title: Strongly heterogeneous transmission of COVID-19 in mainland China: local and regional variation

text: Background The outbreak of novel coronavirus disease 2019 (COVID-19) started in the city of Wuhan, China, with a period of rapid initial spread. Transmission on a regional and then national scale was promoted by intense travel during the holiday period of the Chinese New Year. We studied the variation in transmission of COVID-19, locally in Wuhan, as well as on a larger spatial scale, among different cities and even among provinces in mainland China. Methods In addition to reported numbers of new cases, we have been able to assemble detailed contact data for some of the initial clusters of COVID-19. This enabled estimation of the serial interval for clinical cases, as well as reproduction numbers for small and large regions. Findings We estimated the average serial interval was 4.8 days. For early transmission in Wuhan, any infectious case produced as many as four new cases, transmission outside Wuhan was less intense, with reproduction numbers below two. During the rapid growth phase of the outbreak the region of Wuhan city acted as a hot spot, generating new cases upon contact, while locally, in other provinces, transmission was low. Interpretation COVID-19 is capable of spreading very rapidly. The sizes of outbreak in provinces of mainland China mainly depended on the numbers of cases imported from Wuhan as the local reproduction numbers were low. The COVID-19 epidemic should be controllable with appropriate interventions. Funding No specific funding.


title: Decontamination of N95 masks against coronavirus: a scoping review

text: Background: At present, it remains uncertain which method to decontaminate N95 is most suitable and should be recommended to healthcare professionals worldwide. Objectives: The aim of this scoping review was to map and compile the available evidence about the effectiveness of decontaminating N95 masks against coronavirus. Methods: We selected studies written in English assessing or discussing decontamination strategies of N95 masks against coronavirus. The search and study screening were performed in PubMed and SCOPUS by two independent researchers. A descriptive analysis was performed considering the study design of included studies. Results: We included nineteen studies. Eight articles were letter to the editors, five were in vitro studies, three were literature reviews, and three were classified as other study designs. The use of vaporized hydrogen peroxide and ultraviolet irradiation were the strategies most cited. However, there is a lack of evidence and consensus related to the best method of N95 masks decontamination. Conclusion: The evidence towards decontamination strategies of N95 masks against coronavirus remains scarce. Vaporized hydrogen peroxide and ultraviolet irradiation seem the current standard for N95 masks decontamination.


title: Covid-19 Pandemic- Pits and falls of major states of India.

text: Covid-19, just like SARS and MERS before it, is a disease caused by corona virus and can lead to severe respiratory diseases in humans. With the outbreak of novel corona virus, WHO on 30th January 2020 declared it a Public Health Emergency and further on 11th March 2020, Covid-19 disease was declared a pandemic. India in the initial stages of the pandemic dealt with it in a very effective manner. With timely implementation of lockdown, India was able to contain the spread of Covid-19 to some extent. However with the recently announced Unlock 1.0, the SARS CoV-2 is expected to spread. This study aims to track and analyze the Covid-19 situation in major states that constitute of 70 percent of the total cases. Thus the states selected for the study are: Maharashtra, Delhi, Tamil Nadu, Gujarat, Uttar Pradesh and Rajasthan. These are the states which had more than ten thousand Covid-19 patients as/on June 10th 2020. The analysis period is from March 25th to June 10th and the data source is India Covid-19 tracker. To assess the previous and current Covid-19 situations in these states indicators such as Active rates, Recovery rate, Case fatality rate, Test positivity rate, tests per million, cases per million, test per confirmed case has been used. The study finds that although the absolute number of active cases may be rising, however it is showing a decreasing trend with an increase in recovery rates. With increasing number of Covid-19 cases, testing also has increased however not in the similar proportion and thus by developed nation standard we are lagging. With increasing TPR and cases per million, Delhi is well on its way to surpass even Mumbai which till now has proven to be worst hit in this pandemic. An interesting finding is that of test per confirmed case which shows that every 6th person in Maharashtra and every 8th in Delhi is showing positive result of Covid-19 test. Given such an increase and unlocked India, Delhi might soon enter into the third stage of community transmission where source of 50 percent or more cases would be unknown. There has been an increase in the Covid-19 related health infrastructure with the public-private partnership which involved both private hospitals and lab joining hands to battle Covid-19, however, affordability still remains an issue. If experts are to be believed, pandemic is not over because we have unlocked. The worst is yet to come as Covid-19 is predicted to peak in mid-July to August in India. Thus, it would be advisable to not venture out unnecessarily just because restrictions have been lifted. Also, following the guidelines- hand-washing, avoiding public gathering, social distancing and covering nose and mouth has now become imperative.


title: The Potential Impact of Intensified Community Hand Hygiene Interventions on Respiratory tract Infections: A Modelling Study

text: Increased hand hygiene amongst the general public has been widely promoted as one of the most important non-pharmaceutical interventions for reducing transmission during the ongoing COVID-19 pandemic and is likely to continue to play a key role in long-term efforts to suppress transmission before a vaccine can be deployed. For other respiratory tract infections community hand hygiene interventions are supported by evidence from randomised trials, but information on how effectiveness in reducing transmission scales with achieved changes in hand hygiene behaviour is lacking. This information is of critical importance when considering the potential value of substantially enhancing community hand hygiene frequency to help suppress COVID-19. Here, we developed a simple model-based framework for understanding the key determinants of the effectiveness of changes in hand hygiene behaviour in reducing transmission and use it to explore the potential impact of interventions aimed at achieving large-scale population-wide changes in hand hygiene behaviour. Our analyses show that the effect of hand hygiene is highly dependent on the duration of viral persistence on hands and that hand washing needs to be performed very frequently or immediately after hand contamination events in order to substantially reduce the probability of infection. Hand washing at a lower frequency, such as every 30 minutes or with a delay of 15 minutes after contamination events, may be adequate to reduce the probability of infection when viral survival on hands is longer, such as when hands are contaminated with mucus. Immediate hand washing after contamination is more effective than hand washing at fixed-time intervals even when the total number of hand washing events is similar. This event-prompted hand washing strategy is consistently more effective than fixed-time strategy regardless of hand contamination rates and should be highlighted in hand hygiene campaigns.


title: Civil liberties or public health, or civil liberties and public health? Using surveillance technologies to tackle the spread of COVID-19

text: To help tackle the spread of COVID-19 a range of surveillance technologies–smartphone apps, facial recognition and thermal cameras, biometric wearables, smart helmets, drones, and predictive analytics–have been rapidly developed and deployed. Used for contact tracing, quarantine enforcement, travel permission, social distancing/movement monitoring, and symptom tracking, their rushed rollout has been justified by the argument that they are vital to suppressing the virus, and civil liberties have to be sacrificed for public health. I challenge these contentions, questioning the technical and practical efficacy of surveillance technologies, and examining their implications for civil liberties, governmentality, surveillance capitalism, and public health.


title: How to differentiate COVID-19 pneumonia from heart failure with computed tomography at initial medical contact during epidemic period

text: OBJECTIVES To compare chest CT findings in heart failure with those of Corona Virus Disease 2019 (COVID-19) pneumonia. BACKGROUND During epidemic period, chest computed tomography (CT) has been highly recommended for screening patients with suspected COVID-19. However, the comparison of CT imaging between heart failure and COVID-19 pneumonia has not been fully elucidated. METHODS Patients with heart failure (n=12), COVID-19 pneumonia (n=12) and one patient with both diseases were retrospectively enrolled. Clinical information and imaging of chest CT were collected and analyzed. RESULTS There was no difference of ground glass opacity (GGO), consolidation, crazy paving pattern, lobes affected and septal thickening between heart failure and COVID-19 pneumonia. However, less rounded morphology (8.3% vs. 67%, p=0.003), more peribronchovascular thickening (75% vs. 33%, p=0.041) and fissural thickening (33% vs. 0%, p=0.028), less peripheral distribution (33% vs. 92%, p=0.003) were found in heart failure group than that in COVID-19 group. Importantly, there were also more patients with upper pulmonary vein enlargement (75% vs. 8.3%, p=0.001), subpleural effusion and cardiac enlargement in heart failure group than that in COVID-19 group (50% vs. 0%, p=0.005, separately). Besides, more fibrous lesions were found in COVID-19 group although there was no statistical difference (25% vs. 0%, P=0.064) CONCLUSIONS Although there are some overlaps of CT imaging between heart failure and COVID-19, CT is still a useful tool in differentiating COVID-19 pneumonia.


title: Factors associated with adherence to self-isolation and lockdown measures in the UK; a cross-sectional survey

text: Objectives: To investigate factors associated with adherence to self-isolation and lockdown measures due to COVID-19 in the UK. Design: Online cross-sectional survey. Setting: Data were collected between 6th and 7th May 2020. Participants: 2240 participants living in the UK aged 18 years or over. Participants were recruited from YouGov's online research panel. Main outcome measures: Having gone out in the last 24 hours in those who reported symptoms of COVID-19 in their household. Having gone out shopping for items other than groceries, toiletries or medicines (non-essentials), and total number of outings, in the last week in those who reported no symptoms of COVID-19 in their household. Results: 217 people (9.7%) reported that they or someone in their household had symptoms of COVID-19 (cough or high temperature / fever) in the last seven days. Of these people, 75.1% had left the home in the last 24 hours (defined as non-adherent). Factors associated with non-adherence were being male, less worried about COVID-19, and perceiving a smaller risk of catching COVID-19. Adherence was associated with having received help from someone outside your household. Results should be taken with caution as there was no evidence for associations when controlling for multiple analyses. Of people reporting no symptoms in the household, 24.5% had gone out shopping for non-essentials in the last week (defined as non-adherent). Factors associated with non-adherence and with a higher total number of outings in the last week included decreased perceived effectiveness of Government "lockdown" measures, decreased perceived severity of COVID-19, and decreased estimates of how many other people were following lockdown rules. Having received help was associated with better adherence. Conclusions: Adherence to self-isolation is poor. As we move into a new phase of contact tracing and self-isolation, it is essential that adherence is improved. Communications should aim to increase knowledge about actions to take when symptomatic or if you have been in contact with a possible COVID-19 case. They should also emphasise the risk of catching and spreading COVID-19 when out and about and the effectiveness of preventative measures. Using volunteer networks effectively to support people in isolation may promote adherence.


