title: The COVID-19 pandemic: Lessons on building more equal and sustainable societies

text: This discussion paper by a group of scholars across the fields of health, economics and labour relations argues that COVID-19 is an unprecedented humanitarian crisis from which there can be no return to the ‘old normal’. The pandemic’s disastrous worldwide health impacts have been exacerbated by, and have compounded, the unsustainability of economic globalisation based on the neoliberal dismantling of state capabilities in favour of markets. Flow-on economic impacts have simultaneously created major supply and demand disruptions, and highlighted the growing within-country inequalities and precarity generated by neoliberal regimes of labour market regulation. Taking an Australian and international perspective, we examine these economic and labour market impacts, paying particular attention to differential impacts on First Nations people, developing countries, women, immigrants and young people. Evaluating policy responses in a political climate of national and international leadership very different from those in which major twentieth century crises were addressed, we argue the need for a national and international conversation to develop a new pathway out of crisis. JEL Codes: E18, HO, I1, J64, J88


title: New development: COVID-19 as an accelerator of digital transformation in public service delivery

text: In an unexpected circumstance, such as the COVID-19 pandemic, public service delivery cannot be suspended, but must be delivered online, relying on the available digital technology. Social media, specifically, have been widely used to reach a broader portion of the population. This article discusses the digital acceleration that governments and organizations are now facing. The focus is on Italian state museums, which have been pushed for years to adopt digital tools to increase participation. This article highlights three main dilemmas in service delivery: user engagement; planning and control; and costs. The three dilemmas show the social and organizational challenges connected to digital transformation, underlining the issues that organizations will have to face in the future and not just in an emergency such as COVID-19.IMPACT: How should public sector institutions use digital technologies for service delivery in unexpected circumstances, such as the COVID-19 pandemic? Starting from the empirical setting of 100 Italian state museums, this article shows how digital technologies, and social media particularly, can be a powerful tool for public service delivery when an onsite service cannot be provided. The authors explain the benefits of online service delivery, for example broader audiences and new ways of interacting with users. They also highlight areas that need discussion and further research, for example whether online services should be provided with a fee or free and the trade-off between carefully planning a digital transformation and reacting promptly to catastrophic events.


PARP Inhibitor Drugs Can Be ‘Tuned’ to Better Kill Tumor Cells Life in the Time of COVID-19


title: Prolonged viral RNA shedding after COVID-19 symptom resolution in older convalescent plasma donors

text: Importance: The novel coronavirus, SARS-CoV-2, is responsible for a world-wide pandemic. While the medical community understands the mode of viral transmission, less is known about how long viral shedding occurs once viral symptoms have resolved. Objective: To determine how long the SARS-CoV-2 remains detectable following self-reporting of viral symptom resolution. Design: A cohort of 86 previously SARS-CoV-2 positive patients were re-tested for proof of viral recovery by nasal swab and nucleic acid amplification less than 28 days after self-reported symptom resolution. Setting: A tertiary care center in a mid-size city utilizing a drive-through SAR-CoV-2 testing center. Participants: 86 previously confirmed SARS-CoV-2 positive individuals less than 28 days after self-reported resolution of symptoms evaluated as potential donors for COVID-19 convalescent plasma. Intervention: Participants underwent nasopharyngeal sampling and subsequent nucleic acid amplification for SARS-CoV-2 genes. Main Outcome: SARS-CoV-2 RNA in nasopharyngeal secretions detected by rtPCR. Results: 11/86 (13%) previously confirmed SARS-CoV-2 subjects were still positive at a median of 19 days (range 12-24 days) after symptom resolution. Older patients were more likely to be test-positive, and older positive patients had lower rtPCR CT values. Test-positive patients were not significantly different from test-negative patients with respect to days since symptom recovery. Conclusions and Resolution: These results underscore the necessity of testing COVID-19 convalescent plasma donors less than 28 days after symptom resolution and suggests that COVID-19 positive patients may need to remain in quarantine beyond the recommended two weeks following "recovery."


title: Understanding the B and T cells epitopes of spike protein of severe respiratory syndrome coronavirus-2: A computational way to predict the immunogens

text: The 2019 novel severe respiratory syndrome coronavirus-2 (SARS-CoV-2) outbreak has caused a large number of deaths with thousands of confirmed cases worldwide. The present study followed computational approaches to identify B- and T-cell epitopes for spike glycoprotein of SARS-CoV-2 by its interactions with the human leukocyte antigen alleles. We identified twenty-four peptide stretches on the SARS-CoV-2 spike protein that are well conserved among the reported strains. The S protein structure further validated the presence of predicted peptides on the surface. Out of which twenty are surface exposed and predicted to have reasonable epitope binding efficiency. The work could be useful for understanding the immunodominant regions in the surface protein of SARS-CoV-2 and could potentially help in designing some peptide-based diagnostics.


title: Rigorous surveillance is necessary for high confidence in end-of-outbreak declarations for Ebola and other infectious diseases

text: The World Health Organization considers an Ebola outbreak to have ended once 42 days have passed since the last possible exposure to a confirmed case. Benefits of a quick end-of-outbreak declaration, such as reductions in trade/travel restrictions, must be balanced against the chance of flare-ups from undetected residual cases. We show how epidemiological modelling can be used to estimate the surveillance level required for decision-makers to be confident that an outbreak is over. Results from a simple model characterising an Ebola outbreak suggest that a surveillance sensitivity (i.e. case reporting percentage) of 79% is necessary for 95% confidence that an outbreak is over after 42 days without symptomatic cases. With weaker surveillance, unrecognised transmission may still occur: if the surveillance sensitivity is only 40%, then 62 days must be waited for 95% certainty. By quantifying the certainty in end-of-outbreak declarations, public health decision-makers can plan and communicate more effectively.


title: Mobility Reduction and Covid-19 Transmission Rates

text: Assessing the contribution of mobility restrictions to the control of Covid-19 diffusion is an urgent challenge of global import. We analyze the relation between transmission rates (estimated effective reproduction numbers) and societal mobility levels using fine-grained daily mobility data from Google and Apple in an international panel of 87 countries and a panel of all states in the United States. Reduced form regression estimates that flexibly control for time trends suggest that a 10 percentage point reduction in mobility is associated with a 0.04-0.09 reduction in the value of the effective reproduction number, R(t), depending on geographical region and modelling choice. According to these estimates, to avoid the critical value of R = 1, easing mobility restrictions may have to be limited to below pre-pandemic levels or delayed until other non-mobility related preventative measures reduce R to a level of 0.55-0.7 in Europe, a level of 0.64-0.76 in Asia, and a level of 0.8 in the United States. Given gaps in data availability and inference challenges, these estimates should be interpreted with caution.


title: A mobile genetic element in the SARS-CoV-2 genome is shared with multiple insect species

text: Unprecedented quantities of sequence data have been generated from the newly emergent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causative agent of COVID-19. We document here the presence of s2m, a highly conserved, mobile genetic element with unknown function, in both the SARS-CoV-2 genome and a large number of insect genomes. Although s2m is not universally present among coronaviruses and appears to undergo horizontal transfer, the high sequence conservation and universal presence of s2m among isolates of SARS-CoV-2 indicate that, when present, the element is essential for viral function.


title: Estimation of SARS-CoV-2 Infection Prevalence in Santa Clara County

text: To reliably estimate the demand on regional health systems and perform public health planning, it is necessary to have a good estimate of the prevalence of infection with SARS-CoV-2 (the virus that causes COVID-19) in the population. In the absence of wide-spread testing, we provide one approach to infer prevalence based on the assumption that the fraction of true infections needing hospitalization is fixed and that all hospitalized cases of COVID-19 in Santa Clara are identified. Our goal is to estimate the prevalence of SARS-CoV-2 infections, i.e. the true number of people currently infected with the virus, divided by the total population size. Our analysis suggests that as of March 17, 2020, there are 6,500 infections (0.34% of the population) of SARS-CoV-2 in Santa Clara County. Based on adjusting the parameters of our model to be optimistic (respectively pessimistic), the number of infections would be 1,400 (resp. 26,000), corresponding to a prevalence of 0.08% (resp. 1.36%). If the shelter-in-place led to R0 < 1, we would expect the number of infections to remain about constant for the next few weeks. However, even if this were true, we expect to continue to see an increase in hospitalized cases of COVID-19 in the short term due to the fact that infection of SARS-CoV-2 on March 17th can lead to hospitalizations up to 14 days later.


title: Psychological impact of the coronavirus disease 2019 (COVID-19) outbreak on healthcare workers in China

text: Introduction Since the outbreak of coronavirus disease 2019 (COVID-19), more than 3000 (including clinical diagnosis) healthcare workers (HCWs) have been infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) in China. This study is aimed to investigate the risk perception and immediate psychological state of HCWs in the early stage of the COVID-19 epidemic. Methods This study utilized a cross-sectional survey designed on a convenient sample of 4357 HCWs in China. Its data were collected using anonymous structured questionnaires distributed through social software. 6 questions were set to evaluate the participants' risk perception of COVID-19, and a General Health Questionnaire was used to identify the participants' immediate psychological status. Descriptive statistics were used for data analysis. Risk perception and psychological status were compared by demographic characteristics and COVID-19 exposure experiences. Result A total of 4,600 questionnaires were distributed, and 4,357 qualified ones (94.7%) were collected. The main concerns of HCWs are: infection of colleagues (72.5%), infection of family members (63.9%), protective measures (52.3%) and medical violence (48.5%). And 39.1% of the HCWs had psychological distress, especially working in Wuhan, participating in frontline treatments, having been isolated and having family members or colleagues infected. Conclusions The finding indicating that, faced with the COVID-19 epidemic, HCWs, especially in Wuhan, were worried about the risks of infection and protective measures, resulting in psychological distress, so further actions should be taken.


title: Synonymous sites in SARS-CoV-2 genes display trends affecting translational efficiency

text: A novel coronavirus, SARS-CoV-2, has caused a pandemic of COVID-19. The evolutionary trend of the virus genome may have implications for infection control policy but remains obscure. We introduce an estimation of fold change of translational efficiency based on synonymous variant sites to characterize the adaptation of the virus to hosts. The increased translational efficiency of the M and N genes suggests that the population of SARS-CoV-2 benefits from mutations toward favored codons, while the ORF1ab gene has slightly decreased the translational efficiency. In the coding region of the ORF1ab gene upstream of the −1 frameshift site, the decreasing of the translational efficiency has been weakening parallel to the growth of the epidemic, indicating inhibition of synthesis of RNA-dependent RNA polymerase and promotion of replication of the genome. Such an evolutionary trend suggests that multiple infections increased virulence in the absence of social distancing.


