title: A Kinematic Error Observer for Robot End Effector Estimation

text: Abstract Industrial robots were initially designed to be low cost and highly repeatable for pick-and-place and assembly operations. As a result, their construction does not support the high-precision accuracy and bandwidth needed for more advanced industrial automation. Due to the growing interest in replacing high precision manufacturing equipment with industrial robots for some applications, external high-precision feedback sensors (e.g., laser trackers), are needed to improve robot position and orientation accuracy. Before external sensors can be combined with control methodologies to improve robot accuracy, it is important to properly condition the measurement signals. In this paper, a Kinematic Error Observer (KEO) is derived and used to estimate a robot’s slowly changing kinematic errors in real-time. An analysis of the KEO is first conducted to demonstrate its stability properties, transient response characteristics, noise sensitivity, and performance in non-deterministic measurement systems. Next, an implementation of the KEO was used in conjunction with a laser tracker and 6DoF sensor to dynamically estimate the kinematic errors of a Yaskawa/Motoman MH180 industrial robot. The results show that the KEO is capable of estimating the robot’s quasi-static kinematic errors in both static and dynamic environments. It was also found that the KEO, with small enough observer gain, attenuates high frequency measurement noise and produces a smooth estimation of the robot’s kinematic error.


title: The BCG dilemma: linear versus non-linear correlation models over the time of the COVID-19 pandemic

text: In this work we have analysed the use of two different correlation metrics and two different datasets, detecting differences in the extent and directionality of the correlation between COVID-19 infection and BCG immunization. Correlation between COVID-19 infection, death rates and BCG immunization is strongly affected by the correlation metrics and so will be their biological interpretation


title: Predicting COVID-19 peaks around the world

text: The official data for the time evolution of active cases of COVID-19 pandemics around the world are available online. For all countries, a peak has been either observed (China and South Korea) or is expected in near future. The approximate dates and heights of those peaks imply in important epidemiological issues. Inspired by similar complex behaviour of volumes of transactions of stocks at NYSE and NASDAQ, we propose a q-statistical functional form which appears to describe satisfactorily the available data of all countries. Consistently, predictions become possible of the dates and heights of those peaks in severely affected countries unless efficient treatments or vaccines, or sensible modifications of the adopted epidemiological strategies, emerge.


title: Bayesian investigation of SARS-CoV-2-related mortality in France

text: The SARS-CoV-2 epidemic in France has focused a lot of attention as it has had one of the largest death tolls in Europe. It provides an opportunity to examine the effect of the lockdown and of other events on the dynamics of the epidemic. In particular, it has been suggested that municipal elections held just before lockdown was ordered may have helped spread the virus. In this manuscript we use a Bayesian model of the number of deaths through time to study the epidemic in 13 regions of France. We found that the model accurately predicts the number of deaths 2 to 3 weeks in advance, and recovers estimates that are in agreement with recent models that rely on a different structure and different input data. We found that the lockdown had a similar effect on the reproduction rate in all 13 regions, decreasing it by 80 %. Our model predicts that 2.09 (95% CI : 1.69-2.66) million people had been infected by May 11, and that there were 2793 (95% CI : 1761-4543) new infections on May 11. We found no evidence that the reproduction rates differ between week-ends and week days, and no evidence that the reproduction rates increased on the election day. Finally, we evaluated counterfactual scenarios showing that ordering the lockdown 1 to 7 days sooner would have resulted in 18% to 85% fewer deaths, but that ordering it 1 to 7 days later would have resulted in 21% to 262% more deaths. Overall, the predictions of the model indicate that holding the elections on March 15 did not have a detectable impact on the total number of deaths, unless it motivated a delay in imposing the lockdown.


title: Comparative Analysis of the Application of Behavioural Insights of 33 Worldwide Governments on the Landing Pages of their COVID-19 Official Websites and their Impact on the Growth Scale of the Pandemic

text: The COVID-19 crisis has seen over a third of the world population locked down and this article has sought to understand human behaviour in response to a historical and unprecedented global pandemic. Through the analysis 18 behavioural mechanisms present on the landing pages of the websites of 33 institutional governments from March 1st til May 1st 2020 compared to the WHO data on the number of COVID-19 cases and deaths per million for each country, the authors show that a behavioural consensus was observed across all 33 countries and that Individual and Social nudges had no impact. Whilst the decisions in essentially every country on Earth, were taken with the same aim: to limit population movements and social life, two aggravating factors of the spread of the virus, only the environmental nudges effectively helped slow the virus growth scale. The authors explain the rationale behind these results and suggest that people seek information beyond governmental websites that they generally mistrust. They further suggest using Scientists as role models to encourage governmental website's traffic and designing recursive nudges to increase the impact of individual and social interventions. Together with the new phases of the spread of the virus will come new rules and guidance. Public health policies need to address behavioural change of the population on a global scale in a more targeted manner and it is hoped that this paper will provide some insight on how to do so.


title: On predicting the novel COVID-19 human infections by using Infectious Disease modelling method in the Indian State of Tamil Nadu during 2020

text: Since the introduction of the novel Corona Virus (The COVID 19) to the Chinese city Wuhan in the Hubei province during the late December 2019, the effectiveness of the deadly disease, its human infection, spreading severity and the mortality rate of the infection has been an issue of debate. The outbreak of the virus along the time has become a massive threat to the global public health security and has been declared as a pandemic. Accounting the radical number of increases in the infected cases and the death due to COVID 19 infections around the globe, there is a need to predict the infections among the people by making proper optimization and using various Infectious Disease modelling (IDM) methods, in order to challenge the outcome. In comparison with previous diseases like SARS and Ebola viruses, the new corona virus (COVID 19) infections are infectious during the incubation period. In addition to that, naturally produced droplets from humans (e.g. droplets produced by breathing, talking, sneezing, coughing) and Person-to-person contact transmission are reported to be the foremost ways of transmission of novel corona virus. By considering the above two factors, a modified SEIR (Susceptibility Exposure Infection Recovery) method have been used for predicting the spread of the infections in the state of Tamil Nadu which is located in the southern part of India. Further, we have utilized the current surveillance data from Health and Family Welfare Department, Government of Tamil Nadu to accurately predict the spreading trend of the infection on a state level.


title: Clinical features and progression of acute respiratory distress syndrome in coronavirus disease 2019

text: Background: The outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) results in a cluster of coronavirus disease 2019 (COVID-19). We reported the clinical characteristics of COVID-19 patients with acute respiratory distress syndrome (ARDS), and further investigated the treatment and progression of ARDS in COVID-19. Methods: This study enrolled 109 patients with COVID-19 admitted to the Central Hospital of Wuhan, a designated hospital in Wuhan, China, from January 2 to February 1, 2020. Patients were followed up to February 12, 2020. The clinical data were collected from the electronic medical records. The differences in the treatment and progression with the time and the severity of ARDS were determined. Findings: Among 109 patients, mean age was 55 years, and 59 patients were male. With a median 15 days (range, 4 to 30 days) follow-up period, 31 patients (28.4%) died, while 78 (71.6%) survived and discharged. Of all patients, 53 (48.6%) developed ARDS. Compared to non-ARDS patients, ARDS patients were elder (mean age, 61 years vs. 49 years), and more likely to have the coexistent conditions, including diabetes (20.8% vs. 1.8%), cerebrovascular disease (11.3% vs. 0%), and chronic kidney disease (15.1% vs. 3.6%). Compared to mild ARDS patients, those with moderate and severe ARDS had higher mortality rates. No significant effect of antivirus, glucocorticoid, or immunoglobulin treatment on survival was observed in patients with ARDS. Interpretation: The mortality rate increased with the severity of ARDS in COVID-19, and the effects of current therapies on the survival for these patients were not satisfactory, which needs more attention from clinicians. Funding: Health and Family Planning Commission of Wuhan Municipality.


title: Molecular Basis for ADP-ribose Binding to the Macro-X Domain of SARS-CoV-2 Nsp3

text: The virus that causes COVID-19, SARS-CoV-2, has a large RNA genome that encodes numerous proteins that might be targets for antiviral drugs. Some of these proteins, such as the RNA-dependent RNA polymers, helicase and main protease, are well conserved between SARS-CoV-2 and the original SARS virus, but several others are not. This study examines one of the proteins encoded by SARS-CoV-2 that is most different, a macrodomain of nonstructural protein 3 (nsp3). Although 26% of the amino acids in this SARS-CoV-2 macrodomain differ from those seen in other coronaviruses, biochemical and structural data reveal that the protein retains the ability to bind ADP-ribose, which is an important characteristic of beta coronaviruses, and potential therapeutic target.


docid: icituitn

title: Forecasting the Spread of COVID-19 under Different Reopening Strategies

text: We combine COVID-19 case data with demographic and mobility data to estimate a modified susceptible-infected-recovered (SIR) model for the spread of this disease in the United States. We find that the incidence of infectious COVID-19 individuals has a concave effect on contagion, as would be expected if people have inter-related social networks. We also demonstrate that social distancing and population density have large effects on the rate of contagion. The social distancing in late March and April substantially reduced the number of COVID-19 cases. However, the concave contagion pattern means that when social distancing measures are lifted, the growth rate is considerable but will not be exponential as predicted by standard SIR models. Furthermore, counties with the lowest population density could likely avoid high levels of contagion even with no social distancing. We forecast rates of new cases for COVID-19 under different social distancing norms and find that if social distancing is eliminated there will be a massive increase in the cases of COVID-19, about double what would occur if the US only restored to 50% of the way to normalcy.


