title: A globally available COVID-19 - Template for clinical imaging studies

text: Background The pandemic spread of COVID-19 has caused worldwide implications on societies and economies. Chest computed tomography (CT) has been found to support both, current diagnostic and disease monitoring. A joint approach to collect, analyze and share clinical and imaging information about COVID-19 in the highest quality possible is urgently needed. Methods An evidence-based reporting template was developed for assessing COVID-19 pneumonia using an FDA-approved medical software. The annotation of qualitative and quantitative findings including radiomics features is performed directly on primary imaging data. For data collection, secondary information from the patient history and clinical data such as symptoms and comorbidities are queried. Results License-royalty free, cloud-based web platform and on-premise deployments are offered. Hospitals can upload, assess, report and if pseudonymized share their COVID-19 cases. The aggregation of radiomics in correlation with rt-PCR, patient history, clinical and radiological findings, systematically documented in a single database, will lead to optimized diagnosis, risk stratification and response evaluation. A customizable analytics dashboard allows the explorative real-time data analysis of imaging features and clinical information. Conclusions The COVID-19-Template is based on a systematic, computer-assisted and context-guided approach to collect, analyze and share data. Epidemiological and clinical studies for therapies and vaccine candidates can be implemented in compliance with high data quality, integrity and traceability.


title: Estimating the Effect of Social Distancing Interventions on COVID-19 in the United States

text: Since its global emergence in 2020, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has caused multiple epidemics in the United States. Because medical treatments for the virus are still emerging and a vaccine is not yet available, state and local governments have sought to limit its spread by enacting various social distancing interventions such as school closures and lockdown, but the effectiveness of these interventions is unknown. We applied an established, semi-mechanistic Bayesian hierarchical model of these interventions on SARS-CoV-2 spread in Europe to the United States. We estimated the effect of interventions across all states, contrasted the estimated reproduction number, Rt , for each state before and after lockdown, and contrasted predicted future fatalities with actual fatalities as a check on the model's validity. Overall, school closures and lockdown are the only interventions modeled that have a reliable impact on Rt , and lockdown appears to have played a key role in reducing Rt below 1.0. We conclude that reversal of lockdown, without implementation of additional, equally effective interventions, will enable continued, sustained transmission of SARS-CoV-2 in the United States.


title: The Association of Social Distancing, Population Density, and Temperature with the SARS-CoV-2 Instantaneous Reproduction Number in Counties Across the United States

text: Importance: The Covid-19 pandemic has been marked by considerable heterogeneity in outbreaks across the United States. Local factors that may be associated with variation in SARS-CoV-2 transmission have not been well studied. Objective: To examine the association of county-level factors with variation in the SARS-CoV-2 reproduction number over time. Design: Observational study Setting: 211 counties in 46 states and the District of Columbia between February 25, 2020 and April 23, 2020. Participants: Residents within the counties (55% of the US population) Exposures: Social distancing as measured by percent change in visits to non-essential businesses, population density, lagged daily wet bulb temperatures. Main Outcomes and Measures: The instantaneous reproduction number (Rt) which is the estimated number of cases generated by one case at a given time during the pandemic. Results: Median case incidence was 1185 cases and fatality rate was 43.7 deaths per 100,000 people for the top decile of 21 counties, nearly ten times the incidence and fatality rate in the lowest density quartile. Average Rt in the first two weeks was 5.7 (SD 2.5) in the top decile, compared to 3.1 (SD 1.2) in the lowest quartile. In multivariable analysis, a 50% decrease in visits to non-essential businesses was associated with a 57% decrease in Rt (95% confidence interval, 56% to 58%). Cumulative temperature effects over 4 to 10 days prior to case incidence were nonlinear; relative Rt decreased as temperatures warmed above 32F to 53F, which was the point of minimum Rt, then increased between 53F and 66F, at which point Rt began to decrease. At 55F, and with a 70% reduction in visits to non-essential business, 96% of counties were estimated to fall below a threshold Rt of 1.0, including 86% of counties among the top density decile and 98% of counties in the lowest density quartile. Conclusions and Relevance: Social distancing, lower population density, and temperate weather change were associated with a decreased SARS-Co-V-2 Rt in counties across the United States. These relationships can inform selective public policy planning in communities during the SARS-CoV-2 pandemic.


title: Introductions and early spread of SARS-CoV-2 in France

text: Following the emergence of coronavirus disease (COVID-19) in Wuhan, China in December 2019, specific COVID-19 surveillance was launched in France on January 10, 2020. Two weeks later, the first three imported cases of COVID-19 into Europe were diagnosed in France. We sequenced 97 severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) genomes from samples collected between January 24 and March 24, 2020 from infected patients in France. Phylogenetic analysis identified several early independent SARS-CoV-2 introductions without local transmission, highlighting the efficacy of the measures taken to prevent virus spread from symptomatic cases. In parallel, our genomic data reveals the later predominant circulation of a major clade in many French regions, and implies local circulation of the virus in undocumented infections prior to the wave of COVID-19 cases. This study emphasizes the importance of continuous and geographically broad genomic sequencing and calls for further efforts with inclusion of asymptomatic infections.


title: Age-dependence of mortality from novel coronavirus disease (COVID-19) in highly exposed populations: New York transit workers and residents and Diamond Princess passengers.

text: Background. Populations heavily exposed to the novel coronavirus provide an opportunity to estimate the mortality from COVID-19 in different age groups. Methods. The mortality reported by May 13 from COVID-19 among Diamond Princess cruise ship passengers, and New York residents and Metropolitan Transit Authority (MTA) workers was estimated based on publicly available information. Results. The mortality among children (age 0 to 17 yrs) in New York City was 1 in 172,692. The mortality in New York state was 1 in 322,217 for ages 10-19 yrs., and 1 in 36,725 for ages 20-29 yrs. The mortality among New York transit workers was estimated to be 1 in 7,329 for ages 30-39 years; 1 in 1,075 for ages 40-49 yrs.; 1 in 343 for ages 50-59 yrs.; and 1 in 178 for ages 60-69 yrs. Among Diamond Princess passengers, the mortality was estimated to be 1 in 145 for ages 70-79, and 1 in 54 for ages 80-89. Conclusions: Mortality among populations exposed to the novel coronavirus increases with age, ranging from about 1 in 170,000 below the age of 18 years, to 1 in 54 above the age of 80 years.


title: Combining Bioimpedance and EMG Measurements for Reliable Muscle Contraction Detection

text: Objective: Muscle contractions are commonly detected by performing EMG measurements. The major disadvantage of this technique is that mechanical disturbances to the electrodes are in the same frequency and magnitude range as the desired signal. In this work we propose an approach and a realized measurement system to combine EMG and bioimpedance measurements for higher reliabilities of muscle contraction detections. Methods: We propose the development of a modular four-channel measurement system, whereat each channel is capable of acquiring EMG, the bioimpedance magnitude and phase, simultaneously. The modules are synchronized by an additional interface board, which communicates with a PC. A graphical user interface enables to control the bioimpedance excitation current in a range from 100 {\mu}A to 1 mA in a frequency range from 50 kHz to 333 kHz. Results: A system characterization demonstrated that bioimpedance magnitude changes of less than 250 ppm and phase changes below 0.05{\deg} can be detected reliably. Measurements from a subject have shown the timing relationship between EMG and bioimpedance signals as well as their robustness against mechanical disturbances. A measurement of five exemplary hand gestures has demonstrated the increase of usable information for detecting muscle contractions. Conclusion: Bioimpedance measurements of muscles provide useful information about contractions. Furthermore, the usage of a known high-frequency excitation current enables a reliable differentiation between the actual information and disturbances. Significance: By combining EMG and bioimpedance measurements, muscle contractions can be detected much more reliably. This setup can be adopted to prostheses and many other human-computer interfaces.


title: Evaluation of national responses to COVID-19 pandemic based on Pareto optimality

text: Countries worldwide have adopted various strategies to minimize the socio-economic impact of the ongoing COVID-19 pandemic. Stringency and efficacy of imposed measures vary due to diversity of organizational cultures and ingrained societal practices, but also universally reflect the standpoint from which protecting public health and saving economy are seen as contradictory objectives. We analyzed cumulative deaths per capita and cumulative mobility reduction related to the decrease of economic activity in terms of Pareto optimality to show that as long as epidemic suppression is the aim, the trade-off between the death toll and economic loss is illusory: high death toll correlates with deep lockdown and thus, very likely, with severe economic downturn. We explained this effect by analyzing national epidemic trajectories in the mobility reduction vs. reproduction number (R) plane. When the number of daily new infections is high, mobility reduction is the only way to bring R below 1, but when new infections become sporadic, the epidemic can be suppressed by efficient testing complemented by relatively mild restrictions. South American trajectories suggest that lifting mobility restrictions at R [≥] 1 may ultimately lead to the "herd immunity scenario", in which transient lockdown only adds economic costs to an inevitably high death toll.