Pay attention to SARS-CoV-2 infection in children


title: Sequence analysis of travel-related SARS-CoV-2 cases in the Greater Geelong region, Australia

text: This study reports the sequence analysis of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) from infected individuals within the Greater Geelong region, Victoria, Australia. All but one individual had recently returned from travelling abroad, and all had clinical signs consistent with SARS-CoV-2 infection. SARS-CoV-2 belonging to three lineages were detected and represent separate introductions of the virus into the region. Sequence data were consistent with the recent travel history of each case. Full virus genome sequencing can play an important role in supporting local epidemiological tracing and monitoring for community transmission. Quality of the SARS-CoV-2 sequences obtained was highly dependent on appropriate sample collection and handling.


title: Rapidly Measuring Spatial Accessibility of COVID-19 Healthcare Resources: A Case Study of Illinois, USA

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), causing the coronavirus disease 2019 (COVID-19) pandemic, has infected millions of people and caused hundreds of thousands of deaths. While COVID-19 has overwhelmed healthcare resources (e.g., healthcare personnel, testing resources, hospital beds, and ventilators) in a number of countries, limited research has been conducted to understand spatial accessibility of such resources. This study fills this gap by rapidly measuring the spatial accessibility of COVID-19 healthcare resources with a particular focus on Illinois, USA. Specifically, the rapid measurement is achieved by resolving computational intensity of an enhanced two-step floating catchment area (E2SFCA) method through a parallel computing strategy based on cyberGIS (cyber geographic information science and systems). The study compared the spatial accessibility measures for COVID-19 patients to those of general population, identifying which geographic areas need additional healthcare resources to improve access. The results also help delineate the areas that may face a COVID-19-induced shortage of healthcare resources caused by COVID-19. The Chicagoland, particularly the southern Chicago, shows an additional need for resources. Our findings are relevant for policymakers and public health practitioners to allocate existing healthcare resources or distribute new resources for maximum access to health services.


title: Evaluating the adequacy of Prima Covid-19 IgG/IgM Rapid Test for the assessment of exposure to SARS-CoV-2 virus

text: The outbreak of the SARS-CoV-2 in early 2020 found health authorities worldwide unprepared to control the pandemic. The adoption of accurate, rapid and inexpensive methods to identify infected subjects in the general population is of paramount relevance for the control of the disease. We evaluated one of the available serological tests, the Prima Lab Covid-19 IgG/IgM Rapid Tests, on 739 volunteers. We first assessed the test's reproducibility by administering it twice on the same day on 104 subjects obtaining and overall score of 93 percent. Since the intensity of the color in the test line regions varies depending on the concentration of Covid-19 antibodies in each sample and that the determination of the positivity depends strictly on the subjective assessment by the reader, after excluding the subjects whose color intensity was too tenuous to be deemed unquestionably positive by the reader the reproducibility increased to 96%. The test would not perform properly for 6 subjects for a very limited overall technical failure of 0.83%. For 138 subjects information was available regarding a previous Real Time PCR nasopharyngeal swab test performed elsewhere. The correspondence of positive results between the two tests was 90.58% (125/138). In spite of some limitation owing especially to the choice of a self selected population sample, we conclude that Prima Lab Covid-19 IgG/IgM Rapid Test represents a low-cost, easily applicable and reproducible tool in detecting SARS-Cov-2 diffusion in the general population.


Commentary: Spaces of Solidarity and Spaces of Exception at the times of Covid‐19


title: Symptomatology during seasonal coronavirus infections in children is associated with viral and bacterial co-detection

text: Lower respiratory tract symptoms during seasonal coronavirus infections in children are associated with RSV co-detection and increased levels of Haemophilus and Fusobacterium species.


title: Severity of respiratory failure and outcome of patients needing a ventilatory support in the Emergency Department during Italian novel coronavirus SARS-CoV2 outbreak: Preliminary data on the role of Helmet CPAP and Non-Invasive Positive Pressure Ventilation

text: BACKGROUND: Novel Coronavirus SARS-CoV-2 pandemic is spreading around the world. At the end of February, the outburst of the pandemic has hit hard on northern Italian's hospitals. As of today, no data have been published regarding the severity of respiratory failure of patients presenting to the Emergency Departments. Moreover, the outcome the patients forced to undergo Continuous Positive Airway Pressure (CPAP) or Non-Invasive Positive Pressure Ventilation (NIPPV) due to lack of Intensive Care resources is unknown. “Papa Giovanni XXIII” hospital (HPG23) of Bergamo is one of the largest hospitals in the Country, with an Emergency Department (ED) managing over 100,000 patients per year. METHODS: This is a retrospective observational study based on chart review of patients presenting to the Emergency Department of HPG23 from 29/02/2020 to 10/03/2020 with a clinical condition highly suspicious for COVID-19 infection. Registration of admission rates, severity of respiratory failure (ARDS classification), need of respiratory support, SARS-CoV-2 PCR test and outcome of patients treated with a ventilatory support were registered on 10th of May 2020. FINDINGS: From 29/02 to 10/03 611 patients with a suspected diagnosis of COVID-19 infection were evaluated in our ED; 320 (52%) met the criteria for hospital admission and 99 (31%) needed to be immediately started on ventilatory support (81% CPAP, 7% NIPPV, 12% Invasive Mechanical Ventilation). Eighty-five (86%) of the 99 patients needing a ventilatory support eventually had SARS-CoV-2 infection confirmed by PCR test on nasal-pharyngeal swab. Their median PO2/FiO2 ratio was 128 (IQR 85–168), with 23 patients (29.5%) classified as severe ARDS. Mortality rate as of 10th of May was 76.5%, ranging from 44.4% within patients <60 years old to 85% within those older than 60 years (p = 0.001). NIPPV/CPAP failure occurred in 91.5% of patients. INTERPRETATION: The population of patients suspected for COVID-19 infection presenting at our ED showed a very high rate of severe respiratory failure, with urgent need of a large amount of intensive care resources. Mortality rates of critically ill patients with confirmed COVID-19 (76.5%) are similar to previously reported studies with similar population. CPAP/NIPPV could be a valid strategy to treat severely hypoxic patients that cannot be intubated in the ED due to lack of intensive care resources. FUNDING: No funds were received for this research project.


title: Contact tracing and isolation of asymptomatic spreaders to successfully control the COVID-19 epidemic among healthcare workers in Milan (Italy)

text: Objective To study the source, symptoms, and duration of infection, preventive measures, contact tracing and their effects on SARS-CoV-2 epidemic among healthcare workers (HCW) in 2 large hospitals and 40 external healthcare services in Milan (Italy) to propose effective measures to control the COVID-19 epidemic among healthcare workers. Design Epidemiological observational study. Setting Two large hospitals and 40 territorial healthcare units, with a total of 5700 workers. Participants 143 HCWs with a SARS-CoV-2 positive nasopharyngeal (NF) swab in a population made of 5,700 HCWs. Main outcome measures Clinical data on the history of exposure, contacts inside and outside of the hospital, NF swab dates and results. A daily online self-reported case report form consisting of the morning and evening body temperature and 11 other symptoms (cough, dyspnoea, discomfort, muscle pain, headache, sore throat, vomiting, diarrhoea, anosmia, dysgeusia, conjunctival hyperaemia). Results Most workers were tested and found positive due to a close contact with a positive colleague (49%), followed by worker-initiated testing due to symptoms (and unknown contact, 28%), and a SARS-CoV-2 positive member of the family (9.8%). 10% of NF swabs performed in the framework of contact tracing resulted positive, compared to only 2.6% through random testing. The first (index) case caused a cluster of 7 positive HCWs discovered through contact tracing and testing of 250 asymptomatic HCWs. HCWs rarely reported symptoms of a respiratory infection, and up to 90% were asymptomatic or with mild symptoms in the days surrounding the positive NF swab. During the 15-day follow-up period, up to 40% of HCWs reported anosmia and dysgeusia/ageusia as moderate or heavy, more frequently than any other symptom. The time necessary for 95% of HCWs to be considered cured (between the positive and two negative NF swabs) was 30 days. Conclusion HCWs represent the main source of infection in healthcare institutions, 90% are asymptomatic or with symptoms not common in a respiratory infection. The time needed to overcome the infection in 95% of workers was 30 days. Contact tracing allows identifying asymptomatic workers which would spread SARS-CoV-2 in the hospital and is a more successful strategy than random testing.


title: Is India heading towards a new high? : An optimistic approach to estimate ending life-cycle and cumulative cases by the end of the major COVID-19 pandemic wave in India and some of its states.

text: Projecting the COVID-19 curve parameters such as ending-lifecycle and cumulative cases are helpful in guiding the policy makers to mitigate the outbreak. However, overestimating these parameters may put the public and policymakers in a muddle. In this paper, an optimistic scenario is simulated, wherein the dynamics of the COVID-19 curve is allowed to spread to such an extent that the projections of the COVID-19 parameters do not take excessively high values. Based on this scenario, the ending life-cycle and cumulative cases for India and some of its states, are predicted. Our study, suggests that the fall of the peak amplitude (95%) of the major COVID-19 wave in India may take place by the 8th of September 2020 with a total count of 655000 cases. Simulation results, also indicate that Maharashtra, Tamil Nadu, Delhi, Gujarat, Uttar Pradesh, Bihar, Madhya Pradesh, and Rajasthan may end up with 263700,29360,50600,21130,24420,44170,27080,28200 cumulative cases respectively.


