title: Detection of COVID-19 Infection from Routine Blood Exams with Machine Learning: a Feasibility Study

text: Background - The COVID-19 pandemia due to the SARS-CoV-2 coronavirus, in its first 4 months since its outbreak, has to date reached more than 200 countries worldwide with more than 2 million confirmed cases (probably a much higher number of infected), and almost 200,000 deaths. Amplification of viral RNA by (real time) reverse transcription polymerase chain reaction (rRT-PCR) is the current gold standard test for confirmation of infection, although it presents known shortcomings: long turnaround times (3-4 hours to generate results), potential shortage of reagents, false-negative rates as large as 15-20%, the need for certified laboratories, expensive equipment and trained personnel. Thus there is a need for alternative, faster, less expensive and more accessible tests. Material and methods - We developed two machine learning classification models using hematochemical values from routine blood exams (namely: white blood cells counts, and the platelets, CRP, AST, ALT, GGT, ALP, LDH plasma levels) drawn from 279 patients who, after being admitted to the San Raffaele Hospital (Milan, Italy) emergency-room with COVID-19 symptoms, were screened with the rRT-PCR test performed on respiratory tract specimens. Of these patients, 177 resulted positive, whereas 102 received a negative response. Results - We have developed two machine learning models, to discriminate between patients who are either positive or negative to the SARS-CoV-2: their accuracy ranges between 82% and 86%, and sensitivity between 92% e 95%, so comparably well with respect to the gold standard. We also developed an interpretable Decision Tree model as a simple decision aid for clinician interpreting blood tests (even off-line) for COVID-19 suspect cases. Discussion - This study demonstrated the feasibility and clinical soundness of using blood tests analysis and machine learning as an alternative to rRT-PCR for identifying COVID-19 positive patients. This is especially useful in those countries, like developing ones, suffering from shortages of rRT-PCR reagents and specialized laboratories. We made available a Web-based tool for clinical reference and evaluation. This tool is available at https://covid19-blood-ml.herokuapp.com.


title: Substitutions in Spike and Nucleocapsid proteins of SARS-CoV-2 circulating in Colombia

text: Introduction: SARS-CoV-2 is a new member of the genus Betacoronavirus, responsible for the COVID-19 pandemics. The virus crossed the species barrier and established in the human population due to its ability to exploit the ACE receptor for virus entry, which is present and abundant in several tissues, including the lung and respiratory tract, gastrointestinal tract and hearth. Virus interaction with the cellular receptor is mediated by the surface protein, known as Spike. Another structural protein of major importance in the Nucleocapsid, directly interacting with the viral RNA to form the ribonucleocapsid, considered a multifunctional protein, and being the target of the most molecular diagnostics assays. Objective: To describe the frequency of substitutions in spike and nucleocapsid proteins of SARS-CoV-2 circulating in Colombia and evaluate the frequency of these substitutions in SARS-CoV-2 sequences from other countries of South America. Materials and methods: Samples of 43 patients were included for viral RNA detection by real-time RT-PCR using the Charite-Berlin protocol for the amplification of the SARS-CoV-2 E and RdRp genes. Genome sequences were obtained through the Oxford Nanopore and Illumina MiSeq technologies, following the artic.network "nCoV-2019 sequencing protocol". Available genomes were consulted from GISAID, GenBank, and Genome sequence archive (GSA) and a total of 371 genomes sequences from South America were included. The genome sequences were aligned with the Muscle tool using the MEGA X software. Substitution matrices of the Colombian sequences respect to the reference genome (NC_045512) at the nucleotide and amino acid levels were generated for the spike and nucleocapsid gene. Results: substitution D614G in the amino acid sequence of spike protein was found in 86.7% of the Colombian sequences; substitutions G181V and D936Y in 2.3%, respectively. Five substitutions were found in the nucleocapsid protein, with substitution R203K and G204R being the most frequent (13.95 %) in Colombia. The substitutions D614G in Spike and R203K-G204R in nucleocapsid have a frequency of 83% and 28% respectively in sequences from South America. Conclusion: Non-synonymous substitutions were found in the spike and nucleocapsid proteins in Colombian genomes, the most frequent being D614G in Spike and R203K-G204R in nucleocapsid. These substitutions are frequent in the genomes reported for other South American countries. It is necessary to continue with genomic surveillance of the changes in Spike and Nucleocapsid proteins during the SARS-CoV-2 pandemic in Colombia and South America, even more considering that these proteins are the most commonly used antigen in serological tests.


title: Modeling the COVID-19 outbreak in Ecuador: Is it the right time to lift social distancing containment measures?