title: The Cardiac Toxicity of Chloroquine or Hydroxychloroquine in COVID-19 Patients: A Systematic Review and Meta-regression Analysis

text: Abstract Importance The antimalarial agents chloroquine (CQ) and hydroxychloroquine (HCQ) have been proposed as a potential treatment for COVID-19 due their effect on several cellular processes that impact viral replication. Although more than 100 ongoing trials are testing their efficacy, CQ and HCQ are being used widely in clinical practice, exposing COVID-19 patients to potentially significant cardiac adverse effects. Objective To systematically review the literature and estimate the risk of cardiac toxicity in patients receiving CQ or HCQ for COVID-19. Data Sources A systematic search was conducted on May 27, 2020 of Ovid EBM Reviews, Ovid Embase (1974+), Ovid Medline (1946+ including epub ahead of print, in-process & other non-indexed citations), Scopus (1970+) and Web of Science (1975+) and preprint servers (Medrvix and ResearchSquare) and manual search of references lists. Study Selection Studies that included COVID-19 patients treated with CQ or HCQ, with or without azithromycin, were included as follows: (1) COVID-19 patient population, (2) the study included more than 10 patients receiving either one of the medications, (3) reported electrocardiographic changes and/or cardiac arrhythmias. Data Extraction and Synthesis Study characteristics and endpoints incidence were extracted. Due to the very low incidence of torsades de pointes (TdP) and other endpoints (rare events), the arcsine transformation was used to obtain a pooled estimate of the different incidences using a random-effects meta-analysis. Meta-regression analyses were used to assess whether the incidence of different endpoints significantly varied by multiple study-level variables specified a priori. Main Outcomes and Measures Pooled Incidence of: (1) change in QTc value from baseline [≥] 60 ms, (2) QTc [≥] 500 ms, (3) the composite of endpoint 1 and 2, (4) TdP arrhythmia or ventricular tachycardia (VT) or cardiac arrest, (5) discontinuation of treatment due to drug-induced QT prolongation or arrhythmias. Results A total of 19 studies with a total of 5652 patients were included. All included studies were of high methodological quality in terms of exposure ascertainment or outcome assessment. Among 2719 patients treated with CQ or HCQ, only two episodes of TdP were reported; the pooled incidence of TdP arrhythmia or VT or cardiac arrest was 3 per 1000, 95% CI (0-21), I2=96%, 18 studies with 3725 patients. Among 13 studies of 4334 patients, the pooled incidence of discontinuation of CQ or HCQ due to prolonged QTc or arrhythmias was 5%, 95% CI (1-11), I2=98%. The pooled incidence of change in QTc from baseline of [≥] 60 ms was 7%, 95% CI (3-14), I2=94% (12 studies of 2008 patients). The pooled incidence of QTc [≥] 500 ms was 6%, 95% CI (2-12), I2=95% (16 studies of 2317 patients). Among 11 studies of 3127 patients, the pooled incidence of change in QTc from baseline of [≥] 60 ms or QTc [≥] 500 ms was 9%, 95% CI (3-17), I2=97%. Mean/median age, coronary artery disease, hypertension, diabetes, concomitant QT prolonging medications, ICU care, and severity of illness in the study populations explained between-studies heterogeneity. Conclusions and Relevance Treatment of COVID-19 patients with CQ or HCQ is associated with a significant risk of drug-induced QT prolongation, which is a harbinger for drug-induced TdP/VT or cardiac arrest. CQ/HCQ use resulted in a relatively higher incidence of TdP as compared to drugs withdrawn from the market for this particular adverse effect. Therefore, these agents should be used only in the context of randomized clinical trials, in patients at low risk for drug-induced QT prolongation, with adequate safety monitoring.


title: Recommendations of the Brazilian College of Surgeons for laparoscopic surgery during the COVID-19 pandemic/ Recomendacoes do Colegio Brasileiro de Cirurgioes para cirurgia videolaparoscopica durante a pandemia por COVID-19

text: During the current COVID-19 pandemic, the surgical community faces the possible risk of infection of health care professionals involved in the surgical procedure This leaves to concerns and questions referred to the most adequate surgical approach at this moment With the objective of guiding surgeons, and based in many different protocols published until now, the Brazilian College of surgeons brings recommendations about this subject The aim of this technical note is, trough a compilaton of publications and recommendations from Scientific Societies of Surgery worldwide, to provide guidelines regarding laparoscopic access during the COVID-19 pandemic Diante do quadro de pandemia da COVID-19, a comunidade cirurgica enfrenta o possivel risco de contagio de profissionais envolvidos no ato operatorio;gerando preocupacoes e duvidas referentes a escolha da via de acesso mais adequada nesse momento Com objetivo de orientar os cirurgioes, baseado em diversos protocolos publicados ate o momento, o Colegio Brasileiro de Cirurgioes traz recomendacoes acerca deste assunto O objetivo desta nota tecnica e, atraves de uma compilacao de publicacoes e recomendacoes de Sociedades Cientificas de Cirurgia de todo mundo, trazer orientacoes relativas ao acesso laparoscopico durante a pandemia por COVID-19


title: Case fatality rate of novel coronavirus disease 2019 in China

text: Abstract Background: A pandemic of coronavirus disease 2019 (COVID-19) which have caused more than 80 thousand persons infected globally is still ongoing. This study aims to calculate its case fatality rate (CFR). Methods: The method, termed as converged CFR calculation, was based on the formula of dividing the number of known deaths by the number of confirmed cases T days before, where T was an average time period from case confirmation to death. It was found that supposing a T, if it was smaller (bigger) than the true T, calculated CFRs would gradually increase (decrease) to infinitely near the true T with time went on. According to the law, the true T value could be determined by trends of daily CFRs calculated with different assumed T values (left of true T is decreasing, right is increasing). Then the CFR could be calculated. Results: CFR of COVID-19 in China except Hubei Province was 0.8% to 0.9%. So far, the CFR had accurately predicted the death numbers more than 3 weeks. CFR in Hubei of China was 5.4% by which the calculated death number corresponded with the reported number for 2 weeks. Conclusion: The method could be used for CFR calculating while pandemics are still ongoing. Dynamic monitoring of the daily CFRs trends could help outbreak-controller to have a clear vision in the timeliness of the case confirmation.


title: COVID 19: Neuromuscular Manifestations

text: COVID-19 pandemic is ongoing and information on the neurological aspects of this viral infection is being gathered. Neuromuscular manifestations have been reported uncommonly in these early stages of the analysis. This manuscript studies the available information on the neuromuscular manifestations of COVID-19.


title: Two-Stage Adaptive Pooling with RT-qPCR for COVID-19 Screening

text: We propose two-stage adaptive pooling schemes, 2-STAP and 2-STAMP, for detecting COVID-19 using real-time reverse transcription quantitative polymerase chain reaction (RT-qPCR) test kits. Similar to the Tapestry scheme of Ghosh et al., the proposed schemes leverage soft information from the RT-qPCR process about the total viral load in the pool. This is in contrast to conventional group testing schemes where the measurements are Boolean. The proposed schemes provide higher testing throughput than the popularly used Dorfman's scheme. They also provide higher testing throughput, sensitivity and specificity than the state-of-the-art non-adaptive Tapestry scheme. The number of pipetting operations is lower than state-of-the-art non-adaptive pooling schemes, and is higher than that for the Dorfman's scheme. The proposed schemes can work with substantially smaller group sizes than non-adaptive schemes and are simple to describe. Monte-Carlo simulations using the statistical model in the work of Ghosh et al. (Tapestry) show that 10 infected people in a population of size 961 can be identified with 70.86 tests on the average with a sensitivity of 99.50% and specificity of 99.62%. This is 13.5x, 4.24x, and 1.3x the testing throughput of individual testing, Dorfman's testing, and the Tapestry scheme, respectively.


title: SARS-CoV-2 assays to detect functional antibody responses that block ACE2 recognition in vaccinated animals and infected patients

text: SARS-CoV-2 (Severe Acute Respiratory Syndrome Coronavirus 2) has caused a global pandemic of COVID-19 resulting in cases of mild to severe respiratory distress and significant mortality. The global outbreak of this novel coronavirus has now infected >8 million people worldwide with >2 million cases in the US (June 17th, 2020). There is an urgent need for vaccines and therapeutics to combat the spread of this coronavirus. Similarly, the development of diagnostic and research tools to determine infection and vaccine efficacy are critically needed. Molecular assays have been developed to determine viral genetic material present in patients. Serological assays have been developed to determine humoral responses to the spike protein or receptor binding domain (RBD). Detection of functional antibodies can be accomplished through neutralization of live SARS-CoV2 virus, but requires significant expertise, an infectible stable cell line, a specialized BioSafety Level 3 (BSL-3) facility. As large numbers of people return from quarantine, it is critical to have rapid diagnostics that can be widely adopted and employed to assess functional antibody levels in the returning workforce. This type of surrogate neutralization diagnostic can also be used to assess humoral immune responses induced in patients from the large number of vaccine and immunotherapy trials currently on-going. Here we describe a rapid serological diagnostic assay for determining antibody receptor blocking and demonstrate the broad utility of the assay by measuring the antibody functionality of sera from small animals and non-human primates immunized with an experimental SARS-CoV-2 vaccine and using sera from infected patients.


docid: odeitnli

title: Correlation between prevalence of tobacco smoking and risk and severity of COVID-19 at the national level in the European Union: an ecological study.

text: The Angiotensin-converting enzyme 2 (ACE2) protein is the receptor for different coronaviruses, including Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of Coronavirus disease 2019 (COVID-19). Previous studies suggested the hypothesis that nicotine could downregulate the expression of the ACE2. Due to the high level of nicotine intake, the objective of this preliminary study was to assess, at the ecological level, the correlation between tobacco smoking and the attack rate and severity of COVID-19 in the European Union (EU). We have found that there is a statistically significant negative correlation between the age-standardized prevalence of tobacco smoking and the attack rate of COVID-19 in member states of the EU [Spearman's correlation coefficient = -0.476 (95% confidence interval -0.117, -0.725) (p-value = 0.012)], meaning that in member states with a higher age-standardized prevalence of tobacco smoking the attack rate of COVID-19 has been so far lower. Further research is needed to understand the possible effect of nicotine exposure in the expression of the ACE2 protein.


title: Knowledge, attitude, and practices of Community pharmacists about COVID-19: A cross-sectional survey in two provinces of Pakistan.

text: Amidst to current Coronavirus infectious disease 2019 (COVID-19) pandemic, the international pharmaceutical federation stated that pharmacists being a part of the healthcare system had a crucial role in the management cycle of COVID-19 outbreak. The purpose of this study was to assess the knowledge, attitude and practice of community pharmacists, to snapshot their current preparedness and awareness regarding COVID-19. An online survey was conducted among a sample of 393 community pharmacists from two provinces; Punjab and Khyber-Pakhtunkhwa, Pakistan during a period of strict lockdown (10th to 30th April 2020). A validated (Cronbach alpha= 0.077) self-administered questionnaire comprised of five sections (Demographics, source of information, knowledge, attitude, and practice) was used for data collection. Logistic regression was applied to find potential factors associated with good knowledge, attitude, and practice by using SPSS version 21. Of total 393 participants, 71.5% (n=281) had good knowledge, 44% (n=175) had positive attitude and 57.3% (n=225) had good practice regarding COVID-19. Social media (45.29%, n=178) was reported as the main source to seek information regarding COVID-19. Results revealed that the age of [≥]26 years, Ph.D. degree level, and good knowledge were the substantial determinants (P<0.05) of a good attitude. Similarly, community pharmacist who had an experience of >5 years, hold a Ph.D. degree, good knowledge and good attitude had higher odds of good practice compared to reference categories (P<0.05). The findings demonstrated that the majority of community pharmacists had good knowledge, but had a poor attitude and practice towards the COVID-19. This study also highlighted the disparity in some aspects of knowledge, attitude, and practice that must be addressed in future educational, awareness, and counselling programs.