title: Coronavirus infection in children

text: Currently, 7 coronaviruses that cause human disease are known, 3 of which over the past 20 years have caused epidemics with a large number of severe cases, a high mortality rate and infection from the primary focus to other countries, followed by the formation of epidemic foci. The last The last epidemic of coronavirus infection (CVI) COVID-19 (COrona VIrus Disease 2019) arose at the end of December 2019 in the province of Hubei, China and still continues. Objective of the research: comparative epidemiological and clinical characteristics of the new CVI and peculiarities of its course in children. An analysis of 64 publications in in peer-reviewed journals and official sources of health care in Russia and China, WHO, devoted to epidemiologically significant CVI, including COVID-19. According to the literature, in all three epidemics of CVI, children, including newborns, were involved in the epidemic process. Almost all sources indicate a milder course of CVI in young children. Cases of perinatal infection are described. The review provides a comparative analysis of the clinical and epidemiological features of CVI in children using SARS, MERS as an example, gives basic approaches and recommendations for the diagnosis and treatment of COVID-19 with an assessment of the possibility of using antiviral drugs in children.


title: Integrative Bioinformatics Analysis Provides Insight into the Molecular Mechanisms of 2019-nCoV

text: The 2019-nCoV is reported to share the same entry (ACE2) as SARS-CoV according to the updated findings. Analyzing the distribution and expression level of the route of coronavirus may help reveal underlying mechanisms of viral susceptibility and post-infection modulation. In this study, we found that the expression of ACE2 in healthy populations and patients with underlying diseases was not significantly different, suggesting relatively similar susceptibility, which was consistent with current clinical observations. Moreover, based on the expression of ACE2 in smoking individuals, we inferred that long-term smoking might be a risk factor for 2019-nCoV. Analyzing the ACE2 in SARS-CoV infected cells suggested that ACE2 was more than just a receptor but also participated in post-infection regulation, including immune response, cytokine secretion, and viral genome replication. We also constructed Protein-protein interaction (PPI) networks and identified hub genes in viral activity and cytokine secretion. Our findings could explain the clinical symptoms so far and help clinicians and researchers understand the pathogenesis and design therapeutic strategies for 2019-nCoV.


title: News from the front: Excess mortality and life expectancy in two major epicentres of the COVID-19 pandemic in Italy

text: Existing studies commonly rely on national official reports to estimate the impact of COVID-19 on population health and human life. However, relying on national reports is problematic because classification and estimation of COVID-19 mortality are not consistent across countries. Likewise, delay coronavirus test results and shortage of testing kits can result in undercounting of coronavirus deaths. To overcome these problems, this study exploits all cause daily death registrations data provide by the Italian Statistical Office (ISTAT) from 1st January to 4th April 2020. This allows us to: 1) calculate excess mortality in 2020 compared to the years 2015 to 2019; and 2) estimate life expectancy on a seasonal and annual basis. We focus our analysis on Bergamo and Brescia, the two hardest hit provinces in Lombardy, northern Italy. Given the clustering nature of the epidemic, focusing on the areas with high concentration of severe illness and deaths allows us to capture the true impact of COVID-19 on mortality and life expectancy, which are likely to be underestimated in the national level data. We find that on the period 1 Jan to 4 April 2020, seasonal life expectancy in Bergamo reduced by around 8.1 and 6.5 years compared to 2019 for men and women respectively (4.5 and 3.4 years in Brescia). The drop in period life expectancy for 2020 may total up to 3 years in the case of men and 2 years in the case of women. Such a sharp decrease in life expectancy has not been experienced in modern history since the Second World War. This study shows that, in the absence of public health interventions to reduce the spread of the virus, COVID-19 has set life expectancy in Bergamo and Brescia back to the Italian life expectancy of 15 years ago.


title: Detecting Suspected Epidemic Cases Using Trajectory Big Data

text: Emerging infectious diseases are existential threats to human health and global stability. The recent outbreaks of the novel coronavirus COVID-19 have rapidly formed a global pandemic, causing hundreds of thousands of infections and huge economic loss. The WHO declares that more precise measures to track, detect and isolate infected people are among the most effective means to quickly contain the outbreak. Based on trajectory provided by the big data and the mean field theory, we establish an aggregated risk mean field that contains information of all risk-spreading particles by proposing a spatio-temporal model named HiRES risk map. It has dynamic fine spatial resolution and high computation efficiency enabling fast update. We then propose an objective individual epidemic risk scoring model named HiRES-p based on HiRES risk maps, and use it to develop statistical inference and machine learning methods for detecting suspected epidemic-infected individuals. We conduct numerical experiments by applying the proposed methods to study the early outbreak of COVID-19 in China. Results show that the HiRES risk map has strong ability in capturing global trend and local variability of the epidemic risk, thus can be applied to monitor epidemic risk at country, province, city and community levels, as well as at specific high-risk locations such as hospital and station. HiRES-p score seems to be an effective measurement of personal epidemic risk. The accuracy of both detecting methods are above 90\% when the population infection rate is under 20\%, which indicates great application potential in epidemic risk prevention and control practice.


Coronavirus disease 2019 pandemic: Time to optimize the potential of telepsychiatric aftercare clinic to ensure the continuity of care


A novel coronavirus threatens the world/ Un nouveau coronavirus menace le monde


title: The representation of women as authors of submissions to ecology journals during the COVID-19 pandemic

text: Observations made from papers submitted to preprint servers, and the speculation of editors on social media platforms, suggest that women are submitting fewer papers to scholarly journals than are men during the COVID-19 pandemic. Here I examine whether submissions by men and women to six ecology journals (all published by the British Ecological Society) have changed since the start of COVID disruptions. At these six ecology journals there is no evidence of a decline in the proportion of submissions that are authored by women (as either first or submitting author) since the start of the COVID-19 disruptions; the proportion of papers authored by women in the post-COVID period of 2020 has increased relative to the same period in 2019, and is higher than in the period pre-COVID in 2020. There is also no evidence of a change in the geographic pattern of submissions from across the globe.


title: Avoiding COVID-19: Aerosol Guidelines

text: The COVID-19 pandemic has brought into sharp focus the need to understand respiratory virus transmission mechanisms. In preparation for an anticipated influenza pandemic, a substantial body of literature has developed over the last few decades showing that the short-range aerosol route is an important, though often neglected transmission path. We develop a simple mathematical model for COVID-19 transmission via aerosols, apply it to known outbreaks, and present quantitative guidelines for ventilation and occupancy in the workplace.


title: The COVID-19 Pandemic: A Comprehensive Review of Taxonomy, Genetics, Epidemiology, Diagnosis, Treatment, and Control

text: A pneumonia outbreak with unknown etiology was reported in Wuhan, Hubei province, China, in December 2019, associated with the Huanan Seafood Wholesale Market. The causative agent of the outbreak was identified by the WHO as the severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), producing the disease named coronavirus disease-2019 (COVID-19). The virus is closely related (96.3%) to bat coronavirus RaTG13, based on phylogenetic analysis. Human-to-human transmission has been confirmed even from asymptomatic carriers. The virus has spread to at least 200 countries, and more than 1,700,000 confirmed cases and 111,600 deaths have been recorded, with massive global increases in the number of cases daily. Therefore, the WHO has declared COVID-19 a pandemic. The disease is characterized by fever, dry cough, and chest pain with pneumonia in severe cases. In the beginning, the world public health authorities tried to eradicate the disease in China through quarantine but are now transitioning to prevention strategies worldwide to delay its spread. To date, there are no available vaccines or specific therapeutic drugs to treat the virus. There are many knowledge gaps about the newly emerged SARS-CoV-2, leading to misinformation. Therefore, in this review, we provide recent information about the COVID-19 pandemic. This review also provides insights for the control of pathogenic infections in humans such as SARS-CoV-2 infection and future spillovers.


title: Covid-19 Seroprevalence rate in healthy blood donors from a community under strict lockdown measures

text: Background: Covid-19 seroprevalence rates and serological tests are important tools in understanding the epidemiology of the disease and help in the fight against it. Seroprevalence rates vary according to the population studied and the test employed and they range from 0.133 to 25.7%. The purpose of this study is to assess the seroprevalence rate in a population of healthy blood donors living under strict lockdown measures in Jordan which has in total 71 confirmed cases per million population. Methods: Left over sera and plasma samples from 746 healthy blood donors were tested using a commercially available FDA approved kit having a specificity of 100%. External positive controls were used for validation. Results: More than 80% of the donors were men 18-63 year old and residing in the capital city of Jordan, Amman. All tested specimens were negative yielding a zero seroprevalence rate in this healthy blood donor population. Conclusion: Strict lockdown measures effectively limit intracommunity spread of the infection, however at the cost of lack of any acquired community immunity. Additionally the use of highly specific test is recommended in low prevalence setting.


title: Exploring potential effect of Shengjiang San on SARS-CoV-2 based on network pharmacology and molecular docking/ 基于网络药理学和分子对接探寻升降散抗新型冠状病毒潜在作用机制研究

text: Objective: To explore the potential effect of Shengjiang San for inhibiting SARS-CoV-2. Methods: The target genes of Beauveria bassiana, Cryptotympana pustulata, Curcuma longa, Rheum officinale in Shengjiang San were screened out through the database analysis of Encyclopedia of Traditional Chinese Medicine (ETCM), and traditional Chinese medicine system pharmacology platform (TCMSP), Bioinformatics Analysis Tool for Molecular Mechanism of Traditional Chinese Medicine (BATMAN-TCM) and Collective Molecular Activities of Useful Plants (CMAUP). GeneCards database was used to obtain target genes of antivirus. The intersection method was used to obtain the target genes related to the antiviral effect of Shengjiang San. Cytoscape 3.7.2 software was applied for the construction of prescription-CMM-targets (genes) networks. Kyoto Encyclopedia of Genes and Genomes (KEGG) pathway enrichment analysis and gene ontology (GO) functional enrichment analysis were performed by R language to predict the potential mechanism of Shengjiang San against the virus. TCMSP, CNKI and PubChem databases were used to retrieve the chemical components of B. bassiana, C. pustulata, C. longa and R. officinale in Shengjiang San. AutoDock Vina 1.1.2 was used for molecular docking to study the interactions of each chemical component with SARS-CoV-2 3CL hydrolase or angiotensin converting enzyme II (ACE2). Results: Shengjiang San could play an antiviral role through the corresponding 663 target genes. Top ten pathways were related to antivirus (P < 0.01) in the KEGG pathway enrichment screening, including influenza A, etc. The affinity values of a total of 133 compounds in Shengjiang San were < -29.3 kJ/mol for molecular docking with SARS-CoV-2 3CL hydrolase. The affinity values of 145 compounds for molecular docking with ACE2 were < -29.3 kJ/mol. Conclusion: Shengjiang San could regulate multiple signaling pathways to inhibit virus, and have a potential inhibiting effect on SARS-Cov-2.


