Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe

Experts compare strategies for easing lockdown restrictions in Europe and Asia Pacific and identify key cross-country lessons – knowledge of infection levels, community engagement, public health capacity, health system capacity, and border control measures. They find an absence of clear and consistent strategies for exiting restrictions and identify key cross-country lessons that can still be learnt. Experience with past pandemics in Asia Pacific meant they were more prepared than European countries. An ambition to achieve a ‘Zero COVID’ strategy (eliminating domestic transmission), like in New Zealand, should be considered, suggest the authors.

Link to article https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)32007-9/fulltext

Social distancing to slow the US COVID-19 epidemic: Longitudinal pretest–posttest comparison group study

Across US States social distancing measures played a major role in slowing the spread of COVID-19 this spring, researchers have reported. Between March 10 and March 25, all 50  American states and the District of Columbia adopted at least one form of social distancing. These restrictions prevented 621,000 cases of COVID-19 across the United States within three weeks of being implemented, the researchers estimated. In addition, after a state enacted social distancing, its rate of deaths related to COVID-19 dropped, on average, after one week.

Link to article: https://journals.plos.org/plosmedicine/article?id=10.1371/journal.pmed.1003244

It is Time to Address Airborne Transmission of COVID-19

Converging lines of evidence indicate that SARS-CoV-2, the coronavirus responsible for the COVID-19 pandemic, can pass from person to person in tiny droplets called aerosols that waft through the air and accumulate over time.  An international group of 237 clinicians, infectious-disease physicians, epidemiologists, engineers, and aerosol scientists have published a commentary in the journal Clinical Infectious Diseases that urges the medical community and public health authorities to acknowledge the potential for airborne transmission. They also call for preventive measures to reduce this type of risk.

Link to article https://academic.oup.com/cid/article/doi/10.1093/cid/ciaa939/5867798

Selection of viral variants during persistent infection of insectivorous bat cells with Coronavirus

New paper shows that when exposed to the MERS Coronavirus (CoV)  bat cells adapt—not by producing inflammation-causing proteins but rather by maintaining a natural antiviral response. Simultaneously, the MERS virus also adapts to the bat host cells by very rapidly mutating one specific gene. Operating together, these adaptations result in the virus remaining long-term in the bat but being rendered harmless. Instead of killing bat cells as the virus does with human cells, the MERS coronavirus enters a long-term relationship with the host, maintained by the bat’s unique ‘super’ immune system. SARS-CoV-2 is thought to operate in the same way. The work suggests that stresses on bats—such as wet markets, other diseases, and possibly habitat loss—may have a role in coronavirus spilling over to other species.

Link to paper: https://www.nature.com/articles/s41598-020-64264-1

Stopping Deforestation Can Prevent Pandemics – Scientific American

This article in Scientific American points out that three-quarters of the emerging pathogens that infect humans leaped from animals, many of the creatures in the forest habitats that we are slashing and burning to create land for crops, including biofuel plants, and for mining and housing. The more we clear, the more we come into contact with wildlife that carries microbes well suited to kill us—and the more we concentrate those animals in smaller areas where they can swap infectious microbes, raising the chances of novel strains.

Link to article: https://www.scientificamerican.com/article/stopping-deforestation-can-prevent-pandemics/

Outcomes of hydroxychloroquine usage in United States veterans hospitalized with Covid-19

A pre-print of the results of a study of 386 coronavirus patients in a US government hospital for military veterans found more deaths among those treated with hydroxychloroquine than those treated with standard care. These findings highlight the importance of awaiting the results of ongoing prospective, randomized, controlled studies before widespread adoption of this drug, say the authors of the study.

