title: COVID-19 and Older Adults. Lessons Learned from the Italian Epicenter

text: On March 13th, 2020, The World Health Organization effectively established that Europe is the new the COVID-19 pandemic world epicenter, as cases in Italy and other European nations soared. The numbers in Italy have climbed with over 80,000 cases as of March 25th, 2020 and with over 8000 deaths, placing Italy now as the country with the highest mortality rate. Importantly, older adults are particularly vulnerable to get severe illness, complications, and to have a higher mortality rate than any other age group. The clinical presentation in older adults with severe illness, in the experience from geriatricians in Lombardy, is described as quite sudden; patients can develop severe hypoxemia with the need of ventilation support in few hours. Geriatric syndromes are not a common form of presentation for COVID-19 in severe illness. It is suggested that stratification by frailty level may help to detect the most vulnerable, and decisions about healthcare resource prioritization should not be taken based only on age itself or previous diagnosis, such as having dementia.


title: Chloroquine and hydroxychloroquine effectiveness in human subjects during coronavirus: a systematic review

text: In a search to find effective treatments for COVID-19, chloroquine and hydroxychloroquine have gained attention. We aim to provide evidence to support clinical decision-making regarding medication for the treatment of COVID-19 by carrying out a systematic review of the literature. The electronic databases MEDLINE, EMBASE, Global Health, and HMIC were searched up to April 2020. Eligible study outcomes included: extubation or patient recovery. Relevant data were extracted and analysed by narrative synthesis. Our results included six studies in the review of which four studies were of good or fair quality. All eligible studies included were for coronavirus involving the use of either chloroquine or hydroxychloroquine to treat common symptoms such as fever, cough, shortness of breath and fatigue. Outcomes most commonly reported were improved lung function, viral clearance, and hospital discharge. Strong evidence to support the use of chloroquine and hydroxychloroquine in the treatment of COVID-19 is lacking. Fast track trials are riddled with bias and may not conform to rigorous guidelines which may lead to inadequate data being reported. The use of these drugs in combination with other medications may be useful but without knowing which groups they are suited for and when they may cause more harm than good.


Recognizing and controlling airborne transmission of SARS‐CoV‐2 in indoor environments


title: Tocilizumab in Severe COVID-19 Pneumonia and Concomitant Cytokine Release Syndrome

text: Younger patients with COVID-19 may experience an exaggerated immune response to SARS-CoV-2 infection and develop cytokine release syndrome (CRS), which may be life threatening. There is no proven antiviral therapy for COVID-19 so far, but profound immunosuppression has recently been suggested as a treatment for COVID-19-associated CRS. We present a case of life-threatening CRS caused by COVID-19 infection with a favourable response to immunosuppressive therapy with tocilizumab (TCZ). The rapid clinical and biochemical improvement following TCZ administration suggests that treatment with immunotherapy can be life-saving in selected patients with COVID-19-induced CRS. LEARNING POINTS: Cytokine release syndrome may cause sudden and potentially life-threatening clinical deterioration in COVID-19 pneumonia, particularly in younger patients. Immunosuppressive therapy may provide important additional therapeutic benefit in these patients. Tocilizumab, a specific IL-6 inhibitor, led to dramatic clinical improvement in a young patient with severe COVID-19-associated cytokine release syndrome.


title: Preprinting a pandemic: the role of preprints in the COVID-19 pandemic

text: The world continues to face an ongoing viral pandemic that presents a serious threat to human health. The virus underlying the COVID-19 disease, SARS-CoV-2, has caused over 3.2 million confirmed cases and 220,000 deaths between January and April 2020. Although the last pandemic of respiratory disease of viral origin swept the globe only a decade ago, the way science operates and responds to current events has experienced a paradigm shift in the interim. The scientific community has responded rapidly to the COVID-19 pandemic, releasing over 16,000 COVID-19 related scientific articles within 4 months of the first confirmed case, of which at least 6,000 were hosted by preprint servers. We focused our analysis on bioRxiv and medRxiv, two growing preprint servers for biomedical research, investigating the attributes of COVID-19 preprints, their access and usage rates, characteristics of their sharing on online platforms, and the relationship between preprints and their published articles. Our data provides evidence for increased scientific and public engagement (COVID-19 preprints are accessed and distributed at least 15 times more than non-COVID-19 preprints) and changes in journalistic practice with reference to preprints. We also find evidence for changes in preprinting and publishing behaviour: COVID-19 preprints are shorter, with fewer panels and tables, and reviewed faster. Our results highlight the unprecedented role of preprints and preprint servers in the dissemination of COVID-19 science, and the likely long-term impact of the pandemic on the scientific publishing landscape.


title: Single Nucleus Multiomic Profiling Reveals Age-Dynamic Regulation of Host Genes Associated with SARS-CoV-2 Infection

text: Respiratory failure is the leading cause of COVID-19 death and disproportionately impacts adults more than children. Here, we present a large-scale snATAC-seq dataset (90,980 nuclei) of the human lung, generated in parallel with snRNA-seq (46,500 nuclei), from healthy donors of ~30 weeks, ~3 years and ~30 years of age. Focusing on genes implicated in SARS-CoV-2 cell entry, we observed an increase in the proportion of alveolar epithelial cells expressing ACE2 and TMPRSS2 in adult compared to young lungs. Consistent with expression dynamics, 10 chromatin peaks linked to TMPRSS2 exhibited significantly increased activity with age and harbored IRF and STAT binding sites. Furthermore, we identified 14 common sequence variants in age-increasing peaks with predicted regulatory function, including several associated with respiratory traits and TMPRSS2 expression. Our findings reveal a plausible contributor to why children are more resistant to COVID-19 and provide an epigenomic basis for transferring this resistance to older populations.


docid: nfzgpicu

title: Additional challenges faced by cancer patients in Gaza due to COVID-19

text: Cancer patients in conflict settings experience significant barriers in accessing chemotherapy and radiotherapy as well as palliative care and psychosocial support. Now they face an additional possible risk of infection by SARS-CoV-2 novel coronavirus and the indirect impact of the COVID-19 pandemic on movement restrictions and their access to care. In this commentary, we highlight that despite the low COVID-19 burden in conflict settings like Gaza, COVID-19 could lead to further inequity in cancer care and poorer outcomes for Palestinians with cancer. This is due to the pre-existing shortage in cancer resources as well as the lack of context-specific guidelines to prepare for COVID-19 in war-torn settings.


title: SARS-CoV-2, an evolutionary perspective of interaction with human ACE2 reveals undiscovered amino acids necessary for complex stability

text: The emergence of SARS-CoV-2 has resulted in more than 200,000 infections and nearly 9,000 deaths globally so far. This novel virus is thought to have originated from an animal reservoir, and acquired the ability to infect human cells using the SARS-CoV cell receptor hACE2. In the wake of a global pandemic it is essential to improve our understanding of the evolutionary dynamics surrounding the origin and spread of a novel infectious disease. One way theory predicts selection pressures should shape viral evolution is to enhance binding with host cells. We first assessed evolutionary dynamics in select betacoronavirus spike protein genes to predict where these genomic regions are under directional or purifying selection between divergent viral lineages at various scales of relatedness. With this analysis, we determine a region inside the receptor-binding domain with putative sites under positive selection interspersed among highly conserved sites, which are implicated in structural stability of the viral spike protein and its union with human receptor hACE2. Next, to gain further insights into factors associated with coronaviruses recognition of the human host receptor, we performed modeling studies of five different coronaviruses and their potential binding to hACE2. Modeling results indicate that interfering with the salt bridges at hot spot 353 could be an effective strategy for inhibiting binding, and hence for the prevention of coronavirus infections. We also propose that a glycine residue at the receptor binding domain of the spike glycoprotein can have a critical role in permitting bat variants of the coronaviruses to infect human cells.


title: Risk map of the novel coronavirus (2019-nCoV) in China: proportionate control is needed

text: Background China is running a national level antivirus campaign against the novel coronavirus (2019-nCoV). Strict control measures are being enforced in either the populated areas and remote regions. While the virus is closed to be under control, tremendous economic loss has been caused. Methods and findings We assessed the pandemic risk of 2019-nCoV for all cities/regions in China using the random forest algorithm, taking into account the effect of five factors: the accumulative and increased numbers of confirmed cases, total population, population density, and GDP. We defined four levels of the risk, corresponding to the four response levels to public health emergencies in China. The classification system has good consistency among cities in China, as the error rate of the confusion matrix is 1.58%. Conclusions The pandemic risk of 2019-nCoV is dramatically different among the 442 cities/regions. We recommend to adopt proportionate control policy according to the risk level to reduce unnecessary economic loss.


title: High incidence of asymptomatic SARS-CoV-2 infection, Chongqing, China

text: Background: SARS-CoV-2 has been a global pandemic, but the emergence of asymptomatic patients has caused difficulties in the prevention of the epidemic. Therefore, it is significant to understand the epidemiological characteristics of asymptomatic patients with SARS-CoV-2 infection. Methods: In this single-center, retrospective and observational study, we collected data from 167 patients with SARS-CoV-2 infection treated in Chongqing Public Health Medical Center (Chongqing, China) from January to March 2020. The epidemiological characteristics and variable of these patients were collected and analyzed. Findings: 82.04% of the SARS-CoV-2 infected patients had a travel history in Wuhan or a history of contact with returnees from Wuhan, showing typical characteristics of imported cases, and the proportion of severe Covid-19 patients was 13.2%, of which 59% were imported from Wuhan. For the patients who was returnees from Wuhan, 18.1% was asymptomatic patients. In different infection periods, compared with the proportion after 1/31/2020, the proportion of asymptomatic patient among SARS-CoV-2 infected patient was higher(19% VS 1.5%). In different age groups, the proportion of asymptomatic patient was the highest(28.6%) in children group under 14, next in elder group over 70 (27.3%). Compared with mild and common Covid-19 patients, the mean latency of asymptomatic was longer (11.25 days VS 8.86 days), but the hospital length of stay was shorter (14.3 days VS 16.96 days) . Conclusion: The SARS-CoV-2 prevention needs to focus on the screening of asymptomatic patients in the community with a history of contact with the imported population, especially for children and the elderly population.