title: Taking back vacant property

text: “Taking back” has long been a rallying call of urban social movements asserting land rights. This call often involves seeking to ward off dispossession by taking possession. Scholars rethinking property beyond the normative “ownership model” have explored the seeming paradoxicality of resisting dispossession through legal forms of possession that reproduce deprivation. In this paper, I consider the possibilities for taking back the concept of possession itself by examining claims to “vacant” property in Philadelphia. I put taking back through a citywide “land bank” in conversation with the taking over of a poor people’s movement that occupies government-owned properties as a means of survival and political mobilization. I argue that outside or on the edge of legal recognition, the effort to take back property functions not as an end in itself, but rather as an explicitly political taking on of the notion of possessive ownership.


title: Voluntary Cyclical Distancing: A potential alternative to constant level mandatory social distancing, relying on an 'infection weather report'

text: COVID-19 has significantly changed our daily lives. Stay-at-home orders and forced closings of all non-essential businesses has had a significant impact on our economy. While it is important to ensure that the healthcare system is not overwhelmed, there are many questions that remain about the efficacy of extreme social distancing, and whether there are alternatives to mandatory lockdowns. This paper analyzes the utility of various levels of social distancing, and suggests an alternative approach using voluntary distancing informed by an infectious load index or 'infection weather report.'


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title: Physician Deaths from Corona Virus Disease (COVID-19)

text: OBJECTIVE: The COVID-19 pandemic has caused much morbidity and mortality to patients but also health care providers. We tabulated the cases of physician deaths from COVID-19 associated with front-line work in hopes of mitigating future events. METHOD: On April 5, 2020, Google internet search was performed using the keywords doctor, physician, death, COVID, COVID-19, and coronavirus in English and Farsi, and in Chinese using the Baidu search engine. RESULTS: We found 198 physician deaths from COVID-19, but complete details were missing for 49 individuals. The average age of the physicians that died was 63.4 years (range 28 to 90 years) and the median age was 66 years of age. Ninety percent of the deceased physicians were male (175/194). General practitioners and emergency room doctors (78/192), respirologists (5/192), internal medicine specialists (11/192) and anesthesiologists (6/192) comprised 52% of those dying. Two percent of the deceased were epidemiologists (4/192), 2% were infectious disease specialists (4/192), 5% were dentists (9/192), 4% were ENT (8/192), and 4% were ophthalmologists (7/192). The countries with the most reported physician deaths were Italy (79/198), Iran (43/198), China (16/198), Philippines (14/198), United States (9/192) and Indonesia (7/192). CONCLUSION: Physicians from all specialties may die from COVID, and these deaths will likely increase as the pandemic progresses. Lack of personal protective equipment was cited as a common cause of death. Consideration should be made to exclude older physicians from front-line work.


title: Considerations for the design of vaccine efficacy trials during public health emergencies

text: Public Health Emergencies (PHEs) provide a complex and challenging environment for vaccine evaluation. Under the R&D Blueprint Plan of Action, the World Health Organization (WHO) has convened a group of experts to agree on standard procedures to rapidly evaluate experimental vaccines during PHEs while maintaining the highest scientific and ethical standards. The Blueprint priority diseases, selected for their likelihood to cause PHEs and the lack of adequate medical countermeasures, were used to frame our methodological discussions. Here, we outline major vaccine study designs to be used in PHEs and summarize high-level recommendations for their use in this setting. We recognize that the epidemiology and transmission dynamics of the Blueprint priority diseases may be highly uncertain and that the unique characteristics of the vaccines and outbreak settings may affect our study design. To address these challenges, our group underscores the need for novel, flexible, and responsive trial designs. We conclude that assignment to study groups using randomization is a key principle underlying rigorous study design and should be utilized except in exceptional circumstances. Advance planning for vaccine trial designs is critical for rapid and effective response to a PHE and to advance knowledge to address and mitigate future PHEs. One Sentence Summary As part of the WHO research and development Blueprint for action to prevent epidemics, we describe key considerations for the design and analysis of trials and studies to evaluate experimental vaccines during public health emergencies.


docid: pcmnbdjj

title: The Use of Microbial Accessible and Fermentable Carbohydrates and/or Butyrate as Supportive Treatment for Patients With Coronavirus SARS-CoV-2 Infection


title: Imitation dynamics in the mitigation of the novel coronavirus disease (COVID-19) outbreak in Wuhan, China from 2019 to 2020

text: Background: The coronavirus disease 2019 (COVID-19) was first identified in Wuhan, China on December 2019 in patients presenting with atypical pneumonia. Although 'city-lockdown' policy reduced the spatial spreading of the COVID-19, the city-level outbreaks within each city remain a major concern to be addressed. The local or regional level disease control mainly depends on individuals self-administered infection prevention actions. The contradiction between choice of taking infection prevention actions or not makes the elimination difficult under a voluntary acting scheme, and represents a clash between the optimal choice of action for the individual interest and group interests. Methods: We develop a compartmental epidemic model based on the classic susceptible-exposed-infectious-recovered model and use this to fit the data. Behavioral imitation through a game theoretical decision-making process is incorporated to study and project the dynamics of the COVID-19 outbreak in Wuhan, China. By varying the key model parameters, we explore the probable course of the outbreak in terms of size and timing under several public interventions in improving public awareness and sensitivity to the infection risk as well as their potential impact. Results: We estimate the basic reproduction number, R0, to be 2.5 (95% CI: 2.4-2.7). Under the current most realistic setting, we estimate the peak size at 0.28 (95% CI: 0.24-0.32) infections per 1,000 population. In Wuhan, the final size of the outbreak is likely to infect 1.35% (95% CI: 1.00-2.12%) of the population. The outbreak will be most likely to peak in the first half of February and drop to daily incidences lower than 10 in June 2020. Increasing sensitivity to take infection prevention actions and the effectiveness of infection prevention measures are likely to mitigate the COVID-19 outbreak in Wuhan. Conclusions: Through an imitating social learning process, individual-level behavioral change on taking infection prevention actions have the potentials to significantly reduce the COVID-19 outbreak in terms of size and timing at city-level. Timely and substantially resources and supports for improving the willingness-to-act and conducts of self-administered infection prevention actions are recommended to reduce to the COVID-19 associated risks.


title: Inactivated trivalent influenza vaccine is associated with lower mortality among Covid-19 patients in Brazil

text: We analyzed data from 92,664 clinically and molecularly confirmed Covid-19 cases in Brazil to understand the potential associations between influenza vaccination and Covid-19 outcomes. Controlling for health facility of treatment, comorbidities as well as an extensive range of sociodemographic factors, we show that patients who received a recent influenza vaccine experienced on average 8% lower odds of needing intensive care treatment (95% CIs [0.86, 0.99]), 18% lower odds of requiring invasive respiratory support (0.74, 0.88) and 17% lower odds of death (0.75, 0.89). Large scale promotion of influenza vaccines seems advisable, especially in populations at high risk of severe SARS-CoV-2 infection.


title: Analytical performance of lateral flow immunoassay for SARS-CoV-2 exposure screening on venous and capillary blood samples

text: Objectives: Numerous serologic immunoassays have been launched to detect antibodies to SARS-CoV-2, including rapid tests. Here, we validate use of a lateral flow immunoassay (LFI) intended for rapid screening and qualitative detection of anti-SARS-CoV-2 IgM and IgG in serum, plasma, and whole blood, and compare results with ELISA. We also seek to establish the value of LFI testing on blood obtained from a capillary blood sample. Methods: Samples collected by venous blood draw and capillary finger stick were obtained from patients with SARS-CoV-2 detected by RT-qPCR and control patients negative for SARS-CoV-2. Samples were tested with the 2019-nCoV IgG/IgM Detection Kit (Colloidal Gold) lateral flow immunoassay, and antibody calls were compared with results obtained by ELISA. Results: The Biolidics LFI kit shows clinical sensitivity of 92% at 7 days after PCR diagnosis of SARS-CoV-2 on venous blood. Test specificity was 92% for IgM and 100% for IgG. There was no significant difference in detecting IgM and IgG with Biolidics LFI and ELISA at D0 and D7 (p=1.00), except for detection of IgM at D7 (p=0.04). Finger stick whole blood of SARS-CoV-2 patients showed 93% sensitivity for antibody detection. Conclusions: Clinical performance of Biolidics 2019-nCoV IgG/IgM Detection Kit (Colloidal Gold) is comparable to ELISA and showed consistent results across different sample types. Furthermore, we show that capillary blood obtained by finger stick shows similar sensitivity for detecting anti-SARS-CoV-2 IgM and IgG antibodies as venous blood samples. This provides an opportunity for decentralized rapid testing in the community and may allow point-of-care and longitudinal self-testing for the presence of anti-SARS-CoV-2 antibodies.


title: Estimating unobserved SARS-CoV-2 infections in the United States

text: By March 2020, COVID-19 led to thousands of deaths and disrupted economic activity worldwide. As a result of narrow case definitions and limited capacity for testing, the number of unobserved SARS-CoV-2 infections during its initial invasion of the US remains unknown. We developed an approach for estimating the number of unobserved infections based on data that are commonly available shortly after the emergence of a new infectious disease. The logic of our approach is, in essence, that there are bounds on the amount of exponential growth of new infections that can occur during the first few weeks after imported cases start appearing. Applying that logic to data on imported cases and local deaths in the US through March 12, we estimated that 22,876 (95% posterior predictive interval: 7,451 - 53,044) infections occurred in the US by this date. By comparing the model's predictions of symptomatic infections to local cases reported over time, we obtained daily estimates of the proportion of symptomatic infections detected by surveillance. This revealed that detection of symptomatic infections decreased throughout February as exponential growth of infections outpaced increases in testing. Between February 21 and March 12, we estimated an increase in detection of symptomatic infections, which was strongly correlated (median: 0.97, 95% PPI: 0.85 - 0.98) with increases in testing. These results suggest that testing was a major limiting factor in assessing the extent of SARS-CoV-2 transmission during its initial invasion of the US.