Supporting the Emotional Well-being of Health Care Workers During the COVID-19 Pandemic


title: Leveraging wearable technology to predict the risk of COVID-19 infection.

text: COVID-19, the disease caused by the SARS-CoV-2 virus, can cause shortness of breath, lung damage, and impaired respiratory function. Containing the virus has proven difficult, in large part due to its high transmissibility during the pre-symptomatic incubation. The study's aim was to determine if changes in respiratory rate could serve as a leading indicator of SARS-CoV-2 infections. A total of 271 individuals (age = 37.3 {+/-} 9.5, 190 male, 81 female) who experienced symptoms consistent with COVID-19 were included - 81 tested positive for SARS-CoV-2 and 190 tested negative; these 271 individuals collectively contributed 2672 samples (days) of data (1856 healthy days, 231 while infected with COVID-19 and 585 while infected with something other than COVID-19). To train a novel algorithm, individuals were segmented as follows; (1) a training dataset of individuals who tested positive for COVID-19 (n=57 people, 537 samples); (2) a validation dataset of individuals who tested positive for COVID-19 (n=24 people, 320 samples) ; (3) a validation dataset of individuals who tested negative for COVID-19 (n=190 people, 1815 samples). All data was extracted from the WHOOP system, which uses data from a wrist-worn strap to produce validated estimates of respiratory rate and other physiological measures. Using the training dataset, a model was developed to estimate the probability of SARS-CoV-2 infection based on changes in respiratory rate during night-time sleep. The model's ability to identify COVID-positive individuals not used in training and robustness against COVID-negative individuals with similar symptoms were examined for a critical six-day period spanning the onset of symptoms. The model identified 20% of COVID-19 positive individuals in the validation dataset in the two days prior to symptom onset, and 80% of COVID-19 positive cases by the third day of symptoms.


title: Predictions for COVID-19 outbreak in India using Epidemiological models

text: COVID-19 data from India is compared against several countries as well as key states in the US with a major outbreak, and it is found that the basic reproduction number R_0 for India is in the expected range of 1.4-3.9. Further, the rate of growth of infections in India is very close to that in Washington and California. Exponential and classic susceptible-infected-recovered (SIR) models based on available data are used to make short and long-term predictions on a daily basis. Based on the SIR model, it is estimated that India will enter equilibrium by the end of May 2020 with the final epidemic size of approximately 13,000. However, this estimation will be invalid if India enters the stage of community transmission. The impact of social distancing, again with the assumption of no community transmission, is also assessed by comparing data from different geographical locations.


title: Epidemiological characteristics of novel coronavirus infection: A statistical analysis of publicly available case data

text: Following the first report of coronavirus disease 2019 (COVID-19) in Sapporo City, Hokkaido Prefecture, Japan on 14 February 2020, a surge of cases was observed in Hokkaido during February and March. As of 6 March, 90 cases were diagnosed in Hokkaido. Unfortunately, many infected persons may not have been recognized as cases due to having mild or no symptoms. We therefore estimated the actual number of COVID-19 cases in (i) Hokkaido Prefecture and (ii) Sapporo City using data on cases diagnosed outside these areas. The estimated cumulative incidence in Hokkaido as of 27 February was 2297 cases (95% confidence interval [CI]: 382, 7091) based on data on travelers outbound from Hokkaido. The cumulative incidence in Sapporo City as of 28 February was estimated at 2233 cases (95% CI: 0, 4893) based on the count of confirmed cases within Hokkaido. Both approaches resulted in similar estimates, indicating higher incidence of infections in Hokkaido than were detected by the surveillance system. This quantification of the gap between detected and estimated cases can help inform public health response as it provides insight into the possible scope of undetected transmission.


title: COVID19: The need of an integrated and critical view

text: To understand and act upon a complex reality like COVID19, we need to integrate knowledge from different academic sciences, in interdisciplinary efforts, and academic knowledge and other knowledge systems, in transdisciplinary processes. Without an integrated view leading to socially robust orientations, we are less likely to successfully navigate our challenging times. However, COVID19 became a "wicked problem", in which there is broad disagreement on what the very 'problem' is, and instead of a "wholeofgovernment, wholeofsociety approach", we find partial solutions that fall short of dealing with the complex dilemmas posed by the wicked problem. To build an integrated view, different scientists and social actors should engage in trust relationships and accept mutual epistemic dependencies, as requisites for a concerted way of understanding and acting on the problem. This is particularly hard, however, in a wicked problem. In building an integrated view on COVID19, the role of academic sciences should be surely recognized, but we should avoid turning this recognition into an advocacy for scientism. It remains necessary to recognize and value the plurality of knowledge systems that span over human history, as well as their integration for mutual learning and concerted action. It is worth briefly examining, then, an integration initiative in COVID19 treatment, namely between traditional Chinese and Western medicine. Finally, an integrated and critical view of COVID19 demands that we cast aside the myth of valuefree science, consider the relationships between values and scientific work, and conceive how knowledge can be objective without being neutral.


title: Knowledge, attitudes, and practices (KAP) towards COVID-19: A quick online cross-sectional survey among Tanzanian residents.

text: In Tanzania, Unprecedented measures have been adopted to control the rapid spread of the ongoing COVID-19 epidemic. Residents adherence to control measures is affected by their knowledge, attitudes, and practices (KAP) towards COVID-19. In this study, we investigated Tanzanian residents KAP towards COVID-19 during the rapid rise period of the outbreak.This was a cross sectional study that involved sample of online Tanzanian residents who was recruited via authors networks with residents and social media. A self-developed online KAP questionnaire using Survey Monkey tool was used to collect data from participants. The questionnaire assessed demographic and had 12 questions on COVID Knowledge and 5 questions on attitude and practice. Descriptive and inferential analysis was carried out using SPSS 17.Four hundred residents completed a survey. The mean age of study participants was 28 years, and majorities were females 216 (54.0%). There were no significant different in relation to demographic variables (p>0.3). Those who held a bachelor degree or above (60.3%) had more correct score. The overall, (84.4%) of participants had good knowledge level and the good knowledge was associated with education level (p=0.001). Nearly all of the participants (96.0%) had confidence that Tanzania can win the battle against COVID-19. The majority of the respondents (77%) did not do to the crowded place in recent says. Multiple linear regression analysis showed that male gender, age-group of 16-29 years and education of secondary or lower were significantly associated with lower knowledge score.Our findings suggest that residents of a relatively high level of socioeconomic status, have had good knowledge, optimistic attitudes, and appropriate practices towards COVID-19 during the rapid rise period of the COVID-19 outbreak. Suggesting that health education programs aimed at improving COVID-19 knowledge are helpful for encouraging an optimistic attitudes and maintaining safe practices. Due to the limitation in representativeness of the sample, more studies are warranted to investigate the KAP towards COVID-19 among Tanzania residents of a low socioeconomic status.


title: Tourism, animals and the scales of justice

text: Animals are used in tourism in many ways. Some uses are more benign such as ecotourism (e.g., viewing elephants in natural settings), while others induce significant levels of suffering, pain and distress with the denial of dignity and respect (e.g., elephants performing at a circus). What is missing is a comprehensive overview of how just these uses may or may not be. Justice, as a concept, is complex and controversial—even more so when applied to animals. In this paper, we propose a “scales of justice” framework for animals used in tourism (deep, intermediate, shallow, and no justice) based on two different normative ethics models. The first model is based on the conventional normative ethical domain that includes deontology and consequentialism (i.e., what we are told to do), while the second model is rooted in virtue ethics (i.e., what we ought to do as individuals). The intent is to “weigh” the just and unjust use of animals in the tourism industry based on these contrasting theoretical perspectives. Elephants are used as an example through the paper. We view this approach as a springboard for more intensive investigations on how animals are used in tourism in a variety of contexts.


title: Assessment of Experiences of Preventive Measures Practice including Vaccination History and Health Education among Umrah Pilgrims in Saudi Arabia, 1440H-2019

text: Background Annually, approximately 10 million Umrah pilgrims travel to the Kingdom of Saudi Arabia for Umrah from more than 180 countries. This event presents major challenges for the Kingdom public health sector, which strives to decrease the burden of infectious diseases and to adequately control its spread. Aims of the study The aims of the study were to assess the experiences of preventive measures practice, including vaccination history and health education, among Umrah pilgrims in Saudi Arabia. Methods A cross sectional survey administered to a randomly selected group of pilgrims by the research team members from February to the end of April 2019 at the departure lounge at King Abdul Aziz International airport, Jeddah city. The questionnaire was comprised of questions on the following factors: sociodemographic information, level of education, history of vaccinations and chronic illnesses, whether the pilgrim has received any health education and orientation prior to coming Saudi Arabia or on their arrival, and their experiences with preventive medicine. Results Pilgrims (n=1012) of 48 nationalities completed the survey and were reported in this study. Chronic diseases (n=230) were reported among pilgrims, with hypertension being the most reported morbidity (n=124, 53.9%). The majority of pilgrims had taken immunization prior to travel to Saudi Arabia, and the most commonly reported immunizations were meningitis (n=567, 56%), influenza (n=460, 45.5%), and Hepatitis B virus vaccinations (n=324, 32%); however, 223(22%) had not received any vaccinations prior to travel, including meningitis vaccine, which is mandatory in Saudi Arabia. 305 pilgrims (30.1%) had reported never using face masks in crowded areas; however, 63.2% reported lack of availability of these masks. The majority of participants had received health education on preventive measures, including hygienic aspects (n=799, 78.9%) mostly in their home countries (n=450, 56.3%). A positive association was found between receiving health education and practicing of preventive measures, such as wearing masks in crowded areas (P= 0.04) and other health practice scores (P= 0.02). Conclusion Although the experiences of the preventive measures among pilgrims in terms of health education, vaccinations, and hygienic practices were overall positive, this study identified several issues with the following preventive measures: immunizations particularly meningitis vaccine and using face masks in crowded areas. Further studies are required to develop a health education module to promote comprehensive preventive measures for pilgrims. Keywords Umrah, pilgrims, personal preventive measures, COVID-19, Makkah, Saudi Arabia


title: Clinical features of covid-19 in children

text: In early December, pneumonia cases of unknown origin started to appear and, on the 7thof January 2020, these cases were declared to be caused by a novel beta-coronavirus according to viral genome sequencing on the 11thof February, 2020. Coronaviruses are enveloped, single strand RNA viruses that have been known to have the ability to mutate rapidly, alter tissue tropism and adjust to different epidemiological situations. As of the end of April 2020, 122,392 laboratory-confirmed cases of COVID-19 had been detected in Turkey, of whom 3,258 died. From the beginning of the COVID-19 epidemic, children seem to be less affected than adults. Therefore, there are limited data regarding the clinical features of COVID-19 in children. The majority of children with confirmed COVID-19 had a history of household contact. The most common symptoms were fever and cough. Previous data suggest that nearly half of patients are afebrile at the onset of the disease. Hospitalization and PICU admission rates for children were lower than for adults. However, PICU admission can be necessitated in children with severe disease. Infants, particularly under the age of 12 months, were more likely to develop severe disease. In children, milder and asymptomatic cases can be challenging and can play a role in transmission. In particular, clinicians should test those children who have a history of family cluster even though they are asymptomatic or present with mild symptoms.


