored spike-based vaccine (Johnson & Johnson, NCT04505722) in South Africa, where the 501Y.V2 (B.1.351) strain with the Glu484Lys substitution is rapidly replacing pre-existing variants...might provide an opportunity to examine this question. Ultimately, most vaccines are based on a recombinant spike protein sequence. Thus if evidence emerges that particular variants do appear to influence vaccine efficacy, it should be possible to periodically reformulate the vaccines so that they better match the circulating strains.

Importantly, the overall effectiveness of immunisation will correlate with rates of vaccine uptake. We therefore encourage researchers, health-care providers, and policy makers to act as advocates for immunisation, and to advise individuals with questions about vaccines to seek this information from reliable sources. The higher the proportion of a population vaccinated, the lower the number of susceptible individuals, and the fewer opportunities SARS-CoV-2 will have to spread and mutate.

111margd
Editat: feb. 1, 8:57am

Vaccinating people over 60 is the most effective way to mitigate mortality from COVID19, a new age-based modeling study suggests. Prioritizing adults ages 20-49 years minimized cumulative incidence.

Kate M. Bubar et al. 2021. Model-informed COVID-19 vaccine prioritization strategies by age and serostatus. Science 21 Jan 2021:
eabe6959 DOI: 10.1126/science.abe6959 https://science.sciencemag.org/content/early/2021/01/21/science.abe6959

Abstract
Limited initial supply of SARS-CoV-2 vaccine raises the question of how to prioritize available doses. Here, we used a mathematical model to compare five age-stratified prioritization strategies. A highly effective transmission-blocking vaccine prioritized to adults ages 20-49 years minimized cumulative incidence, but mortality and years of life lost were minimized in most scenarios when the vaccine was prioritized to adults over 60 years old. Use of individual-level serological tests to redirect doses to seronegative individuals improved the marginal impact of each dose while potentially reducing existing inequities in COVID-19 impact. While maximum impact prioritization strategies were broadly consistent across countries, transmission rates, vaccination rollout speeds, and estimates of naturally acquired immunity, this framework can be used to compare impacts of prioritization strategies across contexts.

112margd
Editat: feb. 1, 4:20am

Flor M. Munoz. 2021. Can We Protect Pregnant Women and Young Infants From COVID-19 Through Maternal Immunization? (Editorial) JAMA Pediatr. Published online January 29, 2021. doi:10.1001/jamapediatrics.2021.0043 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2775944

...the majority of infants born to seropositive mothers (72 of 83 (87%)) had detectable IgG antibody at birth...transplacental transfer was efficient regardless of the presence of symptoms in the mother or the severity of disease.

...placental transfer ratios increased when the time between maternal infection and delivery was longer

...In this study, no evidence of intrauterine or postnatal infection was identified through serology, viral detection, or clinical findings.

...While there is a potential for some protection from breast milk antibodies in lactating infants, this might be limited and less effective than protection from transplacental antibodies.

... maternal vaccination could (efficient(ly) transfer transplacental antibody to newborns)

...Critical information needs to be collected through carefully designed prospective or longitudinal clinical studies to inform and implement safe and effective maternal and infant vaccination strategies.
_________________________________________________

"Our findings demonstrate the potential for maternally derived SARS-CoV-2 specific antibodies to provide neonatal protection from coronavirus disease 2019."

Dustin D. Flannery 2021. Assessment of Maternal and Neonatal Cord Blood SARS-CoV-2 Antibodies and Placental Transfer Ratios.
JAMA Pediatr. Published online January 29, 2021. doi:10.1001/jamapediatrics.2021.0038 https://jamanetwork.com/journals/jamapediatrics/fullarticle/2775945

...transplacentally acquired antibody rapidly decays by the 2nd month of life & continues to drop so that by 6-12 months, protective efficacy is reduced. Available data on the effect of COVID-19 in newborns and infants suggests that severe disease may occur in early life...

...Discussion
We measured IgG and IgM antibody* directed to the RBD of the SARS-CoV-2 spike protein in 1471 mother/newborn dyads at a single birth center in Philadelphia from April to August 2020 and detected IgG antibody in 83 maternal and 72 cord blood sera. Determination of correlates of maternal and neonatal immunity is a high priority area for SARS-CoV-2 research in maternal-child health domains,... and our findings provide insight into the dynamics of maternally derived, potentially protective neonatal immunity.

Our findings align with current evidence that suggests that although placental and neonatal SARS-CoV-2 transmission may occur,... such events are not common... Of greater concern is the potential for newborns to be infected postnatally from contagious mothers or other household contacts. We found efficient transfer of IgG antibodies from women who were SARS-CoV-2 seropositive ..., and a positive correlation between maternal and cord antibody concentrations... Higher maternal antibody concentrations and a higher transfer ratio were associated with increasing duration between onset of maternal infection and time of delivery. Multiple other factors, such as antigen-elicited IgG subclass, maternal infections, maternal immunodeficiency, placental pathology, and gestational age at birth, are known to affect transfer efficiency and will require further study for SARS-CoV-2.... We did not observe a significant difference in transfer efficiency comparing infants born preterm (defined as fewer than 37 weeks’ gestation), but this finding was likely affected by small numbers (n = 9) of preterm infants, with the earliest born at 31 weeks’ gestation. Further studies will be needed to define transplacental antibody dynamics at earlier gestational ages.

When vaccines are widely available, the optimal timing of maternal vaccination during pregnancy will need to consider maternal and fetal factors including the time needed to ensure neonatal protection. The majority of women in our study who were seropositive were asymptomatic, with uncertain timing of viral exposure. Among the subset of women in our study whose onset of infection could be estimated by symptoms prompting viral NP-PCR testing, all cord sera were seropositive if the maternal NP-PCR testing was 17 days or more prior to delivery.

...Conclusions
Our findings demonstrate the potential for maternally derived antibodies to provide neonatal protection from SARS-CoV-2 infection and will help inform both neonatal management guidance and design of vaccine trials during pregnancy. Further studies are needed to determine if SARS-CoV-2 antibodies are protective against newborn infection; if so, at what concentration; and whether the transplacental kinetics of vaccine-elicited antibodies are similar to naturally acquired antibodies.

* IgG antibodies are conducted from mom to fetus across the placenta. IgM antibodies indicates that the fetus was infected.

113margd
Editat: feb. 1, 10:01am

Ashish K. Jha, MD, MPH (Dean, Brown U School of Public Health) @ashishkjha | 10:16 PM · Jan 31, 2021
Am often asked about different vaccines and their efficacy
Each trials tracks, reports efficacy differently
Currently, we have preliminary results for Novavax and J&J
But what numbers matter? What should you look for?
Here's one set of data to track. In a simple table

Image-Vaccine trials efficacy, safety ( https://twitter.com/ashishkjha/status/1356079020878786561/photo/1 )

114margd
feb. 1, 11:00am

Schizophrenia is 2nd highest risk factor for dying of COVID-19, after age
Yasemin Saplakoglu | 27 January 2021

...The researchers did not find an association between anxiety or mood disorders and death from COVID-19. But they found that people with schizophrenia were about 2.7 times more likely to die from COVID-19 than people without that mental disorder — the second-highest risk factor after age.

By comparison, patients between the ages of 45 and 54 were 3.9 times more likely to die from COVID-19 than younger patients (and that risk doubled every 10 years of age after 54), regardless of whether they had a mental disorder. Patients with heart failure or diabetes had a 1.65 times and 1.28 times higher risk of dying from COVID-19, respectively...

...(senior author Dr. Donald Goff, a professor of psychiatry at the NYU School of Medicine) People with schizophrenia should be among those "prioritized for vaccines"...

https://www.livescience.com/schizophrenia-covid-19-death-risk-factor.html
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"adults with a schizophrenia spectrum disorder diagnosis were associated with an increased risk for mortality, but those with mood and anxiety disorders were not associated with a risk of mortality."