title: Wastewater SARS-CoV-2 Concentration and Loading Variability from Grab and 24-Hour Composite Samples

text: The ongoing COVID-19 pandemic caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) requires a significant, coordinated public health response. Assessing case density and spread of infection is critical and relies largely on clinical testing data. However, clinical testing suffers from known limitations, including test availability and a bias towards enumerating only symptomatic individuals. Wastewater-based epidemiology (WBE) has gained widespread support as a potential complement to clinical testing for assessing COVID-19 infections at the community scale. The efficacy of WBE hinges on the ability to accurately characterize SARS-CoV-2 concentrations in wastewater. To date, a variety of sampling schemes have been used without consensus around the appropriateness of grab or composite sampling. Here we address a key WBE knowledge gap by examining the variability of SARS-CoV-2 concentrations in wastewater grab samples collected every 2 hours for 72 hours compared with corresponding 24-hour flow-weighted composite samples. Results show relatively low variability (mean for all assays = 741 copies 100 mL-1, standard deviation = 508 copies 100 mL-1) for grab sample concentrations, and good agreement between most grab samples and their respective composite (mean deviation from composite = 159 copies 100 mL-1). When SARS-CoV-2 concentrations are used to calculate viral load, the discrepancy between grabs (log10 difference = 12.0) or a grab and its associated composite (log10 difference = 11.8) are amplified. A similar effect is seen when estimating carrier prevalence in a catchment population with median estimates based on grabs ranging 62-1853 carriers. Findings suggest that grab samples may be sufficient to characterize SARS-CoV-2 concentrations, but additional calculations using these data may be sensitive to grab sample variability and warrant the use of flow-weighted composite sampling. These data inform future WBE work by helping determine the most appropriate sampling scheme and facilitate sharing of datasets between studies via consistent methodology.


title: Coronavirus Goes Viral: Quantifying the COVID-19 Misinformation Epidemic on Twitter

text: Background Since the beginning of the coronavirus disease 2019 (COVID-19) epidemic, misinformation has been spreading uninhibited over traditional and social media at a rapid pace. We sought to analyze the magnitude of misinformation that is being spread on Twitter (Twitter, Inc., San Francisco, CA) regarding the coronavirus epidemic. Materials and methods We conducted a search on Twitter using 14 different trending hashtags and keywords related to the COVID-19 epidemic. We then summarized and assessed individual tweets for misinformation in comparison to verified and peer-reviewed resources. Descriptive statistics were used to compare terms and hashtags, and to identify individual tweets and account characteristics. Results The study included 673 tweets. Most tweets were posted by informal individuals/groups (66%), and 129 (19.2%) belonged to verified Twitter accounts. The majority of included tweets contained serious content (91.2%); 548 tweets (81.4%) included genuine information pertaining to the COVID-19 epidemic. Around 70% of the tweets tackled medical/public health information, while the others were pertaining to sociopolitical and financial factors. In total, 153 tweets (24.8%) included misinformation, and 107 (17.4%) included unverifiable information regarding the COVID-19 epidemic. The rate of misinformation was higher among informal individual/group accounts (33.8%, p: <0.001). Tweets from unverified Twitter accounts contained more misinformation (31.0% vs 12.6% for verified accounts, p: <0.001). Tweets from healthcare/public health accounts had the lowest rate of unverifiable information (12.3%, p: 0.04). The number of likes and retweets per tweet was not associated with a difference in either false or unverifiable content. The keyword “COVID-19” had the lowest rate of misinformation and unverifiable information, while the keywords “#2019_ncov” and “Corona” were associated with the highest amount of misinformation and unverifiable content respectively. Conclusions Medical misinformation and unverifiable content pertaining to the global COVID-19 epidemic are being propagated at an alarming rate on social media. We provide an early quantification of the magnitude of misinformation spread and highlight the importance of early interventions in order to curb this phenomenon that endangers public safety at a time when awareness and appropriate preventive actions are paramount.


title: To isolate, or not to isolate: a theoretical framework for disease control via contact tracing

text: Contact tracing is an essential tool in the public health battle for epidemiological control of infectious diseases. Contact tracing via case-by-case interviews is effective when contacts are known and outbreaks are small. Smartphone applications that keep track of contacts between users offer the possibility to scale contact tracing to larger outbreaks with minimal notification delays. While the benefits of reduced delays are widely recognised, it is less well understood how to best implement the tracing and notification protocol. The application will detect a multitude of contacts encountering an individual who later tests positive. Which of these contacts should be advised to self-isolate? The resolution hinges on an inherent trade-off: the more contacts notified, the greater the disease control, at the cost of more healthy individuals being instructed to self-isolate. In this study, based on a compartmental model tailored to the COVID-19 pandemic, we develop a framework to incorporate testing with limited resources coupled with a mechanistic description of digital contact tracing. Specifically, we employ a family of distributions characterising contact exposure and infection risk, and introduce a notification threshold that controls which level of exposure triggers notification. We detail how contact tracing can prevent disease outbreak, as a function of adoption rate, testing limitations, and other intervention methods such as social distancing and lockdown measures. We find an optimal notification threshold that balances the trade-off by minimising the number of healthy individuals instructed to self-isolate while preventing disease outbreak.


title: Isolation and contact tracing can tip the scale to containment of COVID-19 in populations with social distancing

text: Background: Novel coronavirus (SARS-CoV-2) has extended its range of transmission in all parts of the world, with substantial variation in rates of transmission and severity of associated disease. Many countries have implemented social distancing as a measure to control further spread. Methods: We evaluate whether and under which conditions containment or slowing down COVID-19 epidemics are possible by isolation and contact tracing in settings with various levels of social distancing. We use a stochastic transmission model in which every person generates novel infections according to a probability distribution that is affected by the incubation period distribution (time from infection to symptoms), distribution of the latent period (time from infection to onset of infectiousness), and overall transmissibility. The model distinguishes between close contacts (e.g., within a household) and other contacts in the population. Social distancing affects the number of contacts outside but not within the household. Findings: The proportion of asymptomatic or unascertained cases has a strong impact on the controllability of the disease. If the proportion of asymptomatic infections is larger than 30%, contact tracing and isolation cannot achieve containment for an R0 of 2.5. Achieving containment by social distancing requires a reduction of numbers of non-household contacts by around 90%. Depending on the realized level of contact reduction, tracing and isolation of only household contacts, or of household and non-household contacts are necessary to reduce the effective reproduction number to below 1. A combination of social distancing with isolation and contact tracing leads to synergistic effects that increase the prospect of containment. Interpretation: Isolation and contact tracing can be an effective means to slow down epidemics, but only if the majority of cases are ascertained. In a situation with social distancing, contact tracing can act synergistically and tip the scale towards containment, and can therefore be a tool for controlling COVID-19 epidemics as part of an exit strategy from current lockdown measures.


docid: eftsbeec

title: Working-Class Children of Mexican Immigrants in Dallas, Texas


title: COVID-19, SARS-CoV2, Enfeksiyonu: Güncel Epidemiyolojik Analiz ve Hastalık Seyrinin Modellemesi ;COVID-19, SARS-CoV2, Infectıon: Current Epıdemıologıcal Analysıs and Modelıng of Dısease

text: Dünya çapında 19 Mart 2020 itibariyle 170’in üzerinde ülkeyi saran COVID-19 enfeksiyonu neticesinde pozitif vakaların ve ölüm haberlerinin hızla yayıldığı herkes tarafından endişe ile takip edilmektedir Sosyal medya ve internet ortamında çok ciddi düzeyde bilgi birikimi ortaya çıkmıştır Bu çalışmanın amacı an itibariyle elde edilen veriler ışığında tüm dünya ülkelerinde enfeksiyon etkileri ve süreci hakkında genel yapıyı özetleyen istatistiki bilgiler sunmak ve enfeksiyon ölçütlerinin günlük değişimini modellemektir Elde edilen sonuçlar değerlendirildiğinde, birikimli (kümülatif) pozitif vaka sayısı, birikimli ölüm sayısı ve diğer bazı ölçütlerin ülkelere göre seyrinin aynı olmadığı, süreci en iyi kontrol eden ülkelerin başında Almanya ve Güney Kore’nin geldiği, Türkiye’ nin sürecinin ilk 10 günlük süreç itibariyle hızlı yayılım gösteren ülkelere benzediği görüldü Ayrıca Türkiye için 20 – 29 Mart 2020 arasında ortaya çıkabilecek pozitif vaka sayısı ve birikimli ölüm sayıları tahmin edildiğinde 20 Mart itibariyle pozitif vaka sayısının sayının 550 civarında, 4 olan mevcut ölüm sayısının hesaplamalarla birikimli ölüm sayısının ise 11 olacağı öngörülmüştür ;As of March 19, 2020, the worldwide spread of positive cases and news of death as a result of COVID-19 infection, which covers more than 170 countries, is followed with concern There has been a lot of information accumulation in social media and internet The aim of this study is to present statistical information summarizing the general structure about the effects and process of infection in all countries of the world in the light of the data obtained and to model the daily change of infection criteria When the obtained results are evaluated, the cumulative (cumulative) number of positive cases, cumulative number of deaths and some other criteria are not the same of course depending on the country, the process is one of the most well-control countries, Germany and South Korea came from, Turkey 'of the process, the first 10-day period as It was observed that it was similar to the countries with fast spread In addition to Turkey, 20 to 29 March 2020 the number of positive cases that may arise between and when the cumulative number of deaths is estimated the maximum number of positive cases as of March 20 around 550, while the cumulative death toll of 11 would be ,current measurement 4, is provided