text: Objective. Model the effect of partial and full reversal of containment measures on COVID-19 morbidity and mortality in Ecuador. Methods. Susceptible, Infected, Recovered (SIR) models were used to simulate the transmission dynamics of COVID-19 before and after the implementation (and reversal) of containment measures. A Healthcare Compartmental Epidemic Model (HeCEM), which accounts for Hospital and Intensive Care Unit admission rates, was developed to also simulate the effect of reversing social distancing containment measures. Reported COVID-19 cases between February 29th and April 23rd, 2020 were obtained from the Servicio Nacional de Gesti&oacuten de Riesgos y Emergencia, the national emergency management office of Ecuador. An ARIMA model was used to forecast reported number of cases based on the reported number of cases. SIR, HeCEM, and ARIMA model prediction errors were estimated. Results. SIR and HeCEM models predict that, at the moment, hospital and ICU bed needs for COVID-19 patients exceed the capacity in Ecuador. Partial or full reversal of containment measures before reaching the point where hospital and ICU beds are enough to meet the expected demand will result in secondary waves that delay reaching this equilibrium, resulting in thousands of excess deaths. Forecasts predict over 50,000 reported COVID-19 cases by July 25th, 2020. Conclusion. Partial reversal of containment measures should occur only after enough hospital and beds are available to meet the demand.


title: Eco-epidemiological assessment of the COVID-19 epidemic in China, January-February 2020

text: Background: The outbreak of COVID-19 in China in early 2020 provides a rich data source for exploring the ecological determinants of this new infection, which may be of relevance elsewhere. Objectives: Assessing the spread of the COVID-19 across China, in relation to associations between cases and ecological factors including population density, temperature, solar radiation and precipitation. Methods: Open-access COVID-19 case data include 18,069 geo-located cases in China during January and February 2020, which were mapped onto a 0.25° latitude/longitude grid together with population and weather data (temperature, solar radiation and precipitation). Of 15,539 grid cells, 559 (3.6%) contained at least one case, and these were used to construct a Poisson regression model of cell-weeks. Weather parameters were taken for the preceding week given the established 5-7 day incubation period for COVID-19. The dependent variable in the Poisson model was incident cases per cell-week and exposure was cell population, allowing for clustering of cells over weeks, to give incidence rate ratios. Results: The overall COVID-19 incidence rate in cells with confirmed cases was 0.12 per 1,000. There was a single case in 113/559 (20.2%) of cells, while two grid cells recorded over 1,000 cases. Weekly means of maximum daily temperature varied from -28.0 to 30.1 °C, minimum daily temperature from -42.4 to 23.0 °C, maximum solar radiation from 0.04 to 2.74 MJm-2 and total precipitation from 0 to 72.6 mm. Adjusted incidence rate ratios suggested brighter, warmer and drier conditions were associated with lower incidence. Conclusion: Though not demonstrating cause and effect, there were appreciable associations between weather and COVID-19 incidence during the epidemic in China. This does not mean the pandemic will go away with summer weather but demonstrates the importance of using weather conditions in understanding and forecasting the spread of COVID-19.


title: Development and validation of chest CT-based imaging biomarkers for early stage COVID-19 screening

text: Coronavirus Disease 2019 (COVID-19) is currently a global pandemic, and the early screening of COVID-19 is one of the key factors for COVID-19 control and treatment. Here, we developed and validated chest CT-based imaging biomarkers for COVID-19 patient screening. We identified the vasculature-like signals from CT images and found that, compared to healthy and community acquired pneumonia (CAP) patients, the COVID-19 patients revealed significantly higher abundance of these signals. Furthermore, unsupervised feature learning leads to the discovery of clinical-relevant imaging biomarkers from the vasculature-like signals for accurate and sensitive COVID-19 screening that has been double-blindly validated in an independent hospital (sensitivity: 0.941, specificity: 0.904, AUC: 0.952). Our findings could open a new avenue to assist screening of COVID-19 patients.


title: COVID-19 is an emergent disease of aging

text: COVID-19 is an ongoing pandemic caused by the SARS-CoV-2 coronavirus that poses one of the greatest challenges to public health in recent years. SARS-CoV-2 is highly contagious and often leads to severe viral pneumonia with respiratory failure and death in the elderly and subjects with pre-existing conditions, but the reason for this age dependence is unclear. Here, we found that the case fatality rate for COVID-19 grows exponentially with age in Italy, Spain, South Korea, and China, with the doubling time approaching that of all-cause human mortality. In addition, men and those with multiple age-related diseases are characterized by increased mortality. Moreover, similar mortality patterns were found for all-cause pneumonia. We further report that the gene expression of ACE2, the SARS-CoV-2 receptor, grows in the lung with age, except for subjects on a ventilator. Together, our findings establish COVID-19 as an emergent disease of aging, and age and age-related diseases as its major risk factors. In turn, this suggests that COVID-19, and deadly respiratory diseases in general, may be targeted, in addition to therapeutic approaches that affect specific pathways, by approaches that target the aging process.