title: Perinatal and neonatal management plan for prevention and control of 2019 novel coronavirus infection (1st Edition)

text: Since December 2019, the novel coronavirus (2019-nCoV) infection has been prevalent in China Due to immaturity of immune function and the possibility of mother-fetal vertical transmission, neonates are particularly susceptible to 2019-nCoV The perinatal-neonatal departments should cooperate closely and take integrated approaches, and the neonatal intensive care unit should prepare the emergency plan for 2019-nCoV infection as far as possible, so as to ensure the optimal management and treatment of potential victims According to the latest 2019-nCoV national management plan and the actual situation, the Working Group for the Prevention and Control of Neonatal 2019-nCoV Infection in the Perinatal Period of the Editorial Committee of Chinese Journal of Contemporary Pediatrics puts forward recommendations for the prevention and control of 2019-nCoV infection in neonates


title: Facemasks prevent influenza-like illness: implications for COVID-19

text: The coronavirus disease 2019 (COVID-19) pandemic is causing a huge toll on individuals, families, communities and societies across the world. Currently, whether wearing facemasks in public should be a measure to prevent transmission of severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) remains contraversial.1 This is largely because there have been no randomized controlled trials (RCTs) for coronavirus to directly support this. However, lessons may be taken from published RCTs examining influenza-like illness (ILI).2,3 Recent studies suggested that SARS-CoV-2 shares similar transmission route with influenza virus,4 and the incidence of community transmission of SARS-CoV-2 in individuals with ILI is high.5 Therefore, we undertook this meta-analysis of RCTs examining the efficacy of wearing facemasks to prevent ILI in community settings, irrespective of confirmatory testing for the causative virus. We undertook a systematic literature search for RCTs related to facemasks and ILI between 1966 and April 2020 using PUBMED, EMBASE, and Cochrane library. RCTs undertaken in community (not hospital) settings comparing wearing and not wearing facemasks for ILI were included. Incidence of ILI (e.g., fever, cough, headache, sore throat, aches or pains in muscles or joints) was estimated per group. Relative risk (RR) and 95% confidence interval (CI) were calculated. We screened 899 related abstracts and eventually included 8 RCTs (Figure S1). Basic characteristics and quality of included RCTs are listed in Supplement. Participants wearing facemasks had a significantly lower risk of developing ILI than those not wearing facemasks (pooled RR=0.81, 95% CI: 0.70-0.95) and there was no heterogeneity (Figure 1). The decreased risk of ILI was more pronounced if everyone wore facemask irrespective of whether they were infected or not (RR=0.77, 95% CI: 0.65-0.91), compared to those wearing facemasks when infected (RR=0.95, 95% CI: 0.58-1.56) or uninfected (RR=1.26, 95% CI: 0.69-2.31). This study shows that wearing facemasks, irrespective of infection status, is effective in preventing ILI spread in the community. This situation mirrors what is happening now in public settings where we do not know who has been infected and who has not. Although there are no RCTs of facemasks for SARS-CoV-2, as with other simple measures such as social distancing and handwashing, these data support the recommendation to wear facemasks in public to further reduce transmission of SARS-CoV-2 and flatten the curve of this pandemic, especially when social distancing is impractical, such as shopping, or travelling with public transport for work that cannot be done from home.


COVID – 19: A Critical Ontology of the present1


Unerwartete COVID-19-Pneumonie beim MDCT-Re-Staging eines Patienten mit Rektumkarzinom


title: Adjusting Coronavirus prevalence estimates for laboratory test kit error

text: Testing representative populations to determine the prevalence or percent of the population with active SARS-Cov-2 (COVID-19) infection and/or antibodies to infection is being recommended as essential for making public policy decisions to open-up or to continue enforcing national, state and local government rules to shelter-in-place. However, all laboratory tests are imperfect and have estimates of sensitivity and specificity less than 100% - in some cases considerably less than 100%. That error will lead to biased prevalence estimates. If the true prevalence of COVID-19 is low, possibly in the range of 1-5%, then testing error will lead to a constant background of bias that will most likely be larger and possibly much larger than the true prevalence itself. As a result, what is needed is a method for adjusting prevalence estimates for testing error. In this paper we outline methods for adjusting prevalence estimates for testing error both prospectively in studies being planned and retrospectively in studies that have been conducted. The methods if employed would also help to harmonize study results within countries and around the world. Adjustment can lead to more accurate prevalence estimates and to better policy decisions.


title: From high-touch to high-tech: COVID-19 drives robotics adoption

text: Global economic and social life has been severely challenged since the World Health Organization (WHO) declared the COVID-19 disease a pandemic. Travel, tourism and hospitality, in particular, has been massively impacted by the lockdowns used to maintain social distance to manage the disease. Robotics, artificial intelligence, and human-robot interactions have gained an increased presence to help manage the spread of COVID-19 in hospitals, airports, transportation systems, recreation and scenic areas, hotels, restaurants, and communities in general. Humanoid robots, autonomous vehicles, drones, and other intelligent robots are used in many different ways to reduce human contact and the potential spread of the SARS-CoV-2 virus, including delivering materials, disinfecting and sterilizing public spaces, detecting or measuring body temperature, providing safety or security, and comforting and entertaining patients. While controversial in the past due to concerns over job losses and data privacy, the adoption of robotics and artificial intelligence in travel and tourism will likely continue after the COVID-19 pandemic becomes less serious. Tourism scholars should seize this opportunity to develop robotic applications that enhance tourist experiences, the protection of natural and cultural resources, citizen participation in tourism development decision making, and the emergence of new ‘high-touch’ employment opportunities for travel, tourism and hospitality workers.


title: The Age Pattern of the Male- to- Female Ratio in Mortality from COVID-19 Mirrors that of Cardiovascular Disease but not Cancer in the General Population

text: Background: Males are at a higher risk of dying from COVID-19. Older age and cardiovascular disease are also associated with COVID-19 mortality. We compared the male-to-female (sex) ratios in mortality by age for COVID-19 with cardiovascular mortality and cancer mortality in the general population. Methods: We obtained data from official government sources in the US and five European countries: Italy, Spain, France, Germany, and the Netherlands. We analyzed COVID-19 deaths by sex and age in these countries and similarly analyzed their deaths from cardiovascular disease (coronary heart disease or stroke) and cancer, the two leading age-related causes of death in middle-to-high income countries. Findings: In both the US and European countries, the sex ratio of deaths from COVID-19 exceeded one throughout adult life. The sex ratio increased up to a peak in midlife, and then declined markedly in later life. This pattern was also observed for the sex ratio of deaths from cardiovascular disease, but not cancer, in the general populations of the US and European countries. Interpretation: The sex ratios of deaths from COVID-19 and from cardiovascular disease exhibit similar patterns across the adult life course. The underlying mechanisms are poorly understood, but could stem partially from sex-related biological differences that underlie the similar pattern for cardiovascular disease. These include, we propose, comparatively longer telomeres in females, ovarian hormones, and X chromosome mosaicism.


title: GLUCOCOVID: A controlled trial of methylprednisolone in adults hospitalized with COVID-19 pneumonia

text: Background. We aimed to determine whether a 6-day course of intravenous methylprednisolone (MP) improves outcome in patients with SARS CoV-2 infection at risk of developing Acute Respiratory Distress Syndrome (ARDS). Methods. Multicentric, partially randomized, preference, open-label trial, including adults with COVID-19 pneumonia, impaired gas exchange and biochemical evidence of hyper-inflammation. Patients were assigned to standard of care (SOC), or SOC plus intravenous MP [40mg/12h 3 days, then 20mg/12h 3 days]. The primary endpoint was a composite of death, admission to the intensive care unit (ICU) or requirement of non-invasive ventilation (NIV). Results. We analyzed 85 patients (34, randomized to MP; 22, assigned to MP by clinician preference; 29, control group). Patient age (mean 68{+/-}yr) was related to outcome. The use of MP was associated with a reduced risk of the composite endpoint in the intention-to-treat, age-stratified analysis (combined risk ratio -RR- 0.55 [95% CI 0.33-0.91]; p=0.024). In the per-protocol analysis, RR was 0.11 (0.01-0.83) in patients aged 72 yr or less, 0.61 (0.32-1.17) in those over 72 yr, and 0.37 (0.19-0.74, p=0.0037) in the whole group after age-adjustment by stratification. The decrease in C-reactive protein levels was more pronounced in the MP group (p=0.0003). Hyperglycemia was more frequent in the MP group. Conclusions A short course of MP had a beneficial effect on the clinical outcome of severe COVID-19 pneumonia, decreasing the risk of the composite end point of admission to ICU, NIV or death.


title: Covid-19 pandemic- response to challenges by blood transfusion services in india: A review report

text: Abstract The role of blood transfusion services in a pandemic depends on the type, potential of community spread and risk of transfusion transmissibility The Covid-19 pandemic is the biggest pandemic of the 21st century, affecting over 3 million people across the globe as of late April 2020 In India, the count of infected persons and deaths are rising gradually, and to prevent the community spread of the SARS Cov-2 virus the Government of India announced national lockdown which affected the blood transfusion services also There are more than 3000 decentralized blood centers all over the country The major challenges to blood transfusion services are recruitment of healthy blood donors, follow-up of donors and patients, inventory management, staff safety and adequacy for emergency work and consumable management Blood transfusion services also participate in treatment of Covid-19 patients by convalescent plasma collection from recovered patients Blood transfusion services should have a strategic plan to respond to challenges generated during a pandemic which focuses on shortage, wastage and supply of blood and components in a cost-effective manner In this review article we will discuss the challenges to blood transfusion services of India due to Covid-19 pandemic and response to these challenges with experience to previous outbreaks


title: Diverse local epidemics reveal the distinct effects of population density, demographics, climate, depletion of susceptibles, and intervention in the first wave of COVID-19 in the United States

text: The SARS-CoV-2 pandemic has caused significant mortality and morbidity worldwide, sparing almost no community. As the disease will likely remain a threat for years to come, an understanding of the precise influences of human demographics and settlement, as well as the dynamic factors of climate, susceptible depletion, and intervention, on the spread of localized epidemics will be vital for mounting an effective response. We consider the entire set of local epidemics in the United States; a broad selection of demographic, population density, and climate factors; and local mobility data, tracking social distancing interventions, to determine the key factors driving the spread and containment of the virus. Assuming first a linear model for the rate of exponential growth (or decay) in cases/mortality, we find that population-weighted density, humidity, and median age dominate the dynamics of growth and decline, once interventions are accounted for. A focus on distinct metropolitan areas suggests that some locales benefited from the timing of a nearly simultaneous nationwide shutdown, and/or the regional climate conditions in mid-March; while others suffered significant outbreaks prior to intervention. Using a first-principles model of the infection spread, we then develop predictions for the impact of the relaxation of social distancing and local climate conditions. A few regions, where a significant fraction of the population was infected, show evidence that the epidemic has partially resolved via depletion of the susceptible population (i.e., "herd immunity"), while most regions in the United States remain overwhelmingly susceptible. These results will be important for optimal management of intervention strategies, which can be facilitated using our online dashboard.