Smoking and SARS-CoV-2: Are Polish health professionals at higher risk of infection?


title: Sentinel Event Surveillance to Estimate Total SARS-CoV-2 Infections, United States

text: Human infections with a novel coronavirus (SARS-CoV-2) were first identified via syndromic surveillance in December of 2019 in Wuhan China. Since identification, infections (coronavirus disease-2019; COVID-19) caused by this novel pathogen have spread globally, with more than 180,000 confirmed cases as of March 16, 2020. Effective public health interventions, including social distancing, contact tracing, and isolation/quarantine rely on the rapid and accurate identification of confirmed cases. However, testing capacity (having sufficient tests and laboratory throughput) to support these non-pharmaceutical interventions remains a challenge for containment and mitigation of COVID-19 infections. We undertook a sentinel event strategy (where single health events signal emerging trends) to estimate the incidence of COVID-19 in the US. Data from a recent national conference, the Conservative Political Action Conference, (CPAC) near Washington, DC and from the outbreak in Wuhan, China were used to fit a simple exponential growth model to estimate the total number of incident SARS- CoV-2 infections in the United States on March 1, 2020, and to forecast subsequent infections potentially undetected by current testing strategies. Our analysis and forecasting estimates a total of 54,100 SARS-CoV-2 infections (80 % CI 5,600 to 125,300) have occurred in the United States to March 12, 2020. Our forecast predicts that a very substantial number of infections are undetected, and without extensive and far-reaching non-pharmaceutical interventions, the number of infections should be expected to grow at an exponential rate.


title: Genomic epidemiology reveals multiple introductions and spread of SARS-CoV-2 in the Indian state of Karnataka

text: Karnataka, a state in south India, reported its first case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) on March 8, 2020, more than a month after the first case was reported in India. We used a combination of contact tracing and genomic epidemiology to trace the spread of SARS-CoV-2 in the state up until May 21, 2020 (1578 cases). We obtained 47 full genomes of SARS-CoV-2 which clustered into six lineages (Pangolin lineages-A, B, B.1, B.1.1, B.4, and B.6). The lineages in Karnataka were known to be circulating in China, Southeast Asia, Iran, Europe and other parts of India and are likely to have been imported into the state both by international and domestic travel. Our sequences grouped into 12 contact clusters and 11 cases with no known contacts. We found nine of the 12 contact clusters had a single lineage of the virus, consistent with multiple introductions and most (8/12) were contained within a single district, consistent with local spread. In most of the twelve clusters, the index case (9/12) and spreaders (8/12) were symptomatic. Of the 47 sequences, 31 belonged to the B/B.6 lineage, including seven of eleven cases with no known contact, this is consistent with the ongoing transmission of this lineage in the state. Genomic epidemiology of SARS-CoV-2 in Karnataka is consistent with multiple introductions of the virus followed by local transmission in parallel with ongoing viral evolution. This is the first study from India combining genomic data with epidemiological information emphasizing the need for an integrated approach to outbreak response.


title: COVIDPEN: A Novel COVID-19 Detection Model using Chest X-Rays and CT Scans

text: The trending global pandemic of COVID-19 is the fastest ever impact which caused people worldwide by severe acute respiratory syndrome~(SARS)-driven coronavirus. However, several countries suffer from the shortage of test kits and high false negative rate in PCR test. Enhancing the chest X-ray or CT detection rate becomes critical. The patient triage is of utmost importance and the use of machine learning can drive the diagnosis of chest X-ray or CT image by identifying COVID-19 cases. To tackle this problem, we propose~COVIDPEN~-~a transfer learning approach on Pruned EfficientNet-based model for the detection of COVID-19 cases. The proposed model is further interpolated by post-hoc analysis for the explainability of the predictions. The effectiveness of our proposed model is demonstrated on two systematic datasets of chest radiographs and computed tomography scans. Experimental results with several baseline comparisons show that our method is on par and confers clinically explicable instances, which are meant for healthcare providers.


title: Roles of meteorological conditions in COVID-19 transmission on a worldwide scale

text: The novel coronavirus (SARS-CoV-2/ 2019-nCoV) identified in Wuhan, China, in December 2019 has caused great damage to public health and economy worldwide with over 140,000 infected cases up to date. Previous research has suggested an involvement of meteorological conditions in the spread of droplet-mediated viral diseases, such as influenza. However, as for the recent novel coronavirus, few studies have discussed systematically about the role of daily weather in the epidemic transmission of the virus. Here, we examine the relationships of meteorological variables with the severity of the outbreak on a worldwide scale. The confirmed case counts, which indicates the severity of COVID-19 spread, and four meteorological variables, i.e., air temperature, relative humidity, wind speed, and visibility, were collected daily between January 20 and March 11 (52 days) for 430 cities and districts all over China, 21 cities/ provinces in Italy, 21 cities/ provinces in Japan, and 51 other countries around the world. Four different time delays of weather (on the day, 3 days ago, 7 days ago, and 14 days ago) as to the epidemic situation were taken for modeling and we finally chose the weather two weeks ago to model against the daily epidemic situation as its correlated with the outbreak best. Taken Chinese cities as a discovery dataset, it was suggested that temperature, wind speed, and relative humidity combined together could best predict the epidemic situation. The meteorological model could well predict the outbreak around the world with a high correlation (r2>0.6) with the real data. Using this model, we further predicted the possible epidemic situation in the future 12 days in several high-latitude cities with potential outbreak. This model could provide more information for government's future decisions on COVID-19 outbreak control.


Novel corona 2019: Virus above human defying laws


docid: pgsuiisy

title: Elevated levels of PM2.5 in crowded Subways of Cities with High COVID-19 related Mortality

text: BACKGROUND: Recent literature indicates that the pollutant, particulate matter PM2.5, may have an impact on COVID-19 related mortality. COVID-19 has been found adherent to PM2.5 and may be involved in the transmission and the exacerbation of COVID-19 infection, possibly due to PM2.5 adverse influence on respiratory immunity. The PM2.5 levels in underground subways have been found up to 90 times higher than the surface levels. Moreover, the commuter congestion in the presence of such high levels of PM2.5 further encouraged COVID-19 human to human transmission. METHOD: The levels of PM2.5 were retrieved from literature assessing particulate matter PM2.5 measured on subway platforms in two groups of cities. These cities were differentiated by the COVID-19 population percentage mortality rate (0.007% vs 0.09% (p<0.0004) the city population, more than a 10-fold difference. Data regarding the number of stations, length of the networks (km) and the annual ridership were also obtained from literature related to underground commuting. RESULTS: The population percentage mortality related to COVID-19 infection correlated significantly for both minimum (p<0.01) and maximum (p<0.00001) levels of PM2.5. The city subways with low COVID-19 mortality had minimum platform PM2.5 levels of 27.4 (SD+/-17.2g/m3) compared to 63.4g/m3 (SD+/-10.8g/m3) in cities with high COVID-19 associated mortality (p<0.01). Subway maximum levels of PM2.5 in cities with low COVID-19 mortality was 53.4g/m3 (SD+/-21.8g/m3) while that of underground networks with high COVID-19 mortality had maximum platform PM2.5 levels of 172.1g/m3 (SD+/-98g/m3) (p<0.001). The cities with higher COVID-19 mortality had longer networks 230km (SD+/-111km) versus 119km (SD+/-99km) ( p<0.03) and more stations 191 (SD+/-109) versus 102 (SD+/-94) (p<0.047). Although the annual ridership in the cities with the high COVID-19 mortality was higher (1034x106 vs 751x106) this did not achieve statistical significance. The maximum PM2.5 correlated with the number of stations (p<0.045) and the length of the networks (p< 0.044). The minimum PM2.5 did not achieve similar significant correlations to subway variables. Ridership significantly correlated with number of stations (p<0.01) and the length of the network (p<0.02). CONCLUSION: Underground networks may have inherent characteristics accelerating spread of COVID-19 infection and consequent mortality. The highly elevated levels of PM2.5 in overcrowded subways with extensive reach may have acted as a co-factor to disseminate the pandemic. Keywords: COVID-19, mortality, PM2.5, Subway/Underground


title: Social Distancing and Personal Protective Measures Decrease Influenza Morbidity and Mortality

text: Seasonal influenza (flu) is an underappreciated source of disease morbidity and mortality worldwide. While vaccination remains the cornerstone of influenza prevention, common measures practiced during the COVID-19 pandemic such as social distancing, the use of protective face masks, and frequent hand washing are rarely utilized during flu season. In this investigation, we examined the effect of these preventative measures in decreasing influenza burden this year. We examined three countries with major COVID-19 outbreaks i.e. China, Italy and the United States, and compared the flu activity this year to the average of the last 4 years (2015-2019). We found that this year in China and Italy, there was a significantly steeper decline of flu cases than average, which correlated with an increase in positive COVID-19 case reports in those countries. These "averted" cases can be translated into a substantial decrease in morbidity and mortality. As such, we conclude that the current COVID-19 pandemic is a reminder that behavioral measures can decrease the burden of communicable respiratory infections, and these measures should be adopted to an extent during normal influenza season.


title: Knowledge and Beliefs towards Universal Safety Precautions to flatten the curve during Novel Coronavirus Disease (nCOVID-19) Pandemic among general Public in India: Explorations from a National Perspective

text: Background: The novel Coronavirus disease (COVID-19) is being considered as the most serious health threat that the world has never witnessed in the recent times and significantly affecting the daily routine of mankind by emerging as a global pandemic. Yet, as there is no treatment nor a vaccine that was approved so far, universal safety precautions (USPs) and mitigating strategies are the only way to deal with this emergency crisis. However, knowledge and beliefs towards USPs among the general public in countries such as India with a large population are lacking. Methods: A prospective, cross-sectional, web-based online survey was conducted among the general public in India during March 2020. A 20-items self-administered survey questionnaire was developed and randomly distributed among the public using google document forms through social media networks. Descriptive statistics were used in representing the study characteristics, and the Chi-square test was used in assessing the associations among the study variables with a p-value of < 0.05 was considered as statistically significant. Results: Of 1287 participants, 1117 have given their consent of willingness and completed the questionnaire with a response rate of 86.8%. The mean age of the study participants was 28.8 ± 10.9 years, where the majority of them belong to the age category <25 years, and sex was equally distributed. Based upon the socio-demographic information, the majority were post-graduates (32.9%), professional job holders (45%) and belonged to the upper-middle (40%) economic class. Overall, the knowledge and beliefs towards USPs and mitigating strategies among participants varied between moderate to high, with statistically significant associations with their socio-demographic characteristics. Conclusions: Although the knowledge and beliefs of the general public in India towards USPs are encouraging, there is a need for long-term educational interventions as the dynamics and severity of COVID-19 have been changing day-by-day rapidly. The findings of this study could guide the public health authorities in making and implementing decisions to combat this pandemic. Keywords: Coronavirus, COVID-19, outbreak, Pandemic, universal precautions, SARS-CoV-2.