Special attention to psychiatric centers in COVID-19 pandemic


Social distancing impact on companion animal practice


title: Incidence, clinical outcomes, and transmission dynamics of hospitalized 2019 coronavirus disease among 9,596,321 individuals residing in California and Washington, United States: a prospective cohort study

text: Background: The United States is now the country reporting the highest number of 2019 coronavirus disease (COVID-19) cases and deaths. However, little is known about the epidemiology and burden of severe COVID-19 to inform planning within healthcare systems and modeling of intervention impact. Methods: We assessed incidence, duration of hospitalization, and clinical outcomes of acute COVID-19 inpatient admissions in a prospectively-followed cohort of 9,596,321 individuals enrolled in comprehensive, integrated healthcare delivery plans from Kaiser Permanente in California and Washington state. We also estimated the effective reproductive number (RE) describing transmission in the study populations. Results: Data covered 1277 hospitalized patients with laboratory- or clinically-confirmed COVID-19 diagnosis by April 9, 2020. Cumulative incidence of first COVID-19 acute inpatient admission was 10.6-12.4 per 100,000 cohort members across the study regions. Mean censoring-adjusted duration of hospitalization was 10.7 days (2.5-97.5%iles: 0.8-30.1) among survivors and 13.7 days (2.5-97.5%iles: 1.7-34.6) among non-survivors. Among all hospitalized confirmed cases, censoring-adjusted probabilities of ICU admission and mortality were 41.9% (95% confidence interval: 34.1-51.4%) and 17.8% (14.3-22.2%), respectively, and higher among men than women. We estimated RE was 1.43 (1.17-1.73), 2.09 (1.63-2.69), and 1.47 (0.07-2.59) in Northern California, Southern California, and Washington, respectively, for infections acquired March 1, 2020. RE declined to 0.98 (0.76-1.27), 0.89 (0.74-1.06), and 0.92 (0.05-1.55) respectively, for infections acquired March 20, 2020. Conclusions: We identify high probability of ICU admission, long durations of stay, and considerable mortality risk among hospitalized COVID-19 cases in the western United States. Reductions in RE have occurred in conjunction with implementation of non-pharmaceutical interventions.


title: Railway anaesthesiologists and Indian railway COVID-19 management system

text: Ever since the outbreak of novel Corona Virus 2019 pandemic, Anaesthesiologists are among the frontline leaders in not only the prevention of and control over the spread of the pandemic but also planning, organizing and coordinating the deployment and utilization of the medical and all other resources effectively and efficiently in order to minimize the losses and sufferings of human lives and recouping the global wellbeing at large. This article briefly highlights the prompt, optimal and effective contributions of the Indian Railways, Indian Railway Health Services and the Railway Association of ISA (RAISA) towards the provision of safe and scientific health services to maximum number of our fellow citizens.


title: Super Resolution Microscopy and Deep Learning Identify Zika Virus Reorganization of the Endoplasmic Reticulum

text: The endoplasmic reticulum (ER) is a complex subcellular organelle composed of diverse structures such as tubules, sheets and tubular matrices. Flaviviruses such as Zika virus (ZIKV) induce reorganization of endoplasmic reticulum (ER) membranes to facilitate viral replication. Here, using 3D super resolution microscopy, ZIKV infection is shown to induce the formation of dense tubular matrices associated with viral replication in the central ER. Viral non-structural proteins NS4B and NS2B associate with replication complexes within the ZIKV-induced tubular matrix and exhibit distinct ER distributions outside this central ER region. Deep neural networks trained to identify ZIKV-infected versus mock-infected cells successfully identified ZIKV-induced central ER tubular matrices as a determinant of viral infection. Super resolution microscopy and deep learning are therefore able to identify and localize morphological features of the ER and may be of use to screen for inhibitors of infection by ER-reorganizing viruses.


SARS-CoV-2: an unknown agent and challenges in vaccine development


title: Modelling to Predict Hospital Bed Requirements for Covid-19 Patients in California

text: A model to predict hospital bed requirements six weeks in advance to treat Covid-19 patients in California is presented. The model also gives prediction for number of cases and deaths during the same period. The model is versatile and can be applied to other countries and regions as well.


title: Data model to predict prevalence of COVID-19 in Pakistan

text: Coronavirus disease 2019 (COVID19) has spread to 181 countries and regions and leaving behind 1,133,788 confirmed cases and 62784 deaths worldwide. Countries with lower health services and facilities like Pakistan are on great risk. Pakistan so far has 3,277 confirmed cases and 50 reported deaths due to COVID19. Various mathematical models had presented to predict the global and regional size of pandemic. However, all those models have certain limitation due to their dependence on different variables and analyses are subject to potential bias. As each country has its own dimension therefore country specific model are required to develop accurate estimate. Here we present a data model to predict the size of COVID19 in Pakistan. In this mathematical data model, we used the time sequence mean weighting (TSMW) to estimate the expected future number of COVID19 cases in Pakistan until 29th April 2020. For future expected numbers of cases for long terms the data collection have to be maintained in real time.


The 2019 novel coronavirus (COVID-19) outbreak in China and world: A new lesson for public health system


title: Estimation of COVID-2019 burden and potential for international dissemination of infection from Iran

text: The Coronavirus Disease 2019 (COVID-19) epidemic began in Wuhan, China in late 2019 and continues to spread globally, with exported cases confirmed in 28 countries at the time of writing. During the interval between February 19 and 23, 2020, Iran reported its first 43 cases with eight deaths. Three exported cases originating in Iran were identified, suggesting a underlying burden of disease in that country than is indicated by reported cases. A large epidemic in Iran could further fuel global dissemination of COVID-19. We sought to estimate COVID-19 outbreak size in Iran based on known exported case counts and air travel links between Iran and other countries, and to anticipate where infections originating in Iran may spread to next. We assessed interconnectivity between Iran and other countries using using International Air Transport Association (IATA) data. We used the methods of Fraser et al. to estimate the size of the underlying epidemic that would result in cases being observed in the United Arab Emirates (UAE), Lebanon, and Canada. Time at risk estimates were based on a presumed 6 week epidemic age, and length of stay data for visitors to Iran derived from the United Nations World Tourism Organization (UNWTO). We evaluated the relationship between the strength of travel links with Iran, and destination country rankings on the Infectious Disease Vulnerability Index (IDVI), a validated metric that estimates the capacity of a country to respond to an infectious disease outbreak . Scores range between 0-1, with higher scores reflecting greater capacity to manage infectious outbreaks. UAE, Lebanon, and Canada ranked 3rd, 21st, and 31st, respectively, for outbound air travel volume from Iran in February 2019. We estimated that 18,300 (95% confidence interval: 3770 to 53,470) COVID-19 cases would have had to occur in Iran, assuming an outbreak duration of 1.5 months in the country, in order to observe these three internationally exported cases reported at the time of writing. Results were robust under varying assumptions about undiagnosed case numbers in Syria, Azerbaijan and Iraq. Even if it were assumed that all cases were identified in all countries with certainty, the "best case" outbreak size was substantial (1820, 95% CI: 380-5320 cases), and far higher than reported case counts. Given the low volumes of air travel to countries with identified cases of COVID-19 with origin in Iran (such as Canada), it is likely that Iran is currently experiencing a COVID-19 epidemic of significant size for such exportations to be occurring. This is concerning, both for public health in Iran itself, and because of the high likelihood for outward dissemination of the epidemic to neighbouring countries with lower capacity to respond to infectious diseases epidemics.


title: Brazil’s war on COVID-19: Crisis, not conflict—Doctors, not generals

text: This commentary first documents the ways in which President Jair Bolsonaro’s administration has evoked securitized discursive strategies that frame Brazil’s national response to COVID-19 as a matter of defense instead of public health. We then ask: What does it mean to talk about the virus and the ways to address it through war-framings? We argue that the Bolsonaro administration has framed the COVID-19 pandemic as an extra-territorial threat in an effort to create internal stability while failing to handle the matter effectively. Such politically motivated spatial framings inhibit an effective response in Brazil and pose a severe threat to public health. Once COVID-19 becomes securitized, the response is framed by the military bureaucracy rather than public health authorities, resulting in dangerous consequences.


title: A RELAXATION VIEWPOINT TO COVID-19 INFECTION

text: An analogy relaxation model, able to describe the dynamics of Covid-19 pandemics, in terms of daily presented new cases, is obtained. The main objective here is the prediction of pandemic dynamics, as the forecast of herd immunity time, and provide quantitative criteria for some predictions. We propose an analogy based on the concept of fractal derivative and justify the appearance of fractal time. A Burr XII-shaped solution of a fractal-like equation was obtained. The data fitting shows that the obtained function is useful to describe the behavior of the pandemic in the studied countries. The temporal evolution of contagion over different countries and worldwide are presented and discussed. We also show that a deformed derivative model leads to the same analytical results.


title: Effectiveness and Safety of Glucocorticoids to Treat COVID-19: A Rapid Review and Meta-Analysis

text: Background: Glucocorticoids are widely used in the treatment of various pulmonary inflammatory diseases, but they are also often accompanied by significant adverse reactions. Published guidelines point out that low dose and short duration systemic glucocorticoid therapy may be considered for patients with rapidly progressing COVID-19 while the evidence is still limited. Methods: We comprehensively searched electronic databases and supplemented the screening by conducting a manual search. We included RCTs and cohort studies evaluating the effectiveness and safety of glucocorticoids in children and adults with COVID-19, SARS and MERS, and conducted meta-analyses of the main indicators that were identified in the studies. Results: Our search retrieved 23 studies, including one RCT and 22 cohort studies, with a total of 13,815 patients. In adults with COVID-19, the use of systemic glucocorticoid did not reduce mortality (RR=2.00, 95% CI: 0.69 to 5.75, I 2=90.9%) or the duration of lung inflammation (WMD=-1 days, 95% CI: -2.91 to 0.91), while a significant reduction was found in the duration of fever (WMD=-3.23 days, 95% CI: -3.56 to -2.90). In patients with SARS, glucocorticoids also did not reduce the mortality (RR=1.52, 95% CI: 0.89 to 2.60, I2=84.6%), duration of fever (WMD=0.82 days, 95% CI: -2.88 to 4.52, I2=97.9%) or duration of lung inflammation absorption (WMD=0.95 days, 95% CI: -7.57 to 9.48, I2=94.6%). The use of systemic glucocorticoid therapy prolonged the duration of hospital stay in all patients (COVID-19, SARS and MERS). Conclusions: Glucocorticoid therapy was found to reduce the duration of fever, but not mortality, duration of hospitalization or lung inflammation absorption. Long-term use of high-dose glucocorticoids increased the risk of adverse reactions such as coinfections, so routine use of systemic glucocorticoids for patients with COVID-19 cannot be recommend. Keywords: COVID-19; glucocorticoids; meta-analysis; rapid review


title: Impact of the accuracy of case-based surveillance data on the estimation of time-varying reproduction numbers

text: Studies aimed at characterizing the evolution of COVID-19 disease often rely on case-based surveillance data publicly released by health authorities, that can be incomplete and prone to errors. Here, we quantify the biases caused by the use of inaccurate data in the estimation of the Time-Varying Reproduction Number R(t). By focusing on Italy and Spain, two of the hardest-hit countries in Europe and worldwide, we show that if the symptoms' onset time-series is inferred from the notification date series, the R(t) curve cannot capture nor describe accurately the early dynamics of the epidemic. Furthermore, the effectiveness of the containment measures that were implemented, such as national lockdowns, can be properly evaluated only when R(t) is estimated using the real time-series of dates of symptoms' onset. Our findings show that extreme care should be taken when a pivotal quantity like R(t) is used to make decisions and to evaluate different alternatives.