title: Impact of social distancing measures for preventing coronavirus disease 2019 : A systematic review and meta-analysis protocol

text: Abstract Introduction: Social distancing measures (SDMs) protect public health from the outbreak of coronavirus disease 2019 (COVID-19). However, the impact of SDMs has been inconsistent and unclear. This study aims to assess the effects of SDMs (e.g. isolation, quarantine) for reducing the transmission of COVID-19. Methods and analysis: We will conduct a systematic review meta-analysis research of both randomised controlled trials and non-randomised controlled trials. We will search MEDLINE, EMBASE, Allied & Complementary Medicine, COVID-19 Research and WHO database on COVID-19 for primary studies assessing the enablers and barriers associated with SDMs, and will be reported in accordance with PRISMA statement. The PRISMA-P checklist will be used while preparing this protocol. We will use Joanna Briggs Institute guidelines (JBI Critical Appraisal Checklists) to assess the methodological qualities and synthesised performing thematic analysis. Two reviewers will independently screen the papers and extracted data. If sufficient data are available, the random-effects model for meta-analysis will be performed to measure the effect size of SDMs or the strengths of relationships. To assess the heterogeneity of effects, I2 together with the observed effects (Q-value, with degrees of freedom) will be used to provide the true effects in the analysis. Ethics and dissemination: Ethics approval and consent will not be required for this systematic review of the literature as it does not involve human participation. We will be able to disseminate the study findings using the following strategies: we will be publishing at least one paper in peer-reviewed journals, and an abstract will be presented at suitable national/international conferences or workshops. We will also share important information with public health authorities as well as with the World Health Organization.


title: Relaxing lockdown measures in epidemic outbreaks using selective socio-economic containment with uncertainty

text: After an initial phase characterized by the introduction of timely and drastic containment measures aimed at stopping the epidemic contagion from SARS-CoV2, many governments are preparing to relax such measures in the face of a severe economic crisis caused by lockdowns. Assessing the impact of such openings in relation to the risk of a resumption of the spread of the disease is an extremely difficult problem due to the many unknowns concerning the actual number of people infected, the actual reproduction number and infection fatality rate of the disease. In this work, starting from a compartmental model with a social structure, we derive models with multiple feedback controls depending on the social activities that allow to assess the impact of a selective relaxation of the containment measures in the presence of uncertain data. Specific contact patterns in the home, work, school and other locations for all countries considered have been used. Results from different scenarios in some of the major countries where the epidemic is ongoing, including Germany, France, Italy, Spain, the United Kingdom and the United States, are presented and discussed.


title: The expediency of local modelling to aid national responses to SARS-CoV-2.

text: Background: With the SARS-CoV-2 pandemic gripping most of the globe, healthcare and economic recovery strategies are being explored currently as a matter of urgency. Methods: We adopted the epidemiological model which informs United Kingdom government's national policy on the SARS-CoV-2 pandemic and used it in a local context and show how projections in terms of presentations of symptomatic patients in a variety of settings differ depending on local demographics. Setting: England, United Kingdom, population level modelled 3.2m Results: We clearly demonstrate that there is significant difference in the way the modelling behaves in terms of potential subsequent waves for levels of demand on the health and care systems. This provides evidence of differing timeline of peak demands and clearly shows varying levels of demand throughout the four modelled sub-geographies. Conclusions: The study results clearly outline the expediency of national modelling being adopted to reflect local health and care systems. We urge readers to ensure that any national policy is appropriately adopted to suit local health and care systems. In addition, we share our methodology to ensure other professionals could replicate this study elsewhere. Background National governments are forced to take urgent action with national policy restricting social interactions and businesses to temporarily close. In order to fully understand how the limited health and care resources could be targeted in response to this pandemic, we need to create a thorough understanding of the impact of national policy on local health and care systems. The guiding principle and understanding here is that health and care services are provided locally not nationally, not in aggregate but to individuals. Therefore, we conducted a study using existing models which are used to inform national policy and adapted these to consider local nuances to see whether such projective model would behave differently; showing how projections in terms of presentations of symptomatic patients in a variety of settings differ depending on local demographics.