title: Anxiety among the general population during Coronavirus-19 Disease in Saudi Arabia: Implications for a Mental Support Program

text: Background: The 2019 outbreak of coronavirus disease (COVID-19) is an worldwide health emergency that threatens mental health of general public. Research data are required to establish evidence-based approaches to alleviate the symptoms of anxiety during the outbreak. This study aimed to survey the general public in Saudi Arabia to help in understanding their levels of anxiety during the COVID-19 outbreak. Methods: The researchers performed an on-line survey using snowball sampling methods from April 1 through April 10, 2020. The online survey collected demographics information data, while the Social Anxiety Questionnaire for Adults (SAQ-A30) was used to measure anxiety level. Results: This study consisted of 709 respondents from different regions of Saudi Arabia. The general population reported mild to moderate rates of anxiety. Married respondents were associated with a significantly higher level of anxiety (p<0.05). Conclusions: The respondents reported mild to moderate anxiety during the outbreak of COVID-19 in Saudi Arabia. Implication for practice: The results of this study identify the implications to lower levels of anxiety that may be used during the COVID-19 outbreak to develop mental health support programs to improve the mental health of vulnerable groups.


title: Modeling and Prediction of the 2019 Coronavirus Disease Spreading in China Incorporating Human Migration Data

text: This study integrates the daily intercity migration data with the classic Susceptible-Exposed-Infected-Removed (SEIR) model to construct a new model suitable for describing the dynamics of epidemic spreading of Coronavirus Disease 2019 (COVID-19) in China. Daily intercity migration data for 367 cities in China are collected from Baidu Migration, a mobile-app based human migration tracking data system. Historical data of infected, recovered and death cases from official source are used for model fitting. The set of model parameters obtained from best data fitting using a constrained nonlinear optimization procedure is used for estimation of the dynamics of epidemic spreading in the coming weeks. Our results show that the number of infections in most cities in China will peak between mid February to early March 2020, with about 0.8%, less than 0.1% and less than 0.01% of the population eventually infected in Wuhan, Hubei Province and the rest of China, respectively.


title: Characterization of the substitution hotspots in SARS-CoV-2 genome using BioAider and detection of a SR-rich region in N protein providing further evidence of its animal origin

text: The novel human coronavirus (SARS-CoV-2) causes the coronavirus disease 2019 (COVID-19) pandemic worldwide. The increasing sequencing data have shown abundant single nucleotide variations in SARS-CoV-2 genome. However, it is difficult to quickly analyze genomic variation and screen key mutations of SARS-CoV-2. In this study, we developed a visual program, named BioAider, for quick and convenient sequence annotation and mutation analysis on multiple genome-sequencing data. Using BioAider, we conducted a comprehensive genome variation analysis on 3,240 sequences of SARS-CoV-2 genome. Herein, we detected 14 substitution hotspots within SARS-CoV-2 genome, including 10 non-synonymous and 4 synonymous ones. Among these hotspots, NSP13-Y541C was predicted to be a crucial substitution which might affect the unwinding activity of NSP13, a key protein for viral replication. Besides, we also found 3 groups of potentially linked substitution hotspots which were worth further study. In particular, we discovered a SR-rich region (aa 184-204) on the N protein of SARS-CoV-2 distinct from SARS-CoV, indicating more complex replication mechanism and unique N-M interaction of SARS-CoV-2. Interestingly, the quantity of SRXX repeat fragments in the SR-rich region well reflected the evolutionary relationship among SARS-CoV-2 and SARS-CoV-2 related animal coronaviruses, providing further evidence of its animal origin. Overall, we developed an efficient tool for rapid identification of mutations, identified substitution hotspots in SARS-CoV-2 genomes, and detected a distinctive polymorphism SR-rich region in N protein. This tool and the detected hotspots could facilitate the viral genomic study and may contribute for screening antiviral target sites.


title: Therapeutic effects of dipyridamole on COVID-19 patients with coagulation dysfunction

text: The human coronavirus HCoV-19 infection can cause acute respiratory distress syndrome (ARDS), hypercoagulability, hypertension, extrapulmonary multiorgan dysfunction. Effective antiviral and anti-coagulation agents with safe clinical profiles are urgently needed to improve the overall prognosis. We screened an FDA approved drug library and found that an anticoagulant agent dipyridamole (DIP) suppressed HCoV-19 replication at an EC50 of 100 nM in vitro. It also elicited potent type I interferon responses and ameliorated lung pathology in a viral pneumonia model. In analysis of twelve HCoV-19 infected patients with prophylactic anti-coagulation therapy, we found that DIP supplementation was associated with significantly increased platelet and lymphocyte counts and decreased D-dimer levels in comparison to control patients. Two weeks after initiation of DIP treatment, 3 of the 6 severe cases (60%) and all 4 of the mild cases (100%) were discharged from the hospital. One critically ill patient with extremely high levels of D-dimer and lymphopenia at the time of receiving DIP passed away. All other patients were in clinical remission. In summary, HCoV-19 infected patients could potentially benefit from DIP adjunctive therapy by reducing viral replication, suppressing hypercoagulability and enhancing immune recovery. Larger scale clinical trials of DIP are needed to validate these therapeutic effects.


title: Commercial Serology Assays Predict Neutralization Activity Against SARS-CoV-2

text: Background. Currently it is unknown whether a positive serology results correlates with protective immunity against SARS-CoV-2. There are also concerns regarding the low positive predictive value of SARS-CoV-2 serology tests, especially when testing populations with low disease prevalence. Methods. A neutralization assay was validated in a set of PCR confirmed positive specimens and in a negative cohort. 9,530 specimens were screened using the Diazyme SARS-CoV-2 IgG serology assay and all positive results (N=164) were reanalyzed using the neutralization assay, the Roche total immunoglobin assay, and the Abbott IgG assay. The relationship between the magnitude of a positive SARS-CoV-2 serology result and the levels of neutralizing antibodies detected was correlated. Neutralizing antibody titers (ID50) were also longitudinally monitored in SARS-CoV-2 PCR confirmed patients. Results. The SARS-CoV-2 neutralization assay had a PPA of 96.6% with a SARS-CoV-2 PCR test and a NPA of 98.0% across 100 negative controls. ID50 neutralization titers positively correlated with all three clinical serology platforms. Longitudinal monitoring of hospitalized PCR confirmed COVID-19 patients demonstrates they made high neutralization titers against SARS-CoV-2. PPA between the Diazyme IgG assay alone and the neutralization assay was 50.6%, while combining the Diazyme IgG assay with either the Roche or Abbott platforms increased the PPA to 79.2% and 78.4%, respectively. Conclusions. For the first time, we demonstrate that three widely available clinical serology assays positively correlate with SARS-CoV-2 neutralization activity observed in COVID-19 patients. When a two-platform screen and confirm approach was used for SARS-CoV-2 serology, nearly 80% of two-platform positive specimens had neutralization titers (ID50 >50).


title: Meteorological factors and domestic new cases of coronavirus disease (COVID-19) in nine Asian cities: A time-series analysis

text: AIM To investigate the associations of meteorological factors and the daily new cases of coronavirus disease (COVID-19) in nine Asian cities. METHOD Pearson correlation and generalized additive modeling were performed to assess the relationships between daily new COVID-19 cases and meteorological factors (daily average temperature and relative humidity) with the most updated data currently available. RESULTS The Pearson correlation showed that daily new confirmed cases of COVID-19 were more correlated with the average temperature than with relative humidity. Daily new confirmed cases were negatively correlated with the average temperature in Beijing (r=-0.565, P<0.01), Shanghai (r=-0.471, P<0.01), and Guangzhou (r=-0.530, P<0.01) , yet in contrast, positively correlated with that in Japan (r=0.441, P<0.01). In most of the cities (Shanghai, Guangzhou, Hong Kong, Seoul, Tokyo, and Kuala Lumpur), generalized additive modeling analysis showed the number of daily new confirmed cases was positively associated with both average temperature and relative humidity, especially in lagged 3d model, where a positive influence of temperature on the daily new confirmed cases was discerned in 5 cities except in Beijing, Wuhan, Korea, and Malaysia. Nevertheless, the results were inconsistent across cities and lagged time, suggesting meteorological factors were unlikely to greatly influence the COVID-19 epidemic. CONCLUSION The associations between meteorological factors and the number of COVID-19 daily cases are inconsistent across cities and lagged time. Large-scale public health measures and expanded regional research are still required until a vaccine becomes available and herd immunity is established.


title: Pandemic Human Coronavirus – Characterization and Comparison of Selected Properties of Hcov-sars and Hcov-mers

text: It: Two Coronaviruses, HCoV-229E and HCoV-OC43, causing generally mild respiratory tract infections in humans, were described in the XX c Pandemic Coronaviruses were first discovered as late as in the XXI c : SARS-HCoV in 2002 – causing severe respiratory tract infections (SARS) in China;MERS-HCoV in 2012 – circulating mostly on the Arabian Peninsula The SARS epidemic ended in 2004 resulting in morbidity of >8000 and >770 deaths, while the MERS epidemic is still ongoing (>2000 ill, >700 deaths) although its intensity decreased Both viruses are zoonotic and require at least two “host jumps” for the transmission of the infection to humans: for HCoV-SARS – from bat to palm civet and then to human;for HCoV-MERS – from bats to camels and subsequently to humans Primary mode of transmission is droplet in close contact (<1 m), but both viruses remain active in aerosol (up to 24 h), so infection can be also spread by air (ventilation) The ability for human-to-human transmission is higher for HCoV-SARS than for HCoV-MERS (8 generations vs 4, respectively) Moreover, there are differences in genome structure and pathogenic mechanisms: different receptor, cell entry mechanism, different way of host response modulation (e g inhibition of IFNβ cascade), etc Probably, these differences influence the overall manifestation of the disease in humans Infection caused by HCoV-MERS might manifest itself as ARDS, a mild-mannered and asymptomatic disease HCoV-SARS infections seem to be associated with severe disease only In this paper, a comparison of the structure of these viruses, the mechanisms underlying their ability to cross the interspecies barrier and to multiply in the human body, including modulation of IFNβ cascade, as well as routes of infection transmission and symptoms caused, were presented


title: Immune modulation to improve survival of respiratory virus infections in mice

text: Viral pneumonia remains a global health threat requiring novel treatment strategies, as strikingly exemplified in the SARS-CoV-2 pandemic of 2019-2020. We have reported that mice treated with a combination of inhaled Toll-like receptor (TLR) 2/6 and TLR 9 agonists (Pam2-ODN) to stimulate innate immunity are broadly protected against respiratory pathogens, but the mechanisms underlying this protection remain incompletely elucidated. Here, we show in a lethal paramyxovirus model that Pam2-ODN-enhanced survival is associated with robust virus inactivation by reactive oxygen species (ROS), which occurs prior to internalization by lung epithelial cells. However, we also found that mortality in sham-treated mice temporally corresponded with CD8+ T cell-enriched lung inflammation that peaks on days 11-12 after viral challenge, when the viral burden has waned to a scarcely detectable level. Pam2-ODN treatment blocked this injurious inflammation by reducing the viral burden, and alternatively, depleting CD8+ T cells 8 days after viral challenge also decreased mortality. These findings reveal opportunities for targeted immunomodulation to protect susceptible individuals against the morbidity and mortality of respiratory viral infections.