title: Association of national Bacille Calmette-Guerin vaccination policy with COVID-19 epidemiology: an ecological study in 78 countries

text: A possible association between national Bacille Calmette-Guerin (BCG) vaccination policy and lower COVID-19 incidence has been suggested in some preprint papers. Using publicly accessible databases, I explored associations of national BCG vaccination policy with COVID-19 epidemiology in 78 countries. Data collection was conducted from April 25 to May 5, 2020. I compared countries that have a current universal BCG vaccination policy (BCG countries), with countries that currently lack such a policy (non-BCG countries). The mixed effect model revealed national BCG policy decreases in the country-specific risk of death by COVID-19, correspond to odds ratio of 0.446 (95% confidence intervals 0.323 - 0.614, P =1x10-5). In BCG countries, the case increase rate was attenuated marginally by 25.4% (95% CI 3.0 to 42.7, P=0.029) as compared with those of the non-BCG countries. Although the protective mechanism of BCG vaccination against COVID-19 remains unknown, further laboratory and clinical research should be warranted.


title: COVID-19 and Spine Surgery: A Review and Evolving Recommendations

text: Coronavirus-19 (COVID-19) has disrupted the normal delivery of healthcare for spine surgeons across the world. In this review, we will provide an overview of COVID-19's clinical features, and discuss the optimization and treatment of spine pathology during the ongoing global pandemic.


title: Baricitinib restrains the immune dysregulation in COVID-19 patients

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the causative agent of the ongoing pandemic coronavirus disease 2019 (COVID-19). The majority of patients with COVID-19 have a good prognosis, but variable percentages in different countries develop pneumonia associated with lymphocytopenia and severe inflammatory response due to uncontrolled release of cytokines. These immune mediators are transcriptionally regulated by JAK-STAT molecular pathways, which can be disabled by small molecules. Here, we provide evidences on the efficacy of baricitinib, a JAK1/JAK2 inhibitor, in correcting the immune abnormalities observed in patients hospitalized with COVID-19. Indeed, we demonstrate a significant reduction in serum levels of interleukin (IL)-6, IL-1{beta} and tumor necrosis factor (TNF), a rapid recovery in circulating T and B cell frequencies and an increased antibody production against SARS-CoV-2 spike protein in baricitinib-treated patients. Moreover, treated patients underwent a rapid reduction in oxygen flow need and progressive increase in the P/F. Our work provides the basis on developing effective treatments against COVID-19 pathogenesis using on-target therapy.


Coronavirus Disease (COVID-19) in Italy: Analysis of Risk Factors and Proposed Remedial Measures


title: More prevalent, less deadly? Bayesian inference of the COVID19 Infection Fatality Ratio from mortality data

text: We use an established semi-mechanistic Bayesian hierarchical model of the COVID-19 pandemic, driven by European mortality data, to estimate the prevalence of immunity. We allow the infection-fatality ratio (IFR) to vary, adapt the model's priors to better reflect emerging information, and re-evaluate the model fitting in the light of current mortality data. The results indicate that the IFR of COVID-19 may be an order of magnitude smaller than the current consensus, with the corollary that the virus is more prevalent than currently believed. These results emerge from a simple model and ought to be treated with caution. They emphasise the value of rapid community-scale antibody testing when this becomes available.


title: In vivo structural characterization of the whole SARS-CoV-2 RNA genome identifies host cell target proteins vulnerable to re-purposed drugs

text: SARS-CoV-2 is an RNA virus of the Coronaviridae family that is the causal pathogen of the ongoing Coronavirus Disease 2019 pandemic. There are currently no antiviral drugs or vaccines to treat COVID-19, and the failure to identify effective interventions can be blamed on our incomplete understanding of the nature of this virus and its host cell infection process. Here, we experimentally determined structural maps of the SARS-CoV-2 RNA genome in infected human cells and also characterized in vitro refolded RNA structures for SARS-CoV-2 and 6 other coronaviruses. Our in vivo data confirms several structural elements predicted from theoretical analysis and goes much further in revealing many previously unknown structural features that functionally impact viral translation and discontinuous transcription in cells. Importantly, we harnessed our in vivo structure data alongside a deep-learning tool and accurately predicted several dozen functionally related host cell proteins that bind to the SARS-CoV-2 RNA genome, none of which were known previously. Thus, our in vivo structural study lays a foundation for coronavirus RNA biology and indicates promising directions for the rapid development of therapeutics to treat COVID-19. HIGHLIGHTS We mapped the in vivo structure and built secondary structural models of the SARS-CoV-2 RNA genome We discovered functionally impactful structural features in the RNA genomes of multiple coronaviruses We predicted and validated host cell proteins that bind to the SARS-CoV-2 RNA genome based on our in vivo RNA structural data using a deep-learning tool


docid: wofyftrs

title: Prediction of Coronavirus Disease (covid-19) Evolution in USA with the Model Based on the Eyring Rate Process Theory and Free Volume Concept

text: A modification arguing that the human movement energy may change with time is made on our previous infectious disease model, in which infectious disease transmission is considered as a sequential chemical reaction and reaction rate constants obey the Eyrings rate process theory and free volume concept. The modified model is employed to fit current covid-19 outbreak data in USA and to make predictions on the numbers of the infected, the removed and the death in the foreseeable future. Excellent fitting curves and regression quality are obtained, indicating that the model is working and the predictions may be close to reality. Our work could provide some ideas on what we may expect in the future and how we can prepare accordingly for this difficult period.


title: High-throughput organoid screening enables engineering of intestinal epithelial composition

text: Barrier tissue epithelia play an essential role in maintaining organismal homeostasis, and changes in their cellular composition have been observed in multiple human diseases. Within the small intestinal epithelium, adult stem cells integrate diverse signals to regulate regeneration and differentiation, thereby establishing overall cellularity. Accordingly, directing stem cell differentiation could provide a tractable approach to alter the abundance or quality of specialized cells of the small intestinal epithelium, including the secretory Paneth, goblet, and enteroendocrine populations. Yet, to date, there has been a lack of suitable tools and rigorous approaches to identify biological targets and pharmacological agents that can modify epithelial composition to enable causal testing of disease-associated changes with novel therapeutic candidates. To empower the search for epithelia-modifying agents, we establish a first-of-its-kind high-throughput phenotypic organoid screen. We demonstrate the ability to screen thousands of samples and uncover biological targets and associated small molecule inhibitors which translate to in vivo. This approach is enabled by employing a functional, cell-type specific, scalable assay on an organoid model designed to represent the physiological cues of in vivo Paneth cell differentiation from adult intestinal stem cells. Further, we miniaturize and adapt the organoid culture system to enable automated plating and screening, thereby providing the ability to test thousands of samples. Strikingly, in our screen we identify inhibitors of the nuclear exporter Xpo1 modulate stem cell fate commitment by inducing a pan-epithelial stress response combined with an interruption of mitogen signaling in cycling intestinal progenitors, thereby significantly increasing the abundance of Paneth cells independent of known WNT and Notch differentiation cues. We extend our observation in vivo, demonstrating that oral administration of Xpo1 inhibitor KPT-330 at doses 1,000-fold lower than conventionally used in hematologic malignancies increases Paneth cell abundance. In total, we provide a framework to identify novel biological cues and therapeutic leads to rebalance intestinal stem cell differentiation and modulate epithelial tissue composition via high-throughput phenotypic screening in rationally-designed organoid model of differentiation.


title: Dynamic liver function indexes monitoring and clinical characteristics in three types of COVID-19 patients

text: Background and Aims: The abnormal liver function and even liver failure related death were reported in the COVID-19 patients, but less of studies focus on the dynamic liver function changes. We analysed the liver function indexes of COVID-19 patients to explore the characteristics of liver function changes in patients with different severity. Methods: This study included 54 moderate, 50 severe, and 31 death nucleic acid-confirmed COVID-19 patients hospitalized at the central hospital of Wuhan, China. Epidemiological histories, clinical features, imaging materials, medications and especially major liver function laboratory tests were collected for analysis. Results: The clinical symptoms did not present any significant difference in the patients at admission, but the older male patients had pronounced mortality risk. The normal ratio of ALT, TB, and DBIL of moderate patients was 96.3%, 94.44%, and 98.15% separately at the first test, but 59.26% of patients showed declined ALB levels. The normal ratio of all liver function indexes declined after admission, but most abnormalities were mild (1-2 times of upper limit unit) and went back normal before discharge. In severe patients, the normal ratio of ALB dropped down to 30.61% at admission along with the dramatic impaired normal ratio of bilirubin at the second test. The severe patients liver function dysfunction was worse than the moderate patients but without a significant difference. The dead patients showed a significantly higher level of DBIL, AST, GGT and CRP than other groups patients in the final test, along with the hypoalbuminemia. What is worse, 16.13% of non-survivors were diagnosed with liver failure. No medication was found to be related to ALT, AST, and GGT abnormality in our study. Conclusion: In moderate and severe patients, liver dysfunction was mild. Patients widely presented lower level of ALB. The higher level of bilirubin, AST, and GGT was likely to indicate the worse outcome. Dynamic monitoring of liver function indexes could be considered and liver failure related death should be noticed and prevented in the early stage.


title: Reliability of serological tests for COVID-19: Comparison of three immunochromatography test kits for SARS-CoV-2 antibodies.