Link to article: https://www.medrxiv.org/content/10.1101/2020.04.16.20065920v2

Phylogenetic network analysis of SARS-CoV-2 genomes

New important research shows early ‘evolutionary paths’ of COVID-19 in humans – as the infection spread from Wuhan out to Europe and North America – using genetic network techniques. The research revealed three distinct ‘variants’ of COVID-19, consisting of clusters of closely related lineages, which they label ‘A’, ‘B’ and ‘C’. Variant ‘A’, most closely related to the virus found in both bats and pangolins, is described as ‘the root of the outbreak’. Type ‘B’ is derived from ‘A’, separated by two mutations, then ‘C’ is in turn a “daughter” of ‘B’. 

Link to article: https://www.pnas.org/content/early/2020/04/07/2004999117

Extreme genomic CpG deficiency in SARS-CoV-2 and evasion of host antiviral defense

New genetic analysis of SARS-CoV-2 and related coronaviruses suggests the ancestor of COVID-19 and its nearest relative — a bat coronavirus — infected the intestine of dogs, most likely resulting in a rapid evolution of the virus and its jump into humans. This suggests the importance of monitoring SARS-like coronaviruses in feral dogs. It is to be noted however that other experts have doubts.

Link to article: https://academic.oup.com/mbe/article/doi/10.1093/molbev/msaa094/5819559

Global shifts in mammalian population trends reveal key predictors of virus spillover risk

Paper shows that wild mammals that were at risk of extinction owing to human activities carried twice the zoonotic diseases compared to animals that were not at the same risk. Among threatened wildlife species, those with population reductions owing to exploitation and loss of habitat shared more viruses with humans. This has increased opportunities for animal-human interactions and facilitated zoonotic-disease transmission.

Link to article: https://royalsocietypublishing.org/doi/10.1098/rspb.2019.2736

How does COVID-19 kill? Uncertainty is hampering doctors’ ability to choose treatments

How does COVID-19 kill? Uncertainty over whether it is the virus itself — or the response by a person’s immune system — that ultimately overwhelms a patient’s organs, is making it difficult for doctors to determine the best way to treat patients who are critically ill with the coronavirus. Clinical data suggest that the immune system plays a part in the decline and death of people infected with the new coronavirus, and this has spurred a push for treatments such as steroids that rein in that immune response. But some of these treatments act broadly to suppress the immune system.

Link to article: https://www.nature.com/articles/d41586-020-01056-7

Potential vulnerability of COVID-19

An antibody recovered from a survivor of the SARS epidemic in the early 2000s has revealed a potential vulnerability of the new coronavirus at the root of COVID-19.

Published in Science, the study is the first to map a human antibody’s interaction with the new coronavirus at near-atomic-scale resolution. Although the antibody was produced in response to an infection of SARS, which is caused by the SARS-CoV virus, it cross-reacts with the new coronavirus, SARS-CoV-2.

Link to study: https://science.sciencemag.org/content/early/2020/04/02/science.abb7269.full

Coronavirus can infect cats — dogs, not so much

Cats can be infected with COVID-19 and can spread it to other cats, but dogs are not really susceptible to the infection, say researchers in China. The team, at Harbin Veterinary Research Institute, also concludes that chickens, pigs, and ducks are not likely to catch the virus. Other scientists say the findings are interesting but note the results are based on lab experiments in which a small number of animals were deliberately given high doses of the virus, SARS-CoV-2, and do not represent real-life interactions between people and their pets.

Link to article: https://www.nature.com/articles/d41586-020-00984-8

Correlation between universal BCG vaccination policy and reduced morbidity and mortality for COVID-19: an epidemiological study

A preprint of a study says that countries with mandatory policies to vaccinate against tuberculosis register fewer coronavirus deaths than countries that don’t have those policies.

Link to article: https://www.researchgate.net/publication/340263333_Correlation_between_universal_BCG_vaccination_policy_and_reduced_morbidity_and_mortality_for_COVID-19_an_epidemiological_study

Assessment of Narratives and Disinformation Around the COVID-19 Pandemic – EU vs DISINFORMATION

Disinformation and misinformation around COVID-19 continue to proliferate around the world, with potentially harmful consequences for public health and effective crisis communication. In the EU and elsewhere, coordinated disinformation messaging seeks to frame vulnerable minorities as the cause of the pandemic and to fuel distrust in the ability of democratic institutions to deliver effective responses.