title: Prediction of the COVID-19 outbreak based on a realistic stochastic model

text: The current outbreak of coronavirus disease 2019 (COVID-19) has become a global crisis due to its quick and wide spread over the world. A good understanding of the dynamic of the disease would greatly enhance the control and prevention of COVID-19. However, to the best of our knowledge, the unique features of the outbreak have limited the applications of all existing models. In this paper, a novel stochastic model is proposed which aims to account for the unique transmission dynamics of COVID-19 and capture the effects of intervention measures implemented in Mainland China. We find that, (1) instead of aberration, there is a remarkable amount of asymptomatic individuals, (2) an individual with symptoms is approximately twice more likely to pass the disease to others than that of an asymptomatic patient, (3) the transmission rate has reduced significantly since the implementation of control measures in Mainland China, (4) it is expected that the epidemic outbreak would be contained by early March in the the selected provinces and cities.


title: Mental health considerations for children & adolescents in COVID-19 Pandemic

text: Children are not indifferent to the significant psychological impact of the COVID-19 Pandemic. They experience fears, uncertainties, substantial changes to their routines, physical and social isolation alongside high level of parental stress. Understanding their emotions and responses is essential to properly address their needs during this pandemic. In this article, we highlight children’s vulnerability, provide an overview of common symptoms of distress in different age groups, and summarize the interventions and resources available to promote child mental health and wellbeing during these challenging times. We advocate that prioritizing mental health including child & adolescent mental health is an essential component of any universal, community led response to COVID-19 Pandemic.


title: The effects of ARBs, ACEIs and statins on clinical outcomes of COVID-19 infection among nursing home residents

text: Background. COVID-19 infection has limited preventive or therapeutic drug options at this stage. Some of common existing drugs like angiotensin-converting enzyme inhibitors (ACEi), angiotensin II receptor blockers (ARB) and the HMG-CoA reductase inhibitors (statins) have been hypothesised to impact on disease severity. However, up till now, no studies investigating this association were conducted in the most vulnerable and affected population groups, i.e. older people residing in nursing homes. The purpose of this study has been to explore the association of ACEi/ARB and/or statins with clinical manifestations in COVID-19 infected older people residing in nursing homes. Methods and Findings. We undertook a retrospective multi-centre cohort study in two Belgian nursing homes that experienced similar COVID-19 outbreaks. COVID-19 diagnoses were based on clinical suspicion and/or viral presence using PCR of nasopharyngeal samples. A total of 154 COVID-19 positive subjects was identified. The outcomes were defined as 1) serious COVID-19 defined as a long-stay hospital admission (length of stay [≥] 7 days) or death (at hospital or nursing home) within 14 days of disease onset, and 2) asymptomatic, i.e. no disease symptoms in the whole study-period while still being PCR diagnosed. Disease symptoms were defined as any COVID-19-related clinical symptom (e.g. coughing, dyspnoea, sore throat) or sign (low oxygen saturation and fever) for [≥] 2 days out of 3 consecutive days. Logistic regression models with Firth corrections were applied on these 154 subjects to analyse the association between ACEi/ARB and/or statin use with the outcomes. Age, sex, functional status, diabetes and hypertension were used as covariates. Sensitivity analyses were conducted to evaluate the robustness of our statistical significant findings. We found a statistically significant association between statin intake and the absence of symptoms during COVID-19 infection (unadjusted OR 2.91; CI 1.27-6.71; p=0.011), which remained statistically significant after adjusting for age, sex, functional status, diabetes mellitus and hypertension. The strength of this association was considerable and clinically important. Although the effects of statin intake on serious clinical outcome (long-stay hospitalisation or death) were in the same beneficial direction, these were not statistically significant (OR 0.75; CI 0.25-1.85; p=0.556). There was also no statistically significant association between ACEi/ARB and asymptomatic status (OR 1.52; CI 0.62-3.50; p=0.339) or serious clinical outcome (OR 0.79; CI 0.26-1.95; p=0.629). Conclusions. Our data indicate that statin intake in old, frail people could be associated with a considerable beneficial effect on COVID-19 related clinical symptoms. The role of statins and any interaction with renin-angiotensin system drugs need to be further explored in larger observational studies as well as randomised clinical trials.


title: To catch the sparrow that has flown

text: Like a sparrow that has flown, the sense of safety and invincibility that Americans used to enjoy was weakened by 9/11 and eviscerated by the COVID-19 pandemic. Ripple effects from these events demonstrate the need to equip students with the grit and resilience to deliver public services with compassion in the midst of uncertainty. To do so intertwines two subjects–emotional labor and the public encounter–and together they illuminate what is missing in traditional public administration education. At a time when the certainties of spreadsheets come up short, the public encounter becomes more important. Now is an opportunity to re-center our pedagogy and focus on the holistic nature of public service. Emotion and interpersonal competence are as important as rationality and cognitive competence. With attention to introductory, capstone, leadership, and HR courses, suggestions on how to integrate these subjects are offered.


title: Effect of socioeconomic and ethnic characteristics on COVID-19 infection: The case of the Ultra-Orthodox and the Arab communities in Israel

text: Background. During infectious disease outbreaks the weakest communities are more vulnerable to the infection and its deleterious effects. In Israel, the Arab and Ultra-Orthodox Jewish communities have unique demographic and cultural characteristics that place them at risk for infection. Objective. To examine the socioeconomic and ethnic differences in relation to COVID-19 testing, cases and deaths, and to analyze infection spread patterns in ethnically diverse communities. Methods. Consecutive data on COVID-19 diagnostic testing, confirmed cases and deaths collected from March 31st through May 1st, 2020 in 174 localities across Israel (84% of the population) were analyzed by socioeconomic ranking and ethnicity. Findings. Tests were performed on 331,594 individuals (4.29% of the total population). Of those, 14,865 individuals (4.48%) were positive and 203 died (1.37% of confirmed cases). The percentage of the population tested was 26% and the risk of testing positive was 2.16 times higher in the lowest, compared with the highest socioeconomic category. The proportion of confirmed cases was 4.96 times higher in the Jewish compared with the Arab population. The rate of confirmed cases in 2 Ultra-Orthodox localities increased relatively early and quickly. Other Jewish and Arab localities showed consistently low rates of confirmed COVID-19 cases, regardless of socioeconomic ranking. Interpretation Culturally different communities reacted differently to the COVID-19 outbreak and to government measures, resulting in different outcomes. Therefore, socioeconomic and ethnic variables cannot fully explain communities reaction to the pandemic. Our findings stress the need for designing a culturally adapted approach for dealing with health crises.


title: Good communication is critical to supporting people living and working with a rare disease: current rare disease support perceived as inadequate.

text: Background Many people living and working with rare diseases describe consistent difficulties accessing appropriate information and support. In this study an evaluation of the awareness of rare diseases, alongside related information and educational resources available for patients, their families and healthcare professionals, was conducted in 2018-2019 using an online survey and semi-structured interviews with rare disease collaborative groups (charities, voluntary and community groups) active across Northern Ireland (NI). Results Ninety-nine participants engaged with the survey with 31 respondents providing detailed answers. Resources such as information, communication, registries, online services, training and improvements to support services were queried. Excellent communication is an important factor in delivering good rare disease support. Training for health professionals was also highlighted as an essential element of improving support for those with a rare disease to ensure they approach people with these unique and challenging diseases in an appropriate way. Carers were mentioned several times throughout the study; it is often felt they are overlooked in rare disease research and more support should be in place for them. Current care/support for those with a rare disease was highlighted as inadequate. Nine semi-structured interviews were conducted with rare disease collaborative groups. Reoccurring themes included a need for more effective: information and communication, training for health professionals, online presence, support for carers, and involvement in research. Conclusions All rare disease collaborative groups agreed that current services for people living and working with a rare disease are not adequate. An important finding to consider in future research within the rare disease field is the inclusion of carers perceptions and experiences in studies. Due to the unique role a carer has in the life of a person with a rare disease it is vital that their voice is heard and their needs are listened to. This research provides insight into the support available for rare diseases across Northern Ireland, highlights unmet needs in service provision, and suggests approaches to improve rare disease support prioritising improved information and communication provision, improved access to services, and tailored support for carers of people with a rare disease. Keywords Collaboratives groups; communication; Northern Ireland; online; rare disease semi-structured interview; social media; support; survey


title: A vulnerability-based approach to human-mobility reduction for countering COVID-19 transmission in London while considering local air quality

text: An ecologic analysis was conducted to explore the correlation between air pollution, and COVID-19 cases and fatality rates in London. The analysis demonstrated a strong correlation (R2>0.7) between increment in air pollution and an increase in the risk of COVID-19 transmission within London boroughs. Particularly, strong correlations (R2>0.72) between the risk of COVID-19 fatality and NO2 and PM2.5 pollution concentrations were also found. Although this study assumed the same level of air pollution across a particular London borough, it demonstrates the possibility to employ air pollution as an indicator to rapidly identify the vulnerable regions within a city. Such an approach can inform the decisions to suspend or reduce the operation of different public transport modes within a city. The methodology and learnings from the study can thus aid public transport to respond to the COVID-19 outbreak by adopting different levels of human-mobility reduction strategies based on the vulnerability of a given region.