title: Preliminary study of traditional Chinese medicine for preventing COVID-19 based on data mining/ 基于数据挖掘预防新型冠状病毒肺炎中医方药初探

text: To dig out and analyze the drug rule of COVID-19 prevention prescriptions from provinces and cities by using Traditional Chinese Medicine Inheritance Support System, summarize and explore its potential new prescription. The Chinese medicine prevention programs for COVID-19 were collected and searched from the official website of the Health Commission and State Administration Medicine of Traditional Chinese Medicine of the country and provinces, autonomous regions, and municipalities. TCM prevention programs in 17 provinces including Heilongjiang, Beijing, Tianjin, Hebei, Henan, Jiangxi, Sichuan, Hubei, and Hunan, etc were received. A total of 82 herbs were included in 64 prescriptions, the most frequently used Chinese herbs were Astragalus membranaceus, Lonicera japonica, etc. Tonifying deficiency drugs with sweet and warm natures were used the most, the Chinese herbs distributed in the lung channel was the most in channel tropism drugs. Analysis by association rule, eight combinations of commonly used drugs were obtained. Based on entropy clustering method rule analysis, seven potential new prescriptions were obtained. Tonifying deficiency drugs are often used in various places to prevent COVID-19, focusing on the lung, spleen and stomach. Although the specific details are different, they all reflect the preventive thinking of traditional Chinese medicine.


title: High-efficiency simulation framework to analyze the impact of exhaust air from covid-19 temporary hospitals and its typical applications

text: The outbreak of COVID-19 resulted in severe pressure on the existing medical infrastructure in China. Several Chinese cities began to construct temporary hospitals for the centralized treatment of COVID-19 patients. The harmful exhaust air from the outlets of these hospitals may have a significant adverse impact on the fresh-air intakes and surrounding environment. Owing to the need to rapidly construct these hospitals within 6-10 days, just a few hours are allowed for the analysis of the impact of this exhaust air on the environment. To overcome this difficulty, a high-efficiency simulation framework is proposed in this study. Based on the open-source computational fluid dynamics software, FDS, the proposed framework is adaptive and incorporates building information with different levels of detail during various design phases of the hospital, and has been applied in the design of theWuhan Huoshenshan Hospital, the first typical COVID-19 temporary hospital in China. According to the simulation results, neither the fresh-air intakes nor the surrounding buildings would be polluted by the harmful air discharged from the air outlets of the Huoshenshan hospital. The proposed simulation framework can provide a reference for the design and overall planning of similar hospitals in China and other affected countries.


title: Hard times for governing parties: the 2019 federal elections in Belgium

text: On 26 May 2019, European, federal and regional elections in Belgium were held. The main electoral results showed the decline of ruling parties (N-VA, MR, Open VLD, CD&V) and the rise of radical parties on the right (Vlaams Belang) and left (PVDA-PTB). These results have opened a period of deep government instability with very long negotiations to form coalitions at the regional level, and even more so at the federal level. It eventually took the COVID-19 crisis outbreak for a new government to be formed. However, the new minority government obtained external support from six parties for a period of six months only. Over the last decade, forming a coalition has proven itself to be more and more difficult in Belgium. The rise of extreme parties and the decline of mainstream parties are making it even harder. If the trend holds, one might have to question the future capacity of Belgium to form sustainable coalitions.


title: Upheaval in cancer care during the COVID-19 outbreak

text: On Monday, 23 March 2020, Nigeria recorded its first mortality from the novel global COVID-19 outbreak. Before this, the country reported 36 confirmed cases (at the time of writing) and has discharged home two cases after weeks of care at a government-approved isolation centre in Lagos State. This first mortality was that of a 67-year-old man with a history of multiple myeloma, a type of blood cancer. He was undergoing chemotherapy and had just returned to Nigeria following medical treatment in the United Kingdom. The novel COVID-19 pandemic has grounded several global activities including the provision of health care services to people with chronic conditions such as cancer. Evidence from China suggests that cancer patients with COVID-19 infection are a vulnerable group, with a higher risk of severe illness resulting in intensive care unit admissions or death, particularly if they received chemotherapy or surgery. This letter is an attempt to suggest practicable interventions such as the use of existing digital health platforms to limit patients’ and oncology professionals’ physical interactions as a way of reducing the risk of COVID-19 infection transmission amongst cancer patients and oncologists, as well as outlining effective strategies to ensure that cancer care is not completely disrupted during the outbreak.


title: Disease control of 2019-novel coronavirus infection in hospital: West China urgent recommendation/ 新型冠状病毒感染医院内防控的华西紧急推荐

text: China is facing the serious situation of 2019-novel coronavirus (2019-nCoV) infection. The health care institutions have actively participated in the prevention, diagnosis, and treatment of the disease. Proper regulation of in-hospital policy may help control virus spreading. We developed seven key clinical questions about the prevention and control of 2019-novel coronavirus infection in a hospital, and provided recommendations based on the best available evidence and expert experience. We interpret the recommendations for better feasibility in Chinese hospital. We hope to provide evidence and reference for the domestic medical institutions to reasonably adjust the hospital workflow during 2019-nCoV infection period.