title: Discussing the ABCs of Health Security-Antibiotic Resistance, Biothreats, and Coronavirus.

text: According to the World Health Organization (WHO), viral diseases continue to emerge and represent a serious issue to public health In the last twenty years, several viral epidemics such as the severe acute respiratory syndrome coronavirus (SARS-CoV) in 2002 to 2003, and H1N1 influenza in 2009, have been recorded Most recently, the Middle East respiratory syndrome coronavirus (MERS-CoV) was first identified in Saudi Arabia in 2012 In a timeline that reaches the present day, an epidemic of cases with unexplained low respiratory infections detected in Wuhan, the largest metropolitan area in China's Hubei province, was first reported to the WHO Country Office in China, on December 31, 2019 Published literature can trace the beginning of symptomatic individuals back to the beginning of December 2019 As they were unable to identify the causative agent, these first cases were classified as "pneumonia of unknown etiology " The Chinese Center for Disease Control and Prevention (CDC) and local CDCs organized an intensive outbreak investigation program The etiology of this illness is now attributed to a novel virus belonging to the coronavirus (CoV) family, COVID-19 On February 11, 2020, the WHO Director-General, Dr Tedros Adhanom Ghebreyesus, announced that the disease caused by this new CoV was a "COVID-19," which is the acronym of "coronavirus disease 2019" In the past twenty years, two additional coronavirus epidemics have occurred SARS-CoV provoked a large-scale epidemic beginning in China and involving two dozen countries with approximately 8000 cases and 800 deaths, and the MERS-CoV that began in Saudi Arabia and has approximately 2,500 cases and 800 deaths and still causes as sporadic cases This new virus seems to be very contagious and has quickly spread globally In a meeting on January 30, 2020, per the International Health Regulations (IHR, 2005), the outbreak was declared by the WHO a Public Health Emergency of International Concern (PHEIC) as it had spread to 18 countries with four countries reporting human-to-human transmission An additional landmark occurred on February 26, 2020, as the first case of the disease, not imported from China, was recorded in the United States Initially, the new virus was called 2019-nCoV Subsequently, the task of experts of the International Committee on Taxonomy of Viruses (ICTV) termed it the SARS-CoV-2 virus as it is very similar to the one that caused the SARS outbreak (SARS-CoVs) The CoVs have become the major pathogens of emerging respiratory disease outbreaks They are a large family of single-stranded RNA viruses (+ssRNA) that can be isolated in different animal species For reasons yet to be explained, these viruses can cross species barriers and can cause, in humans, illness ranging from the common cold to more severe diseases such as MERS and SARS Interestingly, these latter viruses have probably originated from bats and then moving into other mammalian hosts — the Himalayan palm civet for SARS-CoV, and the dromedary camel for MERS-CoV — before jumping to humans The dynamics of SARS-Cov-2 are currently unknown, but there is speculation that it also has an animal origin The potential for these viruses to grow to become a pandemic worldwide seems to be a serious public health risk Concerning COVID-19, the WHO raised the threat to the CoV epidemic to the "very high" level, on February 28, 2020 Probably, the effects of the epidemic caused by the new CoV has yet to emerge as the situation is quickly evolving World governments are at work to establish countermeasures to stem possible devastating effects Health organizations coordinate information flows and issues directives and guidelines to best mitigate the impact of the threat At the same time, scientists around the world work tirelessly, and information about the transmission mechanisms, the clinical spectrum of disease, new diagnostics, and prevention and therapeutic strategies are rapidly developing Many uncertainties remain with regard to both the virus-host interaction and the evolution of the epidemic, with specific reference to the times when the epidemic will reach its peak At the moment, the therapeutic strategies to deal with the infection are only supportive, and prevention aimed at reducing transmission in the community is our best weapon Aggressive isolation measures in China have led to a progressive reduction of cases in the last few days In Italy, in geographic regions of the north of the peninsula, political and health authorities are making incredible efforts to contain a shock wave that is severely testing the health system In the midst of the crisis, the authors have chosen to use the "Statpearls" platform because, within the PubMed scenario, it represents a unique tool that may allow them to make updates in real-time The aim, therefore, is to collect information and scientific evidence and to provide an overview of the topic that will be continuously updated


title: COVID-19: A relook at healthcare systems and aged populations

text: Using data from the WHO's Situation Report on the COVID-19 pandemic from 21 January 2020 to 30 March 2020 along with other health, demographic, and macroeconomic indicators from the WHO's Application Programming Interface and the World Bank's Development Indicators, this paper explores the death rates of infected persons and their possible associated factors. Through the panel analysis, we found consistent results that healthcare system conditions, particularly the number of hospital beds and medical staff, have played extremely important roles in reducing death rates of COVID-19 infected persons. In addition, both the mortality rates due to different non-communicable diseases (NCDs) and rate of people aged 65 and over were significantly related to the death rates. We also found that controlling international and domestic travelling by air along with increasingly popular anti-COVID-19 actions (i.e., quarantine and social distancing) would help reduce the death rates in all countries. We conducted tests for robustness and found that the Driscoll and Kraay (1998) method was the most suitable estimator with a finite sample, which helped confirm the robustness of our estimations. Based on the findings, we suggest that preparedness of healthcare systems for aged populations need more attentions from the public and politicians, regardless of income level, when facing COVID-19-like pandemics.


docid: wekbdhne

title: Mental wellbeing in the Bangladeshi healthy population during nationwide lockdown over COVID-19: an online cross-sectional survey

text: Background: We aim to profile and contextualize the level of positive mental health among the healthy population during the beginning of nationwide lockdown over COVID-19 in Bangladesh. Design and setting: An online sample of 1404 healthy individuals was collected through the authors' networks with residents and popular media in Bangladesh. The survey was conducted between March 27, 2020, and April 7, 2020, following the Bangladesh government's lockdown announcement. Method: A questionnaire comprising the Warwick Edinburgh Mental Wellbeing Scale (WEMWBS) and sociodemographic information was posted to an online survey. Results: The mean wellbeing value was 38.4 (standard deviation, 11.2), indicating a lower mental health level exist in adults. Also, the mean wellbeing score for males was 39.0 (10.8) units compared to females with scores 37.0 (11.2), and the highest scores for government workers was 41.2 (11.8). Unemployment (35.6) or business employees (35.5) have a lower level of mental health. In the lockout days, the elderly population of age 50 years and above had high day-to-day variation of wellbeing scores. After confounding adjustment in multivariable linear regression models, there found a better wellbeing scores for males (estimate=1.79, 95% CI=0.5, 3.1), and government-workers (estimate=5.86, 95% CI=2.2, 9.5). Moreover, the never-married female had significantly higher well-being score compared to married women (estimate=3.31, 95% CI=1.0, 5.7). Conclusion: The COVID-19 pandemic has been associated with low mental wellbeing that indicates depression in our study. Suggestions for improvement will be implemented to promote the mental health to women, unemployed and business communities. Older people 50 years of age and over reported a greater day-to-day variation in their mental health. The married women with their decreased mental wellbeing should be given special consideration. The research will help let clinicians and policymakers decide where the measures can be implemented to improve their mental health during and after this pandemic.


title: COVID-19 Infection in South Korea: Focusing on Age Distribution of Confirmed Cases

text: A new kind of respiratory infectious disease, COVID-19, which first occurred in Wuhan, China, on December 31st, 2019, has affected all over China After that, the first case of COVID-19 in South Korea was confirmed on January 20th, 2020 Currently, on April 7th, the accumulated number of confirmed cases is 10,331, with 6,694 among them released from quarantine Age distributions among the confirmed cases shows that patients between 20-29 occupy the most portion with 27% The younger generations occupies the highest portion of the confirmed cases Additionally, as their high infection rate can serve as a risk factor of spreading the disease to their family members, they should actively participate in the prevention of the disease by thorough practice of social distancing Their participation is expected to serve an important role in ending COVID-19


title: Analysis of the Worldwide Corona Virus (COVID-19) Pandemic Trend;A Modelling Study to Predict Its Spread

text: Objective: The Coronavirus (COVID-19) has advanced into 197 countries and territories leaving behind a total of 372,757 confirmed cases and 16231 deaths. Methods: One the basis of WHO situation reports data of COVID-19 along with daily official reports from the Japan, China and the Korea we modeled the spread of COVID19 by using the Successive Approximation Method. We defined the two state of data to find the mean ratio (η) of the present cases count to the sum of previous and present cases. This ratio further predicts the future state of COVID-19 pandemic. Results: The mean ratio (η) of expected cases were found 0.485, while the mean ratio for deaths was found to be 0.49. We calculated worldwide expected lower bound value for confirmed cases 247007 cases with maximum limit of 1667719 cases and minimum deaths count 8660 with upper limit of 117397 deaths in next 30 days. While in the case of Iran, a large increase in the number of deaths are expected in the upcoming 30 days with lower bound value of 1140 deaths and maximum value of 598478 deaths. Interpretation: Iran whole population is on risk.


title: Ultra-fast one-step RT-PCR protocol for the detection of SARS-CoV-2

text: The COVID-19 pandemic resulted in lockdowns all over the world thus affecting nearly all aspects of social life and also had a huge impact on global economies. Since vaccines and therapies are still not available for the population, prevention becomes desperately needed. One important aspect for prevention is the identification and subsequent isolation of contagious specimens. The currently used methods for diagnostics are time consuming and also hindered by the limited availability of reagents and reaction costs, thus presenting a bottle neck for prevention of COVID-19 spread. Here, we present a new ultra-fast test method which is ten times faster than conventional diagnostic tests using real time quantitative PCR (RT-qPCR). In addition, this ultra-fast method is easy to handle as well as cost effective. We translated published SARS-CoV-2 testing protocols from the Centers of Disease Control and Prevention (Atlanta, Georgia, USA) and the Charite Berlin (Germany) to the NEXTGENPCR (NGPCR) machine and combined it with a fluorescence-based endpoint measurement. Fluorescence was measured with a commercial blue light scanner. We confirmed the NEXTGENPCR results with commercially available positive controls. In addition, we isolated RNA from SARS-CoV-2 infected patients and achieved similar results to clinical RT-qPCR assays. Here, we could show correlation between the results obtained by NEXTGENPCR and conventional RT-qPCR.