Katlyn Nemani et al. 2021. Association of Psychiatric Disorders With Mortality Among Patients With COVID-19. JAMA Psychiatry. Published online January 27, 2021. doi:10.1001/jamapsychiatry.2020.4442 https://jamanetwork.com/journals/jamapsychiatry/fullarticle/2775179

Abstract
...Results
Of the 26 540 patients tested, 7348 tested positive for SARS-CoV-2 (mean...age, 54...years; 3891 (53.0%) women). Of eligible patients with positive test results, 75 patients (1.0%) had a history of a schizophrenia spectrum illness, 564 (7.7%) had a history of a mood disorder, and 360 (4.9%) had a history of an anxiety disorder. After adjusting for demographic and medical risk factors, a premorbid diagnosis of a schizophrenia spectrum disorder was significantly associated with mortality (odds ratio...2.67...). Diagnoses of mood disorders (OR, 1.14...) and anxiety disorders (OR, 0.96...) were not associated with mortality after adjustment. In comparison with other risk factors, a diagnosis of schizophrenia ranked behind only age in strength of an association with mortality.

Conclusions and Relevance
In this cohort study of adults with SARS-CoV-2–positive test results in a large New York medical system, adults with a schizophrenia spectrum disorder diagnosis were associated with an increased risk for mortality, but those with mood and anxiety disorders were not associated with a risk of mortality. These results suggest that schizophrenia spectrum disorders may be a risk factor for mortality in patients with COVID-19.

115margd
Editat: feb. 1, 1:15pm

Meg Tirrell (CNBC) @megtirrell | 11:30 AM · Feb 1, 2021:
.@aslavitt46 announces Dept of Defense & HHS have awarded $230m to Ellume, maker of first OTC at-home #covid19 test.
Ellume to ship 100k test kits to US per month from Feb - July.
New funding will scale manufacturing capacity to 19m test kits/mo by end of year. 8.5m to US govt.

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COVID-19 HOME TEST FOR CONSUMERS
The Ellume COVID-19 Home Test is an over-the-counter, rapid self-test which detects SARS-CoV-2 antigen... It enables individuals, with and without symptoms, to test for COVID-19 infection in 15 minutes, anywhere."

How it Works
The test includes a sterile Nasal Swab, a Dropper, Processing Fluid, and a Bluetooth® connected Analyzer for use with an App on the user’s smartphone.

Utilizing the dedicated App, the user follows step-by-step instructions to perform the test including a self-collected mid-turbinate swab. The sample is analyzed and results are automatically transmitted to the user’s smartphone via Bluetooth®. Results can be shared with healthcare professionals to enable optimal therapy.

Through a secure cloud connection, the Ellume COVID-19 Home Test provides real time reporting of test results and critical data to health authorities, employers and educators, for efficient COVID-19 mapping.

https://www.ellumehealth.com/products/consumer-products/covid-home-test

116margd
feb. 2, 4:19pm

People who have had COVID may need only one, not two, doses of mRNA vaccine to achieve full immunity.

Florian Krammer et al. 2021. Robust spike antibody responses and increased reactogenicity in seropositive individuals after a 1 single dose of SARS-CoV-2 mRNA vaccine. MedRxiv, posted February 1, 2021 (5 p) ; https://doi.org/10.1101/2021.01.29.21250653 https://www.medrxiv.org/content/10.1101/2021.01.29.21250653v1.full.pdf

This preprint reports new research that has not been certified by peer review and should not be used to guide clinical practice.

Abstract
An important question is arising as COVID-19 vaccines are getting rolled out: Should individuals who already had a SARS-CoV-2 infection receive one or two shots of the currently authorized mRNA 30 vaccines. In this short report, we show that the antibody response to the first vaccine dose in individuals with pre-existing immunity is equal to or even exceeds the titers found in naïve individuals after the second dose. We also show that the reactogenicity is significantly higher in individuals who have been infected with SARS-CoV-2 in the past. Changing the policy to give these individuals only one dose of vaccine would not negatively impact on their antibody titers, spare them from unnecessary pain and free up many 35 urgently needed vaccine doses.

117margd
feb. 2, 5:10pm

Oxford/AstraZeneca study supports UK decision to delay second doses
Donato Paolo Mancini in Rome and Sarah Neville in London | Feb 2, 2021

New Oxford analysis, not yet peer-reviewed, shows single jab to be 76% effective for up to 12 weeks
The Oxford/AstraZeneca may have a significant impact on transmission, after it reduced the number of positive coronavirus tests among those vaccinated by 67 per cent...

https://www.ft.com/content/de00fe75-9ba1-4be7-8cf1-6e9fa55f09ce?a

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Merryn Voysey et al. 2021. Single Dose Administration, And The Influence Of The Timing Of The Booster Dose On Immunogenicity and Efficacy Of ChAdOx1 nCoV-19 (AZD1222) Vaccine. Preprints with the Lancet. 37 Pages Posted: 1 Feb 2021. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3777268

Preprints are early stage research papers that have not been peer-reviewed.

Abstract
Background
Methods
Findings

Interpretation: ChAdOx1 nCoV-19 vaccination programmes aimed at vaccinating a large proportion of the population with a single dose, with a second dose given after a 3 month period is an effective strategy for reducing disease, and may be the optimal for rollout of a pandemic vaccine when supplies are limited in the short term...

118John5918
feb. 2, 11:22pm

COMMUNITY APPROACHES TO EPIDEMIC MANAGEMENT IN SOUTH SUDAN: LESSONS FROM LOCAL HEALTHCARE SYSTEMS IN TACKLING COVID-19 (Rift Valley Institute)

South Sudanese people have extensive knowledge of infectious diseases and experience of organizing responses to epidemics during wars and other crises. There are multiple, locally-specific methods used by communities for interrupting infection transmission and managing epidemics. This report documents these community infectious disease management strategies, based on sustained investigative research in the Yei, Juba, Wau, Malakal, Aweil West and Rubkona areas in 2020. The research encourages collaborative engagement with local knowledge and community healthcare leadership...

119margd
feb. 3, 11:57am

>111 margd: "Vaccinating people over 60 is the most effective way to mitigate mortality from COVID19, a new age-based modeling study suggests. Prioritizing adults ages 20-49 years minimized cumulative incidence."

Sounds like the spike protein mutation E484K, which is able to somewhat evade antibodies (and thus vaccines) may be arising independently and is being selected for--convergent evolution. IF so, we need to double down on efforts to avoid and to vaccine. It may be that vaccinations to maximize life (adults over 60s) should give way to minimizing spread (adults 20-49)?
__________________________________________________​

Investigation of novel SARS-CoV-2 variant Variant of Concern 202012/01Technical briefing 5
Public Health England | update on the briefing of 14 January 2021
19 p

...Detection of E484K mutation in B.1.1.7 VOC 202012/01
The COG-UK dataset (total sequences 214,159) was analysed on 26/01/2021. The spike protein mutation E484K (found in VOC 202012/02 B1.351 and VOC 202101/02 P1) has been detected in 11 B1.1.7 sequences. Preliminary information suggests more than one acquisition event...

https://assets.publishing.service.gov.uk/government/uploads/system/uploads/attac...