text: Background: Several immunochromatographic serological test kits have been developed to detect severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) specific antibodies, but their relative performance and potential clinical utility is unclear. Methods: Three commercially available serological test kits were evaluated using 99 serum samples collected from 29 patients diagnosed with coronavirus disease 2019 (COVID-19). Results: The IgM antibody-positive rates of the three serological test kits for samples taken at the early stage of the disease (0-6 days after onset) were 19.0%, 23.8%, and 19.0%, respectively. The IgM antibody-positive rates over the entire period were 21.2%, 60.6%, and 15.2%, respectively. The IgG antibody-positive rates for samples taken after 13 days of onset were 100.0%, 97.6%, and 97.6%, respectively. Conclusion: There were large differences among the results of the three test kits. Only few cases showed positive results for IgM in the early stage of disease and the IgM antibody-positive rates over the entire period were low, suggesting that the kits used in this study were unsuitable for diagnosis of COVID-19. The IgG antibody was positive in almost all samples after 13 days of onset, suggesting that it may be useful for determining infections in the recent past.


title: The 2019-2020 novel coronavirus (severe acute respiratory syndrome coronavirus 2) pandemic: A joint american college of academic international medicine-world academic council of emergency medicine multidisciplinary COVID-19 working group consensus paper

text: What started as a cluster of patients with a mysterious respiratory illness in Wuhan, China, in December 2019, was later determined to be coronavirus disease 2019 (COVID-19). The pathogen severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a novel Betacoronavirus, was subsequently isolated as the causative agent. SARS-CoV-2 is transmitted by respiratory droplets and fomites and presents clinically with fever, fatigue, myalgias, conjunctivitis, anosmia, dysgeusia, sore throat, nasal congestion, cough, dyspnea, nausea, vomiting, and/or diarrhea. In most critical cases, symptoms can escalate into acute respiratory distress syndrome accompanied by a runaway inflammatory cytokine response and multiorgan failure. As of this article's publication date, COVID-19 has spread to approximately 200 countries and territories, with over 4.3 million infections and more than 290,000 deaths as it has escalated into a global pandemic. Public health concerns mount as the situation evolves with an increasing number of infection hotspots around the globe. New information about the virus is emerging just as rapidly. This has led to the prompt development of clinical patient risk stratification tools to aid in determining the need for testing, isolation, monitoring, ventilator support, and disposition. COVID-19 spread is rapid, including imported cases in travelers, cases among close contacts of known infected individuals, and community-acquired cases without a readily identifiable source of infection. Critical shortages of personal protective equipment and ventilators are compounding the stress on overburdened healthcare systems. The continued challenges of social distancing, containment, isolation, and surge capacity in already stressed hospitals, clinics, and emergency departments have led to a swell in technologically-assisted care delivery strategies, such as telemedicine and web-based triage. As the race to develop an effective vaccine intensifies, several clinical trials of antivirals and immune modulators are underway, though no reliable COVID-19-specific therapeutics (inclusive of some potentially effective single and multi-drug regimens) have been identified as of yet. With many nations and regions declaring a state of emergency, unprecedented quarantine, social distancing, and border closing efforts are underway. Implementation of social and physical isolation measures has caused sudden and profound economic hardship, with marked decreases in global trade and local small business activity alike, and full ramifications likely yet to be felt. Current state-of-science, mitigation strategies, possible therapies, ethical considerations for healthcare workers and policymakers, as well as lessons learned for this evolving global threat and the eventual return to a 'new normal' are discussed in this article.


title: Amplicon based MinION sequencing of SARS-CoV-2 and metagenomic characterisation of nasopharyngeal swabs from patients with COVID-19

text: COVID-19 is a complex disease phenotype where the underlying microbiome could influence morbidity and mortality. Amplicon and metagenomic MinION based sequencing was used to rapidly (within 8 hours) identify SARS-CoV-2 and assess the microbiome in nasopharyngeal swabs obtained from patients with COVID-19 by the ISARIC 4C consortium.


title: Gender, race and parenthood impact academic productivity during the COVID-19 pandemic: from survey to action

text: While the Coronavirus disease 2019 (COVID-19) pandemic is altering academia dynamics, those juggling remote work and domestic demands – including childcare - have already felt the impacts on productivity. Female authors are facing a decrease in papers submission rates since the beginning of the pandemic period. The reasons for this decline in women productivity need to be further investigated. Here we show the influence of gender, parenthood and race in academics productivity during the pandemic period, based on a survey answered by 3,345 Brazilian academics from various knowledge areas and research institutions. Findings revealed that male academics - especially childless ones - were the least affected group, whereas female academics, especially Black women and mothers, were the most impacted group. This scenario will leave long-term effects on the career progression of the most affected groups. The results presented here are crucial for the development of actions and policies that aim to avoid further deepening the gender gap in science. This particular situation we are facing during the pandemic demands institutional flexibility and academia should foster the discussion about actions to benefit Black scientists and academics with families in the post-pandemic scenario.


title: Implied susceptible population size: modelling and projecting Covid19 dynamics via the SIR equations

text: A notion of implied susceptible population size is introduced in the context of the SIR differential equations in Epidemiology. This notion is applied to the analysis and projection of Covid19 2020, illustrated on the data of Germany, Israel and USA.


title: Analyzing the Effect of Temperature on the Outspread of COVID-19 around the Globe

text: The emergence of the pandemic around the world owing to COVID-19 is putting the world into a big threat. Many factors may be involved in the transmission of this deadly disease but not much-supporting data are available. Till now no proper evidences has been reported supporting that temperature changes can affect COVID-19 transmission. This work aims to correlate the effect of temperature with that of Total Cases, Recovery, Death, and Critical cases all around the globe. All the data were collected in April and the maximum and minimum temperature and the average temperature were collected from January to April (i.e the months during which the disease was spread). Regression was conducted to find a non-linear relationship between Temperate and the cases. It was evident that indeed temperature does have a significant effect on the total cases and recovery rate around the globe. It was also evident from the study that the countries with lower temperatures are the hotspots for COVID-19. The Study depicted a non-linear dose-response between temperature and the transmission, indicating the existence of the best temperature for its transmission. This study can indeed put some light on how temperature can be a significant factor in COVID-19 transmission.


title: Is sleep apnoea a risk factor for Covid-19? Findings from a retrospective cohort study

text: Background: In the early phase of the coronavirus disease-19 (Covid-19) pandemic, Southwest Finland remained relatively spared. By the 3rd of May 2020, a total of 28 patients have been admitted to the Turku University Hospital. In this paper, we explore baseline characteristics in order to identify risk for severe Covid-19 disease and critical care admission. Methods For this retrospective cohort study, data were derived from hospital records. Basic descriptive statistics were used to characterise patients, including medians, percentiles and frequencies. Differences were tested with Mann Whitney U-test and Pearson's chi-square test. Results Pre-existent obstructive sleep apnoea (OSA) was present in 29% of patients admitted in the hospital for Covid-19, none of them having severe OSA. Overall, other findings on admission were comparable with those reported elsewhere. C-reactive protein (CRP) and procalcitonin (PCT) were higher in patients who were eventually transferred to critical care in comparison to in those who were not (median CRP 187 mg/L versus 52 mg/L, p<0.005 and median PCT 0.46 versus 0.12, p=0.047). Moreover, there was a trend towards lower oxygen saturation on admission in ICU-patients (87% versus 93%, p=0.09). Discussion OSA was pre-existent in a disproportional large group of patients, which suggests that it is an important risk factor for severe Covid-19. Furthermore, we identified high CRP, PCT and possibly oxygen saturation as useful clinical measures to identify patients at risk for critical care.


Population serology for SARS-CoV-2 is essential to regional and global preparedness


title: Contribution to COVID-19 spread modelling: A physical phenomenological dissipative formalism

text: In this study, we propose an evolution law of COVID-19 transmission based first on a representation of population by a domain part of an infinite ordered lattice in which epidemic evolution is represented by a wave like free spread starting from a first case as an epicentre. Free energy of spread on a given day is defined equal to the natural logarithm of the number of infected cases. Dissipation of propagation is obtained using a postulated form of free energy built using thermodynamics of irreversible processes in analogy to isotherm wave propagation in solids and elastic damage behaviour of materials. The proposed expression of daily free energy rate leads to dissipation of propagation introducing a parameter quantifying measures taking by governments to restrict transmission. Entropy daily rate representing disorder produced in the initial system is also explicitly defined. In this context, a simple law of evolution of infected cases as function of time is given in an iterative form. The model predicts different effects on peak of infected cases Imax and epidemic period, including effects of population size N, effects of measures taking to restrict spread, effects of population density and effect of a parameter T similar to absolute temperature in thermodynamics. Different effects are presented first. The model is than applied to epidemic spread in Tunisia and compared with data registered since the report of the first confirmed case on Mar 2, 2020. It is shown that the low epidemic size in Tunisia is essentially due to a low population density and relatively strict restriction measures including lockdown and quarantine.