title: “Daily Work in the Fever Clinics of Wuhan Union Hospital During the Novel Coronavirus Pneumonia Epidemic: A Special Spring Festival in Wuhan, China”Extracorporeal Membrane Oxygenation for Pediatric Patients With Coronavirus Disease 2019–Related Illness

text: Objective: To describe current hospital guidelines and the opinions of extracorporeal membrane oxygenation leaders at U S children’s hospitals concerning the use of extracorporeal membrane oxygenation for coronavirus disease 2019–positive pediatric patients Design: Confidential, self-administered questionnaire Setting: One hundred twenty-seven U S pediatric extracorporeal membrane oxygenation centers Subjects: Extracorporeal membrane oxygenation center program directors and coordinators Interventions: None Measurements and Main Results: In March 2020, a survey was sent to 127 pediatric extracorporeal membrane oxygenation centers asking them to report their current hospital extracorporeal membrane oxygenation guidelines for coronavirus disease 2019–positive patients Respondents were also asked their opinion on three ethical dilemmas including: prioritization of children over adults for extracorporeal membrane oxygenation use, institution of do-not-resuscitate orders, and the use of extracorporeal cardiopulmonary resuscitation for coronavirus disease 2019–positive patients Forty-seven extracorporeal membrane oxygenation centers had enacted guidelines including 46 (100%) that offer venovenous-extracorporeal membrane oxygenation and 42 (89%) that offer venoarterial-extracorporeal membrane oxygenation for coronavirus disease 2019–positive pediatric patients Forty-four centers (94%) stated that the indications for extracorporeal membrane oxygenation candidacy in coronavirus disease 2019 disease were similar to those used in other viral illnesses, such as respiratory syncytial virus or influenza Most program directors (98%) did not endorse that children hospitalized with coronavirus disease 2019 should be made do-not-resuscitate and had variable opinions on whether children should be given higher priority over adults when rationing extracorporeal membrane oxygenation Over half of program directors (60%) did not support the use of extracorporeal cardiopulmonary resuscitation for coronavirus disease 2019 Conclusions: The majority of pediatric extracorporeal membrane oxygenation centers have proactively established guidelines for the use of extracorporeal membrane oxygenation for coronavirus disease 2019–related illnesses Further work is needed to help guide the fair allocation of extracorporeal membrane oxygenation resources and to determine the appropriateness of extracorporeal cardiopulmonary resuscitation Drs MacGregor and Antiel are co-first authors Supplemental digital content is available for this article Direct URL citations appear in the printed text and are provided in the HTML and PDF versions of this article on the journal’s website (http://journals lww com/pccmjournal) The authors have disclosed that they do not have any potential conflicts of interest For information regarding this article, E-mail: baddr@wustl edu ©2020The Society of Critical Care Medicine and the World Federation of Pediatric Intensive and Critical Care Societies


title: A Mini Review on Current Clinical and Research Findings for Children Suffering from COVID-19

text: Background: As the novel coronavirus triggering COVID-19 has broken out in Wuhan, China and spread rapidly worldwide, it threatens the lives of thousands of people and poses a global threat on the economies of the entire world. However, infection with COVID-19 is currently rare in children. Objective To discuss the latest findings and research focus on the basis of characteristics of children confirmed with COVID-19, and provide an insight into the future treatment and research direction. Methods: We searched the terms "COVID-19 OR coronavirus OR SARS-CoV-2" AND "Pediatric OR children" on PubMed, Embase, Cochrane library, NIH, CDC, and CNKI. The authors also reviewed the guidelines published on Chinese CDC and Chinese NHC. Results: We included 25 published literature references related to the epidemiology, clinical manifestation, accessary examination, treatment, and prognosis of pediatric patients with COVID-19. Conclusion: The numbers of children with COVID-19 pneumonia infection are small, and most of them come from family aggregation. Symptoms are mainly mild or even asymptomatic, which allow children to be a risk factor for transmission. Thus, strict epidemiological history screening is needed for early diagnosis and segregation. This holds especially for infants, who are more susceptible to infection than other age groups in pediatric age, but have most likely subtle and unspecific symptoms. They need to be paid more attention to. CT examination is a necessity for screening the suspected cases, because most of the pediatric patients are mild cases, and plain chest X-ray do not usually show the lesions or the detailed features. Therefore, early chest CT examination combined with pathogenic detection is a recommended clinical diagnosis scheme in children. The risk factors which may suggest severe or critical progress for children are: Fast respiratory rate and/or; lethargy and drowsiness mental state and/or; lactate progressively increasing and/or; imaging showed bilateral or multi lobed infiltration, pleural effusion or rapidly expending of lesions in a short period of time and/or; less than 3 months old or those who underly diseases. For those critical pediatric patients with positive SARS-CoV-2 diagnosis, polypnea may be the most common symptom. For treatment, the elevated PCT seen in children in contrast to adults suggests that the underlying coinfection/secondary infection may be more common in pediatric patients and appropriate antibacterial treatment should be considered. Once cytokine storm is found in these patients, anti-autoimmune or blood-purifying therapy should be given in time. Furthermore, effective isolation measures and appropriate psychological comfort need to be provided timely.