Rebuilding lives post-disaster


title: Persistent viral shedding of SARS-CoV-2 in faeces - a rapid review

text: Background and aims In addition to respiratory symptoms, patients with COVID-19 can present with gastrointestinal complaints suggesting a possible faeco-oral transmission route. The primary aim of this review is to establish the incidence and timing of positive faecal samples for the SARS-CoV-2 virus in patients with COVID-19. Methods A systematic literature review was performed to identify studies describing COVID-19 patients tested for the virus in their stool. Data were extracted concerning the nature of the test, number and timing of positive samples, incidence of positive faecal tests after negative nasopharyngeal swabs and any evidence of viable faecal virus or faeco-oral transmission of the virus. Results There were 26 relevant articles identified. Combining these results demonstrated that 53.9% of those tested for faecal RNA in these studies were positive. Duration of faecal viral shedding ranged from 1 to 33 days after nasopharyngeal swab turned negative with one result remaining positive after 47 days of onset of symptoms. There was insufficient evidence to draw firm conclusions about the proportion of cases potentially transmitted through infection via faecally shed virus. Conclusions There is a relatively high rate of positive tests and persistence of the SARS-CoV-2 virus in faecal samples of selected patients with COVID-19. Further research is needed to demonstrate how much these positive tests correlate with viable virus and transmission through the faeco-oral route. This may have important implications for duration of isolation, precautions recommended in individuals undertaking a period of isolation, protective equipment for health professionals and interventional procedures involving the gastrointestinal tract.


title: Clinical analysis and early differential diagnosis of suspected pediatric patients with 2019 novel coronavirus infection

text: Abstract Background: Early differential diagnosis of suspected pediatric patients is difficult during the 2019-nCoV epidemic. Objective: To identify clinical characteristics and key points of early differential diagnosis. Methods: A retrospective analysis was performed on suspected pediatric cases. Results:A total of 77 suspected cases were admitted from Jan 22nd to Mar 1st. Compared with non-2019-nCoV group (n=33),2019-nCoV confirmed group (n=35) had fewer fever (OR[95% CI] 0.39[0.242 to 0.628];P<.001) and symptoms of ARI (0.454[0.287 to 0.719];P<.001),more asymptomatic (15.086[2.117 to 107.475];P<.001), and more family cluster infections (5.469[2.405 to 12.433]; P<.001),while chest CT had more positive findings of viral pneumonia (1.813[1.131 to 2.908];P=.014).There were significant statistical differences between the two groups in age (7.2[3.9 to 11.4] vs 5[2.1 to 7.8];P=.031),body temperature (36.7[36.2 to 36.9] vs 37[36.7 to 37.9];P=.001), heart rate ([97.1 and 16.8] vs [109.7 and 15.6];P=.002),percentage ([39.4 and 14.9] vs [52.5 and 17.5]; P=.001) and count (2.25[1.43 to 3.53] vs 3.33[2.8 to 5.18];P=.007) of neutrophil, percentage (45.3[39.2 to 56.6] vs 33.2[22.7 to 42.5];P=.001) of lymphocyte,hs-CRP (5.52[1.1 to 9.04] vs 9.04[7.35 to 9.54];P=.002) and PCT (0.05[0.03 to 0.08] vs 0.1[0.05 to 0.21];P<.001),while gender (42.9% vs 57.6%;P=.332),respiratory rate (22[20 to 22] vs 22[20 to 24];P=.092),WBC (5.37[4.67 to 8.08] vs 6.94[5.72 to 8.87];P=.198), lymphocyte count (2.68[1.99 to 4.01] vs 2.26[1.66 to 2.92];P=.096),Hb (128[124 to 142] vs 130[119 to 137];P=.572) and PLT ([279.1 and 77.5] vs [263.4 and 65.1];P=.37) were statistically insignificant. Conclusions: Asymptoms or mild symptoms,positive CT findings and family cluster infection are the main clinical characteristics of infected pediatric patients. The CBC, hs-CRP and PCT can provide an important basis for early differential diagnosis. Compared with other non-bacterial infections,hs-CRP and PCT in 2019-nCoV infection are reduced,but further evidence is needed to support whether their reduction is specific. Keywords: 2019 novel coronavirus;acute respiratory infection; pediatric;differential diagnosis;suspected infection. Abbreviations:2019-nCoV,2019 novel coronavirus;CT,computed tomography; RT-PCR,real-time reverse transcriptase polymerase chain reaction;IQR,interquartile range;OR,odds ratio;CI,confidence interval;SD,standard deviation;ARI,acute respiratory infection; CAP,community-acquired pneumonia;RSV, respiratory syncytial virus; MP, mycoplasma pneumoniae; INF A,B,influenza A,B;CBC,complete blood count;WBC,white blood cell;N%, percentage of neutrophil; L%, percentage of lymphocyte; Hb, Hemoglobin;PLT, platelet; hs-CRP,high sensitivity C-reactive protein; PCT, procalcitonin.


title: Head-to-head comparison of four antigen-based rapid detection tests for the diagnosis of SARS-CoV-2 in respiratory samples

text: In the context of the Covid-19 pandemic, the development and validation of rapid and easy-to-perform diagnostic methods are of high priority. We compared the performance of four rapid antigen detection tests for SARS-CoV-2 in respiratory samples. Immunochromatographic SARS-CoV-2 assays from RapiGEN, Liming bio, Savant, and Bioeasy were evaluated using universal transport medium containing naso-oropharyngeal swabs from suspected Covid-19 cases. The diagnostic accuracy was determined in comparison to SARS-CoV-2 RT-PCR. A total of 111 samples were included; 80 were RT-PCR positive. Median patients’ age was 40 years, 55% were female, and 88% presented within the first week after symptom onset. The evaluation of the Liming bio assay was discontinued due to insufficient performance. The overall sensitivity values of RapiGEN, Liming bio, and Bioeasy tests were 62.0% (CI95% 51.0–71.9), 16.7% (CI95% 10.0–26.5), and 85.0% (CI95% 75.6–91.2), respectively, with specificities of 100%. Sensitivity was significantly higher in samples with high viral loads (RapiGEN, 84.9%; Bioeasy, 100%). The study highlighted the significant heterogeneity of test performance among evaluated assays, which might have been influenced by the use of a non-validated sample material. The high sensitivity of some tests demonstrated that rapid antigen detection has the potential to serve as an alternative diagnostic method, especially in patients presenting with high viral loads in early phases of infection. This is particularly important in situations with limited access to RT-PCR or prolonged turnaround time. Further comparative evaluations are necessary to select products with high performance among the growing market of diagnostic tests for SARS-CoV-2.


title: Appendix A CD Molecules

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title: Meplazumab treats COVID-19 pneumonia: an open-labelled, concurrent controlled add-on clinical trial

text: Background: SARS-CoV-2 is a novel human coronavirus, there is no specific antiviral drugs. It has been proved that host-cell-expressed CD147 could bind spike protein of SARS-CoV-2 and involve in host cell invasion. Antibody against CD147 could block the infection of SARS-CoV-2. We aimed to assess the efficacy and safety of meplazumab, a humanized anti-CD147 antibody, as add-on therapy in patients with COVID-19 pneumonia. Methods: All patients received recommended strategy from Diagnosis and Treatment for 2019 Novel Coronavirus Diseases released by National Health Commission of China. Eligible patients were add-on administered 10 mg meplazumab intravenously at days 1, 2, and 5. Patients hospitalized in the same period were observed as concurrent control. The endpoints include virological clearance rate, case severity, chest radiographic, and laboratory test. This trial was approved by the Ethics Committee of Institution at the Tangdu hospital, and registered with ClinicalTrials.gov, NCT 04275245. Findings:17 patients were enrolled and assigned to meplazumab group between Feb 3, 2020 and Feb 10, 2020. 11 hospitalized patients served as concurrent control. Baseline characteristics were generally balanced across two groups. Compared to control group, meplazumab treatment significantly improved the discharged (p=0.006) and case severity (p=0.021) in critical and severe patients. The time to virus negative in meplazumab group was reduced than that in control group (median 3, 95%CI[1.5-4.5] vs. 13, [6.5-19.5]; p=0.014, HR=0.37, 95%CI[0.155-0.833]). The percentages of patients recovered to the normal lymphocyte count and CRP concentration were also increased remarkably and rapidly in meplazumab group. No adverse effect was found in meplazumab-treated patients. Interpretation:Meplazumab efficiently improved the recovery of patients with SARS-CoV-2 pneumonia with a favorable safety profile. Our results support to carry out a large-scale investigation of meplazumab as a treatment for COVID-19 pneumonia. Funding:National Science and Technology Major Project.


title: Correlation of ELISA based with random access serologic immunoassays for identifying adaptive immune response to SARS-CoV-2

text: Public health emergency of SARS-CoV-2 has facilitated diagnostic testing as a related medical countermeasure against COVID-19 outbreak. Numerous serologic antibody tests have become available through an expedited federal emergency use only process. This paper highlights the analytical characteristic of an ELISA based assay by AnshLabs and three random access immunoassay (RAIA) by DiaSorin, Roche, and Abbott that have been approved for emergency use authorization (EUA), at a tertiary academic center in a low disease-prevalence area. The AnshLabs gave higher estimates of sero-prevalence, over the three RAIA methods. For positive results, AnshLabs had 93.3% and 100% concordance with DiaSorin or Abbott and Roche respectively. For negative results, AnshLabs had 69.7% and 73.0% concordance with DiaSorin and Roche or Abbott respectively. All discrepant samples that were positive by AnshLabs and negative by RAIA tested positive by all-in-one step SARS-CoV-2 Total (COV2T) assay performed on the automated Siemens Advia Centaur XPT analyzer. None of these methods, however, are useful in early diagnosis of SARSCoV- 2.