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Eric Feigl-Ding @DrEricDing | 5:13 PM · Feb 1, 2021:
https://twitter.com/DrEricDing/status/1356365178330378251
https://threadreaderapp.com/thread/1356365178330378251.html

NOT GOOD—so it seems 🇬🇧 government researchers have discovered that the already more contagious #B117 has further acquired the other troublesome E484K mutation seen in 🇿🇦#B1351 & 🇧🇷#P1 variants—in 11 patients. E484k is blamed for partial vaccine-evasion... (report above)

2) Moreover, they believe the 11 samples of #b117 variant that acquired the new E484K acquired them independently of each other (not just one single origin). This suggests convergent evolution taking place—where it evolves to acquire E484K separately—which indicates it is key.
Image ( https://twitter.com/DrEricDing/status/1356366084753027072/photo/1 )

3) One expert thinks it’s because the E484K might enhance another mutation seen in #B117, thereby letting the virus “grip” the human ACE2 receptor (targeted entry portal into human cells) stronger in a more stable way.
https://twitter.com/_b_meyer/status/1356361237395865600

4) Previously— the E484K mutation was shown in a recent study by @jbloom_lab
that E484 mutation (inside the #SARSCoV2’s spike’s critical receptor binding domain) seemed to somewhat escape neutralizing antibodies in 9 out of 11 people tested.
Image ( https://twitter.com/DrEricDing/status/1356367583906246657/photo/1 )

5) How much affect? the E484K shows a 10x reduction of neutralization (“neutralization” = stopping the virus)
by various antibodies compared to wildtype (common #SARSCoV2) in some patients —a rather bad thing. It means the virus with E484K is worrying for “immune escape”.
Image ( https://twitter.com/DrEricDing/status/1356368032612970498/photo/1 )

6) E484K mutation is also not a 1 time fluke. Scientists decided to see what mutations can help virus escape from patients w/ convalescent plasma immunity. So they soaked virus w/ CP over 12x times to speed evolution—80 days later—*E484K arose*!
https://twitter.com/ncholiA/status/1347555563400519682

7) What does E484K mean for prior natural infection immunity and vaccines? Moderna has discovered its vaccine is less efficient for B1351 variant with E484K. But with discovery of E484K now acquired by some B117 variants—this is bad news. Hope it doesn’t become a super strain.
https://twitter.com/drericding/status/1353706396282474499

8) Moreover, in the latest E484K study by South Africa 🇿🇦 CDC @nicd_sa - not only 48% (of 44 formerly infected people tested) had “complete immune escape” to the SA variant #B1351 w/ E484K, but 90% of the people tested showed reduced immunity! That’s pretty large fraction.
Image ( https://twitter.com/DrEricDing/status/1356370206537510912/photo/1 )

9) This is why South African CDC has come out straightforward that the #B1351 variant with E484K mutation has serious potential for reinfection.
https://twitter.com/DrEricDing/status/1351686170044989442

10) Similarly, the new Novavax vaccine had high efficacy for regular #COVID19 but much much lower in South Africa.
https://twitter.com/drericding/status/1354899824370462722

11) this was also recently seen in the single shot Johnson and Johnson vaccine — lower efficacy in South Africa.
https://twitter.com/drericding/status/1355141560514580482

12) Moderna, Pfizer/Biontech, Novavax, J&J have all expressed interest / already begun development of a booster shot #COVID19 vaccine dose for the new strain(s) with the E484K mutation. current vaccine still DOES WORK, just not as efficiently as before for new variants w/ E484K.

13) Vaccines do still work. And even 50% for the few variants with the E484K is still good and better than 0% protection if you didn’t have any vaccine.
And the best news is that vaccines prevent severe #COVID19 and deaths the best!
https://twitter.com/drericding/status/1356080282286379010

14) Today, German chancellor Angela Merkel says that if vaccines do not work on variants of the virus, then "we start all over again” and has said coronavirus vaccines may be needed for "many years to come." She is a scientist herself.
https://amp.dw.com/en/angela-merkel-says-pledge-to-vaccinate-by-end-of-summer-re...
https://twitter.com/kniggem/status/1356377210366676998

15) Pfizer and partner BioNTech are developing booster shots so that their COVID-19 vaccine Comirnaty can protect against new, highly contagious variants, Pfizer CEO Albert Bourla, Ph.D., said Tuesday, according to Bloomberg.

First Moderna, now Pfizer-BioNTech working on booster shot amid rise of COVID-19 variants
One major concern over emerging coronavirus variants focuses on their impact on the efficacy of existing vaccines. Now, Pfizer and partner BioNTech are developing booster shots so that their COVID-19 …
https://www.fiercepharma.com/pharma/first-moderna-now-pfizer-biontech-also-worki...

16) “Every time a new variant comes up we should be able to test whether or not our vaccine is effective. Once we discover something that it is not as effective, we will very, very quickly be able to produce a booster dose that will be a small variation to the current vaccine.”

17) Remember when I said the new E484K seems to have evolved separately in 2 different lineages of #B117 & somehow both converged to find E484K? So here is the genome lineage @nextstrain map—one recently evolved in Wales and one separately in England. Oy.
https://nextstrain.org/groups/neherlab/ncov/S.E484
Image ( https://twitter.com/DrEricDing/status/1356406387010641923/photo/1 )

18) there is also the likelihood that #B117 will also yield more severe outcomes. 7 out of 10 studies suggests 30% increased mortality risk.
https://twitter.com/drericding/status/1353468238773035008

19) This is why we need to avoid the new #B117 as much as possible. Switch to a premium mask for better inhalation filtration. It is CRITICAL folks. @AbraarKaran @RanuDhillon @sri_srikrishna all endorse.
https://twitter.com/drericding/status/1353186978519539712

20) a more contagious virus also means the threshold for reaching herd immunity is now becoming higher... lots of implications what this means and what we need to do...
https://twitter.com/drericding/status/1355697452926590980

21) We need to seriously start thinking about how to rapidly test and approve booster shots. I think they should be expedited now that we know the main #COVID19 is safe. Boosters are needed if these mutations keep arising.

120margd
feb. 3, 12:01pm

'Oxygen, oxygen, oxygen': Nigeria battles shortages amid COVID-19 surge
Libby George, Alexis Akwagyiram | February 2, 2021

...Authorities are battling a second wave of infections that has caused nationwide oxygen shortages. Hospitals in the capital, Abuja, have come close to running out, while demand in Lagos, the centre of the outbreak, has increased as much as sevenfold since early autumn.

...Demand for cylinders in Lagos went from around 70 per day early last year to as high as 500 daily from November...

Nigeria, population 200 million, was spared the worst in its first COVID-19 wave that began in February last year. But a second wave has hit hard. More than half of Nigeria’s 131,242 confirmed cases have been logged in the past three months. Fatalities now total 1,586.

In December, the government enlisted Nigeria’s Air Force to increase liquid oxygen production at a plant in the northeastern city of Yola and fly 117 cylinders to two COVID-19 centres in Abuja.

Authorities pledged in January to build a new oxygen plant in each of Nigeria’s 36 states....

https://www.reuters.com/article/us-health-coronavirus-nigeria-oxygen-idUSKBN2A21...

121margd
feb. 3, 12:12pm

How much more contagious is B.1.1.7. (first reported in UK)? "Following confirmation of the variant, the Simcoe Muskoka District Health Unit has shortened the exposure time to as little as a second if individuals were not wearing face masks."

COVID-19 variant in Barrie ( north of Toronto) outbreak upends conventional wisdom of spread
Karen Howlett | Feb 1, 2021

...The variant known as B.1.1.7 was initially confirmed at Roberta Place on Jan. 23 in six swabs and has since been found in another long-term care home in the Simcoe Muskoka region, where two staff members at Bradford Valley Care Community have tested positive. An additional two confirmed cases in the region are not connected to either home.

More than 300 kilometres away in Southeastern Ontario, public-health officials in Kingston announced their first confirmed case of the variant on Monday. A spokeswoman at the health unit said a Kingston resident, who has since recovered from the virus, travelled several weeks ago on business to Barrie. The individual is not connected to the outbreaks at Roberta Place and Bradford Valley, Suzette Taggart said.

In Southwestern Ontario, public-health officials announced their first case of the variant this weekend at Columbia Forest, a long-term care home in Waterloo. However, there is no known connection to Barrie.

York Region north of Toronto had 15 confirmed cases of the British variant as of last week – the highest in Ontario. Karim Kurji, the region’s Medical Officer of Health, has set up a new contact tracing unit focused exclusively on tracking down anyone who has come in contact with individuals who have tested positive for the variant.