Vertical Transmission


title: Potent antiviral effect of protoporphyrin IX and verteporfin on SARS-CoV-2 infection

text: The infection of SARS-CoV-2 has spread to more than 200 countries and regions and the numbers of infected people and deaths worldwide are expected to continue to rise. Current treatment of COVID-19 is limited and mostly supportive. At present, there is no specific therapeutics against SARS-CoV-2. In this study, we discovered that protoporphyrin IX and verteporfin, two FDA-approved drugs for treatment of human diseases, had significant antiviral effect against SARS-CoV-2, with EC50 values for the reduction of viral RNA at nanomolar concentrations. Both drugs completely inhibited the cytopathic effect (CPE) produced by SARS-CoV-2 infection at lower drug concentrations than that of remdesivir. The selection indices of protoporphyrin IX and verteporfin are 952.74 and 368.93, respectively, suggesting wide safety margins. Both drugs were able to prevent SARS-CoV-2 infection as well as suppress established SARS-CoV-2 infection. The compounds share a porphyrin ring structure. Molecular docking indicates that the compounds may interact with viral receptor ACE2 and could block the cell-cell fusion mediated by ACE2 and viral S protein. Our finding suggests that protoporphyrin IX and verteporfin might be potential antivirals against SARS-CoV-2 infection and also sheds new light on the development of a novel class of small compounds against SARS-CoV-2.


title: Exploring Causal relationship between risk factors and vulnerability to COVID-19Cases of Italy, Spain, France, Greece, Portugal, Morocco and South Africa

text: Even though the infection rate of COVID-19 is very high as of today 31 May: 5,819,962 confirmed cases worldwide, the death rate is only about 6.23%, 362,786 deaths as for the same date. Furthermore, the rate of total infected cases is extremely different from one country to another as well as for the rate of mortality. Therefore, there may be some factors that possibly amplify the rate of infection from one country to another as well as for the rate of mortality due to COVID-19. In the literature, we have found multiple identified risk factors responsible for vulnerability to COVID19, we have chosen pertinent key risk factors for our study: Median-age, age>65 years old, weight, population density, diabetics, International arrivals, median temperature between March and May.


title: Initial analysis of the spatial correlation between the incidence of covid-19 and human development in the municipalities of the state of ceará in brazil/ Análise inicial da correlação espacial entre a incidência de covid-19 e o desenvolvimento humano nos municípios do estado do ceará no brasil

text: Objective: To analyze the spatial distribution of the incidence of COVID-19 and its correlation with the municipal human development index (MHDI) of the municipalities of Ceará. Methods: This is an ecological study with data recovered from the 15thepidemiological week and the 19thone of the year 2020 using the MHDI and the COVID-19 incidence coefficient for each municipality as variables. The univariate spatial correlation and the bivariate one were analyzed using the TerraView and GeoDa softwares. Results: The incidence of COVID-19 has spatial dependence with moderate positive correlation and the formation of high-high clusters located in the metropolitan region of Fortaleza and municipalities in the north region. The lowest incidence was a low-low cluster in the south and west regions. There was a positive bivariate correlation between MHDI and the incidence of COVID-19 with the formation of a cluster in the metropolitan region of Fortaleza. Conclusion: The uneven mapping of COVID-19 and its relationship with MHDI in Ceará can contribute to actions to regional combat the pandemic.


title: Disinfection of N95 Respirators with Ozone

text: The coronavirus disease 2019 crisis is creating a shortage of personal protective equipment (PPE), most critically, N95 respirators for healthcare personnel. Our group was interested in the feasibility of ozone disinfection of N95 respirators as an alternative for healthcare professionals and organizations that might not have access to other disinfection devices. We tested the effectiveness of ozone on killing Pseudomonas aeruginosa (PsA) on three different N95 respirators: 3M 1860, 3M 1870, and 3M 8000. We used an ozone chamber that consisted of: an airtight chamber, an ozone generator, an ozone destruct unit, and an ozone UV analyzer. The chamber was capable of concentrating ozone up to 500 parts per million (ppm) from ambient air, creating an airtight seal, and precisely measuring ozone levels within the chamber. Exposure to ozone at 400 ppm with 80% humidity for two hours effectively killed bacteria on N95 respirators, types 1860, 1870, and 8000. There were no significant changes in filtration efficiency of the 1860 and 1870 type respirators for up to ten cycles of ozone exposure at similar conditions. There was no change in fit observed in the 1870 type respirator after ozone exposure. There was no significant change in the strap integrity of the 1870 type respirator after ozone exposure. Tests for filtration efficiency were not performed on the 8000 type respirator. Tests for fit or strap integrity were not performed on the 8000 or 1860 type respirators. This study demonstrates that an ozone application achieves a high level of disinfection against PsA, a vegetative bacteria that the CDC identifies as more difficult to kill than medium sized viruses such as SARS-CoV-2 (Covid-19). Furthermore, conditions shown to kill these bacteria did not damage or degrade respirator filtration. This is the first report of successful disinfection of N95 PPE with ozone of which the authors are aware. It is also the first report, to the authors' knowledge, to identify necessary conditions for ozone to kill organisms on N95 masks without degrading the function of N95 filters.


title: SOCRATES: An online tool leveraging a social contact data sharing initiative to assess mitigation strategies for COVID-19

text: Objective: Establishing a social contact data sharing initiative and an interactive tool to assess mitigation strategies for COVID-19. Results: We organized data sharing of published social contact surveys via online repositories and formatting guidelines. We analyzed this social contact data in terms of weighted social contact matrices, next generation matrices, relative incidence and R0. We incorporated location-specific isolation measures (e.g. school closure or telework) and capture their effect on transmission dynamics. All methods have been implemented in an online application based on R Shiny and applied to COVID-19 with age-specific susceptibility and infectiousness. Using our online tool with the available social contact data, we illustrate that social distancing could have a considerable impact on reducing transmission for COVID-19. The effect itself depends on assumptions made about disease-specific characteristics and the choice of intervention(s). Keywords: social contact data, user interface, transmission dynamics, infectious diseases, epidemics, social distancing, behavioral changes, data sharing initiative, open-source, COVID-19


title: Anti-SARS-CoV-2 IgG antibodies are associated with reduced viral load

text: Anti-SARS-CoV-2 antibodies have been described, but correlation with virologic outcomes is limited. Here, we find anti-SARS-CoV-2 IgG to be associated with reduced viral load. High viral loads were rare in individuals who had seroconverted. Higher viral load on admission was associated with increased 30-day mortality (OR 4.20 [95% CI: 1.62-10.86]).


title: Are women leaders significantly better at controlling the contagion?

text: Recent media articles have suggested that women-led countries are doing better in terms of their responses to the COVID-19 pandemic. We examine an ensemble of public health metrics to assess the control of COVID-19 epidemic in women- vs men-led countries worldwide based on data available up to June 3. The median of the distribution of median time-varying effective reproduction number for women and men led countries were 0.89 and 1.14 respectively with the 95% two-sample bootstrap-based confidence interval for the difference (women - men) being [-0.335, 0.028]. In terms of scale of testing, the median percentage of population tested were 3.28% (women), 1.59% (men) [95% CI: (-1.285%, 3.600%)] with test positive rates of 2.69% (women) and 4.94% (men) respectively. It appears that though statistically not significant, countries led by women have an edge over countries led by men in terms of public health metrics for controlling the spread of the COVID-19 pandemic worldwide.


title: Risk for pathological contamination fears at coronavirus time: Proposal of early intervention and prevention strategies

text: Covid-19 outbreak represents a stressful life event that might potentially trigger psychopathological symptoms in people with a pre-existing vulnerability. This is particularly relevant for the onset or exacerbation of pathological contamination fears in people with vulnerability to obsessive-compulsive disorder (OCD) or in those individuals with sub-threshold obsessive-compulsive symptoms, or who achieved recovery after a successful treatment. Strict movement restrictions and hygiene habits are essential to limit Covid-19 diffusion and delay its progression. However, the occurrence of dysfunctional, clinically relevant contamination fears may be the downside highlighting the importance of a more comprehensive knowledge on the vulnerability factors of OCD in order to inform policy making and risk communication on one hand, early identification and prevention on the other one. The importance of early identification and prevention of OCD during critical periods, such as the present one, is of paramount importance since this psychiatric condition is associated with a prolonged latency in the correct diagnosis and first professional contact which is in turn associated with worse prognosis and higher resistance to treatment.


title: Genetic Diversity and Genomic Epidemiology of SARS-COV-2 in Morocco

text: COVID-A9 is an infection disease caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), declared as a pandemic due to its rapid expansion worldwide. In this study we investigate the genetic diversity and genomic epidemiology of SARS-CoV-2 using 22 virus genome sequences reported by three different laboratories in Morocco till the date 07/06/2020 as well as (40366) virus genomes from all around the world. The SARS-CoV-2 genomes from Moroccan patients revealed 62 mutations of which 30 were missense mutations. The mutations Spike_D614G and NSP12_P323L were present in all the 22 analyzed sequences, followed by N_G204R and N_R203K which occurred in 9 among the 22 sequences. The mutations NSP10_R134S, NSP15_D335N, NSP16_I169L, NSP3_L431H, NSP3_P1292L and Spike_V6F occurred one time in our sequences with no record in other sequence worldwide. These mutations should be investigated to figure out their potential effects on all around the world virulence. Phylogenetic analyses revealed that Moroccan SARS-CoV-2 genomes included 9 viruses pertaining to clade 20A, 9 to clade 20B and 2 to clade 20C. This finding suggest that the epidemic spread in Morocco did not show a predominant SARS-CoV-2 route. For multiple and unrelated introductions of SARS-CoV-2 into Morocco via different routes have occurred, giving rise to the diversity of virus genomes in the country. Furthermore, very likely, the SARS-CoV-2 virus circulated in cryptic way in Morocco starting from the fifteen January before the discovering of the first case the second of March.