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title: Geographical Distance to the Epicenter of Covid-19 Predicts the Burnout of Working Population: Ripple effect or Typhoon Eye effect?

text: Covid-19 originated in Wuhan and rippled across China. We investigate how the geographical distance of working adults to the epicenter of Wuhan predicts their burnout. Preliminary results of a survey of 308 working adults in 53 cities showed the distance to the epicenter of Wuhan had an inverted U-shaped relationship with the burnout. Such results help to identify regions where people would need more psychiatric assistance, carrying direct implications to healthcare practitioners and policymakers.


title: Immune-Inflammatory Parameters in COVID-19 Cases: A Systematic Review and Meta-Analysis

text: Background: The recent outbreak of coronavirus disease 2019 (COVID-19) has been rapidly spreading on a global scale and poses a great threat to human health. Acute respiratory distress syndrome, characterized by a rapid onset of generalized inflammation, is the leading cause of mortality in patients with COVID-19. We thus aimed to explore the effect of risk factors on the severity of the disease, focusing on immune-inflammatory parameters, which represent the immune status of patients. Methods: A comprehensive systematic search for relevant studies published up to April 2020 was performed by using the PubMed, Web of Science, EMBASE, and China National Knowledge Internet (CNKI) databases. After extracting all available data of immune-inflammatory indicators, we statistically analyzed the risk factors of severe and non-severe COVID-19 patients with a meta-analysis. Results: A total of 4,911 patients from 29 studies were included in the final meta-analysis. The results demonstrated that severe patients tend to present with increased white blood cell (WBC) and neutrophil counts, neutrophil-lymphocyte ratio (NLR), procalcitonin (PCT), C-reaction protein (CRP), erythrocyte sedimentation rate (ESR), and Interleukin-6 (IL-6) and a decreased number of total lymphocyte and lymphocyte subtypes, such as CD4+ T lymphocyte and CD8+ T lymphocyte, compared to the non-severe patients. In addition, the WBC count>10 × 10(9)/L, lymphocyte count<1 × 10(9)/L, PCT>0.5 ng/mL, and CRP>10 mg/L were risk factors for disease progression in patients with COVID-19 (WBC count>10 × 10(9)/L: OR = 2.92, 95% CI: 1.96–4.35; lymphocyte count<1 × 10(9)/L: OR = 4.97, 95% CI: 3.53–6.99; PCT>0.5 ng/mL: OR = 6.33, 95% CI: 3.97–10.10; CRP>10 mg/L: OR = 3.51, 95% CI: 2.38–5.16). Furthermore, we found that NLR, as a novel marker of systemic inflammatory response, can also help predict clinical severity in patients with COVID-19 (OR = 2.50, 95% CI: 2.04–3.06). Conclusions: Immune-inflammatory parameters, such as WBC, lymphocyte, PCT, CRP, and NLR, could imply the progression of COVID-19. NLR has taken both the levels of neutrophil and lymphocyte into account, indicating a more complete, accurate, and reliable inspection efficiency; surveillance of NLR may help clinicians identify high-risk COVID-19 patients at an early stage.


Prescribiendo ejercicio físico en períodos de cuarentena por COVID-19: ¿Es útil la autorregulación perceptual en niños?/ Dosing physical exercise intensity during the COVlD-19 quarantine: Does perceptual self-regulation work in children?


title: SARS-CoV-2 Spike Glycoprotein and ACE2 interaction reveals modulation of viral entry in different hosts

text: Background SARS-CoV-2 is a viral pathogen causing life threatening disease in human. Interaction between spike protein of SARS-CoV-2 and ACE2 receptor on the cells is a potential factor in the infectivity of a host. The interaction of SARS-CoV-2 spike receptor-binding domain with its receptor - ACE2, in different hosts was evaluated to understand and predict viral entry. The protein and nucleotide sequences of ACE2 were initially compared across different species to identify key differences among them. The ACE2 receptor of various species was homology modeled (6LZG as a reference) and its binding ability to the spike receptor-binding domain of SARS-CoV-2 was assessed. Initially, the spike binding properties of ACE2 of known infected and uninfected species was compared with each Order (of animals) as a group. Finally, a logistic regression model vis-a-vis the spike binding properties of ACE2 (Interaction energy, entropy sidechain and entropy mainchain) was constructed to predict the probability of viral entry in different hosts. Results Phylogeny and alignment comparison did not lead to any meaningful conclusion on viral entry in different hosts. Out of several spike binding properties of ACE2, a significant difference between the known infected and uninfected species was observed for five spike binding properties of ACE2. However, these parameters did not specifically categorize the animals into infected or uninfected, for all the Orders (of animals). The logistic regression model constructed revealed that in the mammalian class, most of the species of Carnivores, Artiodactyls, Perissodactyls, Pholidota, and Primates had high probability of viral entry. However, among the primates, baboons have very low probability of viral entry. Among rodents, hamsters were highly probable for viral entry with rats and mice having a very low probability. Rabbits have a medium probability of viral entry. In Birds, ducks have a very low probability, while chickens seemed to have medium probability and turkey showed the highest probability of viral entry. Conclusions Most of the species considered in this study showed high probability of viral entry. This study would prompt us to closely follow certain species of animals for determining pathogenic insult by SARS-CoV-2 and for determining their ability to act as a carrier and/or disseminator.


title: Isolation of and Characterization of Neutralizing Antibodies to Covid-19 from a Large Human Naïve scFv Phage Display Library

text: SARS-CoV-2 (Covid-19) has caused currently ongoing global plague and imposed great challenges to health managing systems all over the world, with millions of infections and hundreds of thousands of deaths. In addition to racing to develop vaccines, neutralizing antibodies (nAbs) to this virus have been extensively sought and are expected to provide another prevention and therapy tool against this frantic pandemic. To offer fast isolation and shortened early development, a large human naïve phage display antibody library, was built and used to screen specific nAbs to the receptor-binding domain, RBD, the key for Covid-19 virus entry through a human receptor, ACE2. The obtained RBD-specific antibodies were characterized by epitope mapping, FACS and neutralization assay. Some of the antibodies demonstrated spike-neutralizing property and ACE2-competitiveness. Our work proved that RBD-specific neutralizing binders from human naïve antibody phage display library are promising candidates to for further Covid-19 therapeutics development.


title: Point prevalence of SARS-CoV-2 and infection fatality rate in Orleans and Jefferson Parish, Louisiana, May 9-15, 2020

text: Using a novel recruitment method to reduce selection bias with paired molecular and antibody testing for SARS-CoV-2 infection, we determined point prevalence in a racially diverse municipality. Infections were highly variable by ZIP and differed by race. Overall census-weighted prevalence was 7.8% and the calculated infection fatality rate was 1.63%.


title: Prospective analysis of levels and correlates of physical activity during COVID-19 pandemic and imposed rules of social distancing; gender specific study among adolescents from Southern Croatia

text: Background: Due to the COVID-19 pandemic, global authorities have imposed rules of social distancing that directly influence overall physical activity in populations. The aim of this study was to evaluate the trends of changes in physical-activity levels (PALs) in adolescents and factors that may be associated with PALs among the studied boys and girls. Methods: Participants in this prospective study comprised 388 adolescents (126 females; mean age: 16.4 ± 1.9 years) from southern Croatia who were tested at a baseline (before the imposed rules of social distancing) and at a follow-up measurement (three weeks after the initiation). Baseline testing included anthropometric variables, variables of fitness status (done at the beginning of the school year), and PALs. At the follow-up, participants were tested on PALs. PALs were evaluated over an online platform using the Physical Activity Questionnaire for Adolescents. Results: A significant decrease of PALs was evidenced for the total sample (t-test = 3.46, p < 0.001), which was primarily influenced by a significant decrease of PALs in boys (t-test = 5.15, p < 0.001). The fitness status (jumping capacity, abdominal strength, aerobic endurance, and anaerobic endurance) was systematically positively correlated with PALs at the baseline and follow-up among boys and girls, with the most evident association between aerobic and anaerobic endurance capacities and PALs. Correlations between anthropometric and fitness variables with changes in physical activity (e.g., the difference between baseline and follow-up PALs) were negligible. Conclusions: Differences in PAL changes between genders were probably related to the fact that PALs among boys were mostly related to participation in organized sports. Correlations between baseline fitness status and PALs indicated the importance of overall physical literacy in preserving PALs in challenging circumstances, such as the COVID-19 pandemic observed here.


title: Investigating the effectiveness of school health services delivered by a health provider: a systematic review of systematic reviews

text: Schools are the only institution regularly reaching the majority of school-age children and adolescents across the globe. Although at least 102 countries have school health services, there is no rigorous, evidence-based guidance on which school health services are effective and should be implemented in schools. To investigate the effectiveness of school health services for improving the health of school-age children and adolescents, a systematic review of systematic reviews (overview) was conducted. Five databases were searched through June 2018. Systematic reviews of intervention studies that evaluated school-based or school-linked health services delivered by a health provider were included. Review quality was assessed using a modified Ballard and Montgomery four-item checklist. 1654 references were screened and 20 systematic reviews containing 270 primary studies were assessed narratively. Interventions with evidence for effectiveness addressed autism, depression, anxiety, obesity, dental caries, visual acuity, asthma, and sleep. No review evaluated the effectiveness of a multi-component school health services intervention addressing multiple health areas. Strongest evidence supports implementation of anxiety prevention programs, indicated asthma education, and vision screening with provision of free spectacles. Additional systematic reviews are needed that analyze the effectiveness of comprehensive school health services, and specific services for under-researched health areas relevant for this population.