First isolation of SARS-CoV-2 from clinical samples in India


docid: jarnavwl

title: Clinical Characteristics on 25 Discharged Patients with COVID-19 Virus Returning

text: Here we report the clinical features of 25 discharged patients with COVID-19 recovery. Our analysis indicated that there was a significant inverse correlation existed between serum D-Dimer level and the duration of antiviral treatment, while lymphocyte concentration significantly positively correlated with the duration of virus reversal.


title: Smart cities and a data-driven response to COVID-19

text: This commentary describes the rapid development of a COVID-19 data dashboard utilising existing Urban Observatory Internet of Things (IoT) data and analytics infrastructure. Existing data capture systems were rapidly repurposed to provide real-time insights into the impacts of lockdown policy on urban governance.


title: Modelling the SARS-CoV-2 first epidemic wave in Greece: social contact patterns and impact assessment of social distancing interventions.

text: In Greece, a nationwide lockdown to mitigate the transmission of SARS-CoV-2 was imposed on March 23, 2020. As by the end of April the first epidemic wave is waning, it is important to assess the infection attack rate and quantify the impact of physical distancing. We implemented a survey to assess social mixing patterns before the epidemic and during lockdown. We estimated R0 from surveillance data and assessed its decline as a result of physical distancing based on social contacts data. We applied a Susceptible-Exposed-Infectious-Recovered model to estimate the infection attack rate and the infection fatality ratio (IFR). As multiple social distancing measures were implemented simultaneously (schools/work/leisure), we assessed their overall impact as well as their relative contribution. R0 was estimated 2.38 (95%CI: 2.01,2.80). By April 26th, the infection attack rate was 0.12% (95% CrI: 0.06%,0.26%) and the IFR 1.12% (95% CrI: 0.55%,2.31%). During lockdown, daily contacts were reduced by 86.9% and the effective reproduction number reached 0.46 (95% CrI: 0.35,0.57). The reduction in R0 attributed to lockdown was 81.0% (95% CrI: 71.8%,86.0%) whereas the reduction attributed to each measure separately ranged between 10%-24%. We assessed scenarios with less disruptive social distancing measures as well as scenarios where measures are partially lifted after lockdown. This is the first impact assessment of the first wave of SARS-CoV-2 in a European country. It suggests that only multiple measures implemented simultaneously could reduce R0 below 1. Measuring social mixing patterns can be a tool for real-time monitoring of the epidemic potential.


docid: bmlufhwg

title: Health literacy and early insights during a pandemic

text: Health communicators can draw some early lessons from the first five to six months of the worldwide experience with the Coronavirus Disease 2019. While it is critically important to apply known efficacious principles of communication strategies, we would do well to imbue our efforts with insights from health literacy studies. We know from national and international assessments that a significant proportion of adults in most industrialized nations have limited literacy and numeracy skills and face difficulty using commonly available materials to accomplish everyday tasks with accuracy and consistency. We must be certain to make information more accessible by being attentive to tone and voice, organization of information, vocabulary, numbers, data presentations–in our talks, writings, and postings. We need to apply rigor to the development of written, spoken, and displayed information and be certain to use available tools to develop, assess, pilot, and re-formulate health messages and materials - to help the public gain access to needed insights, developments, instructions, and actions. The health literacy lens supports a focus on the characteristics of health communications that facilitate or impede access to information, comprehension, and action. We know too that we must make critical information more widely available - considering that the most vulnerable amongst us may have limited literacy skills, have access to scarce resources, and face higher exposure. Health literacy insights can support strategies to broaden the reach of health information and contribute to efforts to mitigate the ravages of disparities.


COVID-19 raises doubts about proposed federal budget cuts to global health, medical research


title: Cross-neutralization antibodies against SARS-CoV-2 and RBD mutations from convalescent patient antibody libraries

text: The emergence of coronavirus disease 2019 (COVID-19) pandemic led to an urgent need to develop therapeutic interventions. Among them, neutralizing antibodies play crucial roles for preventing viral infections and contribute to resolution of infection. Here, we describe the generation of antibody libraries from 17 different COVID-19 recovered patients and screening of neutralizing antibodies to SARS-CoV-2. After 3 rounds of panning, 456 positive phage clones were obtained with high affinity to RBD (receptor binding domain). Then the positive clones were sequenced and reconstituted into whole human IgG for epitope binning assays. After that, all 19 IgG were classified into 6 different epitope groups or Bins. Although all these antibodies were shown to have ability to bind RBD, the antibodies in Bin2 have more superiority to inhibit the interaction between spike protein and angiotensin converting enzyme 2 receptor (ACE2). Most importantly, the antibodies from Bin2 can also strongly bind with mutant RBDs (W463R, R408I, N354D, V367F and N354D/D364Y) derived from SARS-CoV-2 strain with increased infectivity, suggesting the great potential of these antibodies in preventing infection of SARS-CoV-2 and its mutations. Furthermore, these neutralizing antibodies strongly restrict the binding of RBD to hACE2 overexpressed 293T cells. Consistently, these antibodies effectively neutralized pseudovirus entry into hACE2 overexpressed 293T cells. In Vero-E6 cells, these antibodies can even block the entry of live SARS-CoV-2 into cells at only 12.5 nM. These results suggest that these neutralizing human antibodies from the patient-derived antibody libraries have the potential to become therapeutic agents against SARS-CoV-2 and its mutants in this global pandemic.


title: How Efficient Can Non-Professional MasksSuppress COVID-19 Pandemic?

text: The coronavirus disease 2019 (COVID-19) pandemic is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), which can be transmitted via respiratory secretions. Since there are currently no specific therapeutics or vaccines available against the SARS-CoV-2, the commen nonpharmaceutical interventions (NPIs) are still the main measures to curb the COVID-19 epidemic. Face mask wearing is one important measure to suppress the pandemic. In order to know how efficient is face mask wearing in reducing the pandemic even with low efficiency non-professional face masks, we exploit physical abstraction to model the non-professional face masks made from cotton woven fabrics and characterize them by a parameter virus penetration rate (VPR){gamma}. Monte Carlo simulations exhibit that the effective reproduction number R of COVID-19 or similar pandemics can be approximately reduced by factor {gamma}4 with respect to the basic reproduction number R0,if the face masks with 70% <{gamma}< 90% are universally applied for the entire network. Furthermore, thought experiments and practical exploitation examples in country-level and city-level are enumerated and discussed to support our discovery in this study and indicate that the outbreak of a COVID-19 like pandemic can be even suppressed by the low efficiency non-professional face masks.


Changes in diagnostic approach of COVID-19 in China/ Cambios en el abordaje diagnóstico de COVID-19 en China


title: Emotional consequences of COVID-19 home confinement: The ECLB-COVID19 multicenter study

text: Abstract: Background: Public health recommendations and government measures during the COVID-19 pandemic have enforced restrictions on daily living, which may include social distancing, remote work/school, and home confinement. While these measures are imperative to abate the spreading of COVID-19, the impact of these restrictions on mental health and emotional wellbeing is undefined. Therefore, an international online survey was launched on April 6, 2020 in seven languages to elucidate the impact of COVID-19 restrictions on mental health and emotional well-being. This report presents the preliminary results from the first thousand responders on mental wellbeing and mood and feelings questionnaires. Methods: The ECLB-COVID19 electronic survey was designed by a steering group of multidisciplinary scientists and academics, following a structured review of the literature. The survey was uploaded and shared on the Google online survey platform. Thirty-five research organizations from Europe, North-Africa, Western Asia and the Americas promoted the multi-languages survey through their networks to general society. Of the 64 questions, 7 were from the Short Warwick-Edinburgh Mental Well-being Scale (SWEMWBS), and 13 were from the Short Mood and Feelings Questionnaire (SMFQ), which are both validated instruments. Results: Analysis was conducted on the first 1047 replies (54% women) from Asia (36%), Africa (40%), Europe (21%) and other (3%). The COVID-19 home confinement had a negative effect on both mental wellbeing and on mood and feelings. Specifically, a significant decrease (p<0.001 and {Delta}%= 9.4 %) in the total score of mental wellbeing was noted. More individuals (+12.89%) reported a low mental wellbeing during compared to before home confinement. Furthermore, results from the mood and feelings questionnaire (i.e., depressive symptoms) showed a significant increase by 44.9% (p<0.001) in total score with more people (+10%) developing depressive symptoms during compared to before home confinement. Conclusion: The ECLB-COVID19 survey revealed an increased psychosocial strain triggered by the enforced home confinement. To mitigate this high risk of mental disorders and to foster an Active and Healthy Confinement Lifestyle (AHCL), a crisis-oriented interdisciplinary intervention is urgently needed.


title: The effectiveness of interventions to reduce COVID-19 transmission in a large urban jail

text: Objectives: To estimate the impact of various mitigation strategies on COVID-19 transmission in a U.S. jail beyond those offered in national guidelines. Methods: We developed a stochastic dynamic transmission model of COVID-19 in one large urban U.S. jail among staff and incarcerated individuals. We divided the outbreak into four intervention phases: the start of the outbreak, depopulation of the jail, increased proportion of people in single cells, and asymptomatic testing. We used the next generation method to estimate the basic reproduction ratio, R0, in each phase. We estimated the fraction of new cases, hospitalizations, and deaths averted by these interventions along with the standard measures of sanitization, masking, and social distancing interventions. Results: For the first outbreak phase, the estimated R0 was 8.23 (95% CrI: 5.01-12.90), and for the subsequent phases, R0, phase 2 = 3.58 (95% CrI: 2.46-5.08), R0, phase 3 = 1.72 (95% CrI: 1.41-2.12), and R0, phase 4 = 0.45 (95% CrI: 0.32-0.59). In total, the jail's interventions prevented approximately 83% of projected cases and hospitalizations and 89% of deaths over 83 days. Conclusions: Depopulation, single celling, and asymptomatic testing within jails can be effective strategies to mitigate COVID-19 transmission in addition to standard public health measures. Policy Implications: Decision-makers should prioritize reductions in the jail population, single celling, and testing asymptomatic populations, as additional measures to manage COVID-19 within correctional settings.