...Contact tracers in York Region are finding that some individuals who have tested positive for the highly contagious variant have been in a retail store for just a few minutes. Dr. Kurji is in talks with Public Health Ontario to lower the threshold of what is typically considered a high-risk contact: face-to-face interaction within two metres for at least 15 minutes.

A spokeswoman for Ontario Health Minister Christine Elliott said on Sunday that the government has provided interim guidance to the province’s public-health units for screening and tracing contacts of cases associated with COVID-19 variants of concern.

“This guidance does include a lower threshold for classifying contacts as high risk of exposure and requiring quarantine,” Alexandra Hilkene said in an e-mail.

...Following confirmation of the variant, the Simcoe Muskoka District Health Unit has shortened the exposure time to as little as a second if individuals were not wearing face masks...

https://www.theglobeandmail.com/canada/article-covid-19-variant-in-barrie-outbre...

122margd
feb. 3, 12:20pm

The AstraZeneca vaccine is shown to drastically cut transmission of the virus.
Marc Santora and Rebecca Robbins | Feb 3, 2021

The vaccine developed by the University of Oxford and AstraZeneca not only protects people from serious illness and death but also substantially slows the transmission of the virus, according to a new study — a finding that underscores the importance of mass vaccination as a path out of the pandemic.

The study by researchers at the University of Oxford is the first to document evidence that any coronavirus vaccine can reduce transmission of the virus...manuscript that has not been peer-reviewed, found that the vaccine could cut transmission by nearly two-thirds.

...Some scientists looking at the limited information released cautioned that more analysis of the data was needed before such broad conclusions could be firmly stated.

...The Oxford and AstraZeneca researchers also found that a single dose of the vaccine was 76 percent effective at preventing Covid-19. The data measured the three months after the first shot was given, not including an initial three-week period needed for protection to take effect.

...The newly released study builds on data issued late last year, which found that the vaccine was 62 percent effective when given as two standard-strength doses. In those initial findings, the vaccine’s efficacy was much higher, at 90 percent, when the first dose of the vaccine was given at half-strength.

Oxford and AstraZeneca researchers initially attributed the different levels of effectiveness to the lower strength of the initial dose. But they gradually reached a different conclusion: the amount of time between doses was the more likely explanation.

In the United States, the Food and Drug Administration is waiting on data from a clinical trial that enrolled about 30,000 participants, mostly Americans. Results from that study are expected later this month.

The study is expected to arm AstraZeneca with enough safety data to allow it by around early March to seek authorization to provide the vaccine for emergency use.

The United States has agreed to buy 300 million doses of AstraZeneca’s vaccine, but neither the company nor the federal government has said when and in what quantities those doses will be available after the vaccine is approved.

https://www.nytimes.com/live/2021/02/02/world/covid-19-coronavirus#astrazeneca-c...
--------------------------------------------------​

https://www.ox.ac.uk/news/2021-02-02-oxford-coronavirus-vaccine-shows-sustained-...

123margd
Editat: feb. 4, 11:51am

It’s Been 10 Months, and I Still Don’t Know When to Replace My Mask!
Charlie Warzel and Zeynep Tufekci* | Jan. 29, 2021

...Charlie: Which brings us back to my mask problem. For example, I am pretty sure I’d ruin any mask by trying to disinfect it as a hospital worker might. But it’s also clear that what I was doing (keeping a lightly used N95 in my car for months on end) is also not good. So how about reusing those N95s?

Zeynep: I will give a modified version of what health care workers were advised during the worst of the shortages. Rotating a few is enough for disinfection. Just let them rest for a few days in a non-airtight container (like a paper bag or a Tupperware container with holes) and replace one only when it no longer fits well or the elastics have gone soft, or if it is soiled. It’s also good to use hand-sanitizer before putting them on and taking them off. Handle them gently, because a good fit is essential to getting the most out of it. My sense from having heard a lot from people using all the other disinfection methods, like heat, is that they just increase the risk of damaging the mask.

Charlie: And how long can I use them? With the caveat, of course, that you’re not a medical professional but somebody who is trying to get through this safely and responsibly. Also, here’s the C.D.C.’s page on N95 masks ( https://www.cdc.gov/niosh/topics/hcwcontrols/recommendedguidanceextuse.html ).

Zeynep: If I were wearing an N95 just for the weekly grocery store run, I’d probably be fine with alternating two carefully handled masks for many months as long as the elastic works and there’s no soiling. That’s not a lot of use! But if I were wearing one all day, every workday, I’d consider having one for each day and replacing them maybe every month. So that’s about five per month. Could one be really careful and make that two months? Probably.

Also it’s important to emphasize that all this doesn’t mean cloth masks are worthless. Cloth masks do really help with stopping transmission onward, from the wearer to the other people. It would be good to be able to purchase certified cloth masks with the three layers the WHO recommends, with features like nose wires and ties that make them fit better. One can also wear surgical masks — those light, papery ones commonly used in hospitals — with a brace to help hold them in place. Preliminary studies show those do a great job, too. It’s just that medical respirators like the N95s, KN95 (the Chinese standard), disposable K94 (the South Korean standard) and FFP2 (the European standard) do a much better job of protecting the wearer in addition to helping prevent onward transmission — because that’s what they are designed to do! Protecting the wearer is more important if, for example, someone works with other people who don’t mask up well, or if one is high-risk and can’t isolate. This is especially important with the new, more transmissible variants. But you don’t need an N95 for that outdoor walk.

But that brings me to the other problem: How are people supposed to find the right mask? I have purchased KN95s at local reputable stores and checked that they were included in the list of ones approved by the F.D.A. However, I would be careful about buying online, unfortunately. Too many fakes. I have seen reputable retailers like Costco beginning to sell N95s online again, and I would trust that. People can also purchase braces for surgical masks or make a brace themselves from a template, which really improves fit. Fit is very important for upping one’s mask game. We can start by noting that facial hair makes the fit worse, so shaving that beard for the pandemic is an option. (Sorry!) People can check the fit by adjusting the nose bridge to be tight and holding the mask and inhaling sharply, and seeing if they feel cool air coming in from the sides of the mask. The better the fit, the less the air from the sides. Preferably, there’s none. Also, my best-fitting mask does not fog my glasses at all because no air is escaping upward. When I get a new type of mask, I inhale and exhale while focusing to see if I feel if the air is escaping, or if there’s any gaping on the sides or around the nose area (my glasses fog to let me know of that)...

https://www.nytimes.com/2021/01/29/opinion/coronavirus-masks.html

* Zeynep Tufekci was named specifically by (Science Magazine editor?) as a solid source for info on COVID.

124margd
Editat: feb. 5, 3:59am

Michael Warner (MD, MBA) @drmwarner | 9:20 PM · Feb 3, 2021:
The avg. cost of an ICU bed in Canada is $3592/d.
The cost of paid sick leave for an essential worker earning minimum wage is 8h x $14.25 = $114/d.

In addition to being the right thing to do, every paid sick day that prevents a #COVID ICU admission has a 31x ROI.

Image ( https://twitter.com/drmwarner/status/1357152076233646081/photo/1 )

1252wonderY
feb. 5, 5:42am

>123 margd: The other easy trick to improve fit on the cheap masks is twisting the elastic once before hooking over the ears.

I saw one store owner who seems to have been using the same mask the entire year. The blue fibers were shredding so he appeared to have a beard.

126margd
feb. 5, 10:25am

>115 margd: Ellume test

‘A waste of money’: The home Covid-19 test funded by the Biden administration is too costly and complex, critics say
Kathleen McLaughlin | February 5, 2021

...when the Biden administration this week announced a $231.8 million deal to ramp up production of the first fully at-home test, the experts’ response was, to say the least, unenthusiastic....

It’s not that home testing with a 15-minute turnaround time isn’t a good idea, they said, it’s just that the rollout of this initial kit is too little and too late, and the test too expensive and complicated, to help extinguish the raging pandemic fire.