title: Comparison of COVID-19 case and death counts in the United States reported by four online trackers: January 22-May 31, 2020

text: The first purpose of this study is to describe a project focused on comparing the numbers of COVID-19 cases and deaths in the United States reported by four different online trackers, namely, those maintained by USAFacts, the New York Times, Johns Hopkins University, and the COVID Tracking Project. The second purpose of this study is to present results from the first five months of 2020 (January 22-May 31, 2020). This project is ongoing, so it will be updated regularly as new data from each of these trackers become available. Based on the time period included, the NYT has reported more cases than any of the other three trackers since late March/early April, and COVID Tracking Project has reported fewer deaths than any of the other three trackers since mid-March. It is hoped that the discrepancies identified by this project will provide avenues for research on their causes.


title: Chest computed tomography (CT) scan findings in patients with COVID-19: a systematic review and meta-analysis

text: Objectives: Numerous cases of pneumonia of caused by coronavirus disease 2019 (COVID-19) were reported in Wuhan, China. Chest computed tomography (CT) scan is highly important in the diagnosis and follow-up of lung disease treatment. The present meta-analysis was performed to evaluate chest CT findings in COVID-19 patients. Materials and Methods: All research steps were taken according to the MOOSE protocol and the final report was based on PRISMA guidelines. Each stage of the study was conducted by two independent authors. We searched the Web of Science, Ovid, Science Direct, Scopus, EMBASE, PubMed/Medline, Cochrane Library, EBSCO, CINAHL and Google scholar databases. The search was conducted on March 20, 2020. Grey literature was searched at medrxiv website. All analyses were performed using Comprehensive Meta-Analysis. The adapted Newcastle Ottawa Scale was used to evaluate the risk of bias. We registered this review at PROSPERO (registration number: CRD42019127858). Results: Finally, 40 eligible studies with 4,183 patients with COVID-19 were used for meta-analysis. The rate of positive chest CT scan in patients with COVID-19 was 94.5% (95%CI: 91.7-96.3). Bilateral lung involvement, pure ground-glass opacity (GGO), mixed (GGO pulse consolidation or reticular), consolidation, reticular, and presence of nodule findings in chest CT scan of COVID-19 pneumonia patients were respectively estimated to be 79.1% (95% CI: 70.8-85.5), 64.9% (95%CI: 54.1-74.4), 49.2% (95%CI: 35.7-62.8), 30.3% (95%CI: 19.6-43.6), 17.0% (95%CI: 3.9-50.9) and 16.6% (95%CI: 13.6-20.2). The distribution of lung lesions in patients with COVID-19 pneumonia was peripheral (70.0% [95%CI: 57.8-79.9]), central (3.9% [95%CI: 1.4-10.6]), and peripheral and central (31.1% [95%CI: 19.5-45.8]). The most common pulmonary lobes involved were right lower lobe (86.5% [95%CI: 57.7-96.8]) and left lower lobe (81.0% [95%CI: 50.5-94.7]). Conclusion: Our study showed that chest CT scan has little weakness in diagnosis of COVID-19 combined to personal history, clinical symptoms, and initial laboratory findings, and may therefore serve as a standard method for diagnosis of COVID-19 based on its features and transformation rule, before initial RT-PCR screening.


title: COVID-19: Unmasking the new face of education

text: Coronavirus disease (COVID-19) is a newly discovered infectious disease caused by a virus named ”coronavirus.” The lockdown due to COVID 19 has largely affected the lives of students as they no more get to interact on a one on one basis with their teachers. This shift in education from traditional class-room learning to computer-based learning might be one of the largest edu-cational experiments to date. As the online teaching-learning process has become more prevalent in India due to COVID 19 pandemic, it becomes par-ticularly important to know its growth and to know whether it’s actually help-ing the students achieve what they expect out of college. The present study was therefore designed to understand the student’s perspective, attitudes, and readiness about online classes being conducted at the University level. An Observational, Descriptive study was conducted. The data was collected using a Questionnaire. The present study was carried out amongst 200 stu-dents. After analyzing the results, it was found that 74% of the students liked studying through online classes. The most common reason (49%) as to why the students like studying online were that the study time becomes lexible, and they can study anytime they want. Lack of co-curricular activity was the most common issue (34%) of online classes, as reported by the students. Most of the students were found satisied with the content and procedure of online teaching. About 30% of the students reported that they prefer their lecture being delivered through a PPT with an audio recording. The present study that was conducted among college students revealed that maximum students are in favor of studying through online classes, but they feel that there is a lack of co-curricular activities in the online mode of conducting classes. As the students are in favor of online classes, such classes must be continued with some interventions. Education Ministry must develop certain rules and guidelines wherein certain online activity sessions can be made compulsory along with regular lecture sessions.


title: Geopolitical anxieties of tourism: (Im)mobilities of the COVID-19 pandemic

text: Bringing the political geography of tourism to bear on responses to the COVID-19 pandemic, this commentary reveals how the geopolitical anxieties of tourism are mediated by historical geographies of race as well as contemporary geoeconomic relations and the broader pivot to the Asia-Pacific region.


title: CT appearances and short-term changes of COVID-19 in subclinical period/ 新型冠状病毒肺炎亚临床期CT影像特征及短期演变

text: Objective: To explore the characteristics and short-term changes of high resolution CT (HRCT) in subclinical stage of COVID-19. Methods: The HRCT images of 17 COVID-19 patients in subclinical stage were analyzed retrospectively in Union Hospital, Tongji Medical College, Huazhong University of Science and Technology and Wuhan Jinyintan Hospital from January 15 to 31, 2020. There were 4 males and 13 females, age ranged from 25.0 to 51.0 (39.8±7.5) years, who were closely contacted with other COVID-19 patients. The follow-up CT examination was performed within 3 to 6 days after the initial CT examination in all patients. Six patients were treated using anti-virus, anti-inflammation and symptomatic therapy, while the other 11 patients were untreated. The subclinical CT findings and short-term follow-up were analyzed, and the CT changes of short-term follow-up were summarized. Results: The lesions of 17 COVID-19 patients were mainly located at the lower lobes of bilateral lungs (at the left lower lobe in 9 cases and at the right lower lobe in 10 cases in the subclinical stage, at the left lower lobe in 9 cases and at the right lower lobe in 11 cases in the short-term follow-up). The number of involved lung segments increased from 46 in the subclinical stage to 90 in the short-term follow-up. In the subclinical stage, the multiple lesions were found in 13 cases, while in the short-term follow-up, the number of cases with multiple lesions decreased by 7, however the cases with focal lesions increased by 6 and diffuse lesions by 4. The lesions were mainly distributed under the pleura (13 cases) or along the bronchovascular bundle(10 cases). In the short-term follow-up, the lesion in 1 case expanded from the subpleural area to neighbouring bronchovascular bundle. There were 3 main types of the lesions, including ground glass nodule, ground glass opacity and crazy-paving pattern. In the subclinical stage and short-term follow-up, the ground glass opacities were seen in all the 17 cases. In the short-term follow-up, the number of cases with ground glass nodules decreased by 4 and crazy-paving pattern increased by 4. In 6 patients after treatment, the multiple ground glass nodules became single one in 3 cases, and in other 3 cases the multiple ground glass opacities were getting smaller. However, the scope of lesions in 11 patients without treatment enlarged. Conclusion: The HRCT features of the COVID-19 in subcilincal stage have some charicteristics, such as small ground glass nodule, ground glass opacity along the subpleural area or along the bronchovascular bundle, and the great changes can be seen in the short-term follow-up.


Social isolation, loneliness, and hearing loss during COVID-19


title: Combined oropharyngeal/nasal swab is equivalent to nasopharyngeal sampling for SARS-CoV-2 diagnostic PCR

text: Background: Early 2020, a COVID-19 epidemic became a public health emergency of international concern. To address this pandemic broad testing with an easy, comfortable and reliable testing method is of utmost concern. The nasopharyngeal (NP) swab sampling is the reference method though hampered by international supply shortages. A new oropharyngeal/nasal (OP/N) sampling method was investigated using the more readily available throat swab. Methods: In this prospective observational study 36 COVID-19 patients were tested with both a NP and combined OP/N swab for SARS-CoV-2 RNA by PCR. In hospitalized suspect patients, who tested negative on both swabs, extensive retesting was performed. The sensitivity of NP versus combined OP/N swab sampling on admission and the correlation between viral RNA loads recovered was investigated. Results: 35 patients were diagnosed with SARS-CoV-2 by means of either NP or OP/N sampling. The paired swabs were both positive in 31 patients. The one patient who tested negative on both NP and OP/N swab on admission, was ultimately diagnosed on bronchoalveolar lavage fluid. A strong correlation was found between the viral RNA loads of the paired swabs (r = 0.76; P < 0.05). The sensitivity of NP and OP/N analysis in hospitalized patients (n = 28) was 89.3% and 92.7% respectively. Conclusions: This study demonstrates equivalence of NP and OP/N sampling for detection of SARS-CoV-2 by means of rRT-PCR. Sensitivity of both NP and OP/N sampling is very high in hospitalized patients.


title: Human bocavirus in children hospitalized for acute respiratory tract infection in Rome

text: BACKGROUND: The role of human bocavirus (HBoV) as a respiratory pathogen has not been fulfilled yet. We aimed to describe clinical and serological characteristics of children with HBoV hospitalized for acute respiratory tract infection and to evaluate whether differences occur between HBoV alone and in co-infection. METHODS: We retrospectively reviewed data from 60 children (median age of 6.2 months, range 0.6–70.9) hospitalized for acute respiratory symptoms, with HBoV detected from a respiratory sample, using a reverse transcriptase-PCR for 14 respiratory viruses (including respiratory syncytial virus (RSV), influenza virus A and B, human coronavirus OC43, 229E, NL-63 and HUK1, adenovirus, rhinovirus, parainfluenza virus1–3, and human metapneumovirus). RESULTS: HBoV was detected alone in 29 (48.3%) patients, while in co-infection with other viruses in 31 patients (51.7%), with a peak between December and January. Among the 60 patients, 34 were bronchiolitis, 19 wheezing, 3 pneumonia, 2 upper respiratory tract infection, and 2 whooping cough. Seven children (11.6%) required admission to the paediatric intensive care unit (PICU) for respiratory failure. No differences was observed in age, family history for atopy and/or asthma, clinical presentations, chest X-ray, or laboratory findings in children with HBoV alone vs. multiple viral detection. RSV was the most frequently co-detected virus (61.3%). When compared with HBoV detection alone, the co-detection of RSV and HBoV was associated with male sex (P = 0.013), younger age (P = 0.01), and lower blood neutrophil count (P = 0.032). CONCLUSIONS: HBoV can be detected alone and in co-infection respiratory samples of children with an acute respiratory tract infection. A cause–effect relationship between HBoV and respiratory infection is not clear, so further studies are needed to clarify this point.