docid: mxwspczo

title: Epidemic size of novel coronavirus-infected pneumonia in the Epicenter Wuhan: using data of five-countries' evacuation action

text: Background: Since late December 2019, novel coronavirus-infected pneumonia (NCP) emerged in Wuhan, Hubei province, China. Meanwhile, NCP rapidly spread from China to other countries, and several countries' government rush to evacuate their citizens from Wuhan. We analyzed the infection rate of the evacuees and extrapolated the results in Wuhan's NCP incidence estimation. Methods: We collected the total number and confirmed cases of 2019-nCov infection in the evacuation of Korea, Japan, Germany, Singapore, and France and estimated the infection rate of the 2019 novel coronavirus (2019-nCov) among people who were evacuated from Wuhan with a meta-analysis. NCP incidence of Wuhan was indirectly estimated based on data of evacuation. Results: From Jan 29 to Feb 2, 2020, 1916 people have been evacuated from Wuhan, among them 17 have been confirmed 2019-nCov infected. The infection rate is estimated to be 1.1% (95% CI 0.4%-3.1%) using one group meta-analysis method with random effect model. We then estimated that almost 110,000 (95% CI: 40,000-310,000) people were infected with 2019-nCov in Wuhan around Feb 2, 2020, assuming the infection risk of evacuees is close to Chinese citizens in Wuhan. Conclusions: At the beginning of the outbreak, incidence of NCP may be vastly underestimated. Our result emphasizes that 2019-nCov has proposed a huge public health threats in Wuhan. We need to respond more rapidly, take large-scale public health interventions and draconian measures to limiting population mobility and control the epidemic.


title: Transmission of respiratory viruses when using public ground transport: A rapid review to inform public health recommendations during the COVID-19 pandemic

text: In response to the COVID-19 pandemic, numerous countries worldwide declared national states of emergency and implemented interventions to minimise the risk of transmission among the public Evidence was needed to inform strategies for limiting COVID19 transmission on public transport On 20 March 2020, we searched MEDLINE, CENTRAL, Web of Science and the World Health Organization's database of `Global research on coronavirus disease (COVID-19)' to conduct a rapid review on interventions that reduce viral transmission on public ground transport After screening 74 records, we identified 4 eligible studies These studies suggest an increased risk of viral transmission with public transportation use that may be reduced with improved ventilation International and national guidelines suggest the following strategies: keep the public informed, stay at home when sick, and minimise public transport use Where use is unavoidable, environmental control, respiratory etiquette and hand hygiene are recommended, while a risk-based approach needs to guide the use of non-medical masks


title: Are Clinicians Contributing to Excess African American COVID-19 Deaths? Unbeknownst to Them, They May Be

text: African Americans are overrepresented among reported coronavirus disease 2019 (COVID-19) cases and deaths. There are a multitude of factors that may explain the African American disparity in COVID-19 outcomes, including higher rates of comorbidities. While individual-level factors predictably contribute to disparate COVID-19 outcomes, systematic and structural factors have not yet been reported. It stands to reason that implicit biases may fuel the racial disparity in COVID-19 outcomes. To address this racial disparity, we must apply a health equity lens and disaggregate data explicitly for African Americans, as well as other populations at risk for biased treatment in the health-care system.


title: Belgian Covid-19 Mortality, Excess Deaths, Number of Deaths per Million, and Infection Fatality Rates (8 March - 9 May 2020)

text: Objective. Scrutiny of COVID-19 mortality in Belgium over the period 8 March-9 May 2020 (Weeks 11-19), using number of deaths per million, infection fatality rates, and the relation between COVID-19 mortality and excess death rates. Data. Publicly available COVID-19 mortality (2020); overall mortality (2009-2020) data in Belgium and demographic data on the Belgian population; data on the nursing home population; results of repeated sero-prevalence surveys in March-April 2020. Statistical methods. Reweighing, missing-data handling, rate estimation, visualization. Results. Belgium has virtually no discrepancy between COVID-19 reported mortality (confirmed and possible cases) and excess mortality. There is a sharp excess death peak over the study period; the total number of excess deaths makes April 2020 the deadliest month of April since WWII, with excess deaths far larger than in early 2017 or 2018, even though influenza-induced January 1951 and February 1960 number of excess deaths were similar in magnitude. Using various sero-prevalence estimates, infection fatality rates (IFRs; fraction of deaths among infected cases) are estimated at 0.38-0.73% for males and 0.20-0.39% for females in the non-nursing home population (non-NHP), and at 0.79-1.52% for males and 0.88-1.31% for females in the entire population. Estimates for the NHP range from 38 to 73% for males and over 22 to 37% for females. The IFRs rise from nearly 0% under 45 years, to 4.3% and 13.2% for males in the non-NHP and the general population, respectively, and to 1.5% and 11.1% for females in the non-NHP and general population, respectively. The IFR and number of deaths per million is strongly influenced by extensive reporting and the fact that 66.0% of the deaths concerned NH residents. At 764 (our re-estimation of the figure 735, presented by "Our World in Data"), the number of COVID-19 deaths per million led the international ranking on May 9, 2020, but drops to 262 in the non-NHP. The NHP is very specific: age-related increased risk; highly prevalent comorbidities that, while non-fatal in themselves, exacerbate COVID-19; larger collective households that share inadvertent vectors such as caregivers and favor clustered outbreaks; initial lack of protective equipment, etc. High-quality health care countries have a relatively older but also more frail population [1], which is likely to contribute to this result.


title: JAK1 inhibition blocks lethal sterile immune responses: implications for COVID-19 therapy

text: Cytokine storms are drivers of pathology and mortality in myriad viral infections affecting the human population. In SARS-CoV-2-infected patients, the strength of the cytokine storm has been associated with increased risk of acute respiratory distress syndrome, myocardial damage, and death. However, the therapeutic value of attenuating the cytokine storm in COVID-19 remains to be defined. Here, we report results obtained using a novel mouse model of lethal sterile anti-viral immune responses. Using a mouse model of Down syndrome (DS) with a segmental duplication of a genomic region encoding four of the six interferon receptor genes (Ifnrs), we demonstrate that these animals overexpress Ifnrs and are hypersensitive to IFN stimulation. When challenged with viral mimetics that activate Toll-like receptor signaling and IFN anti-viral responses, these animals overproduce key cytokines, show exacerbated liver pathology, rapidly lose weight, and die. Importantly, the lethal immune hypersensitivity, accompanying cytokine storm, and liver hyperinflammation are blocked by treatment with a JAK1-specific inhibitor. Therefore, these results point to JAK1 inhibition as a potential strategy for attenuating the cytokine storm and consequent organ failure during overdrive immune responses. Additionally, these results indicate that people with DS, who carry an extra copy of the IFNR gene cluster encoded on chromosome 21, should be considered at high risk during the COVID-19 pandemic. One Sentence Summary Inhibition of the JAK1 kinase prevents pathology and mortality caused by a rampant innate immune response in mice.


title: Hydroxychloroquine and azithromycin plus zinc vs hydroxychloroquine and azithromycin alone: outcomes in hospitalized COVID-19 patients

text: Background: COVID-19 has rapidly emerged as a pandemic infection that has caused significant mortality and economic losses. Potential therapies and means of prophylaxis against COVID-19 are urgently needed to combat this novel infection. As a result of in vitro evidence suggesting zinc sulfate may be efficacious against COVID-19, our hospitals began using zinc sulfate as add-on therapy to hydroxychloroquine and azithromycin. We performed a retrospective observational study to compare hospital outcomes among patients who received hydroxychloroquine and azithromycin plus zinc versus hydroxychloroquine and azithromycin alone. Methods: Data was collected from electronic medical records for all patients being treated with admission dates ranging from March 2, 2020 through April 5, 2020. Initial clinical characteristics on presentation, medications given during the hospitalization, and hospital outcomes were recorded. Patients in the study were excluded if they were treated with other investigational medications. Results: The addition of zinc sulfate did not impact the length of hospitalization, duration of ventilation, or ICU duration. In univariate analyses, zinc sulfate increased the frequency of patients being discharged home, and decreased the need for ventilation, admission to the ICU, and mortality or transfer to hospice for patients who were never admitted to the ICU. After adjusting for the time at which zinc sulfate was added to our protocol, an increased frequency of being discharged home (OR 1.53, 95% CI 1.12-2.09) reduction in mortality or transfer to hospice remained significant (OR 0.449, 95% CI 0.271-0.744). Conclusion: This study provides the first in vivo evidence that zinc sulfate in combination with hydroxychloroquine may play a role in therapeutic management for COVID-19.


title: The Novel Coronavirus, 2019-nCoV, is Highly Contagious and More Infectious Than Initially Estimated

text: The novel coronavirus (2019-nCoV) is a recently emerged human pathogen that has spread widely since January 2020. Initially, the basic reproductive number, R0, was estimated to be 2.2 to 2.7. Here we provide a new estimate of this quantity. We collected extensive individual case reports and estimated key epidemiology parameters, including the incubation period. Integrating these estimates and high-resolution real-time human travel and infection data with mathematical models, we estimated that the number of infected individuals during early epidemic double every 2.4 days, and the R0 value is likely to be between 4.7 and 6.6. We further show that quarantine and contact tracing of symptomatic individuals alone may not be effective and early, strong control measures are needed to stop transmission of the virus.


title: Healthcare worker mask reuse in a global pandemic: Using idle resources to create an inexpensive, scalable, and accessible UV system for N95 sterilization

text: As the current COVID-19 pandemic illustrates, not all hospitals and other facilities are equipped with enough personal protective equipment to meet the demand in a crisis. Healthcare workers around the world utilize N95 masks to protect themselves and their patients, yet during this global pandemic they are forced to re-wear what is intended to be single-use masks. This poses significant risk to these healthcare workers along with the populations they are trying to protect. Ultraviolet germicidal irradiation (UVGI) has been validated previously as a way to effectively sterilize these masks between use, however, not all facilities have access to the high cost commercial UV-C lamp sterilization equipment. However, UV-C bulbs are sitting idle in biosafety cabinets (BSCs) at universities and research facilities around the globe that have been shuttered to slow the spread of COVID-19. These bulbs may also be available in existing medical centers where infectious diseases are commonly treated. Therefore, we have developed a method to modify existing light fixtures, or create custom light fixtures compatible with new or existing common UV-C bulbs. This system is scalable and can be created for less than 50 US dollars, on site, at the point of need, and leverages resources that are currently untapped and sitting unused in public and private research facilities. The freely-accessible design can be easily modified for use around the world. Hospitals can obtain this potentially life-saving UVGI resource with minimal funds, via collaboration between research facilities to obtain the UV-C meters and limited availability UVGI bulbs. While mask reuse is not ideal, we must do what we can in emergency situations to protect our frontline healthcare workers and the communities they serve.