...The testing landscape is a mix of PCR tests, which have high accuracy rates but often take longer to generate results, and rapid antigen tests that have proven less accurate but give quick answers. Public health experts say that too much of the testing is reactive — used to help diagnose individuals who have possible symptoms or might have been exposed to the virus — instead of being deployed broadly to prevent spread and protect the general public. That’s where the call for cheap home testing comes in.

...Michael Mina, an assistant professor of epidemiology at the Harvard T.H. Chan School of Public Health, has been among the loudest voices calling for federal funding and distribution of cheap, rapid, paper-strip antigen tests as a means to control the pandemic. In an ideal world, Mina said, every American would be able to test for Covid twice a week at home, with supplies paid for and distributed by the federal government.

Mina and others said they have concerns about the equity of the Ellume test. It is priced at $30, far too expensive for most Americans to conduct frequent, regular screening at home. And the test is linked to a smartphone app that requires some tech savvy and steps that Mina and others said add difficulty and confusion for most potential users. The test kit transmits results to users via the app, and conveys data to local public health agencies to enable tracking case counts and contacts...

https://www.statnews.com/2021/02/05/a-waste-of-money-the-home-covid-19-test-fund...

127margd
feb. 5, 12:06pm

Signs that SARS-CoV-2 is evolving to avoid immune responses
Mutations are changing, but not eliminating, the antibody response to the virus.
John Timmer - 2/5/2021

...so far, there's no indication that any of these strains can evade the immunity built up by earlier infection or one of the vaccines currently in use. But the results make clear that the virus is evolving in response to the immune system's reaction to it, and we can't guarantee that further changes won't make COVID-19 harder for our immune systems to keep at bay.

Science, 2021. DOI: 10.1126/science.abf6950

https://arstechnica.com/science/2021/02/signs-that-sars-cov-2-is-evolving-to-avo...

128margd
feb. 5, 12:22pm

Some COVID-19 patients have a higher risk of bleeding
James Kingsland on February 4, 2021

Excessive blood clotting is a recognized feature of severe COVID-19. But a new study suggests that some hospitalized patients may also be vulnerable to bleeding, which is associated with an increased risk of death.

...After an injury, clotting prevents dangerous loss of blood. Blood clots, or “thrombi,” can also block blood vessels, however, with potentially fatal consequences.

Normally, our blood maintains a delicate balance between its tendency to form clots and its tendency to break them down...by continually adjusting the activity of a protein in the blood called plasminogen, which promotes the breakup of blood clots, or “thrombolysis.”

The body performs this balancing act by changing the levels of two other proteins circulating in the bloodstream, known as tissue plasminogen activator (TPA) and plasminogen activator inhibitor-1.

As their names suggest, the former activates plasminogen and therefore promotes thrombolysis, while the latter has the opposite effect.

Sticky blood
Early in the pandemic, research began to show that the blood of critically ill patients with COVID-19 is unusually “sticky” or prone to clotting, with potentially fatal consequences including deep vein thrombosis, stroke, and heart attack.

These findings led to the practice of giving high doses of anticoagulant drugs — which work in various ways to prevent the development of blood clots — to patients hospitalized with COVID-19 throughout their treatment.

However, a new study by researchers at Michigan Medicine and the University of Michigan in Ann Arbor suggests this may not be the best approach for all patients.

They measured levels of TPA and plasminogen activator inhibitor-1 in the blood of 118 patients hospitalized with COVID-19 as well as 30 healthy controls.

They found very high levels of both proteins in the blood of these patients. These proteins were associated with respiratory difficulties, but high levels of TPA had stronger correlations with mortality...

https://www.medicalnewstoday.com/articles/some-covid-19-patients-have-a-higher-r...

--------------------------------------------------​

Yu Zuo et al. 2021. Plasma tissue plasminogen activator and plasminogen activator inhibitor-1 in hospitalized COVID-19 patients.
Scientific Reports volume 11, Article number: 1580 (Jan 15, 2021) https://www.nature.com/articles/s41598-020-80010-z

Abstract
Patients with coronavirus disease-19 (COVID-19) are at high risk for thrombotic arterial and venous occlusions. However, bleeding complications have also been observed in some patients. Understanding the balance between coagulation and fibrinolysis will help inform optimal approaches to thrombosis prophylaxis and potential utility of fibrinolytic-targeted therapies. 118 hospitalized COVID-19 patients and 30 healthy controls were included in the study. We measured plasma antigen levels of tissue-type plasminogen activator (tPA) and plasminogen activator inhibitor-1 (PAI-1) and performed spontaneous clot-lysis assays. We found markedly elevated tPA and PAI-1 levels in patients hospitalized with COVID-19. Both factors demonstrated strong correlations with neutrophil counts and markers of neutrophil activation. High levels of tPA and PAI-1 were associated with worse respiratory status. High levels of tPA, in particular, were strongly correlated with mortality and a significant enhancement in spontaneous ex vivo clot-lysis. While both tPA and PAI-1 are elevated among COVID-19 patients, extremely high levels of tPA enhance spontaneous fibrinolysis and are significantly associated with mortality in some patients. These data indicate that fibrinolytic homeostasis in COVID-19 is complex with a subset of patients expressing a balance of factors that may favor fibrinolysis. Further study of tPA as a biomarker is warranted.

129margd
Editat: feb. 6, 12:50pm

Mutated virus may reinfect people already stricken once with covid-19, sparking debate and concerns
Carolyn Y. Johnson and William Wan | Feb. 5, 2021

...In (preliminary findings of) the placebo group of the (South African) trial for Novavax’s vaccine*, people with prior coronavirus infections appeared just as likely to get sick as people without them, meaning they weren’t fully protected against the B.1.351 variant that has swiftly become dominant in South Africa. The variant has been detected only a handful of times in the United States...

“The data really are quite suggestive: The level of immunity that you get from natural infection — either the degree of immunity, the intensity of the immunity or the breadth of immunity — is obviously not enough to protect against infection with the mutant,” (Anthony S. Fauci, director of the National Institute of Allergy and Infectious Diseases) said.

...Projections created by data scientist Youyang Gu — whose pandemic models have been cited by the Centers for Disease Control and Prevention — suggest that about 65 percent of America’s population will reach immunity by June 1. But built into that 65 percent is roughly 20 percent having immunity from past infections only. Scientists are unsure how the potential for reinfection might influence their projections. They are eager to see if other vaccine trial data in coming weeks will corroborate the trend from the Novavax trial.

..The good news is that vaccine trials from Johnson & Johnson and Novavax show that vaccines can work — even against the B.1.351 variant, and particularly in preventing severe illness.

...A future concern needing close monitoring is whether the reformulation of vaccines to keep up with the evolving virus could drive the virus to continue evolving. There is also a concern that subpar immunity could allow new resistant variants to emerge. That possibility, (Michel Nussenzweig, head of the Laboratory of Molecular Immunology at Rockefeller University) said, is one reason that people should get both doses of a vaccine, on time.

https://www.washingtonpost.com/health/2021/02/05/virus-variant-reinfection-south...
--------------------------------------------------​
*
Efficacy Data Updates from Novavax’ Protein-based Vaccine Candidate
New York Academy of Sciences | February 2, 2021
45 p.
https://www.novavax.com/sites/default/files/2021-02/20210202-NYAS-Novavax-Final....

130stellarexplorer
Editat: feb. 6, 2:06pm

>129 margd: yes, concerning. Thankfully the vaccines do prevent severe disease even with this variant.

131margd
Editat: feb. 6, 3:53pm

>130 stellarexplorer: Surprising that no protection from previous COVID-19. How can that be if there's small, but measurable, cross-reactivity with human coronaviruses that cause some colds?? They are different species, not just strains, more distantly related to COVID than SARS!