Von Viren und Tieren


title: A prototype for decision support tool to help decision-makers with the strategy of handling the COVID-19 UK epidemic

text: The primary objective of this work is to model and compare different exit scenarios from the lock-down for the COVID-19 UK epidemic. In doing so we provide an additional modelling basis for laying out the strategy options for the decision-makers. The main results are illustrated and discussed in Part I. In Part II, we describe the stochastic model that we have developed for modelling this epidemic. As argued in Part II, the developed model is more flexible than the SEIR/SEIRS models and can be used for modelling the scenarios which may be difficult or impossible to model with the SEIR/SEIRS models. To compare different scenarios for exiting from the lock-down, in Part III we provide our previous report on the same topic where similar (although not as detailed) scenarios were considered. As the possible exit dates, we have chosen May 4, May 11, May 18 and May 25. We model differently the regions with high initial reproductive number chosen to be R0=2.5, medium R0=2.3 and low R0=2.The numbers for the whole of the UK can be obtained by appropriate averaging of the numbers given in the report. Typical figures are given in Section 4. For each scenario considered, we plot the expected proportion of infected at time t and the expected number of deaths at time t. To compute the expected numbers of deaths we used the total mortality rate 0.66%. Many recent studies suggest lower values and therefore the numbers in our projections should be considered as rather pessimistic. Our analysis suggests a value around 0.5% for the mortality rate. In the model, we assume that the isolation of older and vulnerable people continues and the public carries on certain level of isolation until the end of 2020; also we assume that immunity is kept for at least a year and there is no international travel influence. Our main conclusions are: In regions with higher initial reproductive number 2.5 the proportion of susceptible at the start of the lock-down should be not smaller than 0.95, the epidemic curve in such regions is in the fast monotonic decline irrespectively of the date of the lock-down lift; In regions with lower initial reproductive number 2.0 the second mild wave can be expected, the difference between the expected mortality rates is very small for all May 2020 lifting lock-down dates; In regions with initial reproductive number 2.3, a mild second wave can be expected in the case of large proportion of susceptible at the start of the lock-down, but its severity and resulting mortality depend very little on the date of lifting the lock-down; For the overall UK epidemic, even for rather pessimistic scenarios considered, the second wave is much less pronounced (in terms of the expected mortality rate) than the first one, and the total numbers of expected deaths are within 2% for all May 2020 dates of lifting the lock-down. Moreover, by keeping R0-value after lifting the lock-down below 1.75 is likely to lead to the avoidance of a UK-wide second wave, see Section 4. We believe that the model build in this work can be considered as an important decision support tool to help decision-makers with the strategy of handling the epidemic. We invite other scholars to participate in an open discussion of the strategy options. We feel that this kind of models should be used in the short and long term management of the disease. We recommend the development of a permanent and modularised modelling suite for COVID-19 management to which additional modules can be added as anti-viral drugs and vaccination are introduced, extending the options. We trust that this work makes a start in that direction and demonstrates the advantages of a heterogeneous demographic refinement, which can only improve targeting role out of treatments.


title: Early Multi-organ Point-of-Care Ultrasound Evaluation of Respiratory Distress During SARS-CoV-2 Outbreak: Case Report

text: INTRODUCTION: Coronavirus disease 2019 (COVID-19) is caused by the virus known as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Several case series from Italy and China have highlighted the lung ultrasound findings of this disease process and may demonstrate its clinical utility during the current pandemic. CASE REPORT: We present a case of a COVID-19 patient who presented to the emergency department twice within a 24-hour period with rapidly progressing illness. A multi-organ point-of-care ultrasound (POCUS) evaluation was used on the return visit and assisted clinical decision-making. DISCUSSION: A multi-organ POCUS exam allows for quick assessment of acute dyspnea in the emergency department. As the lung involvement of COVID-19 is primarily a peripheral process it is readily identifiable via lung ultrasound. We believe that when applied efficiently and safely a POCUS exam can reduce clinical uncertainty and potentially limit the use of other imaging modalities when treating patients with COVID-19. CONCLUSION: This case highlights the utility of an early multiorgan point-of-care assessment for patients presenting with moderate respiratory distress during the severe SARS-CoV-2 pandemic.


title: Screening and testing for a suitable untransfected cell line for SARS-CoV-2 studies

text: At present, the novel pandemic coronavirus SARS-CoV-2 is a major global threat to human health and hence demands united research activities at different levels. Finding appropriate cell systems for drug screening and testing molecular interactions of the virus with the host cell is mandatory for drug development and understanding the mechanisms of viral entry and replication. For this, we selected human cell lines represented in the Cancer Cell Line Encyclopedia (CCLE) based on RNA-seq data determined transcript levels of ACE2 and TMPRSS2, two membrane proteins that have been identified to aid SARS-CoV-2 entry into the host cell. mRNA and protein expression of these host factors were verified via RQ-PCR and western blot. We then tested permissiveness of these cell lines towards SARS-CoV-2 infection, cytopathic effect, and viral replication finding limited correlation between receptor expression and infectability. One of the candidate cancer cell lines, the human colon cancer cell line CL-14, tested positive for SARS-CoV-2 infection. Our data argue that SARS-CoV-2 in vitro infection models need careful selection and validation since ACE2/TMPRSS2 receptor expression on its own does not guarantee permissiveness to the virus. Author summary In the midst of the pandemic outbreak of corona-virus SARS-CoV-2 therapeutics for disease treatment are still to be tested and the virus-host-interactions are to be elucidated. Drug testing and viral studies are commonly conducted with genetically manipulated cells. In order to find a cell model system without genetic modification we screened human cell lines for two proteins known to facilitate entry of SARS-CoV-2. We confirmed and quantified permissiveness of current cell line infection models, but dismissed a number of receptor-positive cell lines that did not support viral replication. Importantly, ACE2/TMPRSS2 co-expression seems to be necessary for viral entry but is not sufficient to predict permissiveness of various cancer cell lines. Moreover, the expression of specific splice variants and the absence of missense mutations of the host factors might hint on successful infection and virus replication of the cell lines.


title: Tourism crises: management responses and theoretical insight, E. Laws, B. Prideaux (Eds.). The Haworth Hospitality Press, New York (160pp), 2005, ISBN: 0-7890-3208-2

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title: Primary understanding of syndrome differentiation treatment of COVID-19 with traditional Chinese medicine based on 3-5 edition of Diagnosis and Treatment of Novel Coronavirus Pneumonia and ancient literatures/ 结合3～5版《新型冠状病毒感染的肺炎诊疗方案》和古代文献初探新型冠状病毒肺炎的中医药辨治

text: There are an increasing number of patients suffering from coronavirus disease 2019 (COVID-19) in our country and overseas. After the outbreak, the state health administrative sections have updated steadily several editions of Diagnosis and Treatment of Novel Coronavirus Pneumonia. According to the change of exposition of traditional Chinese medicine (TCM) treatment in these editions and the characteristics of cases in clinic, COVID-19 corresponds to pestilence category of TCM, which also based on the ancient literatures from the seasonal-febrile-disease subject of TCM. The disease contributes to pestilential pathogen caused by specifically regional climate characteristics of Wuhan city. It is important for COVID-19 patients to eliminate pathogens as soon as possible, which should apply defense-qi-nutrient-blood diagnosis to different courses of disease. The TCM therapy should be established according to the different organs where the virus lives and characters. In order to control the epidemic at an early date, it is necessary to consider the local conditions and use the combination of traditional Chinese and western medicine to treat COVID -19 patients.


title: THE ROLE OF POINT-OF-CARE ULTRASONOGRAPHY IN THE INITIAL CHARACTERIZATION OF COVID-19 PATIENTS: RESULTS FROM A PROSPECTIVE MULTICENTRIC STUDY.

text: INTRODUCTION: Coronavirus Disease 2019 (COVID-19) is a highly contagious illness caused by the Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). There is growing evidence regarding the imaging findings of COVID-19, in Chest X-ray and CT scan, however their availability in this pandemic outbreak might be compromised. At this moment, the role of Point-of-care ultrasonography (POCUS) has yet to be explored. OBJECTIVES: The main purpose of this study is to describe the POCUS findings of the disease in COVID-19 patients admitted to the emergency department (ED). Determining the correlation of these parameters with vital signs, laboratory results and chest X-ray, as well as, therapeutic decisions and prognosis. METHODS: Prospective study carried out in the emergency department (ED) of two academic hospitals. High suspicion or confirmed COVID-19 patients were subjected to the ultrasonographic measurement of the inferior vena cava (IVC), focused cardiac ultrasound (FOCUS), and Lung Ultrasonography (Lung POCUS). RESULTS: Between March and April 2020, ninety-six patients were enrolled. The mean age was 68.2 years (SD 17.5). The most common finding in Lung POCUS was an irregular pleural line (63.2%) followed by bilateral confluent (55.2%) and isolated B-lines (53.1%), which was associated with a positive RT-PCR (OR 4.729, 95% CI: 1.989-11.246; p<0.001), and correlated with IL-6 levels (rho = 0.622; p = 0.002). The IVC moderately correlated with levels of pO2, expiratory (rho = -0.539; p =0.014) and inspiratory (rho = -0.527; p =0.017), with troponin I (rho = 0.509; p=0.03). After POCUS exam, almost 20% of the patients had an associated condition that required a change in the treatment or management. CONCLUSION: In this pandemic era, as the shortage of resources constitutes an undeniable public health threat, POCUS presents the potential to impact in diagnosis, management and prognosis of our confirmed or suspected COVID-19 patients.