Link to article: https://euvsdisinfo.eu/eeas-special-report-update-short-assessment-of-narratives-and-disinformation-around-the-covid-19-pandemic/

Rational use of face masks in the COVID-19 pandemic

Comparison of face mask use recommendations by different health authorities. Despite the consistency in the recommendation that symptomatic individuals and those in health-care settings should use face masks, differences in recommendations were observed for the general public and community settings. Evidence that face masks can provide effective protection against respiratory infections in the community is scarce. However, face masks are widely used by medical workers as part of droplet precautions when caring for patients with respiratory infections. The study suggests vulnerable individuals avoid crowded areas and use surgical face masks rationally when exposed to high-risk areas. 

Link to article: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30134-X/fulltext

Social distancing strategies for curbing the COVID-19 epidemic | medRxiv

In this pre-print a team from Harvard using mathematical model found that one-time interventions will be insufficient to maintain COVID-19 prevalence within the critical care capacity of the United States. Seasonal variation in transmission will facilitate epidemic control during the summer months but could lead to an intense resurgence in the autumn. Intermittent distancing measures can maintain control of the epidemic, but without other interventions, these measures may be necessary into 2022.

Link to article: https://www.medrxiv.org/content/10.1101/2020.03.22.20041079v1

Meteorological factors and Covid-19 incidence in 310 regions across the world

This study analyzed l data from 311 regions across 116 countries with reported cases of COVID-19 by March 12, 2020, and found that temperature, humidity, and wind speed were inversely associated with the incidence rate of Covid-19. This means that it is likely that as temperature, humidity and wind speed increase the spread of COVID-19 decreases.

Link to article: https://www.medrxiv.org/content/10.1101/2020.03.27.20045658v1

Mobility traces and spreading of COVID-19

The authors have built human mobility models, for which they are experts, and attach a virus infection dynamics to it. This results in a virus spreading dynamics model. The preliminary model shows that complete lockdown works. About 10 days after lockdown, the infection dynamics die down in the model. Infections in public transport play an important role, they say. The simulations say that complete removal of infections at child care, primary schools, workplaces and during leisure activities will not be enough to sufficiently slow down the infection dynamics.

Link to article: https://www.medrxiv.org/content/10.1101/2020.03.27.20045302v1

A mathematical model of COVID-19 transmission between frontliners and the general public | medRxiv

This study formulates a conceptual mathematical model on the transmission dynamics of COVID-19 between the frontliners (e.g. healthcare workers, customer service and retail personnel, food service crews) and the general public. The take-home message of this preliminary model is that everyone in the community, whether a frontliner or not, should be protected or should implement preventive measures to avoid being infected.

Link to article: https://www.medrxiv.org/content/10.1101/2020.03.27.20045195v1

Role of Chloroquine and Hydroxychloroquine in the Treatment of COVID-19 Infection- A Systematic Literature Review | medRxiv

This is a systematic literature review summarizing the available evidence regarding the role of chloroquine in treating coronavirus infection. It says there is theoretical, experimental, preclinical and clinical evidence of the effectiveness of chloroquine in patients affected with COVID-19. There is adequate evidence of drug safety from the long-time clinical use of chloroquine and hydroxychloroquine in other indications. More data from ongoing and future trials will add more insight into the role of chloroquine and hydroxychloroquine in COVID-19 infection it concludes.

Link to article: https://www.medrxiv.org/content/10.1101/2020.03.24.20042366v1

Genetic variants of COVID-19

There are several genetic strains of COVID-19 circulating around the world. Information is found on NextStrain, an online resource for scientists that uses data from academic, independent and government laboratories all over the world to visually track the genomics of the SARS-CoV-2 virus. It currently represents genetic sequences of strains from 36 countries on six continents.