132margd
Editat: feb. 7, 7:18am

Should you get the COVID-19 vaccine while pregnant? Here's what experts say.
Amy McKeever | February 5, 2021

Pregnant people might hesitate to get vaccinated because there’s no data on how it works for them. Medical experts lay out what is known and how each person can weigh their own risks and benefits...

...For pregnant women who are at high risk of exposure and who don’t have the option of reducing that risk, it may make sense to consider getting the vaccine as soon as they’re eligible...

https://www.nationalgeographic.com/science/2021/02/should-you-get-covid19-vaccin...

133margd
Editat: feb. 7, 7:47am

Astrazeneca vaccine effectiveness against B.1.1.7 (first reported in UK):

Florian Krammer @florian_krammer | 5:56 AM · Feb 7, 2021:
Other AZ vaccines news:
The vaccine seems to be still effective against B.1.17, despite a 9-fold drop in neutralizing titers:

Katherine R. W. Emary et al. 2021. Efficacy of ChAdOx1 nCoV-19 (AZD1222) Vaccine Against SARS-CoV-2 VOC 202012/01 (B.1.1.7). The Lancet PREPRINT. 40 Pages Posted: 4 Feb 2021. https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3779160

PREPRINT

Abstract
...Interpretation: Efficacy of ChAdOx1 nCoV-19 against the B.1.1.7 variant of SARS-CoV-2 is similar to the efficacy of the vaccine against other lineages. Furthermore, vaccination with ChAdOx1 nCoV-19 results in a reduction in the duration of shedding and viral load, which may translate into a material impact on transmission of disease...

__________________________________________________​

Astrazeneca vaccine effectiveness against B.1.351 (first reported in South Africa)

Oxford/AstraZeneca Covid-19 shot less effective against South African variant: study
Reuters | 07 February 2021

..."In this small phase I/II trial, early data has shown limited efficacy against mild disease primarily due to the B.1.351 South African variant," an AstraZeneca spokesman said in response to the FT report.

The newspaper said none of the more than 2,000 trial participants had been hospitalised or died.

"However, we have not been able to properly ascertain its effect against severe disease and hospitalisation given that subjects were predominantly young healthy adults," the AstraZeneca spokesman said.

The company said it believed its vaccine could protect against severe disease, given that the neutralising antibody activity was equivalent to that of other COVID-19 vaccines that have demonstrated protection against severe disease.

...On Friday Oxford said their vaccine has similar efficacy against the British coronavirus variant (B117) as it does to the previously circulating variants.

https://www.timeslive.co.za/news/south-africa/2021-02-07-oxfordastrazeneca-covid...

134margd
Editat: feb. 7, 2:39pm

AstraZeneca vaccine v B.1.351 (first reported in South Africa) :(

Eric Topol @EricTopol | https://twitter.com/EricTopol/status/1358486648359591937:
More details now available for South African trial w/ Astra Zeneca vaccine, regarding B.1.351 variant.*

Table updated, data here: https://twitter.com/EricTopol/status/1358486648359591937/photo/1
--------------------------------------------------​

* Rollout of AstraZeneca Covid-19 Vaccine Halted in South Africa After Study
Small clinical trial found that it doesn’t appear to protect recipients against mild and moderate illness from a fast-spreading new strain of the coronavirus
https://www.wsj.com/articles/astrazeneca-vaccine-doesnt-protect-against-mild-and...
__________________________________________________​

Eric Topol @EricTopol | 1:52 PM · Feb 7, 2021
Here's the slide of results for that trial, via @HelenBranswell
Image ( https://twitter.com/EricTopol/status/1358488910637060097/photo/1 )

135margd
feb. 7, 3:00pm

Eric Topol @EricTopol | 12:31 PM · Feb 7, 2021:
Summarizing the *preliminary* results of vaccine efficacy for 2 of the major variants that have thus far been studied.
A drop-off is consistent in all 5 studies to date, more than 2X for B.1.351 compared with B.1.1.7, and pertains to less protection from mild/moderate infections
Image ( https://twitter.com/EricTopol/status/1358468531986210817/photo/1 )

Since @BioNTech_Group/@Pfizer & @moderna_tx were not tested against these variants, we should assume there will be an efficacy drop.
Overall, there's likely preserved efficacy vs death & hospitalizations, but some reduced suppression of mild/moderate illness...

136stellarexplorer
feb. 7, 3:16pm

>131 margd: I agree surprising, but we are still learning, and in particular learning about more recent variants. At least we have had a year+ to study the “original” virus, but much less time to look at this variant.
As far as explanation, I don’t know. Maybe the human immune system, when infected by the B1351 variant, preferentially makes antibodies to some aspect of the virus which is more variable in this strain, ie. is less conserved, so the antibodies when the next infection comes around are less active against whatever epitope on the virus it attacked the previous time. Of course this is speculation. Vaccines in general provide better immunity as they tend to stimulate a range of antibodies that is wider and more varied than the one that the body found eliminated a virus in its own infection experience.

137John5918
Editat: feb. 7, 11:28pm

Until Africans get the Covid vaccinations they need, the whole world will suffer (Guardian) by Paul Kagame

We’re not asking for charity, but fairness – instead of the hoarding and protectionism currently in play...

138stellarexplorer
feb. 8, 2:20am

>137 John5918: That’s for sure - this is no time to be parochial

139John5918
feb. 8, 4:16am

>138 stellarexplorer:

Indeed. While all my age mates in UK have either already been vaccinated or have appointments within the next few days, here in Kenya there is no sign nor news of when vaccines might be available.

140stellarexplorer
Editat: feb. 8, 5:49am

>139 John5918: This is both morally problematic and practically shortsighted. It is essential to dramatically reduce the number of cases and the amount of circulating virus expeditiously. Mutations are inevitable and the more people are infected, the more opportunity for new strains of the virus. It’s obviously silly to expect that a successful strain will stay put, respecting borders. This is a global emergency and requires global solutions. Separate, of course, from the ethics of letting those who can less afford protection to risk themselves due to the luck of one's birth.

141margd
feb. 8, 9:47am

>129 margd: Novavax placebo group in South Africa infected with COVID, whether pre-infected or no (bottom line, slide):

slide ( https://twitter.com/kakape/status/1354922533997473798/photo/1 )

Natural immunity:
This was maybe the worst bit of news buried here.
In the placebo group there were previously infected people and people that had not been infected.
In the trial both groups ended up getting #covid19 with the same likelihood: 2%.

- Kai Kupferschmidt (Science Mag) | 5:41 PM · Jan 28, 2021

142margd
feb. 8, 10:22am

South Africa suspends use of AstraZeneca's COVID-19 vaccine after it fails to clearly stop virus variant
Jon Cohen | Feb. 7, 2021

Another COVID-19 vaccine has run into trouble in South Africa, showing less protection there than elsewhere because a SARS-CoV-2 variant that can apparently dodge key antibodies has become widespread. In the wake of the new finding, the country, which had pinned its pandemic hopes on this particular vaccine, halted an immunization campaign launched only last week.

The stakes are high for the vaccine globally because its makers, AstraZeneca and the University of Oxford, hope it will be widely used in developing countries; they project they can produce 3 billion doses this year for about $3 each, far more product at a far lower price than any other vaccine shown to offer protection against COVID-19.

Yet the South African trial of the vaccine, conducted in about 2000 people, found such a low efficacy against mild and moderate disease, under 25%, that it would not meet minimal international standards for emergency use. But scientists are hopeful it might still prevent severe disease and death—arguably the most important job for any COVID-19 vaccine. That was impossible to tell from this placebo-controlled trial because it was small and recruited relatively healthy, young people–their average age was only 31. None of the subjects in either arm of the study developed severe disease or required hospitalization.

...COVID-19 vaccines made by Johnson & Johnson (J&J) and Novavax have also been shown to offer weaker protection against B.1.351 (also known as 501.V2), the SARS-CoV-2 variant that now causes the vast majority of all infections in South Africa, than against older variants. The vaccines’ efficacy against mild disease in South Africa was 57% for J&J and 49% for Novavax—lower than in any other country they were tested.