title: Targeted adaptive isolation strategy for Covid-19 pandemic

text: We investigate the effects of social distancing in controlling the impact of the COVID-19 epidemic using a simple susceptible-infected-removed epidemic model. We show that an alternative or complementary approach based on targeted isolation of the vulnerable sub-population may provide a more efficient and robust strategy at a lower economic and social cost within a shorter timeframe resulting in a collectively immune population.


title: La primera autopsia COVID-19 en España después del inicio de la pandemia

text: Resumen En este artículo presentamos el proceso de implementación de un Programa de Autopsias COVID-19 en nuestro hospital, presentamos los principales hallagos de la primera autopsia realizada y revisamos brevemente la patología pulmonar publicada previamente en estos pacientes. Abstract We describe the implementation of a COVID-19 Autopsy Programme in our Hospital, report the main findings from the first autopsy of the programme and briefly review the reports of lung pathology of these patients.


title: Laboratory Testing Implications of Risk-Stratification and Management for Improving Clinical Outcomes of COVID-19 Patients

text: The high mortality rate of COVID-19 patients is mainly caused by the progression from mild to critical illness. To identify the key laboratory indicators and stratify high-risk COVID-19 patients with progression to severe/critical illness, we compared 474 moderate patients and 74 severe/critical patients. The laboratory indicators, including lactate dehydrogenase (LDH), monocytes percentage, etc. were significantly higher in the severe/critical patients (P <0.001) and showed a noticeable change at about a week before the diagnosis. Based on these indicators, we constructed a risk-stratification model, which can accurately grade the severity of patients with COVID-19 (accuracy = 0.96, 95% CI: 0.94 - 0.989, sensitivity = 0.98, specificity = 0.84). Also, compared with non-COVID-19 viral pneumonia, we found that COVID-19 had weaker dysfunction to the heart, liver, and kidney. The prognostic model based on laboratory indicators could help to diagnose, monitor, and predict severity at an early stage to those patients with COVID-19.


title: Towards a simulation framework for optimizing infectious disease surveillance: An information theoretic approach for surveillance system design

text: Infectious disease surveillance systems provide vital data for guiding disease prevention and control policies, yet the formalization of methods to optimize surveillance networks has largely been overlooked. Decisions surrounding surveillance design parameters, such as the number and placement of surveillance sites, target populations, and case definitions, are often determined by expert opinion or deference to operational considerations, without formal analysis of the influence of design parameters on surveillance objectives. Here we propose a simulation framework to guide evidence-based surveillance network design to better achieve specific surveillance goals with limited resources. We define evidence-based surveillance design as a constrained, multi-dimensional, multi-objective, dynamic optimization problem, acknowledging the many operational constraints under which surveillance systems operate, the many dimensions of surveillance system design, the multiple and competing goals of surveillance, and the complex and dynamic nature of disease systems. We describe an analytical framework for the identification of optimal designs through mathematical representations of disease and surveillance processes, definition of objective functions, and the approach to numerical optimization. We then apply the framework to the problem of selecting candidate sites to expand an existing surveillance network under alternative objectives of: (1) improving spatial prediction of disease prevalence at unmonitored sites; or (2) estimating the observed effect of a risk factor on disease. Results of this demonstration illustrate how optimal designs are sensitive to both surveillance goals and the underlying spatial pattern of the target disease. The findings affirm the value of designing surveillance systems through quantitative and adaptive analysis of network characteristics and performance. The framework can be applied to the design of surveillance systems tailored to setting-specific disease transmission dynamics and surveillance needs, and can yield improved understanding of tradeoffs between network architectures.


title: Asymmetric impact of COVID-19 induced uncertainty on inbound Chinese tourists in Australia: insights from nonlinear ARDL model

text: This paper explores the asymmetric impact of COVID related uncertainty measured by the newly formulated index (Discussion about Pandemics Index), conceptualized by Baker et al (2020) and postulated by Ahir et al (2018) and Ahir et al (2020) on Chinese tourist arrivals in Australia over the period 1996Q1 to 2020Q1 It is worthwhile to investigate how the "quarantine economy" is adversely impacting tourism in Australia concerning an important market namely the Chinese market The paper utilized the novel asymmetric (nonlinear autoregressive distributed lag model) to capture the asymmetric association between tourism and uncertainty The main upshot of the research points out that economic policy uncertainty weighted by the pandemics asymmetrically impacts tourist arrivals One per cent rise in uncertainty leads to a decline in tourist arrivals by 10 per cent while one per cent decline in uncertainty leads to a rise in tourist arrivals by 0 22 per cent The effect of the positive change of the policy uncertainty index is more infusing than the impact of negative change so the asymmetry is confirmed Further, the Wald test endorse asymmetry behaviour across the variables


title: Rethinking COVID-19 Vulnerability: A Call for LGTBQ+ Im/migrant Health Equity in the United States During and After a Pandemic

text: Public health responses to the coronavirus disease 2019 (COVID-19) pandemic have emphasized older adults' vulnerability, but this obfuscates the social and political root causes of health inequity. To advance health equity during a novel communicable disease outbreak, public health practitioners must continue to be attentive to social and political circumstances that inform poor health. Such efforts are especially needed for populations who are exposed to numerous social and political factors that structure health inequity, such as lesbian, gay, bisexual, transgender, or otherwise-queer identifying (LGBTQ+) populations and im/migrant populations. The COVID-19 outbreak is, therefore, a critical time to emphasize root causes of health inequity.


title: Characteristics and outcomes of a cohort of SARS-CoV-2 patients in the Province of Reggio Emilia, Italy

text: Objectives. To describe the age- and sex-specific prevalence of SARS-CoV-2 disease (COVID-19) and its prognostic factors. Design. Population-based prospective cohort study on archive data. Setting. Preventive services and hospital care in the province of Reggio Emilia, Northern Italy. Participants. All 2653 symptomatic patients who tested positive for SARS-CoV-2 from February 27 to April 2, 2020 in the province of Reggio Emilia. Main outcome measures. Hospitalization and death up to April 2, 2020. Results. Females had higher prevalence of infection than males below age 50 (2.61 vs. 1.84 per 1000), but lower in older ages (16.49 vs. 20.86 per 1000 over age 80). Case fatality rate reached 20.7% (22/106) in cases with more than 4 weeks follow up. After adjusting for age and comorbidities, men had a higher risk of hospitalization (hazard ratio (HR) 1.4 95% confidence interval (95% CI) 1.2 to 1.6) and of death (HR 1.6, 95% CI 1.2 to 2.1). Patients over age 80 compared to < age 50 had HR 7.1 (95% CI 5.4 to 9.3) and HR 27.8 (95% CI 12.5 to 61.7) for hospitalization and death, respectively. Immigrants had a higher risk of hospitalization (HR 1.3, 95% CI 0.99 to 1.81) than Italians and a similar risk of death. Risk of hospitalization and of death were higher in patients with heart failure (HR 1.6, 95% CI 1.2 to 2.1and HR 2.3, 95% CI 1.6 to 3.2, respectively), arrhythmia (HR 1.5, 95% CI 1.2 to 1.9 and HR 1.8, 95% CI 1.3 to 2.5, respectively), dementia (HR 1.2, 95% CI 0.9 to 1.8 and HR 1.8, 95% CI 1.1 to 2.8, respectively), ischemic heart disease (HR 1.3, 95% CI 1.0 to 1.7 and HR 1.7, 95% CI 1.2 to 2.5, respectively), diabetes (HR 1.5, 95% CI 1.3 to 1.9 and HR 1.6, 95% CI 1.1 to 2.2, respectively), and hypertensions(HR 1.4, 95% CI 1.2 to 2.6 and HR 1.6, 95% CI 1.2 to 2.1, respectively), while COPD increased the risk of hospitalization (HR 1.9, 95% CI 1.4 to 2.5) but not of death (HR 1.1, 95% CI 0.7 to 1.7). Previous use of ACE inhibitors has no effect on risk of death (HR 0.97, 95% CI 0.69 to 1.34) Conclusions. The mechanisms underlying these associations are mostly unknown. A deeper understanding of the causal chain from infection, disease onset, and immune response to outcomes may explain how these prognostic factors act.


title: Systematic and Statistical Review of COVID19 Treatment Trials

text: Objective: The following systematic review and meta-analysis compiles the current data regarding human controlled COVID-19 treatment trials. Methods: An electronic search of the literature compiled studies pertaining to human controlled treatment trials with COVID-19. Medications assessed included lopinavir/ritonavir, arbidol, hydroxychloroquine, favipiravir, and heparin. Statistical analyzes were performed for common viral clearance endpoints whenever possible. Results: Lopinavir/ritonavir showed no significant effect on viral clearance for COVID-19 cases (OR 0.95 [95% CI 0.50-1.83]). Hydroxychloroquine also showed no significant effect on COVID-19 viral clearance rates (OR 2.16 [95% CI 0.80-5.84]). Arbidol showed no seven-day (OR 1.63 [95% CI 0.76-3.50]) or 14-day viral (OR 5.37 [95% CI 0.35-83.30]) clearance difference compared to lopinavir/ritonavir. Review of literature showed no significant clinical improvement with lopinavir/ritonavir, arbidol, hydroxychloroquine, or remdesivir. Favipiravir showed quicker symptom improvement compared to lopinavir/ritonavir and arbidol. Heparin showed improvement with severe COVID-19 cases. Conclusion: Current medications do not show significant effect on COVID-19 viral clearance rates. Favipiravir shows favorable results compared to other tested medications. Heparin shows benefit for severe cases of COVID-19.