Los valores profesionales de las enfermeras (os) chilenas (os) en tiempos de crisis sanitaria por Covid-19/ The professional values of chilean nurses in times of sanitary crisis by Covid-19


title: Flocked swab might be one main reason causing the high false-negative rate in COVID-19 screening----the advantages of a novel silicone swab

text: RNA testing using RT-PCR can provide direct evidence for diagnoses of COVID-19 which has brought unexpected disasters and changes to our human society. However, the absorption of cotton swab for RNA lysates may lead to a low concentration of detectable RNA, which might be one of the main reasons for the unstable positive detecting rate. We designed and manufactured a kind of silicone swab with concave-convex structure, and further compared the effects of silicone and cotton swab on RNA extraction. Principal component analysis and Paired Wilcoxcon test suggested that a higher RNA concentration and A260/A280 would be obtained using silicone swab. The results indicated that our silicone swab had a more excellent ability to sample than the cotton swab, characterized by the higher quantity and quality of extracted RNA. Thus, we advised that the current cotton swabs need to be improved urgently in COVID-19 diagnoses and the process of “sample collection” and “sample pre-processing” must be standardized and emphasized. Highlights The current cotton swabs need to be improved urgently in COVID-19 screening.


title: Estimated Average Probabilities of COVID-19 Infection, Hospitalization, and Death From Community Contact in the United States

text: Importance: Case and death counts, government rules limiting social contact, media attention, peer behaviors, and analogies to war have all influenced public perceptions of risk to COVID-19. During an epidemic, the general public may not be accurately interpreting their individual risks from COVID19. U.S. public sentiment surveys indicate a high level of apprehension about routine community activities. Sufficient data allow estimating individual-level probabilities of infection, hospitalization, and death from community level contacts. Objective: Our objective is to estimate the average probability of acquiring COVID19 infection, being hospitalized or dying from a single unprotected and substantive community level contact with an individual of unknown infection status. Design: We estimate individual level probability of a contact resulting in infection using established principles of infection transmission, published data on the secondary attack rate, the current case incidence, the infectious period, the proportion of asymptomatic infection, and the case hospitalization and infection fatality ratios. Setting: U.S. Counties Outcomes: Probabilities of COVID19 infection, hospitalization, and death from a single unprotected person-contact in a community setting. Results: Among the 100 most populous US Counties, the median probability of COVID19 infection transmission at the end of May 2020 is 1 infection per 3836 unprotected community-level contacts (Range: 626 to 31,800). For a 50 to 64 year old individual, the estimated median probability of hospitalization is 1 hospitalization per 852,000 community level person contacts (Range: 139,000 to 7,080,000). For a 50 to 64 year old individual, the median probability of a fatality is 1 fatality per 19.1million community-level person-contacts (Range,:3.13 million to 159,000,000 million). Conclusions and Relevance: Across the country, current probabilities of infection transmission, hospitalization, and death from COVID19 vary substantially, yet severe outcomes are still rare events. Individuals may be overestimating their risks of hospitalization and death and a moderate number and frequency of community contacts is unlikely to overwhelm hospital capacity in most U.S. settings. Systematic public reporting of COVID19 case incidence and prevalence of seropositivity by age, risk group, locality and setting would improve individual-level risk estimation.


title: What can trends in hospital deaths from COVID-19 tell us about the progress and peak of the pandemic? An analysis of death counts from England announced up to 25 April 2020

text: Background. Reporting of daily hospital COVID-19 deaths in the UK are promoted by the government and scientific advisers alike as a key metric for assessing the progress in the control of the epidemic. These data, however, have certain limitations, among which one of the most significant concerns the fact that the daily totals span deaths that have occurred between 1 and 10 days or more in the past. Data and methods. We obtained daily data published published by NHS England up to and including April 25 in the form of Excel spreadsheets in which deaths counts are presented by date of death according to age and region. Simple descriptive analyses were conducted and presented in graphical and tabular form which were aimed at illustrating the biases inherent in focussing on daily counts regardless of when the deaths occurred. We then looked at how a less biased picture could be obtained by looking at trends in death counts stratifying by individual period of delay in days between occurrence of death and when the death was included in the daily announcement. Findings. The number of hospital COVID-19 deaths announced daily overestimates the maximum number of deaths actually occurring so far in the epidemic in the UK, and also obscures the pattern of decline in deaths. Taking account of reporting delays suggests that for England as a whole a peak in hospital COVID-19 deaths may have been reached on April 8 with a subsequent gradual decline suggested. The same peak is also seen among those aged 60-79 and 80+, although there is slightly shallower decline in the oldest age group (80+ years). Among those aged 40-59 years a later peak on April 11 is evident. London shows a peak on April 8 and a clearer and steeper pattern of subsequent decline compared to England as a whole. Interpretation. Analyses of mortality trends must take account of delay, and in communication with the public more emphasis should be placed on looking at trends based on deaths that occurred 5 or more days prior to the announcement day. The slightly weaker decline seen at age 80+ may reflect increased hospitalisation of people from care homes, whereas the later peak under the age of 60 years may reflect the higher proportions at these younger ages being admitted to critical care resulting in an extension of life of several days.


title: Problems and pitfalls of retrospective survey questions in COVID-19 studies

text: This paper examines and discusses the biases and pitfalls of retrospective survey questions that are currently being used in many medical, epidemiological, and sociological studies on the COVID-19 pandemic. By analyzing the consistency of answers to retrospective questions provided by respondents who participated in the first two waves of a survey on the social consequences of the COVID-19 pandemic, we illustrate the insights generated by a large body of survey research on the use of retrospective questions and recall accuracy.


title: Modelling epidemics: Technical and critical issues in the context of COVID-19

text: This commentary reflects upon my experiences modelling epidemics from a geographical perspective. In particular, I consider different approaches to the modelling of epidemics and other forms of data analysis relevant to the COVID-19 pandemic within a geographical context, especially with respect to the need for ‘just in time’ policy-relevant research.


title: HOW THE COVID-19 PANDEMIA IS SPREADING IN ITALY

text: This article describes a method for evaluating the course of Covid infection in Italy and for estimating the time needed to block the spread of the virus.


title: Novel coronavirus found in sewage

text: Because SARS-CoV-2, the novel coronavirus that causes COVID-19, has been found in the feces of confirmed COVID-19 patients, wastewater-based epidemiology might be an effective way to track the extent of the disease in a population Wastewater epidemiology is most commonly used to monitor drug usage in a community It can also provide information about the spread of infection when individual tests are limited A team led by Eric J Alm of the Massachusetts Institute of Technology and Biobot Analytics has now used quantitative reverse transcription polymerase chain reaction (RT-PCR) to measure SARS-CoV-2 in sewage from a wastewater treatment facility in Massachusetts (medRxiv 2020, DOI: 10 1101/2020 04 05 20051540) The Biobot team analyzed four samples taken before the first known US case of COVID-19, and all tested negative for the virus All 10 samples taken between March 18 and March 25 tested positive for SARS-CoV-2, at levels higher than the researchers expected based on


title: Estimation of country-level basic reproductive ratios for novel Coronavirus (COVID-19) using synthetic contact matrices

text: The outbreak of novel coronavirus (COVID-19) has the potential for global spread, infecting large numbers in all countries. In this case, estimating the country-specific basic reproductive ratio is a vital first step in public-health planning. The basic reproductive ratio (R0) is determined by both the nature of pathogen and the network of contacts through which the disease can spread - with this network determined by socio-demographics including age-structure and household composition. Here we focus on the age-structured transmission within the population, using data from China to inform age-dependent susceptibility and synthetic age-mixing matrices to inform the contact network. This allows us to determine the country-specific basic reproductive ratio as a multiplicative scaling of the value from China. We predict that R0 will be highest across Eastern Europe and Japan, and lowest across Africa, Central America and South-Western Asia. This pattern is largely driven by the ratio of children to older adults in each country and the observed propensity of clinical cases in the elderly.


title: Machinability Of Polyamide 6 Under Cryogenic Cooling Conditions

text: Abstract Machining of polymeric materials can attain interest when the production lot does not justify the cost of molds or extrusion dies, or when the product to be manufactured requires dimensional accuracy not achievable otherwise. In this framework, the present study aims at evaluating the machinability of the polyamide 6 as a function of the cooling conditions. Two different cryogenic cooling configurations were adopted, whereas the conventional flood cooling was used as reference for sake of comparison, leading to machining conditions under very different temperature ranges. The polyamide 6 machinability was evaluated in terms of surface integrity (surface roughness, surface defects, crystallinity percentage and hardness) and chip morphology. Results show that the polyamide 6 has to be cut in a specific temperature range, namely between -20°C to 20°C, in order to get the best surface finish, namely achieving the lowest surface roughness and density of defects. In addition, the cryogenic cooling is proved to produce harder surfaces than the flood condition, but leaving unaltered the polymer crystallinity degree.