title: Climatic influence on the magnitude of COVID-19 outbreak: a stochastic model-based global analysis

text: This study examines the association between community transmission of COVID-19 cases and climatic predictors, considering travel information and annual parasite index across the three climatic zones, i.e., tropical, subtropical, and temperate. A Boosted Regression Tree model has been employed to understand the association between the COVID-19 cases. The results show that average temperature and average relative humidity are the major contributors in explaining the differentials of COVID-19 transmission in temperate and subtropical regions whereas the mean diurnal temperature range and temperature seasonality are the most significant determinants in tropical regions. The average temperature is the most influential factor affecting the number of COVID-19 cases in France, Turkey, the US, the UK, and Germany, and the cases decrease sharply above 10oC. Among the tropical countries, India found to be most affected by mean diurnal temperature, and Brazil fazed by temperature seasonality. Most of the temperate countries like France, USA, Turkey, UK, and Germany with an average temperature between 5-12oC had high number of COVID-19 cases. The findings are expected to add to the ongoing debates on the influence of climatic factors influencing the number of COVID-19 cases and could help researchers and policymakers to make appropriate decisions for preventing the spread.


title: TRACKING AND PREDICTING COVID-19 RADIOLOGICAL TRAJECTORY USING DEEP LEARNING ON CHEST X-RAYS: INITIAL ACCURACY TESTING

text: Background - Decision scores and ethically mindful algorithms are being established to adjudicate mechanical ventilation in the context of potential resources shortage due to the current onslaught of COVID-19 cases. There is a need for a reproducible and objective method to provide quantitative information for those scores. Purpose - Towards this goal, we present a retrospective study testing the ability of a deep learning algorithm at extracting features from chest x-rays (CXR) to track and predict radiological evolution. Materials and Methods - We trained a repurposed deep learning algorithm on the CheXnet open dataset (224,316 chest X-ray images of 65,240 unique patients) to extract features that mapped to radiological labels. We collected CXRs of COVID-19-positive patients from two open-source datasets (last accessed on April 9, 2020)(Italian Society for Medical and Interventional Radiology and MILA). Data collected form 60 pairs of sequential CXRs from 40 COVID patients (mean age +/- standard deviation: 56 +/- 13 years; 23 men, 10 women, seven not reported) and were categorized in three categories: Worse, Stable, or Improved on the basis of radiological evolution ascertained from images and reports. Receiver operating characteristic analyses, Mann-Whitney tests were performed. Results - On patients from the CheXnet dataset, the area under ROC curves ranged from 0.71 to 0.93 for seven imaging features and one diagnosis. Deep learning features between Worse and Improved outcome categories were significantly different for three radiological signs and one diagnostic (Consolidation, Lung Lesion, Pleural Effusion and Pneumonia; all P < 0.05). Features from the first CXR of each pair could correctly predict the outcome category between Worse and Improved cases with 82.7% accuracy. Conclusion - CXR deep learning features show promise for classifying the disease trajectory. Once validated in studies incorporating clinical data and with larger sample sizes, this information may be considered to inform triage decisions.


title: Applying Heat and Humidity using Stove Boiled Water for Decontamination of N95 Respirators in Low Resource Settings

text: Global shortages of N95 masks have led to an urgent need of N95 decontamination and reuse methods that are scientifically validated and available globally. Although several large scale decontamination methods have been proposed (hydrogen peroxide vapor, UV-C); many of them are not applicable in remote and low resource settings. Heat with humidity has been demonstrated as a promising decontamination approach, but care must be taken when implementing this method at a grassroots level. Here we present a simple method to provide stable humidity and temperature for individual N95 masks which can be simply scaled in low resource settings. Moist heat (>50% humidity, 65-80C temperature) was applied to Kimberly-Clark N95 respirators for over 30 minutes by placing sealed containers with N95 respirators into water that had been brought to a rolling boil and removed from heat, and then allowing the containers to sit for over 45 minutes. After rising to their threshold points, temperature and humidity remained above 65C and 50% for a treatment time of at least 30 minutes. Filtration efficiency of 0.3-4.99um particles remained above 97% after 5 treatment cycles across all particle size sub-ranges, which is consistent with previously-reported data for similar heat and humidity conditions on different N95 FFR models. Although no fit tests were conducted on these masks after treatment, prior data on moist heat based treatment indicates consistent fit for up to five cycles of decontamination. This method of applying heat and humidity for the purpose of N95 respirator decontamination can be implemented on open flame stoves for low resource settings without reliable electricity access or where other methods of decontamination are not accessible. Higher temperatures or longer treatment times, such as treatment at >70C for over 30 minutes, could be achieved by increasing the volumes of boiled water used. Although fresh N95 masks should always be used - whenever available - we believe this simple yet reliable method provides a low cost, electricity free method for N95 decontamination in remote parts of the world.


docid: jnytdvtr

title: Comparing Metapopulation Dynamics of Infectious Diseases under Different Models of Human Movement

text: Newly available data sets present an exciting opportunity to investigate how human population movement contributes to the spread of infectious diseases across large geographical distances. It is now possible to construct realistic models of infectious disease dynamics for the purposes of understanding global-scale epidemics. Nevertheless, a remaining unanswered question is how best to leverage the new data to parameterize models of movement, and whether one's choice of movement model impacts modeled disease outcomes. We adapt three well-studied models of infectious disease dynamics, the SIR model; the SIS model; and the Ross-Macdonald model, to incorporate either of two candidate movement models. We describe the effect that the choice of movement model has on each disease model's results, finding that in all cases there are parameter regimes where choosing one movement model instead of another has a profound impact on epidemiological outcomes. We further demonstrate the importance of choosing an appropriate movement model using the applied case of malaria transmission and importation on Bioko Island, Equatorial Guinea, finding that one model produces intelligible predictions of R0 while the other produces nonsensical results.


title: The impact of lockdown measures on COVID-19: a worldwide comparison

text: Objective We aimed to determine which aspects of the COVID-19 national response are independent predictors of COVID-19 mortality and case numbers. Design Comparative observational study between nations using publically available data Setting Worldwide Participants Covid-19 patients Interventions Stringency of 11 lockdown policies recorded by Blavatnik School of Government database and earliness of each policy relative to first recorded national cases Main outcome measures Association with log10 National deaths (LogD) and log10 National cases (LogC) on the 29th April 2020 corrected for predictive demographic variables Results Early introduction was associated with reduced mortality (n=137) and case numbers (n=150) for every policy aside from testing policy, contact tracing and workplace closure. Maximum policy stringency was only found to be associated with reduced mortality (p=0.003) or case numbers (p=0.010) for international travel restrictions. A multivariate model, generated using demographic parameters (r2=0.72 for LogD and r2=0.74 for LogC), was used to assess the timing of each policy. Early introduction of first measure (significance p=0.048, regression coefficient {beta}=-0.004, 95% confidence interval 0 to -0.008), early international travel restrictions (p=0.042, ({beta}=-0.005, -0.001 to -0.009) and early public information (p=0.021, {beta}=-0.005, -0.001 to -0.009) were associated with reduced LogC. Early introduction of first measure (p=0.003, {beta}=-0.007, -0.003 to -0.011), early international travel restrictions (p=0.003, {beta}=-0.008, -0.004 to-0.012), early public information (p=0.003, {beta}=-0.007, 0.003 to -0.011), early generalised workplace closure (p=0.031, {beta}=-0.012, -0.002 to -0.022) and early generalised school closure (p=0.050, {beta}=-0.012, 0 to -0.024) were associated with reduced LogC. Conclusions At this stage in the pandemic, early institution of public information, international travel restrictions, and workplace closure are associated with reduced COVID-19 mortality and maintaining these policies may help control the pandemic.


title: SELF-POLICING COVID-19 AND CIVIC RESPONSIBILITIES IN LAGOS METROPOLIS, NIGERIA

text: This study investigated self-policing COVID-19 and civic responsibilities in Lagos Metropolis, Nigeria adopting an online qualitative interview due to the current lockdown that denied field (face to face) interview. Fifty out of the feedbacks from the online interview were picked randomly to arrive at the conclusion of this study. The feedbacks suggested that there is adequate awareness of the COVID-19 pandemic among the people living in Lagos Metropolis, Nigeria and that they are following the directives of federal and state governments in an effort to reduce the community transmission of the infectious diseases. However, the ban on public gatherings and movements has made it impossible for many homes to meet their basic needs especially feeding. The government provided palliatives have also been largely insufficient to cater for the vulnerable. There could be a crisis (such as hunger) and the breakdown of law and order if the government does not increase their capacity to mitigate the hardship which the ongoing lockdown has imposed on the people.


title: Pneumask: Modified Full-Face Snorkel Masks as Reusable Personal Protective Equipment for Hospital Personnel

text: Here we adapt and evaluate a full-face snorkel mask for use as personal protective equipment (PPE) for health care workers, who lack appropriate alternatives during the COVID-19 crisis in the spring of 2020. The design (referred to as Pneumask) consists of a custom snorkel-specific adapter that couples the snorkel-port of the mask to a rated filter (either a medical-grade ventilator inline filter or an industrial filter). This design has been tested for the sealing capability of the mask, filter performance, CO2 buildup and clinical usability. These tests found the Pneumask capable of forming a seal that exceeds the standards required for half-face respirators or N95 respirators. Filter testing indicates a range of options with varying performance depending on the quality of filter selected, but with typical filter performance exceeding or comparable to the N95 standard. CO2 buildup was found to be roughly equivalent to levels found in half-face elastomeric respirators in literature. Clinical usability tests indicate sufficient visibility and, while speaking is somewhat muffled, this can be addressed via amplification (Bluetooth voice relay to cell phone speakers through an app) in noisy environments. We present guidance on the assembly, usage (donning and doffing) and decontamination protocols. The benefit of the Pneumask as PPE is that it is reusable for longer periods than typical disposable N95 respirators, as the snorkel mask can withstand rigorous decontamination protocols (that are standard to regular elastomeric respirators). With the dire worldwide shortage of PPE for medical personnel, our conclusions on the performance and efficacy of Pneumask as an N95-alternative technology are cautiously optimistic.