title: Searching for a coronavirus cure in the blood

text: The blood of people who have recovered from COVID-19 may be the world’s most sought-after substance right now It contains a stockpile of antibodies made by immune cells that have successfully mounted an attack on the invading virus, SARS-CoV-2 While multiple efforts are focusing on repurposing existing drugs, like remdesivir or chloroquine, to fight this new virus, many scientists think that the fastest route to novel therapies specifically designed to treat the infection could come by harvesting those antibodies These antibody-based therapies could take many forms The simplest, and the only that is already being tested in people with COVID-19, is convalescent plasma, the antibody-rich portion of blood donated from someone who recovered from the disease At the other end of the spectrum, companies are meticulously analyzing plasma from recovered humans or immunized animals to select the very best antibodies, which they can use to manufacture traditional monoclonal antibody therapies These approaches, and others in between, are barreling toward the clinic at a pandemic pace


title: Risk factors and interventions associated with mortality or survival in adult covid-19 patients admitted to critical care: A systematic review and meta-analysis

text: Background: Patients with confirmed COVID-19 admitted to intensive care units have a high mortality rate, which appears to be associated with increasing age, male sex, smoking history, hypertension and diabetes mellitus. Methods: A systematic review to determine risk factors and interventions associated with mortality/survival in adult patients admitted to an intensive care unit (ICU) with confirmed COVID-19/SARS-CoV-2 infection. The protocol was registered with PROSPERO (CRD42020181185). Results: The search identified 483 abstracts between 1 January and 7 April 2020, of which nine studies were included in the final review. Only one study was of low bias. Advanced age (odds ratio [OR] 11.99, 95% confidence interval [CI] 5.35–18.62) and a history of hypertension were associated with mortality (OR 4.17, 95% CI 2.90–5.99). Sex was not associated with mortality. There was insufficient data to assess the association between other comorbidities, laboratory results or critical care risk indices and mortality. The critical care interventions of mechanical ventilation (OR 6.25, 95% CI 0.75–51.93), prone positioning during ventilation (OR 2.06, 95% CI 0.20–21.72), and extracorporeal membrane oxygenation (ECMO) (OR 8.00, 95% CI 0.69, 92.33) were not associated with mortality. The sample size was insufficient to conclusively determine the association between these interventions and ICU mortality. The need for inotropes or vasopressors was associated with mortality (OR 6.36, 95% CI 1.89–21.36). Conclusion: The studies provided little granular data to inform risk stratification or prognostication of patients requiring intensive care admission. Larger collaborative research is needed to address this limitation.


title: Levers of control for supply chain sustainability: Control and governance mechanisms in a cross-boundary setting

text: The rise of global supply chains as well as attention to the Triple Bottom Line provides organizations with new conditions and strategy paradoxes to be dealt with when it comes to sustainability in supply chain management. This study of a large multinational organization with a strong Triple Bottom Line focus provides a comprehensive analysis of the use of control and governance mechanisms in supply chain context. Through the Levers of Control framework, the application of these mechanisms both internally and across organizational boundaries is shown. The interplay between levers helps in dealing with the in itself paradoxical nature of Triple Bottom Line goalsetting. The results show that the "softer" elements of the Triple Bottom Line, i.e., People and Planet, are approached with the lever associated with the beliefs system, which in turn enforces the boundary and interactive control systems. Ultimately, applying the Levers of Control in supply chain context might contribute to pursuing a holistic approach of sustainable supply chain management.


title: Partial unlock caseload management for COVID-19 can save 1-2 million lives worldwide

text: This paper analyzes the stability and usefulness of a human-in-the-loop caseload management method for COVID-19. This can control the balance between medical resource utilization and economic shutdown duration across significant scenario variation. It reduce the total cases by controlling the rate of spreading as groups cross the herd immunity threshold, and suggests late intervention has more effect on total cases than early intervention once containment has failed. Data as of April 11, 2020 show that flattening strategy for COVID-19 in both the world and the U.S. is working so well that a significantly effective removal of social distancing (aka unlock) at any time in the next few years, other than after widespread and effective vaccination, will produce a rebound overloading the healthcare system. For the world, by early April flattening was working so well that a world rebound could be projected in 2021 that would exceed in critical demand even the additional million or so ventilators requested by world governments. In the U.S., whose trajectory is somewhat ahead of the world, the projected rebound of a late year unlock is already greater than the current crisis projected peak. Most citizens are tacitly expecting much sooner rather than much later unlocks. Leaving economies locked down for a long time is its own catastrophe, especially for countries that cannot provide substantial economic aid to their citizens. An SIR-type model was used with clear parameters suitable for public information, and both tracking and predictive capabilities, and an additional simulation of a decision-maker on selected-day partial unlock designed mainly to manage ventilator or other critical resource utilization, to make sure they are neither idle nor over committed. Using certain days of the week, already practiced by some countries, is not a necessary part of the method, but was used in the simulation to give a highly quantified unlock scheme. It also helps restore economic activity. While the model shows total cumulative cases, and therefore deaths, declining initially with flattening, when flattening begins to produce large rebounds the death rate goes back up. Partial unlock to manage critical resources brings the cumulative cases down about 8-12% between now and the second half of 2021, and therefore saves lives with some degree of certainty.


title: Taking Account of Asymptomatic Infections in Modeling the Transmission Potential of the COVID-19 Outbreak on the Diamond Princess Cruise Ship

text: We take the case of the Diamond Princess (DP) cruise ship as an experimental model for studying the transmission potential of COVID-19 in a closed environment. We investigate the changes in R0 for COVID-19 on the DP from January 21 to February 19, 2020 with a chain-binomial model at different times under two scenarios: no quarantine assuming a random mixing condition, and quarantine of passengers in cabins -- passengers may get infected either by an infectious case in a shared cabin or by asymptomatic crew who continued to work. Our modeling approach takes account of the asymptomatic ratio of crew members during the quarantine of passengers, which has not been explored in the literature. Assuming an asymptomatic ratio 0.505 and the proportion of infections in cabins 0.2, R0 at the beginning of the epidemic was 3.27 (95% CI (3.02, 3.54)) and 3.78 (95% CI (3.49, 4.09)) respectively for serial intervals of 5 and 6 days, and increased for passengers in contact with asymptomatic crew during quarantine. We find evidence to support a CDC report that "a high proportion of asymptomatic infections could partially explain the high attack rate among cruise ship passengers and crew." This emphasizes the importance of improved reporting and quarantine of asymptomatic cases, and raises questions on quarantine procedures in closed environments such as military vessels, cruise ships, dormitories, prisons, and other enclosed living complexes with high population densities.


Lessons Amidst a Pandemic


title: Effects of medical resource capacities and intensities of public mitigation measures on outcomes of COVID-19 outbreaks

text: The COVID-19 pandemic is complex and is developing in different ways according to the country involved. To identify the key parameters or processes that have the greatest effects on the pandemic and reveal the different progressions of epidemics in different countries, we quantified enhanced control measures and the dynamics of the production and provision of medical resources. We then nested these within a COVID-19 epidemic transmission model, which is parameterized by multi-source data. We obtained rate functions related to the intensity of mitigation measures, the effective reproduction numbers and the timings and durations of runs on medical resources, given differing control measures implemented in various countries. Increased detection rates may induce runs on medical resources and prolong their durations, depending on resource availability. Nevertheless, improving the detection rate can effectively and rapidly reduce the mortality rate, even after runs on medical resources. Combinations of multiple prevention and control strategies and timely improvement of abilities to supplement medical resources are key to effective control of the COVID-19 epidemic. A 50% reduction in comprehensive control measures would have led to the cumulative numbers of confirmed cases and deaths exceeding 590000 and 60000, respectively, by 27 March 2020 in mainland China. The proposed model can assist health authorities to predict when they will be most in need of hospital beds and equipment such as ventilators, personal protection equipment, drugs and staff.


title: A web-based Diagnostic Tool for COVID-19 Using Machine Learning on Chest Radiographs (CXR)

text: This paper reports the development and web deployment of an inference model for Coronavirus COVID-19 using machine vision on chest radiographs (CXR). The transfer learning from the Residual Network (RESNET-50) was leveraged for model development on CXR images from healthy individuals, bacterial and viral pneumonia, and COVID-19 positives patients. The performance metrics showed an accuracy of 99%, a recall valued of 99.8%, a precision of 99% and an F1 score of 99.8% for COVID-19 inference. The model was further successfully validated on CXR images from an independent repository. The implemented model was deployed with a web graphical user interface for inference (https://medics-inference.onrender.com ) for the medical research community; an associated cron job is scheduled to continue the learning process when novel and validated information becomes available


title: Prevention of household transmission crucial to stop the catastrophic spread of COVID-19 in cities

text: After weeks under lockdown, metropolitan areas fighting the spread of COVID-19 aim to balance public health goals with social and economic standards for well-being. Mathematical models of disease transmission seeking to evaluate mitigation strategies must assess the possible impacts of social distancing, economic lockdowns and other measures. However, obscure relations between model parameters and real-world phenomena complicate such analyses. Here, we use a high-resolution metapopulation model of Guadalajara (GDL, Western Mexico) to represent daily mobility patterns driven by economic activities and their relation to epidemic growth. Given the prominence of essential activities in the city's economy, we find that strategies aiming to mitigate the risk of out-of-home interactions are insufficient to stop the catastrophic spread of COVID-19. Using baseline reproduction numbers R0 = [2.5, 3.0] in the absence of interventions, our simulations suggest that household transmission alone can make Rt ~ 1, and is estimated to drive 70 {+/-} 15% of current epidemic growth. This sets an upper bound for the impact of mobility-based interventions, which are unlikely to lower Rt below 1.3 and must be complemented with aggressive campaigns for early case detection and isolation. As laboratory testing and health services become insufficient to meet demand in GDL and most other cities, we propose that cities facilitate guidelines and equipment to help people curb spreading within their own homes. Postponing these actions will increase their economic cost and decrease their potential returns.