title: The incubation period of COVID-19: A rapid systematic review and meta-analysis of observational research

text: Background: Reliable estimates of the incubation period are important for decision making around the control of infectious diseases. Knowledge of the incubation period distribution can be used directly to inform decision-making or as inputs into mathematical models. Objectives: The aim of this study was to conduct a rapid systematic review and meta-analysis of estimates of the incubation periods of COVID-19. Design: Rapid systematic review and meta-analysis of observational research Data sources: Publications on the electronic databases PubMed, Google Scholar, MedRxiv and BioRxiv were searched. The search was not limited to peer-reviewed published data, but also included pre-print articles. Study appraisal and synthesis methods: Studies were selected for meta-analysis if they reported either the parameters and confidence intervals of the distributions fit to the data, or sufficient information to facilitate calculation of those values. The majority of studies suitable for inclusion in the final analysis modelled incubation period as a lognormal distribution. We conducted a random effects meta-analysis of the parameters of this distribution. Results: The incubation period distribution may be modelled with a lognormal distribution with pooled mu and sigma parameters of 1.63 (1.51, 1.75) and 0.50 (0.45, 0.55) respectively. The corresponding mean was 5.8 (5.01, 6.69 days). It should be noted that uncertainty increases towards the tail of the distribution: the pooled parameter estimates resulted in a median incubation period of 5.1 (4.5, 5.8) days, whereas the 95th percentile was 11.6 (9.5, 14.2) days. Conclusions and implications: The choice of which parameter values are adopted will depend on how the information is used, the associated risks and the perceived consequences of decisions to be taken. These recommendations will need to be revisited once further relevant information becomes available. Finally, we present an RShiny app that facilitates updating these estimates as new data become available.


docid: rgqjolue

title: SEROPREVALENCE AND CLINICAL SPECTRUM OF SARS-CoV-2 INFECTION IN THE FIRST VERSUS THIRD TRIMESTER OF PREGNANCY

text: Introduction: Case registries of pregnant women diagnosed with coronavirus disease (COVID-19) by polymerase chain reaction (PCR) have reported that the majority experienced mild infection, but up to 9% may require critical care. Most COVID-19 cases published were in the third trimester of pregnancy, which could reflect reporting bias, higher risk of infection or increased disease severity in late pregnancy. Seroprevalence studies may allow reliable estimates of the susceptibility to infection and clinical spectrum since they include asymptomatic and mild infections not tested for PCR. We evaluated the seroprevalence and clinical presentation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection in pregnant women in the first and third trimester. Methods: The study was approved by the Institutional Review Board at each institution and informed consent was obtained. We recruited 874 consecutive pregnancies attending for first trimester screening (10-16 weeks of gestation, n=372) or delivery (n=502) from April 14 to May 5. All women were interviewed with a structured questionnaire for COVID-19 symptoms two months prior to sampling. SARS-CoV-2 IgG and IgM/IgA antibodies were tested (COVID-19 VIRCLIA Monotest, Vircell Microbiologist, Spain; reported sensitivity 70% IgG and 89% IgM/IgA, and specificity 89% and 99% respectively). Indeterminate results were re-tested (VITROS Immunodiagnostic Products Anti-SARS-CoV2 Total Tests, Ortho Clinical Diagnostics, USA; 100% sensitivity and specificity) and re-classified as positive or negative. Women with COVID-19 were diagnosed and managed according to standard protocols and guidelines3,4. Statistical differences were tested using the {chi}2 test or Student t-test as appropriate (p<0.05). Results: A total of 125 of 874 women (14.3%) were positive for either IgG or IgM/IgA SARS-CoV-2 antibodies, 54/372 (14.5%) in the first and 71/502 (14.1%) in the third trimester. A total of 75/125 (60%) reported no symptoms of COVID-19 in the past 2 months, whereas 44 (35.2%) reported one or more symptoms, of which 31 (24.8%) had at least 3 symptoms or anosmia and 8 (6.4%) dyspnea. Overall, 7 women (5.6%) were admitted for persistent fever despite paracetamol and dyspnea, of which 3 had signs of pneumonia on chest radiography. All 3 had criteria for severity (bilateral chest condensation, respiratory rate>30 and leukopenia) and required oxygen support but not critical care or mechanical ventilation, and they were all discharged well. The rates of symptomatic infection, hospital admission or dyspnea were significantly higher in third trimester women (Table and Figure). Discussion: The 14.3% seroprevalence of SARS-COV-2 in pregnant women in this study was substantially larger than the contemporary rates of PCR positive cases (0.78%) reported for women 20-40y in Barcelona. The data confirm that COVID-19 is asymptomatic in the majority of pregnant women6 and illustrate the value of seroprevalence studies to capture the high proportion of asymptomatic or mild infections. In this study, none of the 125 pregnant women with SARS-CoV-2 infection required critical care as compared to 9% reported in cases diagnosed with PCR. However, the proportion of infections with symptoms or dyspnea was remarkably higher in the third trimester, and these results are in line with COVID-19 registries, reporting that 81% of hospitalized women were in late pregnancy or peripartum. These results provide reassuring information that, even in settings with a high prevalence, SARS-CoV-2 infection in pregnancy mostly presents with asymptomatic or mild clinical forms. The susceptibility to infection seemed to be the same in the first and the third trimesters of gestation. The data further suggest that, as with other respiratory viruses, COVID-19 could be more severe and require increased surveillance in late pregnancy. These findings should be confirmed and extended with larger consecutive prevalence studies in pregnancy.


title: Bayesian Network Analysis of Covid-19 data reveals higher Infection Prevalence Rates and lower Fatality Rates than widely reported

text: Widely reported statistics on Covid-19 across the globe fail to take account of both the uncertainty of the data and possible explanations for this uncertainty. In this paper we use a Bayesian Network (BN) model to estimate the Covid-19 infection prevalence rate (IPR) and infection fatality rate (IFR) for different countries and regions, where relevant data are available. This combines multiple sources of data in a single model. The results show that Chelsea Mass. USA and Gangelt Germany have relatively higher infection prevalence rates (IPR) than Santa Clara USA, Kobe, Japan and England and Wales. In all cases the infection prevalence is significantly higher than what has been widely reported, with much higher community infection rates in all locations. For Santa Clara and Chelsea, both in the USA, the most likely IFR values are 0.3-0.4%. Kobe, Japan is very unusual in comparison with the others with values an order of magnitude less than the others at, 0.001%. The IFR for Spain is centred around 1%. England and Wales lie between Spain and the USA/German values with an IFR around 0.8%. There remains some uncertainty around these estimates but an IFR greater than 1% looks remote for all regions/countries. We use a Bayesian technique called "virtual evidence" to test the sensitivity of the IFR to two significant sources of uncertainty: survey quality and uncertainty about Covid-19 death counts. In response the adjusted estimates for IFR are most likely to be in the range 0.3%-0.5%.


title: Impact of Coronavirus disease (COVID-19) pandemic on health professionals

text: OBJECTIVE: Recognizing the huge potential ramifications of COVID-19 pandemic, this study explores its impact on health professionals personally and professionally along with the associated challenges. METHODS: A descriptive cross-sectional qualitative survey was conducted from March-April 2020. Participants included health professionals from various disciplines in both public and private-sector institutions of Pakistan. The sample size was not predetermined, and an iterative approach of simultaneous data collection and analysis was taken until data and time saturation were reached. Thematic analysis of the qualitative data was carried out by two analysts. RESULTS: Two hundred and Ninety health professionals responded. They reported an impact on their mental, physical and social well-being. The clinicians mentioned facing an unprecedented workload in overstretched health facilities, while those in academia become engaged with planning/providing emergency remote teaching for the students affecting work-life balance. Some challenges associated with work-from-home and in the hospitals were identified. CONCLUSION: During COVID-19, the health professionals are anxious, overworked and financially unstable while planning, creating and caring for others and their families. We need to support them to do their jobs, be safe and stay alive. Future research should explore the fears and coping strategies of health professionals during pandemics.


The Science of the Future: Establishing a Citizen-Scientist Collaborative Agenda After Covid-19


title: Network-based Drug Repurposing for Human Coronavirus

text: Human Coronaviruses (HCoVs), including severe acute respiratory syndrome coronavirus (SARS-CoV), Middle east respiratory syndrome coronavirus (MERS-CoV), and 2019 novel coronavirus (2019-nCoV), lead global epidemics with high morbidity and mortality. However, there are currently no effective drugs targeting 2019-nCoV. Drug repurposing, represented as an effective drug discovery strategy from existing drugs, could shorten the time and reduce the cost compared to de novo drug discovery. In this study, we present an integrative, antiviral drug repurposing methodology implementing a systems pharmacology-based network medicine platform, quantifying the interplay between the HCoV-host interactome and drug targets in the human protein-protein interaction network. Phylogenetic analyses of 15 HCoV whole genomes reveal that 2019-nCoV has the highest nucleotide sequence identity with SARS-CoV (79.7%) among the six other known pathogenic HCoVs. Specifically, the envelope and nucleocapsid proteins of 2019-nCoV are two evolutionarily conserved regions, having the sequence identities of 96% and 89.6%, respectively, compared to SARS-CoV. Using network proximity analyses of drug targets and known HCoV-host interactions in the human protein-protein interactome, we computationally identified 135 putative repurposable drugs for the potential prevention and treatment of HCoVs. In addition, we prioritized 16 potential anti-HCoV repurposable drugs (including melatonin, mercaptopurine, and sirolimus) that were further validated by enrichment analyses of drug-gene signatures and HCoV-induced transcriptomics data in human cell lines. Finally, we showcased three potential drug combinations (including sirolimus plus dactinomycin, mercaptopurine plus melatonin, and toremifene plus emodin) captured by the Complementary Exposure pattern: the targets of the drugs both hit the HCoV-host subnetwork, but target separate neighborhoods in the human protein-protein interactome network. In summary, this study offers powerful network-based methodologies for rapid identification of candidate repurposable drugs and potential drug combinations toward future clinical trials for HCoVs.


title: Long-Term Persistence of IgG Antibodies in SARS-CoV Infected Healthcare Workers

text: BACKGROUND: The ongoing worldwide outbreak of the 2019-nCoV is markedly similar to the severe acute respiratory syndrome (SARS) outbreak 17 years ago. During the 2002-2003 SARS outbreak, healthcare workers formed a special population of patients. Although virus-specific IgG play important roles in virus neutralization and prevention against future infection, limited information is available regarding the long term persistence of IgG after infection with SARS-like coronavirus. METHODS: A long-term prospective cohort study followed 34 SARS-CoV-infected healthcare workers from a hospital with clustered infected cases during the 2002-2003 SARS outbreak in Guangzhou, China, with a 13-year follow-up. Serum samples were collected annually from 2003-2015. Twenty SARS-CoV-infected and 40 non-infected healthcare workers were enrolled in 2015, and their serum samples were collected. All sera were tested for IgG antibodies with ELISA using whole virus and a recombinant nucleocapsid protein of SARS-CoV, as a diagnostic antigen. RESULTS: Anti SARS-CoV IgG was found to persist for up to 12 years. IgG titers typically peaked in 2004, declining rapidly from 2004-2006, and then continued to decline at a slower rate. IgG titers in SARS-CoV-infected healthcare workers remained at a significantly high level until 2015. Patients treated with corticosteroids at the time of infection were found to have lower IgG titers than those without. CONCLUSIONS: IgG antibodies against SARS-CoV can persist for at least 12 years. The presence of SARS-CoV IgG might provide protection against SARS-CoV and other betacoronavirus. This study provides valuable information regarding humoral immune responses against SARS-CoV and the 2019-nCoV.