Link to article: https://nextstrain.org

A map of the main known genetic variants of the SARS-CoV-2 virus that causes COVID-19 disease. The map is being kept on the nextstrain.org website, which tracks pathogen evolution.

Physical interventions to interrupt or reduce the spread of respiratory viruses: systematic review

A wide-ranging study points out that simple public health measures seem to be highly effective at reducing the transmission of respiratory viruses. It recommends implementing the following interventions: frequent handwashing (with or without antiseptics), barrier measures (gloves, gowns, and masks), and isolation of people with suspected respiratory tract infections.

Link to article: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC2190272/

What is the evidence for loss of smell and loss of taste as a clinical feature of COVID-19?

The authors are of the opinion that evidence regarding the complete loss of smell, or anosmia and the loss of taste or dysgeusia in people who had no other symptoms but who tested positive for COVID-19 are mostly anecdotal and therefore should be treated as preliminary and with caution.

Link to article: https://www.cebm.net/covid-19/what-is-the-evidence-for-anosmia-loss-of-smell-as-a-clinical-feature-of-covid-19/

Identifying SARS-CoV-2 related coronaviruses in Malayan pangolins

A new paper, 26 March, describes multiple lineages of pangolin coronavirus and their similarity to the SARS-CoV-2. A previous study had suggested that Pangolins could be intermediate hosts.  Although bats are likely reservoir hosts for SARS-CoV-2, this study says that pangolins should be considered as possible hosts in the emergence of novel coronaviruses and should be removed from wet markets to prevent zoonotic transmission. The study was done on Malayan pangolins (Manis javanica) seized in anti-smuggling operations in southern China. Pangolins are the world’s most trafficked animals. 

Link to article: https://www.nature.com/articles/s41586-020-2169-0

Expert comment about COVID-19 and having sex while either socially distancing or self-isolating with symptoms

Prof Paul Hunter, Professor in Medicine, University of East Anglia, U.K, talks to the Science Media Centre on whether its advisable expert to have sex while either socially distancing or self-isolating with symptoms.

Link to article: https://www.sciencemediacentre.org/expert-comment-about-covid-19-and-having-sex-while-either-socially-distancing-or-self-isolating-with-symptoms/

We shouldn’t worry when a virus mutates during disease outbreaks

Mutation. The word naturally conjures fears of unexpected and freakish changes. Ill-informed discussions of mutations thrive during virus outbreaks, including the ongoing spread of SARS-CoV-2. In reality, mutations are a natural part of the virus life cycle and rarely impact outbreaks dramatically say virologists writing in the journal Nature Microbiology.

Link to article: https://www.nature.com/articles/s41564-020-0690-4

Are viruses alive?

 Viruses are kind of mysterious – there is debate on whether on not they are “alive”.  At a basic level, viruses are proteins and genetic material that survive and replicate within their environment, inside another life form. In the absence of their host, viruses are unable to replicate and many are unable to survive for long outside the host. Therefore, if they cannot survive independently, can they be defined as being ‘alive’? Taking opposing views, two microbiologists discuss how viruses fit with the concept of being ‘alive’ and how they should be defined.

Link to article: https://microbiologysociety.org/publication/past-issues/what-is-life/article/are-viruses-alive-what-is-life.html

WHO launches global megatrial of the four most promising coronavirus treatments

An article from the publishers of Science on 22 March on WHO megatrials. WHO is focusing on what it says are the four most promising therapies: an experimental antiviral compound called remdesivir; the malaria medications chloroquine and hydroxychloroquine; a combination of two HIV drugs, lopinavir, and ritonavir; and that same combination plus interferon-beta, an immune system messenger that can help cripple viruses. 