Management of Personal Protective Equipment in Plastic Surgery in the Era of Coronavirus Disease


title: Coronavirus disease 2019 (COVID 19): The portraits of a perfect storm

text: The "novel" coronavirus disease 2019 (abbreviated "COVID-19") is the third coronavirus outbreak emerging during the past two decades. This infectious disease, sustained by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has been recently declared a global pandemic by the World Health Organization. Despite the concerning epidemiological burden, many people, including some policymakers, are underestimating this pandemic and are remaining enigmatically inactive against a human pathology which, for a combination of reasons, can be reasonably defined as a perfect storm (i.e., the "wrong virus" at the "wrong time"). These many paradigmatic aspects include SARS-CoV-2 structure and peculiar biology of infection, high risk of inter-human transmission, long incubation time combined with early and sustained viral load, existence of asymptomatic or mildly-symptomatic carriers, viral shedding for days after symptom relief, unfavorable progression towards respiratory distress and death in up to 5-10% of patients thus causing dramatic healthcare challenges, as well as environmental contamination. Last but not least, the combination of the current case fatality rate with the extraordinary number of people that could be potentially infected by SARS-CoV-2 would permit to estimate that the worldwide deaths for COVID-19 may even approximate those recorded during World War II if appropriate restrictive measures for preventing human-to-human transmission are not readily undertaken. Everybody should be inexcusably aware that this is not a drill, and that the consequences of inadequate action will be tragedy.


title: The COVID-19 outbreak and public perceptions of sport events in Japan

text: The pandemic of the COVID-19 has forced various sport organizations to postpone or cancel sport events The current investigation provides a rapid analysis of public perceptions of (1) postponement and cancelation decisions made by sport organizations, and (2) whether the Tokyo Olympics 2020 should be held in July 2020 Data from Japanese citizens (n= 529) show that approximately 75% supported postponement decisions made by professional sport leagues Surprisingly, only fewer than 50% supported the cancelation decision of the high school baseball tournament (i e , Spring Koshien) Regarding the Tokyo Olympics, 35 2% disagreed with holding the games, which was almost identical to those who were in favour of holding it (35 3%) The government and decision-makers should recognize the potential biases in public opinions and prioritize the scientific evidence to protect the health of the community (Note: The Tokyo Olympics and Paralympics 2020 was postponed after the completion of this study)


title: N95 Mask Decontamination using Standard Hospital Sterilization Technologies

text: The response to the COVID19 epidemic is generating severe shortages of personal protective equipment around the world. In particular, the supply of N95 respirator masks has become severely depleted with supplies having to be rationed and health care workers having to use masks for prolonged periods in many countries. We sought to test the ability of 4 different decontamination methods including autoclave treatment, ethylene oxide gassing, ionized hydrogen peroxide fogging and vaporized hydrogen peroxide exposure to decontaminate 4 different N95 masks of experimental contamination with SARS-CoV-2 or vesicular stomatitis virus as a surrogate. In addition, we sought to determine whether masks would tolerate repeated cycles of decontamination while maintaining structural and functional integrity. We found that one cycle of treatment with all modalities was effective in decontamination and was associated with no structural or functional deterioration. Vaporized hydrogen peroxide treatment was tolerated to at least 5 cycles by masks. Most notably, standard autoclave treatment was associated with no loss of structural or functional integrity to a minimum of 10 cycles for the 3 pleated mask models. The molded N95 mask however tolerated only 1 cycle. This last finding may be of particular use to institutions globally due to the virtually universal accessibility of autoclaves in health care settings.


docid: umcbulcw

title: In silico design and validation of commercial kit GPS™ CoVID-19 dtec-RT-qPCR Test under criteria of UNE/EN ISO 17025:2005 and ISO/IEC 15189:2012

text: Background The Corona Virus Disease 2019 (COVID-19), caused by Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), has become a serious infectious disease affecting human health worldwide and rapidly declared a pandemic by WHO. Early, several RT-qPCR were designed by using only the first SARS-CoV-2 genome sequence. Objectives A few days later, when additional SARS-CoV-2 genome were retrieved, the kit GPS™ CoVID-19 dtec-RT-qPCR Test was designed to provide a highly specific detection method and commercially available worldwide. The kit was validated following criteria recommended by the UNE/EN ISO 17025:2005 and ISO/IEC 15189:2012. Methods The present study approached the in silico specificity of the GPS™ CoVID-19 dtec-RT-qPCR Test and RT-qPCR designs currently published. The empirical validation parameters specificity (inclusivity/exclusivity), quantitative phase analysis (10-106 copies), reliability (repeatability/reproducibility) and sensitivity (detection/quantification limits) were evaluated for a minimum of 10-15 assays. Diagnostic validation was achieved by two independent reference laboratories, the Instituto de Salud Carlos III (ISCIII), (Madrid, Spain) and the Public Health England (PHE; Colindale, London, UK). Results The GPS™ RT-qPCR primers and probe showed the highest number of mismatches with the closet related non-SARS-CoV-2 coronavirus, including some indels. The kits passed all parameters of validation with strict acceptance criteria. Results from reference laboratories 100% correlated with these obtained by suing reference methods and received an evaluation with 100% of diagnostic sensitivity and specificity. Conclusions The GPS™ CoVID-19 dtec-RT-qPCR Test, available with full analytical and diagnostic validation, represents a case of efficient transfer of technology being successfully used since the pandemic was declared. The analysis suggested the GPS™ CoVID-19 dtec-RT-qPCR Test is the more exclusive by far.


title: Genomic variations in SARS-CoV-2 genomes from Gujarat: Underlying role of variants in disease epidemiology

text: Humanity has seen numerous pandemics during its course of evolution. The list includes many such as measles, Ebola, SARS, MERS, etc. Latest edition to this pandemic list is COVID-19, caused by the novel coronavirus, SARS-CoV-2. As of 4th July 2020, COVID-19 has affected over 10 million people from 170+ countries, and 5,28,364 deaths. Genomic technologies have enabled us to understand the genomic constitution of the pathogens, their virulence, evolution, rate of mutations, etc. To date, more than 60,000 virus genomes have been deposited in the public depositories like GISAID and NCBI. While we are writing this, India is the 3rd most-affected country with COVID-19 with 0.6 million cases, and >18000 deaths. Gujarat is the fourth highest affected state with 5.44 percent death rate compared to national average of 2.8 percent. Here, 361 SARS-CoV-2 genomes from across Gujarat have been sequenced and analyzed in order to understand its phylogenetic distribution and variants against global and national sequences. Further, variants were analyzed from diseased and recovered patients from Gujarat and the World to understand its role in pathogenesis. From missense mutations, found from Gujarat SARS-CoV-2 genomes, C28854T, deleterious mutation in nucleocapsid (N) gene was found to be significantly associated with mortality in patients. The other significant deleterious variant found in diseased patients from Gujarat and the world is G25563T, which is located in Orf3a and has a potential role in viral pathogenesis. SARS-CoV-2 genomes from Gujarat are forming distinct cluster under GH clade of GISAID.


title: Disability-inclusive COVID-19 response: What it is, why it is important and what we can learn from the United Kingdom’s response

text: All too often, disabled people are left behind in emergencies, and this is a risk in the ongoing COVID-19 pandemic. This is an important issue, as globally there are approximately one billion people with disabilities. This number includes one in three people aged over 60, who are the group at greatest risk from COVID-19. The COVID-19 pandemic in the UK has highlighted additional difficulties that disabled people may face. Complying with preventative measures, like social distancing, can be challenging, particular for people who rely on carers. Disabled people may also be at greater risk of morbidity and mortality if they contract the virus, yet in danger of being de-prioritised for care. Many people with disabilities have ongoing healthcare needs, and these need to still be supported during the pandemic. Furthermore, people may become newly disabled as a result of the pandemic, and therefore require appropriate care. Good practice examples have emerged for meeting these challenges, such as guidance for healthcare professionals on treating people with dementia, but these need to be scaled up further and adapted for other settings. In conclusion, it is clear that a disability-inclusive COVID-19 response is needed, both in the UK and as the pandemic unfolds globally. This response will require inclusion of disability measures within data collection, consulting with disabled people, and tailoring responses to be appropriate for this group.


title: Early Prediction of the 2019 Novel Coronavirus Outbreak in the Mainland China Based on Simple Mathematical Model

text: The 2019 novel coronavirus (2019-nCoV) outbreak has been treated as a Public Health Emergency of International Concern by the World Health Organization. This work made an early prediction of the 2019-nCoV outbreak in China based on a simple mathematical model and limited epidemiological data. Combing characteristics of the historical epidemic, we found part of the released data is unreasonable. Through ruling out the unreasonable data, the model predictions exhibit that the number of the cumulative 2019-nCoV cases may reach 76,000 to 230,000, with a peak of the unrecovered infectives (22,000-74,000) occurring in late February to early March. After that, the infected cases will rapidly monotonically decrease until early May to late June, when the 2019-nCoV outbreak will fade out. Strong anti-epidemic measures may reduce the cumulative infected cases by 40%-49%. The improvement of medical care can also lead to about one-half transmission decrease and effectively shorten the duration of the 2019-nCoV.


title: COVID-19 and lessons learned from the pandemic wave of meningococcal meningitis (1985-1990)

text: A novel coronavirus was first identified in late 2019 to cause an outbreak of acute respiratory illness in Wuhan city in China The disease was designated COVID-19 (coronavirus disease 2019) by the World Health Organization (WHO) in February 2020 Worldwide, the infection spread affecting more than 3 million confirmed cases, mainly in Europe and USA, and was characterised by the WHO as a pandemic in March 2020 During 1985-1990, a similar pandemic wave of meningococcal (MC) meningitis spread over vast territories in Asia (including Saudi Arabia) and Africa (including Sudan and Ethiopia with more than 70,000 cases) The Sudanese Journal of Paediatrics (SJP) is taking the opportunity to document the history of this pandemic in Sudan, which has been successfully managed within Sudan/Sweden scientific link program involving the University of Khartoum, Sudan and Uppsala University, Sweden This joint research project evaluated a rapid antigen test for the diagnosis of acute bacterial meningitis which later proved to be adaptable to the field situation during the 1988 MC epidemic It also constituted one of the pioneering works in molecular epidemiology and proved to be vital in controlling epidemic meningitis worldwide Based on this and other bacteriologic and epidemiologic data, a new conjugate vaccine was later developed which put an end to Group A meningococcal epidemics Lessons learnt from this pandemic, which also applied in case of coronavirus disease 2019 (COVID-19), are also highlighted


title: Self-isolation or borders closing: what prevents epidemic spreading better?

text: Pandemic distribution of COVID-19 in the world has motivated us to discuss combined effects of network clustering and adaptivity on epidemic spreading. We address the question concerning the choice of optimal mechanism for most effective prohibiting disease propagation in a connected network: adaptive clustering, which mimics self-isolation (SI) in local communities, or sharp instant clustering, which looks like frontiers closing (FC) between cities and countries. SI-networks are"adaptively grown"under condition of maximization of small cliques in the entire network, while FC-networks are"instantly created". Running the standard SIR model on clustered SI- and FC-networks, we demonstrate that the adaptive network clustering prohibits the epidemic spreading better than the instant clustering in the network with similar parameters. We found that SI model has scale-free property for degree distribution $P(k)\sim k^{\eta}$ with small critical exponent $-2<\eta<-1$ and argue that scale-free behavior emerges due to the randomness in the initial degree distributions and is absent for random regular graphs.