But the J&J vaccine, which was put to the test in the largest of the studies, convincingly protected against severe disease and death, even against the B.1.351 variant, and (Shabir Madhi of the University of the Witwatersrand, the trial’s principal investigator) remains “somewhat optimistic” that the AstraZeneca-Oxford vaccine will, too; the results are not “all doom and gloom,” he said.

...The AstraZeneca-Oxford vaccine has produced confusing results from the start. Earlier preliminary results from trials in different countries showed a wide range of success rates against mild and moderate disease, but researchers have had difficulty interpreting the data because of differences in dose, intervals between doses, and variants in circulation. Just on Friday, a study suggested the vaccine offered strong protection against a more transmissible variant, B.1.1.7, that exploded in the United Kingdom and is now spreading fast throughout Europe.

In South Africa, the vaccine was given in two doses spaced 21 to 35 days apart. Antibodies made by vaccine recipients can typically “neutralize” SARS-CoV-2, meaning they can prevent it from infecting cells in culture experiments. But lab studies show they have far less power against B.1.351.

...The Oxford team that originally designed the vaccine says it already has begun to work on a second-generation candidate that targets the mutated spike protein of the B.1.351 variant. Oxford’s Sarah Gilbert, who leads that effort, suggested in a press statement that a reformulated vaccine might be given as a booster shot to the existing one. “This is the same issue faced by all of the vaccine developers, and we will continue to monitor the emergence of new variants that arise in readiness for a future strain change,” Gilbert noted.

https://www.sciencemag.org/news/2021/02/south-africa-suspends-use-astrazenecas-c...

143stellarexplorer
feb. 8, 12:42pm

>141 margd: I took this as unfortunate news regarding reinfection, but fantastic news about J and J protecting against severe disease. After all, the most important thing is that if you get it you won’t die or end up in the hospital. Total protection is a bonus. I hope this increases the incentives to rapidly produce a booster against this strain. I think the companies have all gotten that message. And if we don’t vaccinate the world rapidly, we will have more variants to deal with.

144margd
feb. 9, 4:36am

Gum disease linked to COVID-19 complications
European Federation of Periodontology | February 3, 2021

...The study of more than 500 patients with COVID-19 found that those with gum disease were 3.5 times more likely to be admitted to intensive care, 4.5 times more likely to need a ventilator, and almost nine times more likely to die compared to those without gum disease.

...The authors stated: "If a causal link is established between periodontitis and increased rates of adverse outcomes in COVID-19 patients, then establishing and maintaining periodontal health may become an important part of the care of these patients."

Professor Mariano Sanz of the Complutense University of Madrid, Spain, one of the study's authors, noted that oral bacteria in patients with periodontitis can be inhaled and infect the lungs, particularly in those using a ventilator. He said: "This may contribute to the deterioration of patients with COVID-19 and raise the risk of death. Hospital staff should identify COVID-19 patients with periodontitis and use oral antiseptics to reduce transmission of bacteria."

Professor Shapira said that the association between periodontitis and lung diseases including asthma, pneumonia, and chronic obstructive pulmonary disease (COPD) is well established.3 He said: "This study adds further evidence to the links between oral health and respiratory conditions. Periodontitis is a common disease but can be prevented and treated."

Professor Nicola West, EFP secretary general, added: "This study highlights another association between gum disease and our systemic health and reiterates the need for ongoing, lifelong dental care for people susceptible to gum disease and a strong preventive approach to periodontitis for populations as a whole."...

https://medicalxpress.com/news/2021-02-gum-disease-linked-covid-complications.ht...

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Nadya Marouf et ai. 2021. Association between periodontitis and severity of COVID‐19 infection: a case‐control study. J Clin Periodontol. 01 February 2021. https://doi.org/10.1111/jcpe.13435 https://onlinelibrary.wiley.com/doi/10.1111/jcpe.13435

Abstract...
Results
In total, 568 patients were included. After adjusting for potential confounders, periodontitis was associated with COVID‐19 complication including death (OR=8.81...), ICU admission (OR=3.54...), and need for assisted ventilation (OR=4.57...). Similarly, blood levels of white blood cells, D‐dimer, and C Reactive Protein, were significantly higher in COVID‐19 patients with periodontitis.

Conclusion
Periodontitis was associated with higher risk of ICU admission, need for assisted ventilation and death of COVID‐19 patients, and with increased blood levels of biomarkers linked to worse disease outcomes...

145EllaTim
feb. 9, 5:08am

So what about the new Russian vaccine, Sputnik?

According to the BBC it is very effective, 92 %. Doesn't need heavy refrigeration. It seems to use two slightly different vaccine variants for the first and the second injection, so might be useful dealing with those mutations.

https://www.bbc.com/news/health-55900622

(I am scheduled for the Astra Zeneca vaccine, not too happy to read it isn't very effective against the South-African mutation, and of course that mutation is already travelling the world)

146John5918
feb. 9, 9:56am

Covid: WHO team says 'extremely unlikely' virus leaked from lab (BBC)

A team of international experts investigating the origins of Covid-19 have all but dismissed a theory that the virus came from a laboratory. Peter Ben Embarek, the head of the World Health Organization (WHO) mission, said it was "extremely unlikely" that the virus leaked from a lab in the Chinese city of Wuhan. He said more work was needed to identify the source of the virus...

147margd
feb. 9, 11:26am

Dementia Patients Have Twice the Risk of COVID-19
— African Americans with dementia have even higher risks, especially for hospitalization
Judy George, Senior Staff Writer, MedPage | February 9, 2021

...After adjusting for age, sex, race, and COVID-19 risk factors including comorbidities and nursing home stay, people with dementia had twice the risk of developing COVID-19 as other adults (adjusted OR 2.00...), according to Rong Xu, PhD, of Case Western Reserve University School of Medicine in Cleveland, and co-authors.*

Among people with dementia, African-American patients were nearly three times as likely to be infected with SARS-CoV-2 as white patients (adjusted OR 2.86...), they reported in Alzheimer's & Dementia.

The 6-month mortality risk for patients with dementia and COVID-19 was 20.99%. Hospitalization risk was 59.26%...

https://www.medpagetoday.com/neurology/dementia/91108

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* QuanQiu Wang et al. 2021. COVID‐19 and dementia: Analyses of risk, disparity, and outcomes from electronic health records in the US. alzheimer's and Dementia. 09 February 2021. https://doi.org/10.1002/alz.12296 https://alz-journals.onlinelibrary.wiley.com/doi/10.1002/alz.12296

Abstract
...Results
Patients with dementia were at increased risk for COVID‐19 compared to patients without dementia (adjusted odds ratio AOR: 2.00 ...), with the strongest effect for vascular dementia (AOR: 3.17...), followed by presenile dementia (AOR: 2.62 ...), Alzheimer's disease (AOR: 1.86... ), senile dementia (AOR: 1.99... ) and post‐traumatic dementia (AOR: 1.67...). Blacks with dementia had higher risk of COVID‐19 than Whites (AOR: 2.86...). The 6‐month mortality and hospitalization risks in patients with dementia and COVID‐19 were 20.99% and 59.26%, respectively.

Discussion
These findings highlight the need to protect patients with dementia as part of the strategy to control the COVID‐19 pandemic...

148margd
Editat: feb. 9, 11:59am

>145 EllaTim: Hopefully, they'll have a booster in a few months to address the S. African strain.
I'd take the AZ vaccine if offered to me--and keep up defensive measures!

(I think I read somewhere above that the most worrisome mutation (E 484??), immunity-wise, in B.1.351 strain, first reported in S Africa, is popping up independently elsewhere (UK? US?). I'll link if I find it above.)