COVID-19 and civilian hoarding of medical masks: Time for legal measures


title: Molecular detection of SARS-CoV-2 using a reagent-free approach

text: Shortage of reagents and consumables required for the extraction and molecular detection of SARS-CoV-2 RNA in respiratory samples has led many laboratories to investigate alternative approaches for sample preparation. Fomsgaard et al 2020 recently presented results using heat-processing of respiratory samples prior to RT-qPCR as an economical method enabling an extremely fast streamlining of the processes at virtually no cost. Here, we present our results using this method and highlight some major pitfalls that diagnostics laboratories should be aware of before proceeding with this technique. We first investigated various treatments using different temperatures, incubation times and sample volumes based on the above study to optimise the heat-treatment conditions. Although the initial data confirmed the published results, further investigations revealed unexpected inhibitory properties of some commonly used virus transport media (VTMs) on some commercially available RT-qPCR mixes, emphasising the critical importance of a thorough validation process to determine the most adapted reagents to be used depending on the sample types to be tested. In conclusion, although the method works, with very consistent Ct values and an excellent sensitivity when compared to a conventional RNA extraction method, it is critical to include an internal control to check each sample for potential inhibition.


title: A big data analysis on the five dimensions of emergency management information in the early stage of COVID-19 in China

text: The all-round and multilevel responses to the epidemic, with professional medical institutions, the governments and the public as the main agents of response and the media as the bridge of communication, are key to developing the public health emergency management system with regard to emerging infectious diseases and diseases with unknown etiology in the information age. This study creates an analysis framework concerning the five dimensions of information—the epidemic itself and the medical, governmental, public and media responses—and analyzes the evolution, interaction and trends of five dimensions using big data within the period of observation For the four dimensions other than the media response, the level of information related to the epidemic and the medical response is relatively high, while the level of response by medical institutions and the governments are similar, and both are higher than the public response. The media coverage of the epidemic remains at a high level of information. In relation to such diseases, the government should take the role of big data analytics seriously, lead a multi-agent social collaboration network, and further strengthen the ‘One Planning Plus Three Systems’ framework related to emergency management in China.


title: Closed Loop Feedback Mechanism Effect Pilot Investigation on Manual Assembly Time and Process Variation

text: Abstract Increasing customer demand for individualized and cost-effective products within shorter production times is reshaping the manufacturing and production environment. Human workers and machines must be able to react to changes with increased flexibility and efficiency. To meet these needs, the tools and products of modern assembly have continually updated and changed, but much work remains to incorporate the natural intelligence of an assembly worker more deeply into future assembly system information flow, both to and from the worker (feedback loop). This work presents a pilot lab evaluation of varied real-time feedback mechanisms for human workers on manual assembly processes to understand better how the method of the information feedback loop to the assembly associate affects their assembly time, variance, and accuracy as well as their perceived acceptance of each mechanism for information feedback. Lego building block models were used as the assembly product to build while wearing a wireless feedback mechanism device. The device incorporated LED lights, vibration, a text screen, and an image screen to provide feedback to the worker. All feedback was provided by an administrator who was able to send commands to the respective feedback methods as needed. Early conclusions in the pilot show a difference in the assembly time depending on both the feedback mechanism used and the complexity of the assembled model. Future work will include expanding the number of participants per test case and increasing the number and types of feedback provided to include non-wearable types such as stationary monitors and sound.


title: Modelling of the second (and subsequent) waves of the coronavirus epidemic. Spain and Germany as case studies

text: The first wave of the coronavirus pandemic is waning in many countries. Some of them are starting to lift the confinement measures adopted to control it, but there is considerable uncertainty about if it is too soon and it may cause a second wave of the epidemic. To explore this issue, I fitted a SEIR model with time-dependent transmission and mortality rates to data from Spain and Germany as contrasting case studies. The model reached an excellent fit to the data. I then simulated the post-confinement epidemic under several scenarios. The model shows that (in the absence of a vaccine) a second wave is likely inevitable and will arrive soon, and that a strategy of adaptive confinement may be effective to control it. The model also shows that just a few days delay in starting the confinement may have caused and excess of thousands of deaths in Spain.


The oral surgery response to coronavirus disease (COVID-19). Keep calm and carry on?


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title: Molecular Basis of Binding between Middle East Respiratory Syndrome Coronavirus and CD26 from Seven Bat Species

text: Continued reports of Middle East respiratory syndrome coronavirus (MERS-CoV) infecting humans have occurred since the identification of this virus in 2012. MERS-CoV is prone to cause endemic disease in the Middle East, with several dozen spillover infections to other continents. It is hypothesized that MERS-CoV originated from bat coronaviruses and that dromedary camels are its natural reservoir. Although gene segments identical to MERS-CoV were sequenced from certain species of bats and one species experimentally shed the virus, it is still unknown whether other bats can transmit the virus. Here, at the molecular level, we found that all purified bat CD26s (bCD26s) from a diverse range of species interact with the receptor binding domain (RBD) of MERS-CoV, with equilibrium dissociation constant values ranging from several to hundreds at the micromolar level. Moreover, all bCD26s expressed in this study mediated the entry of pseudotyped MERS-CoV to receptor-expressing cells, indicating the broad potential engagement of bCD26s as MERS-CoV receptors. Further structural analysis indicated that in the bat receptor, compared to the human receptor, substitutions of key residues and their adjacent amino acids leads to decreased binding affinity to the MERS-RBD. These results add more evidence to the existing belief that bats are the original source of MERS-CoV and suggest that bCD26s in many species can mediate the entry of the virus, which has significant implications for the surveillance and control of MERS-CoV infection. IMPORTANCE In this study, we found that bat CD26s (bCD26s) from different species exhibit large diversities, especially in the region responsible for binding to the receptor binding domain (RBD) of Middle East respiratory syndrome coronavirus (MERS-CoV). However, they maintain the interaction with MERS-RBD at varied affinities and support the entry of pseudotyped MERS-CoV. These bat receptors polymorphisms seem to confer evolutionary pressure for the adaptation of CD26-binding virus, such as the ancestor of MERS-CoV, and led to the generation of diversified CD26-engaging CoV strains. Thus, our data add more evidence to support that bats are the reservoir of MERS-CoV and similar viruses, as well as further emphasize the necessity to survey MERS-CoV and other CoVs among bats.


title: Advantages, Limitations and Recommendations for online learning during COVID-19 pandemic era

text: OBJECTIVE: During COVID-19 pandemic, the institutions in Pakistan have started online learning. This study explores the perception of teachers and students regarding its advantages, limitations and recommendations. METHODS: This qualitative case study was conducted from March to April 2020. Using maximum variation sampling, 12 faculty members and 12 students from University College of Medicine and University College of Dentistry, Lahore were invited to participate. Four focus group interviews, two each with the faculty and students of medicine and dentistry were carried out. Data were transcribed verbatim and thematically analyzed using Atlas Ti. RESULTS: The advantages included remote learning, comfort, accessibility, while the limitations involved inefficiency and difficulty in maintaining academic integrity. The recommendations were to train faculty on using online modalities and developing lesson plan with reduced cognitive load and increased interactivities. CONCLUSION: The current study supports the use of online learning in medical and dental institutes, considering its various advantages. Online learning modalities encourage student-centered learning and they are easily manageable during this lockdown situation.


title: A Systems Approach to Assess Transport and Diffusion of Hazardous Airborne Particles in a Large Surgical Suite: Potential Impacts on Viral Airborne Transmission

text: Airborne transmission of viruses, such as the coronavirus 2 (SARS-CoV-2), in hospital systems are under debate: it has been shown that transmission of SARS-CoV-2 virus goes beyond droplet dynamics that is limited to 3-6 feet, but it is unclear if the airborne viral load is significant enough to ensure transmission of the disease. Surgical smoke can act as a carrier for tissue particles, viruses, and bacteria. To quantify airborne transmission from a physical point of view, we consider surgical smoke produced by thermal destruction of tissue during the use of electrosurgical instruments as a marker of airborne particle diffusion-transportation. Surgical smoke plumes are also known to be dangerous for human health, especially to surgical staff who receive long-term exposure over the years. There are limited quantified metrics reported on long-term effects of surgical smoke on staff's health. The purpose of this paper is to provide a mathematical framework and experimental protocol to assess the transport and diffusion of hazardous airborne particles in every large operating room suite. Measurements from a network of air quality sensors gathered during a clinical study provide validation for the main part of the model. Overall, the model estimates staff exposure to airborne contamination from surgical smoke and biological material. To address the clinical implication over a long period of time, the systems approach is built upon previous work on multi-scale modeling of surgical flow in a large operating room suite and takes into account human behavior factors.


title: Mortality reduction in 46 severe Covid-19 patients treated with hyperimmune plasma. A proof of concept single arm multicenter interventional trial

text: BACKGROUND Hyperimmune plasma from Covid-19 convalescent is a potential treatment for severe Covid-19. METHODS We conducted a multicenter one arm proof of concept interventional study. Patients with Covid-19 disease with moderate-to-severe Acute Respiratory Distress Syndrome, elevated C-reactive Protein and need for mechanical ventilation and/or CPAP were enrolled. One to three 250-300 ml unit of hyperimmune plasma (neutralizing antibodies titer [≥]1:160) were administered. Primary outcome was 7-days hospital mortality. Secondary outcomes were PaO2/FiO2, laboratory and radiologic changes, as well as weaning from mechanical ventilation and safety. RESULTS The study observed 46 patients from March, 25 to April, 21 2020. Patients were aged 63, 61% male, 30 on CPAP and 7 intubated. PaO2/FiO2 was 128 (SD 47). Symptoms and ARDS duration were 14 (SD 7) and 6 days (SD 3). Three patients (6.5%) died within 7 days. The upper one-sided 90%CI was 13.9%, allowing to reject the null hypothesis of a 15% mortality. PaO2/FiO2 increased by 112 units (95%CI 82 to142) in survivors, the chest radiogram severity decreased in 23% (95%CI 5% to 42%); CRP, Ferritin and LDH decreased by 60, 36 and 20% respectively. Weaning from CPAP was obtained in 26/30 patients and 3/7 were extubated. Five serious adverse events occurred in 4 patients (2 likely, 2 possible treatment related). CONCLUSIONS Hyperimmune plasma in Covid-19 shows promising benefits, to be confirmed in a randomized controlled trial. This proof of concept study could open to future developments including hyperimmune plasma banking, development of standardized pharmaceutical products and monoclonal antibodies.