title: Extracellular histones trigger disseminated intravascular coagulation by lytic cell death

text: Histones are cationic nuclear proteins that are essential for the structure and functions of eukaryotic chromatin. However, extracellular histones trigger inflammatory responses and contribute to death in sepsis by unknown mechanisms. We recently reported that inflammasome activation and pyroptosis trigger coagulation activation through a tissue factor (TF)-dependent mechanism. Here, we show that histones trigger coagulation activation in vivo as evidenced by coagulation parameters and fibrin deposition in tissues. However, histone-induced coagulopathy was neither dependent on caspase 1/11 and gasdermin D (GSDMD), nor on TLR2 and TLR4, as deficiency of these genes in mice did not protect against histone-induced coagulopathy. Incubation of histones with macrophages induced lytic cell death and phosphatidylserine (PS) exposure, which is required for TF activity, a key initiator of coagulation. Neutralization of TF diminished histone-induced coagulation. Our findings reveal lytic cell death as a novel mechanism of histone-induce coagulation activation and thrombosis. Key Points Histones trigger DIC in a tissue factor dependent mechanism Histones induce tissue factor activation through lytic cell death


title: A network-informed analysis of SARS-CoV-2 and hemophagocytic lymphohistiocytosis genes' interactions points to Neutrophil Extracellular Traps as mediators of thrombosis in COVID-19

text: Abnormal coagulation and an increased risk of thrombosis are features of severe COVID-19, with parallels proposed with hemophagocytic lymphohistiocytosis (HLH), a life-threating condition associated with hyperinflammation. The presence of HLH was described in severely ill patients during the H1N1 influenza epidemic, presenting with pulmonary vascular thrombosis. We tested the hypothesis that genes causing primary HLH regulate pathways linking pulmonary thromboembolism to the presence of SARS-CoV-2 using novel network-informed computational algorithms. This approach led to the identification of Neutrophils Extracellular Traps (NETs) as plausible mediators of vascular thrombosis in severe COVID-19 in children and adults. Taken together, the network-informed analysis led us to propose the following model: the release of NETs in response to inflammatory signals acting in concert with SARS-CoV-2 damage the endothelium and direct platelet-activation promoting abnormal coagulation leading to serious complications of COVID-19. The underlying hypothesis is that genetic and/or environmental conditions that favor the release of NETs may predispose individuals to thrombotic complications of COVID-19 due to an increase risk of abnormal coagulation. This would be a common pathogenic mechanism in conditions including autoimmune/infectious diseases, hematologic and metabolic disorders.


title: Comparison of different exit scenarios from the lock-down for COVID-19 epidemic in the UK and assessing uncertainty of the predictions

text: We model further development of the COVID-19 epidemic in the UK given the current data and assuming different scenarios of handling the epidemic. In this research, we further extend the stochastic model suggested in [1] and incorporate in it all available to us knowledge about parameters characterising the behaviour of the virus and the illness induced by it. The models we use are flexible, comprehensive, fast to run and allow us to incorporate the following: - time-dependent strategies of handling the epidemic; - spatial heterogeneity of the population and heterogeneity of development of epidemic in different areas; - special characteristics of particular groups of people, especially people with specific medical pre-histories and elderly. Standard epidemiological models such as SIR and many of its modifications are not flexible enough and hence are not precise enough in the studies that requires the use of the features above. Decision-makers get serious benefits from using better and more flexible models as they can avoid of nuanced lock-downs, better plan the exit strategy based on local population data, different stages of the epidemic in different areas, making specific recommendations to specific groups of people; all this resulting in a lesser impact on economy, improved forecasts of regional demand upon NHS allowing for intelligent resource allocation.


title: Reporting the life tracks of confirmed cases can effective prevent and control the COVID-19 outbreak in China

text: Since late December 2019, a novel coronavirus (COVID-19) has emerged in Wuhan city and rapidly spread throughout China. Fears were raised higher, so effective policies about the emergency prevention and control were concerned. Till March 3, 91273 confirmed COVID-19 cases were included in. Using Mann-Whitney U test, the provinces that reported the life tracks of confirmed cases to public have lower increased in daily new confirmed cases. Compared with the paired province, Tianjin, Jilin, Gansu, Shanxi, Hainan and Guizhou have significant differences in the number of new confirmed cases and have lower mean rank (P<0.05). Compared with the matched municipalities, Shanghai has not significant difference but has a lower mean rank (P=0.175). Besides this, the success prevention and control work need other effective strategies, such as the appointment and removal of leaders in Hubei province, real time media coverage, isolating the suspected cases or even close contacts, encouraging people to avoid going outside, delaying the return of work, closing schools, wearing facial masks, and disinfecting the communities, et.al, have kept China's epidemic under control. Strategies in China were adjusted in real time according to the epidemic which made a well prevention and control. They may be suggestions to other counties with an outbreak of COVID-19.