ETA: >119 margd: From UK government report "The COG-UK dataset (total sequences 214,159) was analysed on 26/01/2021. The spike protein mutation E484K (found in VOC 202012/02 B1.351 and VOC 202101/02 P1) has been detected in 11 B1.1.7 sequences. Preliminary information suggests more than one acquisition event..."

149stellarexplorer
feb. 9, 12:02pm

>145 EllaTim: The Russian vaccine finally had real trials and in contrast to the early expectation of poor performance and premature approval, it looks to be about 91% effective. Russia is anxious to sell this in the developing world, so this could be another good option for vaccinating the world. Good news from this perspective!

150stellarexplorer
feb. 9, 12:04pm

>146 John5918: It seems scientists are now freed up to ask this again. There are definitely questions. I can’t get away myself from the circumstantial evidence, and I’d love to have a full investigation. I’m not accusing, but it would be better to erase all doubt.

151margd
feb. 9, 12:20pm

Comparing the neutralization potency of sera from patients with acute infection, recovered individuals, and healthy vaccinees, “...natural infection or (Moderna mRNA) vaccination with are effective against the UK variant (B.1.1.7) and viral strains containing single point mutations at positions 501 and 614 within the spike protein.”

Moderna's COVID-9 vaccine effective against emerging variants
Sally Robertson | Feb 8 2021

...What did the researchers do?
(Mehul) Suthar (Emory U School of Medicine) and colleagues compared the neutralization potency of sera from 20 patients with acute infection, 20 recovered individuals, and 14 healthy vaccinees, against a panel of SARS-CoV-2 variants....

The panel of SARS-CoV-2 variants included an early variant isolated from an individual in Washington (WA1); a later D614G variant isolated from a patient in Georgia in March 2020 (EHC-083E), and a B.1.1.7 variant isolated from a patient in California.

The team also included a recombinant SARS-CoV-2 virus containing a single point mutation within the spike protein at position 501 (N501Y)....

What did they find?
The findings showed that antibodies were effective at neutralizing all variants, whether they were generated following natural infection or vaccination.

The team observed no significant reduction in levels of neutralizing antibodies against any of the variants.

“These results show that neutralizing antibody titers following natural infection or vaccination are effective against the UK variant (B.1.1.7) and viral strains containing single point mutations at positions 501 and 614 within the spike protein,” writes the team.

The researchers say the findings suggest that in the context of the UK variant, vaccine-induced immunity can provide protection against COVID-19.

“As additional SARS-CoV-2 viral variants continue to emerge, it is crucial to monitor their impact on neutralizing antibody responses following infection and vaccination,” they conclude.

https://www.news-medical.net/news/20210208/Modernas-COVID-9-vaccine-effective-ag...

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Suthar M, et al. Infection and mRNA-1273 vaccine antibodies neutralize SARS-CoV-2 UK variant. medRxiv, 2021. doi: https://doi.org/10.1101/2021.02.02.21250799, https://www.medrxiv.org/content/10.1101/2021.02.02.21250799v1
Infection and mRNA-1273 vaccine antibodies neutralize SARS-CoV-2 UK variant

This article is a preprint and has not been certified by peer review

Abstract

Antibody responses against the SARS-CoV-2 Spike protein correlate with protection against COVID-19. Serum neutralizing antibodies appear early after symptom onset following SARS-CoV-2 infection and can last for several months. Similarly, the messenger RNA vaccine, mRNA-1273, generates serum neutralizing antibodies that are detected through at least day 119. However, the recent emergence of the B.1.1.7 variant has raised significant concerns about the breadth of these neutralizing antibody responses. In this study, we used a live virus neutralization assay to compare the neutralization potency of sera from infected and vaccinated individuals against a panel of SARS-CoV-2 variants, including SARS-CoV-2 B.1.1.7. We found that both infection- and vaccine-induced antibodies were effective at neutralizing the SARS-CoV-2 B.1.1.7 variant. These findings support the notion that in the context of the UK variant, vaccine-induced immunity can provide protection against COVID-19. As additional SARS-CoV-2 viral variants continue to emerge, it is crucial to monitor their impact on neutralizing antibody responses following infection and vaccination.

152margd
Editat: feb. 9, 1:59pm

>145 EllaTim: I assume Russia's vaccine was tested on original strain of SARS-CoV-2, as quick google turned up first report of B117 (first reported in UK) on Jan 10, 2021: https://medicalxpress.com/news/2021-01-russia-case-uk-virus-strain.html . No doubt they will soon--if they haven't already-- test neutralizing potency of vaxxed people's sera against the new variants as did Moderna (>151 margd:). Neat that Russians have a new approach to overcoming any pre-existing immunity to adenovirus.

Russia's Sputnik V COVID-19 shown to have 91.6 percent efficacy
Angela Betsaida B. Laguipo BSN| Feb 3 2021

...Russia joined the vaccine race early on with the Sputnik V COVID-19 vaccine (Gam-COVID-Vac). Sputnik V, is a COVID-19 vaccine developed by the Gamaleya Research Institute of Epidemiology and Microbiology, and registered on August 11, 2020, by the Russian Ministry of Health as Gam-COVID-Vac. Sputnik V is an adenovirus viral vector vaccine...

On February 2, 2021, an interim analysis from the trial was published in The Lancet, indicating 91.6% efficacy without unusual side effects.

...Sputnik V uses a heterologous recombinant adenovirus approach utilizing adenovirus 26 (Ad26) and adenovirus 5 (Ad5) as vectors for the expression of SARS-CoV-2 spike (S) protein.

Sputnik V uses a weakened virus to deliver small parts of a pathogen and induce an immune response. It is a vector vaccine based on adenovirus deoxyribonucleic acid (DNA), wherein the SARS-CoV-2 gene is integrated. The use of two varying stereotypes, which are administered 21 days apart, is intended to overcome any pre-existing adenovirus immunity in the population.

Unlike other vaccines against SARS-CoV-2, only Gam-COVID-Vac or Sputnik V uses this approach.
The study's primary outcome was the proportion of participants with COVID-19 confirmed by polymerase chain reaction (PCR) test from day 21 after receiving the initial dose. The secondary outcomes were the severity of COVID019, changes in antibody levels against SARS-CoV-2 glycoprotein S, changes in SARS-CoV-2 neutralizing antibody titers, proportion of participants with antibodies against SARS-CoV-2 N protein, and incidence and severity of adverse events.

Of the 14,964 people in the vaccine group, only 16 had developed symptomatic cases of COVID-19 after receiving the second dose of the vaccine. In the placebo group, however, 62 were infected in the 4,902-strong placebo group.

Hence, the vaccine efficacy was computed at 91.6 percent. The observed vaccine efficacy was greater than 87 percent in all age and sex subgroups. Also, vaccine efficacy was 91.8 percent in participants who are older than 60 years.

Further, the group did not receive reports of moderate or severe COVID-19 confirmed cases at least 21 days after the first dose, compared to 20 cases in the placebo group. This means that the vaccine efficacy against moderate or severe COVID-19 was 100 percent.

..By January 23, 2021, more than 2 million doses of the vaccine have already been administered to the public.

https://www.news-medical.net/news/20210203/Russias-Sputnik-V-COVID-19-shown-to-h...

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U.S. National Library of Medicine. (2021). Clinical Trial of Efficacy, Safety, and Immunogenicity of Gam-COVID-Vac Vaccine Against COVID-19 (RESIST) https://clinicaltrials.gov/ct2/show/NCT04530396

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Logunov, D., Dolzhikova, I., Shcheblyakov, D. et al. (2021). Safety and efficacy of an rAd26 and rAd5 vector-based heterologous prime-boost COVID-19 vaccine: an interim analysis of a randomised controlled phase 3 trial in Russia. The Lancet. DOI:https://doi.org/10.1016/S0140-6736(21)00234-8 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(21)00234-8/fulltext

En/na SARS-CoV-2 and COVID-19 (18) ha continuat aquest tema.