title: Pooled RNA extraction and PCR assay for efficient SARS-CoV-2 detection

text: Testing for active SARS-CoV-2 infection is a fundamental tool in public health measures taken to control the COVID-19 pandemic. Due to the overwhelming use of SARS-CoV-2 RT-PCR tests worldwide, availability of test kits has become a major bottleneck. Here we demonstrate the reliability and efficiency of two simple pooling strategies that can increase testing capacity about 5-fold to 7.5-fold, in populations with a low infection rate. We have implemented the method in a routine clinical diagnosis setting, and already tested 2,168 individuals for SARS-CoV-2 using 311 RNA extraction and RT-PCR kits.


title: Testing for tracing or testing just for treating? A comparative analysis between strategies to face COVID-19 pandemic.

text: There is some consensus in Europe and Asia about testing rates being crucial to controlling COVID-19 pandemics. There are though misconceptions on what means an effective high testing rate. This paper demonstrates that the rate of tests per detected case (Tests/Case) is the important variable, correlating negatively with the number of deaths. The higher the Tests/Case rate, the lower the death rate, as this predictor is causally related to contact tracing and isolation of the vectors of the disease. Doubling Tests/Case typically divides by three the number of deaths. On the other hand, per capita testing rate is a poor predictor for the performance of policies to fight the pandemics. The number of tests per 1,000 inhabitants (Tests/1,000) tends to correlate positively with the number of deaths. In some cases, high levels of Tests/1,000 just mean an epidemic that ran out of control, with an explosion of cases that demands high testing rates just to confirm the diagnosis of the very sick.


title: Fevers Are Rarest in the Morning: Could We Be Missing Infectious Disease Cases by Screening for Fever Then?

text: Body temperatures are less likely to reach the fever range in the morning, but it is unknown how this affects practice during disease outbreaks. We retrospectively investigated fever-range temperatures ([≥]100.4{degrees}F, [≥]38.0{degrees}C) during seasonal influenza outbreaks and the 2009 H1N1 (swine flu) pandemic, which have recently been used as preparatory models for coronavirus disease 2019 (COVID-19). Our analyses included a nationally representative sample of records from adult visits to US emergency departments (n=202,181) and data from a Boston emergency department (n=93,225). Fever-range temperatures were about half as common in the morning as in the evening, suggesting that morning temperatures can be much less diagnostic, and that revisions may be needed to the practice of once-daily temperature screens at morning arrival to workplaces and schools. Twice-daily screens could be a simple solution, but similar research is still needed on fevers in COVID-19 itself.


title: Effect of evacuation of Japanese residents from Wuhan, China, on preventing transmission of novel coronavirus infection: a modelling study

text: Objective: In late January 2020, the Japanese government carried out three evacuations by aircraft from Wuhan, China, to avoid further cases of coronavirus disease 2019 (COVID-19) among Wuhan's Japanese residents. Evacuation by aircraft may be an effective countermeasure against outbreaks of infectious diseases, but evidence of its effect is scarce. This study estimated how many COVID-19 cases were prevented among the Japanese residents of Wuhan by the evacuation countermeasure. Results: Eleven imported COVID-19 cases were reported on Feb 1 from among the total 566 evacuees who returned to Japan. In the case of no evacuations being made, the cumulative number of COVID-19 cases among Wuhan's Japanese residents was estimated to reach 25 (95% CI [20,29]) on Feb 8 and 34 (95% CI [28,40]) on Feb 15. A 1-week delay in the evacuation might be led to 14 additional cases and a 2-week delay to 23 additional cases. Evacuation by aircraft can contribute substantially to reducing the number of infected cases in the initial stage of the outbreak.


title: ACE2 expression in human dorsal root ganglion sensory neurons: implications for SARS-CoV-2 virus-induced neurological effects

text: SARS-CoV-2 has created a global crisis. COVID-19, the disease caused by the virus, is characterized by pneumonia, respiratory distress and hypercoagulation and is often fatal1. An early sign of infection is loss of smell, taste and chemesthesis - loss of chemical sensation2. Other neurological effects of the disease have been described, but not explained3,4. We show that human dorsal root ganglion (DRG) neurons express the SARS-CoV-2 receptor5,6, ACE2. ACE2 mRNA is expressed by a subset of nociceptors that express MRGPRD mRNA suggesting that SARS-CoV-2 may gain access to the nervous system through entry into neurons that form free-nerve endings at the outer-most layers of skin and luminal organs. Therefore, sensory neurons are a potential target for SARS-CoV-2 invasion of the nervous system.


docid: hewzgkwl

title: The serotonin reuptake inhibitor Fluoxetine inhibits SARS-CoV-2

text: To circumvent time-consuming clinical trials, testing whether existing drugs are effective inhibitors of SARS-CoV-2, has led to the discovery of Remdesivir. We decided to follow this path and screened approved medications “off-label” against SARS-CoV-2. In these screenings, Fluoxetine inhibited SARS-CoV-2 at a concentration of 0.8µg/ml significantly, and the EC50 was determined with 387ng/ml. Fluoxetine is a racemate consisting of both stereoisomers, while the S-form is the dominant serotonin reuptake inhibitor. We found that both isomers show similar activity on the virus. Fluoxetine treatment resulted in a decrease in viral protein expression. Furthermore, Fluoxetine inhibited neither Rabies virus, human respiratory syncytial virus replication nor the Human Herpesvirus 8 or Herpes simplex virus type 1 gene expression, indicating that it acts virus-specific. We see the role of Fluoxetine in the early treatment of SARS-CoV-2 infected patients of risk groups.


title: Predictive model of COVID-19 incidence and socioeconomic description of municipalities in Brazil

text: Coronaviruses are enveloped viruses that can cause respiratory, gastrointestinal, hepatic, and neurological diseases. In December 2019, a new highly contagious coronavirus termed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) emerged in China. SARS-CoV-2 causes a potentially lethal human respiratory infection, COVID-19, that is associated with fever and cough and can progress to pneumonia and dyspnea in severe cases. Since the virus emerged, it has spread rapidly, reaching all continents around the world. A previous study has shown that, despite being the best alternative in the current pandemic context, social distancing measures alone may not be sufficient to prevent COVID-19 spread, and the overall impact of the virus is of great concern. The present study aims to describe the demographic and socioeconomic characteristics of 672 cities with cases of COVID-19, as well as to determine a predictive model for the number of cases. We analyzed data from cities with at least 1 reported case of COVID-19 until June 26, 2020. It was observed that cities with confirmed cases of the disease are present in all Brazilian states, affecting 36.5% of the municipalities in Rio de Janeiro State. The inhabitants in cities with reported cases of COVID-19 represent more than 73.1% of the Brazilian population. Stratifying the age groups of the inhabitants and accounting for the percentage of women and men does not affect COVID-19 incidence (confirmed cases/100,000 inhabitants). The demographic density, the MHDI and the per capita income of the municipalities with cases of COVID-19 do not affect disease incidence. In addition, if conditions are maintained, our model predicts 2,358,703 (2,172,930 to 2,544,477) cumulative cases on July 25, 2020.


title: Containing the Spread of Coronavirus Disease 2019 (COVID-19): Meteorological Factors and Control Strategies

text: The novel coronavirus disease 2019 (COVID-19) has spread globally and the meteorological factors vary greatly across the world. Understanding the effect of meteorological factors and control strategies on COVID-19 transmission is critical to contain the epidemic. Using individual-level data in mainland China, Hong Kong, and Singapore, and the number of confirmed cases in other regions, we explore the effect of temperature, relative humidity, and control measures on the spread of COVID-19. We found that high temperature mitigates the transmission of the disease. High relative humidity promotes COVID-19 transmission when temperature is low, but tends to reduce transmission when temperature is high. Implementing classical control measures can dramatically slow the spread of the disease. However, due to the occurrence of pre-symptomatic infections, the effect of the measures to shorten onset-to-isolation time is markedly reduced and the importance of contact tracing and quarantine and social distancing increases. The analytic results also highlight the importance of early intervention to contain the spread of COVID-19.


title: Core warming of coronavirus disease 2019 (COVID-19) patients undergoing mechanical ventilation: protocol for a randomized controlled pilot study

text: Background: Coronavirus disease 2019 (COVID-19), caused by the virus SARS-CoV-2, is spreading rapidly across the globe, with no proven effective therapy. Fever is seen in most cases of COVID-19, at least at the initial stages of illness. Although fever is typically treated (with antipyretics or directly with ice or other mechanical means), increasing data suggest that fever is a protective adaptive response that facilitates recovery from infectious illness. Objective: To describe a randomized controlled pilot study of core warming patients with COVID-19 undergoing mechanical ventilation. Methods: This prospective single-site randomized controlled pilot study will enroll 20 patients undergoing mechanical ventilation for respiratory failure due to COVID-19. Patients will be randomized 1:1 to standard-of-care or to receive core warming via an esophageal heat exchanger commonly utilized in critical care and surgical patients. The primary outcome is the severity of acute respiratory distress syndrome (as measured by PaO2/FiO2 ratio) 24 hours after initiation of treatment. Secondary outcomes include hospital and intensive care unit length of stay, duration of mechanical ventilation, amount of viral shedding, and 30-day mortality. Results: Resulting data will provide effect size estimates to guide a definitive multi-center randomized clinical trial. ClinicalTrials.gov registration number: pending. Conclusions: With growing data to support clinical benefits of elevated temperature in infectious illness, this study will provide data to guide further understanding of the role of active temperature management in COVID-19 treatment and provide effect size estimates to power larger studies.