COVID and the Renin-Angiotensin System: Are Hypertension or Its Treatments Deleterious?


title: SARS-CoV-2 activates lung epithelia cell proinflammatory signaling and leads to immune dysregulation in COVID-19 patients by single-cell sequencing

text: Objective: The outbreak of Coronavirus disease 2019 (COVID-19) caused by SARS-CoV-2 infection has become a global health emergency. We aim to decipher SARS-CoV-2 infected cell types, the consequent host immune response and their interplay in the lung of COVID-19 patients. Design: We analyzed single-cell RNA sequencing (scRNA-seq) data of lung samples from 17 subjects (6 severe COVID-19 patients, 3 mild patients who recovered and 8 healthy controls). The expression of SARS-CoV-2 receptors (ACE2 and TMPRSS2) was examined among different cell types in the lung. The immune cells infiltration patterns, their gene expression profiles, and the interplay of immune cells and SARS-CoV-2 target cells were further investigated. Results: Compared to healthy controls, the overall ACE2 (receptor of SARS-CoV-2) expression was significantly higher in lung epithelial cells of COVID-19 patients, in particular in ciliated cell, club cell and basal cell. Comparative transcriptome analysis of these lung epithelial cells of COVID-19 patients and healthy controls identified that SARS-CoV-2 infection activated pro-inflammatory signaling including interferon pathway and cytokine signaling. Moreover, we identified dysregulation of immune response in patients with COVID-19. In severe COVID-19 patients, significantly higher neutrophil, but lower T and NK cells in lung were observed along with markedly increased cytokines (CCL2, CCL3, CCL4, CCL7, CCL3L1 and CCL4L2) compared with healthy controls as well as mild patients who recovered. The cytotoxic phenotypes were shown in lung T and NK cells of severe patients as evidenced by enhanced IFN{gamma}, Granulysin, Granzyme B and Perforin expression. Moreover, SARS-CoV-2 infection altered the community interplay of lung epithelial cells and immune cells: the interaction between epithelial cells with macrophage, T and NK cell was stronger, but their interaction with neutrophils was lost in COVID-19 patients compared to healthy controls. Conclusions: SARS-CoV-2 infection activates pro-inflammatory signaling in lung epithelial cells expressing ACE2 and causes dysregulation of immune response to release more pro-inflammatory cytokines. Moreover, SARS-CoV-2 infection breaks the interplay of lung epithelial cells and immune cells.


title: COVID-19 DYNAMICS CONSIDERING THE INFLUENCE OF HOSPITAL INFRASTRUCTURE: AN INVESTIGATION OF BRAZILIAN SCENARIOS

text: This paper deals with the mathematical modeling and numerical simulations related to the coronavirus dynamics. A description is developed based on the framework of susceptible-exposed-infectious-removed model. Removed population is split into recovered and death populations allowing a better comprehension of real situations. Besides, total population is reduced based on the number of deaths. Hospital infrastructure is also included into the mathematical description allowing the consideration of collapse scenarios. Initially, a model verification is carried out calibrating system parameters with data from China outbreak that is considered a benchmark due the availability of data for the entire cycle. Afterward, numerical simulations are performed to analyze COVID-19 dynamics in Brazil. Results show several scenarios showing the importance of social isolation. System dynamics has a strong sensitivity to transmission rate showing the importance of numerical simulations to guide public health decision strategies.


title: Common CT Findings of Novel Coronavirus Disease 2019 (COVID-19): A Case Series

text: Given the highly infectious nature of the coronavirus disease 2019 (COVID-19) virus and the lack of proven specific therapeutic drugs and licensed vaccines effective against it, early diagnosis of the disease is of paramount importance. The common chest CT imaging of confirmed COVID-19 cases is discussed here, which shows ground-glass opacity, crazy paving, and consolidation.


title: Protocol and reagents for pseudotyping lentiviral particles with SARS-CoV-2 Spike protein for neutralization assays

text: SARS-CoV-2 enters cells using its Spike protein, which is also the main target of neutralizing antibodies. Therefore, assays to measure how antibodies and sera affect Spike-mediated viral infection are important for studying immunity. Because SARS-CoV-2 is a biosafety-level-3 virus, one way to simplify such assays is to pseudotype biosafety-level-2 viral particles with Spike. Such pseudotyping has now been described for single-cycle lentiviral, retroviral and VSV particles, but the reagents and protocols are not widely available. Here we detail how to effectively pseudotype lentiviral particles with SARS-CoV-2 Spike and infect 293T cells engineered to express the SARS-CoV-2 receptor, ACE2. We also make all the key experimental reagents available in the BEI Resources repository of ATCC and the NIH. Furthermore, we demonstrate how these pseudotyped lentiviral particles can be used to measure the neutralizing activity of human sera or plasma against SARS-CoV-2 in convenient luciferase-based assays, thereby providing a valuable complement to ELISA-based methods that measure antibody binding rather than neutralization.


title: The socioeconomic determinants of COVID-19: A spatial analysis of German county level data

text: The study explores the influence of socio-economic variables on case and death rates of the COVID-19 pandemic in Germany until mid-June 2020. It covers 401 counties by multivariate spatial models that can take into account regional interrelationships and possible spillover effects. The case and death rates are, for example, significantly positively associated with early cases from the beginning of the epidemic, the average age, the population density and the number of people employed in elderly care. By contrast, they are significantly negatively associated with the density of schoolchildren and infant care as well as the density of doctors. In addition, for individual variables significant spillover effects on the case numbers of neighbouring regions could be identified, which have a different sign than the overall effects and thus give cause for further analyses of the mechanisms of action of COVID-19 infections. The results complement the knowledge about COVID-19 infection beyond the clinical risk factors discussed so far by a socio-economic perspective. The findings can contribute to the targeted derivation of political measures and their review, as is currently being discussed in particular for the tourism and education sectors.


title: Drugmakers connect with Gates Foundation

text: Fifteen pharmaceutical and life sciences companies will work with the Bill and Melinda Gates Foundation to accelerate the development of vaccines, diagnostics, and treatments for COVID-19 The group will share proprietary compound libraries, along with safety and activity data, with the COVID-19 Therapeutics Accelerator, an effort the foundation launched last month with Wellcome and Mastercard The 15 firms are also involved in other partnerships to develop COVID-19 therapies


title: Estimates of COVID-19 case-fatality risk from individual-level data

text: When calculated from aggregate data on confirmed cases and deaths, the case-fatality risk (CFR) is a simple ratio between the former and the latter, which is prone to numerous biases. With individual-level data, the CFR can be estimated as a true measure of risk as the proportion of incidence for the disease. We present the first estimates of the CFR for COVID-19 by age and sex based on event history modelling of the risk of dying among confirmed positive individuals in the Canadian province of Ontario, which maintains one of the few individual-level datasets on COVID-19 in the world.


title: Genomic surveillance and phylogenetic analysis reveal multiple introductions of SARS-CoV-2 into a global travel hub in the Middle East

text: International travel played a significant role in the early global spread of SARS-CoV-2. Understanding transmission patterns from different regions of the world will further inform global dynamics of the pandemic. Using data from Dubai in the United Arab Emirates (UAE), a major international travel hub in the Middle East, we establish SARS-CoV-2 full genome sequences from the index and early COVID-19 patients in the UAE. The genome sequences are analyzed in the context of virus introductions, chain of transmissions, and possible links to earlier strains from other regions of the world. Phylogenetic analysis showed multiple spatiotemporal introductions of SARS-CoV-2 into the UAE from Asia, Europe, and the Middle East during the early phase of the pandemic. We also provide evidence for early community-based transmission and catalogue new mutations in SARS-CoV-2 strains in the UAE. Our findings contribute to the understanding of the global transmission network of SARS-CoV-2.


title: Molecular tracing of SARS-CoV-2 in Italy in the first three months of the epidemic

text: The aim of this study is the characterization and genomic tracing by phylogenetic analyses of 59 new SARS-CoV-2 Italian isolates obtained from patients attending clinical centres in North and Central Italy until the end of April 2020. All but one of the newly characterized genomes belonged to the lineage B.1, the most frequently identified in European countries, including Italy. Only a single sequence was found to belong to lineage B. A mean of 6 nucleotide substitutions per viral genome was observed, without significant differences between synonymous and non-synonymous mutations, indicating genetic drift as a major source for virus evolution. tMRCA estimation confirmed the probable origin of the epidemic between the end of January and the beginning of February with a rapid increase in the number of infections between the end of February and mid-March. Since early February, an effective reproduction number (Re) greater than 1 was estimated, which then increased reaching the peak of 2.3 in early March, confirming the circulation of the virus before the first COVID-19 cases were documented. Continuous use of state-of-the-art methods for molecular surveillance is warranted to trace virus circulation and evolution and inform effective prevention and containment of future SARS-CoV-2 outbreaks.


title: ViralMSA: Massively scalable reference-guided multiple sequence alignment of viral genomes

text: Motivation In molecular epidemiology, the identification of clusters of transmissions typically requires the alignment of viral genomic sequence data. However, existing methods of multiple sequence alignment scale poorly with respect to the number of sequences. Results ViralMSA is a user-friendly reference-guided multiple sequence alignment tool that leverages the algorithmic techniques of read mappers to enable the multiple sequence alignment of ultra-large viral genome datasets. It scales linearly with the number of sequences, and it is able to align tens of thousands of full viral genomes in seconds. Availability ViralMSA is freely available at https://github.com/niemasd/ViralMSA as an open-source software project. Contact a1moshir@ucsd.edu


title: Statistics based predictions of coronavirus 2019-nCoV spreading in mainland China

text: Background. The epidemic outbreak cased by coronavirus 2019-nCoV is of great interest to researches because of the high rate of spread of the infection and the significant number of fatalities. A detailed scientific analysis of the phenomenon is yet to come, but the public is already interested in the questions of the duration of the epidemic, the expected number of patients and deaths. For long time predictions, the complicated mathematical models are necessary which need many efforts for unknown parameters identification and calculations. In this article, some preliminary estimates will be presented. Objective. Since the reliable long time data are available only for mainland China, we will try to predict the epidemic characteristics only in this area. We will estimate some of the epidemic characteristics and present the most reliable dependences for victim numbers, infected and removed persons versus time. Methods. In this study we use the known SIR model for the dynamics of an epidemic, the known exact solution of the linear equations and statistical approach developed before for investigation of the children disease, which occurred in Chernivtsi (Ukraine) in 1988-1989. Results. The optimal values of the SIR model parameters were identified with the use of statistical approach. The numbers of infected, susceptible and removed persons versus time were predicted. Conclusions. Simple mathematical model was used to predict the characteristics of the epidemic caused by coronavirus 2019-nCoV in mainland China. The further research should focus on updating the predictions with the use of fresh data and using more complicated mathematical models.