title: A Bayesian analysis of the total number of cases of the COVID 19 when only a few data is available. A case study in the state of Goias, Brazil

text: The outbreak of COVID 19 has been provoking several problems to the health system around the world. One of the concerning is the crash of the health system due to the increasing demand suddenly. To avoid it, knowing the total number and daily new cases is crucial. In this study, we fitted curves growth models using a Bayesian approach. We extracted information obtained from some countries to build the prior distribution of the model. The total number of cases of the COVID 19 in the state of Goias was analyzed. Results from analyses indicated that the date of the outbreak peak is between 51 and 68 days after the beginning. Moreover, the total number of cases is around 3180 cases. The analysis did not take into consideration possibles changes in government control measures. We hope this study can provide some valuable information to public health management.


title: Estimates of the severity of COVID-19 disease

text: Background: A range of case fatality ratio (CFR) estimates for COVID 19 have been produced that differ substantially in magnitude. Methods: We used individual-case data from mainland China and cases detected outside mainland China to estimate the time between onset of symptoms and outcome (death or discharge from hospital). We next obtained age-stratified estimates of the CFR by relating the aggregate distribution of cases by dates of onset to the observed cumulative deaths in China, assuming a constant attack rate by age and adjusting for the demography of the population, and age and location-based under ascertainment. We additionally estimated the CFR from individual linelist data on 1,334 cases identified outside mainland China. We used data on the PCR prevalence in international residents repatriated from China at the end of January 2020 to obtain age-stratified estimates of the infection fatality ratio (IFR). Using data on age stratified severity in a subset of 3,665 cases from China, we estimated the proportion of infections that will likely require hospitalisation. Findings: We estimate the mean duration from onset-of-symptoms to death to be 17.8 days (95% credible interval, crI 16.9,19.2 days) and from onset-of-symptoms to hospital discharge to be 22.6 days (95% crI 21.1,24.4 days). We estimate a crude CFR of 3.67% (95% crI 3.56%,3.80%) in cases from mainland China. Adjusting for demography and under-ascertainment of milder cases in Wuhan relative to the rest of China, we obtain a best estimate of the CFR in China of 1.38% (95% crI 1.23%,1.53%) with substantially higher values in older ages. Our estimate of the CFR from international cases stratified by age (under 60 or 60 and above) are consistent with these estimates from China. We obtain an overall IFR estimate for China of 0.66% (0.39%,1.33%), again with an increasing profile with age. Interpretation: These early estimates give an indication of the fatality ratio across the spectrum of COVID-19 disease and demonstrate a strong age-gradient in risk.


title: Multilevel Integrated Model with a Novel Systems Approach (MIMANSA) for Simulating the Spread of COVID-19

text: Abstract COVID-19 has affected people's lives all over the world. It has created a perplexing situation about what actions one should and should not take. Mathematical modeling of biological systems is challenging and gives a different perspective, especially in decision making under multiple complex scenarios. Public health officials grapple with multiple issues such as recommending a lockdown, contact tracing, promoting the mask usage, social distancing, and frequent handwashing, as well as keeping the families of patients in isolation for the incubation period. It is even more challenging to find the optimal combination of all of the above without the use of a suitable mathematical model. There are many different approaches to modeling the spread of SARS-CoV-2, the virus that causes COVID-19. Some models are easy to use, while others need extensive use of high-end computers. However, models to assist public health official's decision making are hard to find. In this paper, we discuss a novel systems approach to building a model for simulating the spread of COVID-19. The model, MIMANSA, divides an individual's in-person social interactions into three areas, namely home, workplace, and public places. While tracking the in-person interactions, the model follows the virus spread. Internally, the model labels healthy people who turn into silent carriers, virus-infected patients, or healthy carriers. It tracks down to the smallest level of a single day interaction. As and when a new silent carrier is created, the model automatically expands and builds a network of virus spread. All single-day blocks are integrated to get the final result. MIMANSA is novel due to its ability to build a virus spread network as a multilevel, integrated model, and in the end, enable one to make complex decisions with ease. MIMANSA is trained and validated using the data from the www.COVID-19India.org website. It does not use any arbitrary constants. All its parameters have a physical significance and are measurable. Once trained, the parameter estimation is complete, and the model is ready to run multiple scenarios. MIMANSA has four control mechanisms that a user can use. It helps one simulate the what-if scenarios. The first one is to control the exposure level to the virus depending on the number of hours spent with a silent carrier. The second provides control over the infection rate or the probability of a healthy person getting infected in the presence of a silent carrier. The third one allows the user to control lockdown effectiveness percentage, and the fourth one gives control over quarantine percentage. Inside the model, MIMANSA differentiates between virus-infected patients, silent carriers, and healthy carriers. MIMANSA has the capability to consider variations in virus activity levels of every asymptomatic patient, varying the exposure to the virus, and varying the infection rate depending on the person's immunity. MIMANSA can simulate scenarios to study the impact of many different conditions simultaneously. MIMANSA assists public health officials in complex decision making, enables scientists in projecting the SARS-CoV-2 virus spread, and aids hospital administrators in management. MIMANSA will play a significant role in finding the balance between the effect of strict lockdown on the economy vs. the marginally high number of COVID-19 patients with a bit relaxed lockdown.


title: SARS-CoV-2 receptor mutation in Egyptian population

text: The Coronavirus disease 2019 (COVID-19) is a respiratory tract infectious disease caused by Severe Acute Respiratory Syndrome coronavirus 2 (SARS-CoV-2). SARS-CoV-2 triggers severe pneumonia leading to acute respiratory distress syndrome and death in severe cases. According to WHO reported, Egypt is among the countries with low confirmed SARS CoV2 infected symptomatic cases and death. We postulate that one of the reasons for this may be due mutations in the viral receptor. Therefore this study was conducted to confirm or reject this postulation.


title: Global convergence of COVID-19 basic reproduction number and estimation from early-time SIR dynamics

text: The SIR ('susceptible-infectious-recovered') formulation is used to uncover the generic spread mechanisms observed by COVID-19 dynamics globally, especially in the early phases of infectious spread. During this early period, potential controls were not effectively put in place or enforced in many countries. Hence, the early phases of COVID-19 spread in countries where controls were weak offer a unique perspective on the ensemble-behavior of COVID-19 basic reproduction number Ro. The work here shows that there is global convergence (i.e. across many nations) to an uncontrolled Ro=4.5 that describes the early time spread of COVID-19. This value is in agreement with independent estimates from other sources reviewed here and adds to the growing consensus that the early estimate of Ro=2.2 adopted by the World Health Organization is low. A reconciliation between power-law and exponential growth predictions is also featured within the confines of the SIR formulation. Implications for evaluating potential control strategies from this uncontrolled Ro are briefly discussed in the context of the maximum possible infected fraction of the population (needed for assessing health care capacity) and mortality (especially in the USA given diverging projections). Model results indicate that if intervention measures still result in Ro > 2.7 within 49 days after first infection, intervention is unlikely to be effective in general for COVID-19. Current optimistic projections place mortality figures in the USA in the range of 100,000 fatalities. For fatalities to be confined to 100,000 requires a reduction in Ro from 4.5 to 2.7 within 17 days of first infection assuming a mortality rate of 3.4%.


Two things can be true at once: Surviving Covid‐19


title: Challenges and countermeasures of thoracic oncology in the epidemic of COVID-19

text: Since December, 2019, a 2019 novel coronavirus disease (COVID-19) infected by the severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) emerged in Wuhan, Hubei province, and the epidemic situation has continued to spread globally. The epidemic spread of COVID-19 has brought great challenges to the clinical practice of thoracic oncology. Outpatient clinics need to strengthen the differential diagnosis of initial symptoms, pulmonary ground-glass opacity (GGO), consolidation, interstitial and/or interlobular septal thickening, and crazy paving appearance. In the routine of oncology, the differential diagnosis of adverse events from COVID-19 is also significant, including radiation pneumonitis, checkpoint inhibitor pneumonitis (CIP), neutropenic fever, and so on. During the epidemic, indications of transbronchial biopsy (TBB) and CT-guided percutaneous thoracic biopsy are strictly controlled. For patients who are planning to undergo biopsy operation, screening to exclude the possibility of COVID-19 should be carried out. For confirmed or suspected patients, three-level protection should be performed during the operation. Disinfection and isolation measures should be strictly carried out during the operation. At last, more attention to the protection of cancer patients and give priority to the treatment of infected cancer patients.


title: A brief note on randomized controlled trials and compassionate/off-label use of drugs in the early phases of the COVID-19 pandemic

text: Randomized controlled trials (RCTs) are the best way to find effective and acceptable safe treatments for COVID-19 and any possible future outbreak. However, caution is needed when comparing the number of participants in RCTs with that of patients with COVID-19 treated with compassionate and/or off-label drugs to support the hypothesis that the latter are preferred by clinicians as an alternative to the former.


title: Countries are Clustered but Number of Tests is not Vital to Predict Global COVID-19 Confirmed Cases: A Machine Learning Approach

text: COVID-19 disease is a global pandemic and it appears as pandemic for each and every nation and territory in the earth.This paper focusses on analysing the global COVID-19 data by popular machine learning techniques to know which covariates are importantly associated with the cumulative number of confirmed cases, whether the countries are clustered with respect to the covariates considered, whether the variation in the covariates are explained by any latent factor. Regression tree, cluster analysis and principal component analysis are implemented to global COVID-19 data of 133 countries obtained from the Worldometer website as reported as on April 17, 2020. Our results suggest that there are four major clusters among the countries. First cluster consists of 8 countries where cumulative infected cases and deaths are highest. It is also revealed that there are two principal components. The countries which play vital role to explain the 60\% variation of the total variations by the first component characterized by all variables except the rate variables include USA, Spain, Italy, France, Germany, UK, and Iran. Remaining countries contribute to explaining 20\% variation of the total variations by the second component characterized by only three rate variables. We also found that the number of tests by the country variable among other variables country, number of active cases, number of deaths, number of recovered patients, number of serious cases, and number of new cases is an unimportant variable to predict cumulative number of confirmed cases. Hence, the number of tests might play vital role to individual country level who are in the primary level of virus spread but not to the global level.