title: Acute kidney injury in COVID-19; A review on current knowledge

text: Coronaviruses are a large family of viruses that can cause a variety of diseases in humans. Some coronaviruses cause only mild illnesses like the common cold. While, some coronaviruses such as SARS-CoV (SARS-associated coronavirus) and Middle East respiratory syndrome coronavirus (MERS-CoV) have, in recent years, been able to cause severe respiratory involvement (pneumonia), leading to death in several patients. By identifying the genomic sequence of the new human coronavirus SARS-CoV-2 (severe acute respiratory syndrome coronavirus 2) it has been revealed that it belongs to the beta coronavirus genus. COVID-19 appears to be transmitted by a mechanism similar to the influenza virus via person to person, sneezing coughing, or contact with the secretions of infected patients. Early symptoms of these respiratory viruses include fever, cough, and shortness of breath, with an incubation period of 2-14 days. SARS-CoV-2 is an acute respiratory disease that initially causes lung damage. SARS-CoV-2 can affect other organs, including the kidneys. Kidney damage may be caused by alterations that occur during coronavirus infection. It seems that low-oxygen delivery to tissues like the kidney in the setting of this disease may lead to ischemic damage of the kidney. Considering the importance of the kidneys, as one, this review study aimed to investigate the effect of the new coronavirus on the kidneys and its role in the development of renal failure.


title: Expression of SARS-CoV-2 receptor, ACE2, and TMPRSS2 in the lung airways is lower in children compared to adults and increases due to smoking and COPD

text: Abstract It has been reported that ACE2 and TMPRSS2 are the main cell entry proteins for SARS-CoV-2 and play a critical role in causing COVID-19. To investigate the expression level of these SARS-CoV-2 host cell entry genes in lung airway, public gene expression datasets were used. We have found a differential expression of ACE2 and TMPRSS2 in nasal and bronchial airways relative to age and diseases status. Children were found to have significantly lower expression of COVID-19 receptors in the upper and lower airways (nasal and bronchial). Moreover, the lung airway expression of both ACE2 and TMPRSS2 was found to be significantly upregulated in smokers compared to non-smokers; and in patients with COPD compared to healthy. No difference was observed in the blood expression levels of ACE2 and TMPRSS2 between children and adults, or in COPD or diabetic patients. However, a significant increase in blood expression levels of these genes was observed in patients with essential hypertension; while only ACE2 was upregulated in the blood of asthmatic. These results suggest that the observed difference in COVID-19 severity between children and adults could, in part, be attributed to the difference in ACE2 and TMPRSS2 airways tissue expression levels.


title: The impact of COVID-19 on stock markets

text: This paper attempts to explore the direct effects and spill-overs of COVID-19 on stock markets. Using conventional (Formula presented.) -tests and non-parametric Mann–Whitney tests, we empirically analyse daily return data from stock markets in the People’s Republic of China, Italy, South Korea, France, Spain, Germany, Japan and the United States of America. Our empirical results show that (i) COVID-19 has a negative but short-term impact on stock markets of affected countries and that (ii) the impact of COVID-19 on stock markets has bidirectional spill-over effects between Asian countries and European and American countries. However, there is no evidence that COVID-19 negatively affects these countries’ stock markets more than it does the global average. The findings contribute to the research on economic impact of the pandemic by providing empirical evidence that COVID-19 has spill-over effects on stock markets of other countries. The results also provide a basis for assessing trends in international stock markets when the situation is alleviated worldwide.


docid: wdithqgh

title: Covid-19 rapid test by combining a random forest based web system and blood tests

text: The disease caused by the new type of coronavirus, the Covid-19, has posed major public health challenges for many countries. With its rapid spread, since the beginning of the outbreak in December 2019, the disease transmitted by SARS-Cov2 has already caused over 400 thousand deaths to date. The diagnosis of the disease has an important role in combating Covid-19. Proposed method In this work, we propose a web system, Heg.IA, which seeks to optimize the diagnosis of Covid-19 through the use of artificial intelligence. The main ideia is that healthcare professionals can insert 41 hematological parameters from common blood tests and arterial gasometry into the system. Then, Heg.IA will provide a diagnostic report. It will indicate if the patient is infected with SARS-Cov2 virus, and also predict the type of hospitalization (regular ward, semi-ICU, or ICU). We developed a web system called Heg.IA to support decision-making regarding to diagnosis of Covid-19 and to the indication of hospitalization on regular ward, semi-ICU or ICU. This application is based on decision trees in a Random Forest architecture with 90 trees. The system showed to be highly efficient, with great results for both Covid-19 diagnosis and to recommend hospitalization. For the first scenario we found average results of accuracy of 92.891% {+/-} 0.851, kappa index of 0.858 {+/-} 0.017, sensitivity of 0.936 {+/-} 0.011, precision of 0.923 {+/-} 0.011, specificity of 0.921 {+/-} 0.012 and area under ROC of 0.984 {+/-} 0.003. As for the indication of hospitalization, we achieved excellent performance of accuracies above 99% and more than 0.99 for the other metrics in all situations. By using a computationally simple method, based on the classical decision trees, we were able to achieve high diagnosis performance. Heg.IA system may be a way to overcome the testing unavailability in the context of Covid-19. We also expect the system will provide wide access to Covid-19 effective diagnosis and thereby reach and help saving lives.