Covid-19 and Barbados: measured and transparent policy responses


COVID-19 Personal Protective Equipment (PPE) for the emergency physician


title: A cohort study to evaluate the effect of combination Vitamin D, Magnesium and Vitamin B12 (DMB) on progression to severe outcome in older COVID-19 patients.

text: Objective: To determine the clinical outcomes of older COVID-19 patients who received DMB compared to those who did not. We hypothesized that fewer patients administered DMB would require oxygen therapy and/or intensive care support than those who did not. Methodology: Cohort observational study of all consecutive hospitalized COVID-19 patients aged 50 and above in a tertiary academic hospital who received DMB compared to a recent cohort who did not. Patients were administered oral vitamin D3 1000 IU OD, magnesium 150mg OD and vitamin B12 500mcg OD (DMB) upon admission if they did not require oxygen therapy. Primary outcome was deterioration post-DMB administration leading to any form of oxygen therapy and/or intensive care support. Results: Between 15 January and 15 April 2020, 43 consecutive COVID-19 patients aged [≥]50 were identified. 17 patients received DMB and 26 patients did not. Baseline demographic characteristics between the two groups were similar. Significantly fewer DMB patients than controls required initiation of oxygen therapy subsequently throughout their hospitalization (17.6% vs 61.5%, P=0.006). DMB exposure was associated with odds ratios of 0.13 (95% CI: 0.03 - 0.59) and 0.15 (95% CI: 0.03 - 0.93) for oxygen therapy need and/or intensive care support on univariate and multivariate analyses respectively. Conclusions: DMB combination in older COVID-19 patients was associated with a significant reduction in proportion of patients with clinical deterioration requiring oxygen support and/or intensive care support. This study supports further larger randomized control trials to ascertain the full benefit of DMB in ameliorating COVID-19 severity.


title: How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes

text: On rounds in a 20-bed intensive care unit (ICU) one recent day, physician Joshua Denson assessed two patients with seizures, many with respiratory failure and others whose kidneys were on a dangerous downhill slide Days earlier, his rounds had been interrupted as his team tried, and failed, to resuscitate a young woman whose heart had stopped All shared one thing, says Denson, a pulmonary and critical care physician at the Tulane University School of Medicine “They are all COVID positive ” As the number of confirmed cases of COVID-19 surges past 2 2 million globally and deaths surpass 150,000, clinicians and pathologists are struggling to understand the damage wrought by the coronavirus as it tears through the body They are realizing that although the lungs are ground zero, its reach can extend to many organs including the heart and blood vessels, kidneys, gut, and brain


Predictive models of COVID-19 in India: A Rapid Review


title: Exosomal microRNAs Drive Thrombosis in COVID-19

text: Thrombotic and thromboembolic complications have been shown to play a critical role in the clinical outcome of COVID-19. Emerging evidence has shown that exosomal miRNAs are functionally involved in a number of physiologic and pathologic processes. However, neither exosomes nor miRNAs have been hitherto investigated in COVID-19. To test the hypothesis that exosomal miRNAs are a key determinant of thrombosis in COVID-19, we enrolled patients positive for COVID-19. Circulating exosomes were isolated from equal amounts of serum and levels of exosomal miRNAs were quantified. We divided our population in two groups based on the serum level of D-dimer on admission. Strikingly, we found that exosomal miR-424 was significantly upregulated whereas exosomal miR-103a, miR-145, and miR-885 were significantly downregulated in patients in the high D-dimer group compared to patients in the low D-Dimer group (p<0.0001).


title: Presence of mismatches between diagnostic PCR assays and coronavirus SARS-CoV-2 genome

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2;initially named as 2019-nCoV) is responsible for the recent COVID-19 pandemic and polymerase chain reaction (PCR) is the current standard method for its diagnosis from patient samples This study conducted a reassessment of published diagnostic PCR assays, including those recommended by the World Health Organization (WHO), through the evaluation of mismatches with publicly available viral sequences An exhaustive evaluation of the sequence variability within the primer/probe target regions of the viral genome was performed using more than 17 000 viral sequences from around the world The analysis showed the presence of mutations/mismatches in primer/probe binding regions of 7 assays out of 27 assays studied A comprehensive bioinformatics approach for in silico inclusivity evaluation of PCR diagnostic assays of SARS-CoV-2 was validated using freely available software programs that can be applied to any diagnostic assay of choice These findings provide potentially important information for clinicians, laboratory professionals and policy-makers


title: A Statistical Model for Quantifying the Needed Duration of Social Distancing for the COVID-19 Pandemic

text: Understanding the effectiveness of strategies such as social distancing is a central question in attempts to control the COVID-19 pandemic. A key unknown in social distancing strategies is the duration of time for which such strategies are needed. Answering this question requires an accurate model of the transmission trajectory. A challenge in fitting such a model is the limited COVID-19 case data available from a given location. To overcome this challenge, we propose fitting a model of SARS-CoV-2 transmission jointly across multiple locations. We apply the model to COVID-19 case data from Spain, UK, Germany, France, Denmark, and New York to estimate the time needed for social distancing to end to be around October 2020. Our method is not specific to COVID-19, and it can also be applied to future pandemics.


title: Computational analysis on the ACE2-derived peptides for neutralizing the ACE2 binding to the spike protein of SARS-CoV-2

text: The severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the causative agent of the COVID-19, is spreading globally and has infected more than 3 million people. It has been discovered that SARS-CoV-2 initiates the entry into cells by binding to human angiotensin-converting enzyme 2 (hACE2) through the receptor binding domain (RBD) of its spike glycoprotein. Hence, drugs that can interfere the SARS-CoV-2-RBD binding to hACE2 potentially can inhibit SARS-CoV-2 from entering human cells. Here, based on the N-terminal helix α1 of human ACE2, we designed nine short peptides that have potential to inhibit SARS-CoV-2 binding. Molecular dynamics simulations of peptides in the their free and SARS-CoV-2 RBD-bound forms allow us to identify fragments that are stable in water and have strong binding affinity to the SARS-CoV-2 spike proteins. The important interactions between peptides and RBD are highlighted to provide guidance for the design of peptidomimetics against the SARS-CoV-2.


docid: hzlkjaqe

title: A scalable device-less biomaterial approach for subcutaneous islet transplantation

text: The subcutaneous space has been shown to be a suitable site for islet transplantation, however an abundance of islets is required to achieve normoglycemia, often requiring multiple donors. The loss of islets is due to the hypoxic conditions islets experience during revascularization, resulting in apoptosis. Therefore, to reduce the therapeutic dosage required to achieve normoglycemia, pre-vascularization of the subcutaneous space has been pursued. In this study, we highlight a biomaterial-based approach using a methacrylic acid copolymer coating to generate a robust pre-vascularized subcutaneous cavity for islet transplantation. We also devised a simple, but not-trivial, procedure for filling the cavity with an islet suspension in collagen. We show that the pre-vascularized site can support a marginal mass of islets to rapidly return streptozotocin-induced diabetic SCID/bg mice to normoglycemia. Furthermore, immunocompetent Sprague Daley rats remained normoglycemia for up to 70 days until they experienced graft destabilization as they outgrew their implants. This work highlights methacrylic acid-based biomaterials as a suitable pre-vascularization strategy for the subcutaneous space that is scalable and doesn’t require exogenous cells or growth factors. Summary In this study methacrylic acid copolymer coated tubes generated a robust vascular response in the subcutaneous space, which was critical to support islet transplantation in a streptozotocin-induced diabetic mouse model. More importantly, the subcutaneous pre-vascularization approach using this copolymer coating was scalable into a larger allogeneic rat model and returned animals to normoglycemia for up to 70 days. This platform highlights the potential of a scalable biomaterial approach for pre-vascularization of the subcutaneous space in larger animal models.


title: Estimating Household Transmission of SARS-CoV-2

text: Introduction and Goals: SARS-CoV-2 is transmitted both in the community and within households. Social distancing and lockdowns reduce community transmission but do not directly address household transmission. We provide quantitative measures of household transmission based on empirical data, and estimate the contribution of households to overall spread. We highlight policy implications from our analysis of household transmission, and more generally, of changes in contact patterns under social distancing. Methods: We investigate the household secondary attack rate (SAR) for SARS-CoV-2, as well as R_h, which is the average number of within-household infections caused by a single index case. We estimate the SAR through a meta-analysis of previous studies. Taking a Bayesian approach, we correct estimates for the false-negative rate (FNR) of testing and compute posterior credible intervals for SAR. We estimate R_h using results from population testing in Vo', Italy and contact tracing data that we curate from Singapore. The code and data behind our analysis are publicly available at: https://github.com/andrewilyas/covid-household-transmission. Results: Our analysis of eight recent attack rate studies yields an SAR estimate of 0.28 (0.10, 0.61). From contact tracing data, we infer an R_h value of 0.32 (0.22, 0.42). Blanket testing data from Vo' yields an R_h estimate of 0.37 (0.34, 040) and a CRI estimate of 0.5 after correcting for FNR and asymptomatic cases. Interpretation: Our estimates of R_h suggest that household transmission was a small fraction (5%-35%) of R before social distancing but a large fraction after (30%-55%). This suggests that household transmission may be an effective target for interventions. A remaining uncertainty is whether household infections actually contribute to further community transmission or are contained within households. This can be estimated given high-quality contact tracing data. More broadly, our study points to emerging contact patterns (i.e., increased time at home relative to the community) playing a role in transmission of SARS-CoV-2. We briefly highlight another instance of this phenomenon (differences in contact between essential workers and the rest of the population), provide coarse estimates of its effect on transmission, and discuss how future data could enable a more reliable estimate.