title: A simple model to assess Wuhan lock-down effect and region efforts during COVID-19 epidemic in China Mainland

text: Since COVID-19 emerged in early December, 2019 in Wuhan and swept across China Mainland, a series of large-scale public health interventions, especially Wuhan lock-down combined with nationwide traffic restrictions and Stay At Home Movement, have been taken by the government to control the epidemic. Based on Baidu Migration data and the confirmed cases data, we identified two key factors affecting the later (e.g February 27, 2020) cumulative confirmed cases in non-Wuhan region (y). One is the sum travelers from Wuhan during January 20 to January 26 (x1), which had higher infected probability but lower transmission ability because the human-to-human transmission risk of COVID-19 was confirmed and announced on January 20. The other is the seed cases from Wuhan before January 19, which had higher transmission ability and could be represented with the confirmed cases before January 29 (x2) due to a mean 10-day delay between infection and detection. A simple yet effective regression model then was established as follow: y= 70.0916+0.0054*x1+2.3455*x2 (n = 44, R2 = 0.9330, P<10-7). Even the lock-down date only delay or in advance 3 days, the estimated confirmed cases by February 27 in non-Wuhan region will increase 35.21% or reduce 30.74% - 48.59%. Although the above interventions greatly reduced the human mobility, Wuhan lock-down combined with nationwide traffic restrictions and Stay At Home Movement do have a determining effect on the ongoing spread of COVID-19 across China Mainland. The strategy adopted by China has changed the fast-rising curve of newly diagnosed cases, the international community should learn from lessons of Wuhan and experience from China. Efforts of 29 Provinces and 44 prefecture-level cities against COVID-19 were also assessed preliminarily according to the interpretive model. Big data has played and will continue playing an important role in public health.


title: Brazilian Modeling of COVID-19 (BRAM-COD): a Bayesian Monte Carlo approach for COVID-19 spread in a limited data set context

text: Background: The new coronavirus respiratory syndrome disease (COVID-19) pandemic has become a major health problem worldwide. Many attempts have been devoted to modeling the dynamics of new infection rates, death rates, and the impact of the disease on health systems and the world economy. Most of these modeling concepts use the Susceptible-Infectious-Susceptible (SIS) and Susceptible-Exposed-Infected-Recovered (SEIR) compartmental models; however, wide imprecise outcomes in forecasting can occur with these models in the context of poor data, low testing levels, and a nonhomogeneous population. Objectives: To predict Brazilian ICU beds demand over time and during COVID-19 pandemic peak. Methods: In the present study, we describe a Bayesian COVID-19 model combined with a Hamiltonian Monte Carlo algorithm to forecast quantitative predictions of infections, number of deaths and the demand for critical care beds in the next month in the Brazilian context of scarce data availability. We also estimated COVID-19 spread tendency in the state of Sao Paulo and forecasted the demand for critical care beds, as Sao Paulo is the epicenter of the Latin America pandemic. Results: Our model estimated that the number of infected individuals would be approximately 6.5 million (median) on April 25, 2020, and would reach 16 to 17 million (median) by the end of August 2020 in Brazil. The probability that an infected individual requires ICU-level care in Brazil is 0.5833% . Our model suggests that the current level of mitigation seen in Sao Paulo is sufficient to reach Rt < 1, thus attaining a peak in the short term. In Sao Paulo state, the total number of deaths is estimated to be around 9,000 (median) with the 2.5% quantile being 6,600 deaths and the 97.5% quantile being around 13,350 deaths. Also, Sao Paulo will not attain its maximum capacity of ICU beds if the current trend persists over the long term. Conclusions: The COVID-19 pandemic should peak in Brazil between May 8 and May 20, 2020 with a fatality rate lower than that suggested in the literature. The northern and northeastern regions of Brazil will suffer from a lack of available ICU beds, whereas the southeastern, southern, and central-western regions appear to have sufficient ICU beds only if they share private system beds with the publicly funded Unified Heath System (SUS). The model predicts that, if the current policies and population behavior are maintained throughout the forecasted period, by the end of August 2020, Brazil will have around 12% of its population immune to COVID-19.


title: Suspending Classes Without Stopping Learning: China’s Education Emergency Management Policy in the COVID-19 Outbreak

text: Against the backdrop of the COVID-19 outbreak, an emergency policy initiative called “Suspending Classes Without Stopping Learning”was launched by the Chinese government to continue teaching activities as schools across the country were closed to contain the virus However, there is ambiguity and disagreement about what to teach, how to teach, the workload of teachers and students, the teaching environment, and the implications for education equity Possible difficulties that the policy faces include: the weakness of the online teaching infrastructure, the inexperience of teachers (including unequal learning outcomes caused by teachers’varied experience), the information gap, the complex environment at home, and so forth To tackle the problems, we suggest that the government needs to further promote the construction of the educational information superhighway, consider equipping teachers and students with standardized home-based teaching/learning equipment, conduct online teacher training, include the development of massive online education in the national strategic plan, and support academic research into online education, especially education to help students with online learning difficulties


title: When will the battle against novel coronavirus end in Wuhan: a SEIR modeling analysis

text: Recent outbreak of 2019-nCoV in Wuhan raised serious public health concerns. By February 15, 2020 in Wuhan, the total number of confirmed infection cases has reached 37,914, and the number of deaths has reached 1123, accounting for 56.9% of the total confirmed cases and 73.7% of the total deaths in China. People are eager to know when the epidemic will be completely controlled and when people's work and life will be on the right track. In this study we analyzed the epidemic dynamics and trend of 2019-nCoV in Wuhan by using the data after the closure of Wuhan city till February 12, 2020 based on the SEIR modeling method. The optimal parameters were estimated as R0=1.44 (interquartile range: 1.40-1.47)，TI=14 (interquartile range: 14-14) and TE=3.0 (interquartile range: 2.8-3.1). Based on these parameters, the number of infected individuals in Wuhan city may reach the peak around February 19 at about 45,000 people. Once entering March, the epidemic would gradually decline, and end around the late March. It is worth noting that the above prediction is based on the assumption that the number of susceptible population N = 200,000 will not increase. If the epidemic situation is not properly controlled, the peak of infected number can be further increased and the peak time will be a little postponed. It was expected that the epidemic would subside in early March, and disappear gradually towards the late March.


title: Handicapés et confinés en résidence universitaire : des étudiants oubliés, à l’épreuve de « la continuité pédagogique »

text: The health crisis due to the outbreak of Coronavirus since the beginning of 2020 has strongly exposed the effect of decades of public service cuts in France, especially in the fields of education or health. Although the French President has recently declared that the living conditions of people with disabilities were a “national priority”, this issue has not been addressed by public authorities while managing the current crisis. This article analyses and helps to understand the situation of young people with disabilities living in student residences in lockdown for about two months, an issue that has been overlooked. The case study is based on a series of interviews with Joseph, a blind Master's student, and some of his relatives. It looks back on Joseph's experience and academic career, his living conditions in lockdown, his difficulties in coping with distance learning, as well as the resources and support he gets to be able to live and get through.


title: Current situation and suggestions for ophthalmic medical work at a non-COVID-19 treatment hospital in later stages of epidemic in Wuhan, China/ 疫情后期武汉非新型冠状病毒肺炎患者定点医院眼科医护人员诊疗工作现状和建议

text: The epidemic of COVID-19 displays a declining trend in China with the enhanced containment and mitigation strategies, and public's normal demand for medical treatment is increasing sharply.The current focus is to ensure the daily medical services needed by non-COVID-19 patients while preventing and controlling the epidemic of COVID-19.Although ophthalmologists do not work on the front lines of COVID-19 outbreak, due to their area of expertise, a variety of situations, such as infection consultations or ophthalmic emergency treatments, can lead to the exposure of ophthalmologists to high-risk environments.This paper mainly analyzes the problems existing in work and life of ophthalmic medical staffs in a fixed-point treatment hospital for non-COVID-19 patients in later stages of the epidemic, and make recommendations and responses, which is helpful to us to obtain guarantee in both safety and quality of medical services, avoid cross-contamination in clinical practice, reduce infectious risk among ophthalmic medical staffs and lessen the mental and spiritual stress for medical staffs.


title: An Evaluation of the MedSnap Medication Authentication System

text: Falsified and substandard (SF) medications are a large and growing global public health threat affecting developed and developing markets. The need for scalable, easy-to-use, accurate methods to detect SF medications continues to grow. We conducted a proof-of-principle laboratory and field-sample evaluation of MedSnap in Vientiane, Lao PDR. Over three days, MedSnap models were created from trusted and authentic medications and tested against samples of authentic/trusted or falsified artesunate, artemether-lumefantrine, azithromycin, and ciprofloxacin. Across 49 tests of authentic/trusted and falsified samples, MedSnap was 100% sensitive and specific. On the final day of the study, a convenience sample of ciprofloxacin and azithromycin was collected from local pharmacies and tested. Each purchased sample matched an authentic or trusted model. The speed and ease of data collection, reference model building, and sample testing suggest scalable use cases for the system.


title: An Automatic Computer-Based Method for Fast and Accurate Covid-19 Diagnosis

text: At present, the whole world is witnessing a horrifying outbreak caused by the Coronavirus Disease 2019 (COVID-19). The virus responsible for this disease is called SARS-CoV-2. It affects its victims respiratory system and causes severe lung inflammation, making it harder for them to breathe. The virus is airborne, and so has a high infection rate. Originated in China last December, the virus has spread across seven continents, affecting the population of over 210 countries, making it one of the fiercest pandemics ever recorded. Despite multiple independent and collaborative attempts to develop a vaccine or a cure, an effective solution is yet to come out. While the disease has put the world in a standstill, detecting the positive subjects and isolating them from the others as soon as possible is the only way to minimize its spread. However, many countries are currently experiencing a massive shortage of diagnostic equipment and medical personals. This insufficiency inspired us to work on a computer-based automatic method for the diagnosis of COVID-19. In this paper, we proposed a sequential Convolutional Neural Network (CNN)-based model to detect COVID-19 through analyzing Computed Tomography (CT) scan images. The model is capable of identifying the disease with almost 92.5% accuracy. We believe the implementation of this model will help the physicians and pathologists all over the world to single out the victims quickly and thus reduce the prevalence of COVID-19.


title: Estimating cost-benefit of quarantine length for COVID-19 mitigation

text: Background: The international community has been put in an unprecedented situation by the COVID-19 pandemic. Creating models to describe and quantify alternative mitigation strategies becomes increasingly urgent. Methods: In this study, we propose an agent-based model of disease transmission in a society divided into closely connected families, workplaces, and social groups. This allows us to discuss mitigation strategies, including targeted quarantine measures. Results: We find that workplace and more diffuse social contacts are roughly equally important to disease spread, and that an effective lockdown must target both. We examine the cost-benefit of replacing a lockdown with tracing and quarantining contacts of the infected. Quarantine can contribute substantially to mitigation, even if it has short duration and is done within households. When reopening society, testing and quarantining is a strategy that is much cheaper in terms of lost workdays than a long lockdown of workplaces. Conclusions: A targeted quarantine strategy is quite efficient with only 5 days of quarantine, and its relative effect increases when supplemented with other measures that reduce disease transmission.