title: Multiple Myeloma and SARS-CoV-2 Infection: Clinical Characteristics and Prognostic Factors of Inpatient Mortality

text: There is limited information on the characteristics, pre-admission prognostic factors, and outcomes of patients with multiple myeloma (MM) hospitalized with coronavirus disease 2019 (COVID-19). This retrospective case series investigated characteristics and outcomes of 167 MM patients hospitalized with COVID-19 reported from 73 hospitals within the Spanish Myeloma Collaborative Group network in Spain between March 1 and April 30, 2020. Outcomes were compared with a randomly selected contemporary cohort of 167 age-/sex-matched non-cancer patients with COVID-19 admitted at 6 participating hospitals. Common demographic, clinical, laboratory, treatment, and outcome variables were collected; specific disease status and treatment data were collected for MM patients. Among the MM and non-cancer patients, median age was 71 years and 57% of patients were male in each series, and 75% and 77% of patients, respectively, had at least one comorbidity. COVID-19 clinical severity was moderate-severe in 77% and 89% of patients and critical in 8% and 4%, respectively. Supplemental oxygen was required by 47% and 55% of MM and non-cancer patients, respectively, and 21%/9% vs 8%/6% required non-invasive/invasive ventilation. Inpatient mortality was 34% and 23% in MM and non-cancer patients, respectively. Among MM patients, inpatient mortality was 41% in males, 42% in patients aged >65 years, 49% in patients with active/progressive MM at hospitalization, and 59% in patients with comorbid renal disease at hospitalization, which were independent prognostic factors of inpatient mortality on adjusted multivariate analysis. This case series demonstrates the increased risk and identifies predictors of inpatient mortality among MM patients hospitalized with COVID-19.


title: Medical molecular farming: production of antibodies, biopharmaceuticals and edible vaccines in plants

text: Abstract The use of plants for medicinal purposes dates back thousands of years but genetic engineering of plants to produce desired biopharmaceuticals is much more recent. As the demand for biopharmaceuticals is expected to increase, it would be wise to ensure that they will be available in significantly larger amounts, on a cost-effective basis. Currently, the cost of biopharmaceuticals limits their availability. Plant-derived biopharmaceuticals are cheap to produce and store, easy to scale up for mass production, and safer than those derived from animals. Here, we discuss recent developments in this field and possible environmental concerns.


title: Appendix CD Molecules

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title: Economy or Health, Constant Dilemma in Times of Pandemic: The Case of Coronavirus Disease 2019 (COVID-19)

text: The multiple faces of the Coronavirus Disease 2019 (COVID-19), also included the impact on the economy As a consequence of the significant life and society disruption, multiple implications are derived from the COVID-19 crisis and pandemic, including a significant backward on the economy In the current mini-review, we discuss some potential considerations about it, including some specific examples of the COVID-19 impact on the economy


title: Liberte, Egalite, Fraternite... Contamine? Estimating the impact of French municipal elections on COVID-19 spread in France

text: On March 15, about 20,000,000 voters cast their vote for the first round of the 2020 French municipal elections. We investigate the extent to which this event contributed to the COVID-19 epidemics in France. To this end, we first predict each departement's own dynamics using information up to the election to calibrate a standard logistic model. We then take advantage of electoral turnout differences between departements to distinguish the impact of the election on prediction errors in hospitalizations from that of simultaneously implemented anti-contagion policies. We report a detrimental effect of the election in locations that were at relatively advanced stages of the epidemics by the time of the election. In contrast, we show that the election did not contribute to the epidemics in departements with lower infection levels by March 15. All in all, our estimates suggest that elections accounted for about 4,000 excess hospitalizations by the end of March, which represents 15% of all hospitalizations by this time. They also suggest that holding elections in June may not be as detrimental.


title: Quantitative assessment of the risk of airborne transmission of SARS-CoV-2 infection: prospective and retrospective applications

text: Airborne transmission is a recognized pathway of contagion; however, it is rarely quantitatively evaluated. This study presents a novel approach for quantitative assessment of the individual infection risk of susceptible subjects exposed in indoor microenvironments in the presence of an asymptomatic infected SARS-CoV-2 subject. The approach allowed the maximum risk for an exposed healthy subject to be evaluated or, starting from an acceptable risk, the maximum exposure time. We applied the proposed approach to four distinct scenarios for a prospective assessment, highlighting that, in order to guarantee an acceptable individual risk of 10-3 for exposed subjects in naturally ventilated indoor environments, the exposure time should be shorter than 20 min. The proposed approach was used for retrospective assessment of documented outbreaks in a restaurant in Guangzhou (China) and at a choir rehearsal in Mount Vernon (USA), showing that, in both cases, the high attack rate values can be justified only assuming the airborne transmission as the main route of contagion. Moreover, we shown that such outbreaks are not caused by the rare presence of a superspreader, but can be likely explained by the co-existence of conditions, including emission and exposure parameters, leading to a highly probable event, which can be defined as a superspreading event.


title: The impossibility of social distancing among the urban poor: the case of an Indian slum in the times of COVID-19

text: As cases of COVID-19 were rising in India and the country’s political leadership instituted a nationwide lockdown, one of the authors of this article received a timely invitation from a friend–a government official–to make rounds with him and his team to various neighbourhoods within the metropolitan city of Bangalore. The team consisted of members working in healthcare, municipal corporation, and local police, and was tasked with ensuring that the government enacted measures of social distancing were being observed by local residents in public spaces. The author witnessed, in real time, the ways in which residents were engaging with the containment measures that were instituted as part of the political leadership’s attempt to flatten the curve of COVID-19. What was observed in an urban slum was particularly poignant and illuminating. The observations captured how, for residents of the urban slum, social distancing is more an aspiration than an attainable reality. Indeed, social distancing is impossible if such a protocol does not come with concomitant economic support targeted to the most socially vulnerable in society.


title: Quantitative COVID-19 infectiousness estimate correlating with viral shedding and culturability suggests 68% pre-symptomatic transmissions

text: A person clinically diagnosed with COVID 19 can infect others for several days before and after the onset of symptoms. At the epidemiological level, this information on how infectious someone is lies embedded implicitly in the serial interval data. Other clinical indicators of infectiousness based on the temporal kinetics of the viral shedding from the nasopharyngeal swabs and sputum show the former decaying weeks sooner than the latter. In this work, we attempt to provide a better quantitative estimate for the temporal infectiousness profile using serial interval data from a combined 1251 individuals reported in the literature. We show that the infectiousness profile which we calculate correlates well with the viral shedding kinetics from nasopharyngeal swabs (rho=0.97, p=0.00) and culturability (rho=0.83, p=0.01). The profile suggests that a 68.4% (95% CI: 67.0-69.7%) of the infections are caused by infections before the symptoms appear, which is a much stronger pre-symptomatic influence than what was predicted in the literature 44% (95% CI: 25-69%) using serial data from 77 individuals.


docid: nwtwymdr

title: Modelling COVID-19 Transmission in the United States through Interstate and Foreign Travels and Evaluating Impact of Governmental Public Health Interventions

text: Background: The first case of COVID-19 was reported in Wuhan, China in December 2019. The disease has spread to 210 countries and has been labeled as a pandemic by WHO. Modelling, evaluating, and predicting the rate of disease transmission is crucial for epidemic prevention and control. Our aim is to assess the impact of interstate and foreign travel and public health interventions implemented by the United States government in response to the Covid-19 pandemic. Methods: A disjoint mutually exclusive compartmental model is developed to study the transmission dynamics of the novel coronavirus. A system of non-linear differential equations was formulated and the basic reproduction number R0 was computed. The stability of the model was evaluated at the equilibrium points. Optimal controls were applied in the form of travel restrictions and quarantine. Numerical simulations were conducted. Results: Analysis shows that the model is locally asymptomatically stable, at endemic and foreigners free equilibrium points. Without any mitigation measures, infectivity and subsequent hospitalization of the population increase while placing interstates individuals and foreigners under quarantine, decreases the chances of exposure and subsequent infection, leading to an increase in the recovery rate. Conclusion: Interstate and foreign travel restrictions, in addition to quarantine, help in effectively controlling the epidemic.


title: COVID-19 preventive behaviors among people with anxiety and depression: Findings from Japan

text: Little is known about COVID-19 preventive behaviors among individuals with mental health problems. This study used cross-sectional online survey data from 2000 Japanese adults collected in April and May, 2020, to examine the association between anxiety and depression and COVID-19 preventive behaviors. Results from logistic regression analyses showed that both anxiety and depression were associated with lower odds for engaging in preventive behaviors such as wearing a face mask and hand washing. Our results highlight the importance of facilitating the performance of preventive behaviors in individuals with mental health problems to prevent the spread of COVID-19 in this population.


title: The impact of SARS-CoV-2 transmission fear and COVID-19 pandemic on the mental health of patients with primary immunodeficiency disorders, severe asthma, and other high-risk groups

text: Background: The adverse effects of COVID-19 pandemic on the mental health of high-risk group patients for morbidity and mortality and its impact on public health in the long term have not been clearly determined. Objective: To determine the level of COVID-19 related transmission fear and anxiety in healthcare workers and patients with primary immunodeficiency disorder (PID), severe asthma, and the ones with other comorbidities. Methods: The healthcare workers and patients with PID, severe asthma (all patients receiving biological agent treatment), malignancy, cardiovascular disease, hypertension (90% of patients receiving ACEI or ARB therapy), diabetes mellitus (42 % of patients receiving DPP-4 inhibitor therapy) were included in the study. A total of 560 participants, 80 individuals in each group, were provided. The hospital anxiety and depression scale ( HADS ) and Fear of illness and virus evaluation (FIVE ) scales were applied to the groups with face to face interview methods. Results: The mean age was 49.30 years and 306 (55 %) were female. The FIVE Scale and HADS-A scale scores of health care workers were significantly higher than other groups' scores (p = 0.001 and 0.006). The second-highest scores belonged to patients with PID. There was no significant difference between the groups for the HADS-D score (p=0.07). The lowest score in all scales was observed in patients with hypertension. Conclusions: This study demonstrated that in the pandemic process, patients with primary immunodeficiency, asthma patients, and other comorbid patients, especially healthcare workers, should be referred to the centers for the detection and treatment of mental health conditions.