title: Epidemiological characteristics of patients with residual SARS-Cov-2 in Linyi, China

text: Patients with 2019 novel Coronavirus infection are probably showing positive testing results again. In order to better treat these patients and provide basis for further control measures, we analyze the epidemiological outcomes and clinical features of patients with residual Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-Cov-2) in Linyi city. From January 23 to March 31 in 2020, epidemiological and clinical information of confirmed patients are collected for analysis. Stool and pharyngeal swab samples are collected for RT-PCR testing. 64 confirmed patients are included and 17 patients present re-positive testing after discharge. For these 17 patients, 70.59% are family aggregated, the interval between first time of negative testing and first time of re-positive testing is 11.82{+/-}3.42 days. There is no difference between patients with continued negative testing results and re-positive testing. After discharge, the interval between first time of negative testing and first time of re-positive testing is associated with severity of disease (p=0.013). Besides, the duration from first time to last time of re-positive testing is associated with exposure or contact history (p=0.049) and severity of disease (p=0.001). The analysis reveals epidemiological characteristics of patients with residual SARS-Cov-2 and provide basis for further control measures.


title: Guidelines for coronavirus disease 2019 response in children and adolescents

text: The Korean Society of Pediatric Infectious Diseases and the Korea Centers for Disease Control and Prevention issued the guidelines about coronavirus disease 2019 (COVID-19) for children and adolescents. Case definitions and management of COVID-19 in neonates, infants, children and adolescents are presented in this guideline. In addition, guidelines for caregiver management are also provided. In this review, we introduce the contents of the current guidelines for COVID-19 in children and adolescents in Korea.


title: Impaired T cell functions along with elevated activated Tregs at the early stage of asymptomatic SARS-CoV-2 infection

text: Background Limited data are available on the T cell responses for the asymptomatic SARS-CoV-2 infection case. Methods The first imported SARS-CoV-2 infection case in Wuhan was admitted in hospital for quarantine and observation. The T cell responses were followed up by flow cytometry analysis of the peripheral blood nonnuclear cells (PBMCs) at days 7, 13, 22, and 28 after admission. Findings We found the first imported SARS-CoV-2 infection in Wuhan is an asymptomatic case. His T cell differentiation, proliferation and activation matched the classical kinetics of T cell responses induced by viral infection, but the activation maintained at a relatively low level. Function analysis indicated frequencies of IFN-{gamma} producing CD4+ and CD8+ T cells were notably lower than that of the healthy controls (HC) at day 7, and then rebound gradually. But IFN-{gamma}+CD8+ T cells were detained at a significant lower level even at day 28, when the SARS-CoV-2 virus had already become undetectable for 3 weeks. Moreover, percentage of IL-17 producing CD4+ T cells was also detained constantly at a much lower level compared to HC. At day 7, although percentage of Tregs was in normal range, the frequency of activated Treg (aTreg) was remarkably as high as 4.4-fold of that in HC. Interpretation The T cell activation in the asymptomatic SARS-CoV-2 infection experienced a significant suppression and presented impairment of Th1/Th17 and CD8+ T cell functions. Early elevation of the aTregs might play role in the activation and function of T cells in the asymptomatic SARS-CoV-2 infection.


title: SARS-CoV-2 infection in primary schools in northern France: A retrospective cohort study in an area of high transmission

text: Background: The extent of SARS-CoV-2 transmission among pupils in primary schools and their families is unknown. Methods: Between 28-30 April 2020, a retrospective cohort study was conducted among pupils, their parents and relatives, and staff of primary schools exposed to SARS-CoV-2 in February and March 2020 in a city north of Paris, France. Participants completed a questionnaire that covered sociodemographic information and history of recent symptoms. A blood sample was tested for the presence of anti-SARS-CoV-2 antibodies using a flow-cytometry-based assay. Results: The infection attack rate (IAR) was 45/510 (8.8%), 3/42 (7.1%), 1/28 (3.6%), 76/641 (11.9%) and 14/119 (11.8%) among primary school pupils, teachers, non-teaching staff, parents, and relatives, respectively (P = 0.29). Prior to school closure on February 14, three SARS-CoV-2 infected pupils attended three separate schools with no secondary cases in the following 14 days among pupils, teachers and non-teaching staff of the same schools. Familial clustering of cases was documented by the high proportion of antibodies among parents and relatives of infected pupils (36/59 = 61.0% and 4/9 = 44.4%, respectively). In children, disease manifestations were mild, and 24/58 (41.4%) of infected children were asymptomatic. Interpretation: In young children, SARS-CoV-2 infection was largely mild or asymptomatic and there was no evidence of onwards transmission from children in the school setting.


title: A simple protein-based SARS-CoV-2 surrogate neutralization assay

text: With the COVID-19 pandemic surpassing 12M confirmed cases and 550K deaths worldwide, defining the key components of the immune response to SARS-CoV-2 infection is critical. Of particular importance is the identification of immune correlates of infection that would support public health decision-making on treatment approaches, vaccination strategies, and convalescent plasma therapy. While ELISA-based assays to detect and quantitate antibodies to SARS-CoV-2 in patient samples have been developed, the detection of neutralizing antibodies typically requires more demanding cell-based viral assays. Here, we present and validate a safe and efficient protein-based assay for the detection of serum and plasma antibodies that block the interaction of the SARS-CoV-2 spike (S) protein receptor binding domain (RBD) with its receptor, angiotensin converting-enzyme 2 (ACE2). This test is performed on the same platform and in parallel with an enzyme-linked immunosorbent assay (ELISA) for the detection of antibodies against the RBD and serves as a surrogate neutralization assay.


docid: jusmicra

title: A pitfall in estimating the effective reproductivenumber Rt for COVID-19

text: The effective reproductive number Rt of COVID-19 is determined indirectly from data that are only incompletely known. Approaches based on reconstructing these data by sampling time lags from suitable distributions introduce noise effects that can result in distorted estimates of Rt. This, in turn, may lead to misleading interpretations of the efficacy of the various measures taken to limit COVID-19 in some detail a study used for real time number in Switzerland. We argue that the method used to derive the time variation of the reproductive numer is systematically flawed and leads to an underestimation of the efficacy of the lock- down. The method adopted by the Robert Koch Institute suffers from similar deficiencies, their impact is however smaller.


title: Correlation of the global spread of coronavirus disease-19 with atmospheric air temperature

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is an enveloped virus that may be sensitive to heat. We assessed whether the spread of coronavirus disease 2019 (COVID-19) correlates with air temperature. We also studied whether additional climate, geographical, and population variables were correlated. The total number of confirmed COVID-19 cases and mortality rates reported in each country between 1st Jan and 31st Mar 2020 were compared with the country's three-month average atmospheric air temperature, precipitation and latitude. Spearman's correlation coefficient (rs) was used to identify significant correlations. Our analysis included a total of 748,555 confirmed COVID-19 cases worldwide. The total number of patients with COVID-19 decreased with increasing atmospheric air temperature (rs = -0.54, 95%CI: [-0.64, -0.42]; P <0.001) and increased with an increasing latitude (rs =0.60, 95%CI: [0.48, 0.70]; P <0.001). Our findings justify further studies to examine the effect of air temperature on infectivity of SAR-CoV-2.


title: A Novel Heuristic Global Algorithm to Predict the COVID-19 Pandemic Trend

text: Background Mathematical models are useful tools to predict the course of an epidemic. The present manuscript proposes a heuristic global algorithm for predicting the COVID-19 pandemic trend. Methods The proposed method utilizes a Gaussian-function-based algorithm for estimating how the temporal evolution of the pandemic develops by predicting daily COVID-19 deaths, for up to 10 days, from the day the prediction is made. This dataset, the number of daily deaths in each country or region, encapsulates information about (a) the quality of the health system of each country or region, (b) the age profile of the country s or region s population, and (c) environmental and other conditions. Findings The validity of the proposed heuristic global algorithm has been tested in the case of China (at different temporal stages of the pandemic), a country where the disease trend seems to have run its course. It has been applied to ten countries/states/cities, namely California, Germany, China, Greece, Iran, Lombardia/Italy, New York, Sweden, United Kingdom and USA, for each one of which predictions have been obtained. The method has also been applied to the United States as a whole, as well as to the states of New York and California, in order to investigate how the pandemic is developing in different parts of the same country. Interpretation Based on the predicted findings, the proposed algorithm seems to offer a robust and reliable method for revealing the SARS-CoV-2 temporal dynamics and disease trend, as such, can be a useful tool for the relevant authorities.


docid: jfdshwfh

title: Human ACE2 receptor polymorphisms predict SARS-CoV-2 susceptibility

text: Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is the cause of coronavirus disease (COVID-19) that has resulted in a global pandemic. It is a highly contagious positive strand RNA virus and its clinical presentation includes severe to critical respiratory disease that appears to be fatal in ∼3-5% of the cases. The viral spike (S) coat protein engages the human angiotensin-converting enzyme2 (ACE2) cell surface protein to invade the host cell. The SARS-CoV-2 S-protein has acquired mutations that increase its affinity to human ACE2 by ∼10-15-fold compared to SARS-CoV S-protein, making it highly infectious. In this study, we assessed if ACE2 polymorphisms might alter host susceptibility to SARS-CoV-2 by affecting the ACE2 S-protein interaction. Our comprehensive analysis of several large genomic datasets that included over 290,000 samples representing >400 population groups identified multiple ACE2 protein-altering variants, some of which mapped to the S-protein-interacting ACE2 surface. Using recently reported structural data and a recent S-protein-interacting synthetic mutant map of ACE2, we have identified natural ACE2 variants that are predicted to alter the virus-host interaction and thereby potentially alter host susceptibility. In particular, human ACE2 variants S19P, I21V, E23K, K26R, T27A, N64K, T92I, Q102P and H378R are predicted to increase susceptibility. The T92I variant, part of a consensus NxS/T N-glycosylation motif, confirmed the role of N90 glycosylation in immunity from non-human CoVs. Other ACE2 variants K31R, N33I, H34R, E35K, E37K, D38V, Y50F, N51S, M62V, K68E, F72V, Y83H, G326E, G352V, D355N, Q388L and D509Y are putative protective variants predicted to show decreased binding to SARS-CoV-2 S-protein. Overall, ACE2 variants are rare, consistent with the lack of selection pressure given the recent history of SARS-CoV epidemics, however, are likely to play an important role in altering susceptibility to CoVs.