Link to article: https://www.sciencemag.org/news/2020/03/who-launches-global-megatrial-four-most-promising-coronavirus-treatments

NIH clinical trial of investigational vaccine for COVID-19 begins

March 17, 2020. A clinical trial of investigational vaccine for COVID-19 has begun.  Phase 1 clinical trial evaluating an investigational vaccine designed to protect against coronavirus disease 2019 (COVID-19) has begun at Kaiser Permanente Washington Health Research Institute (KPWHRI) in Seattle. Currently (March 17, 2020) no approved vaccines exist to prevent infection with SARS-CoV-2.

Link to article: https://www.nih.gov/news-events/news-releases/nih-clinical-trial-investigational-vaccine-covid-19-begins

How to stop future pandemics in 3 easy steps

While many of us are social distancing and self-quarantining, we have a lot of time to wonder, how did we get in this coronavirus mess in the first place? The answer is a zoonotic disease – a disease that can leap from animal to human. In order to prevent future pandemics, we need to change our relationship with wildlife. So what does that mean exactly?

1. Stop wildlife trade
2. Stop wildlife consumption
3. Stop destroying nature

Link to article: https://www.treehugger.com/health/how-stop-pandemics-3-steps.html

Public Health Responses to COVID-19 Outbreaks on Cruise Ships — Worldwide, February–March 2020

More than 800 cases of laboratory-confirmed COVID-19 cases occurred during outbreaks on three cruise ship voyages, and cases linked to several additional cruises have been reported across the United States. Transmission occurred across multiple voyages from ship to ship by crew members; both crew members and passengers were affected; 10 deaths associated with cruise ships have been reported to date.

Link to article: https://www.cdc.gov/mmwr/volumes/69/wr/mm6912e3.htm

Relationship between the ABO Blood Group and the COVID-19 Susceptibility

A new study shows people with blood group A have a significantly higher risk for acquiring COVID-19 whereas blood group O has a significantly lower risk for the infection. However, the paper has not been peer-reviewed yet. This means it has yet to be evaluated and so should not be used to guide clinical practice or to promote the results.

Link to article: https://www.medrxiv.org/content/10.1101/2020.03.11.20031096v1

Mental Health and Faith Community Partnership

This article describes the Mental Health and Faith Community Partnership which is a collaboration between psychiatrists and clergy. The partnership provides an opportunity for psychiatrists and the mental health community to learn from spiritual leaders, to whom people often turn in times of mental distress. At the same time, it provides an opportunity to improve understanding of the best science and evidence-based treatment for psychiatric illnesses among faith leaders and those in the faith community.

Linke to article: https://www.psychiatry.org/psychiatrists/cultural-competency/engagement-opportunities/mental-health-and-faith-community-partnership

The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Decisions on how to apply quarantine should be based on the best available evidence. This paper reviews the psychological impact of quarantine using three electronic databases. Results show that in situations where quarantine is deemed necessary, officials should quarantine individuals for no longer than required, provide a clear rationale for quarantine and information about protocols, and ensure sufficient supplies are provided.

Link to article: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)30460-8/fulltext  

PDF: The psychological impact of quarantine and how to reduce it: rapid review of the evidence

Response to COVID-19 in Taiwan Big Data Analytics, New Technology, and Proactive Testing

Shows Taiwan as an example of how a society can respond quickly to a crisis and protect the interests of its citizens. Taiwan’s government learned from its 2003 SARS experience and established a public health response mechanism for enabling rapid actions for the next crisis. Well-trained and experienced teams of officials were quick to recognize the COVID-19 crisis and activated emergency management structures to address the emerging outbreak.

Link to article: https://jamanetwork.com/journals/jama/fullarticle/2762689

Will the Coronavirus Ever Go Away? Here’s What One of the WHO’s Top Experts Thinks

Time magazine interviews Dr. Bruce Aylward, the senior adviser to the Director-General of the WHO, is one of the world’s top officials in charge of fighting the coronavirus pandemic. Dr. Aylward has almost 30 years of experience in fighting polio, Ebola and other diseases, and now he’s turned his attention to stopping the spread of COVID-19.

Link to article: https://time.com/5805368/will-coronavirus-go-away-world-health-organization/

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