Surgery in the time of Covid-19: Reflections on a pandemic


title: An Efficient Ethanol-Vacuum Method for the Decontamination and Restoration of Polypropylene Microfiber Medical Masks & Respirators

text: A critical shortage of respirators, masks and other personal protective equipment (PPE) exists across all sectors of society afflicted by the COVID-19 pandemic, placing medical staff and service workers at heightened risk and hampering efforts to reduce transmission rates. Of particular need are the N95 medical face respirators that filter 95% of all airborne particles at and above 0.3 um in diameter, many of which use meltblown microfibers of charged polypropylene (e.g, the 3M 8200). An intensive search is underway to find reliable methods to lengthen the useful life of these normally disposable units. It is currently believed that these masks and respirators cannot be cleaned with 70 to 75% alcohol-water solutions, as past wet/dry experiments show that filtration efficiency can drop by ~40% after the first such treatment. This has been interpreted as the liquids disrupting the surface charge on the fibers and has led to a recent CDC/NIOSH advisory against using alcohol for their decontamination. We have replicated the drop in efficiency after alcohol treatment. However, we find that the efficiency can be recovered by more effective drying, which we achieve with a vacuum chamber. Drying at pressures of < ~6 mBar (0.6 kPa) restores the measured filtering efficiency to within 2% or so of the pre-washing value, which we have sustained for 5 cleaning-drying cycles so far in three models of N95 masks. The mechanism seems to be the removal of water molecules adsorbed on the fiber surfaces, a hypothesis which is supported by two independent observations: (A) the filtering efficiency increases non-linearly with the weight loss during drying, and (B) filtration efficiency shows an abrupt recovery as the vacuum pressure drops from 13 to 6 mBar, the range physically attributable to the removal of adsorbed water. These results are not compatible with the electrostatic discharge hypothesis, and rather suggest that water molecules adsorbed to the fiber surface are reducing the filtration efficiency via surface tension interactions (e.g., wicking between the fibers and coating their surfaces with a film). Such a degradation mechanism has two implications: (A) Respirators decontaminated by a soak in 70% v/v ethanol regain their filtration efficiency once they are fully dry. We employ vacuum chambers in this study, which are inexpensive and commonly available. (B) This mechanism presents the possibility that mask filtration performance may be subject to degradation by other sources of moisture, and that the mask would continue to be compromised even if it appears dry. The mask would need to be vacuum-dried to restore its performance. This study introduces a number of methods which could be developed and validated for use in resource-limited settings. As the pandemic spreads to rural areas and developing nations, these would allow for local efforts to decontaminate, restore, monitor, and test medical masks.


title: Too much, too fast?

text: The UK government has been criticised for lifting some coronavirus lockdown restrictions too quickly, reports Adam Vaughan


title: An International Review of Tobacco Use and the COVID-19 Pandemic: Examining Hospitalization, Asymptomatic Cases, and Severity

text: Background and objectives: Since the World Health Organization (WHO) declared a public health emergency of imminent concern in March 2020, the novel coronavirus (SARS-CoV-2) and its related disease (COVID-19) has become a topic of much-needed research. This study primarily focused on what effect smoking had on hospitalization; however, asymptomaticity and severity were discussed. Data: Data was collected through searches on databases including PubMed and Google Scholar. Eligibility criteria included being RT-PCR verified and including smoking data. Discussion: This study found that smokers were significantly underrepresented in COVID-19 hospitalization on a purely epidemiological level in some areas, including China and Manhattan, but not others: Seattle, Greater New York City Area, and Italy. Furthermore, smokers were equally represented in asymptomatic populations, but smokers will likely experience a more severe manifestation of the disease if they are symptomatic. Further inquiry into possible mechanisms by which the observed epidemiological effect is necessary, as it has implications for recommendations on loosening restrictions on social distancing measures. Conclusions and Recommendations: This study recommends that smokers consider themselves to be at higher risk for COVID-19, as they may experience a more severe manifestation of the disease. Health care providers and policymakers should consider smokers at higher risk as well, as there is evidence to claim that smokers may contract a more severe form of COVID-19.


title: Long-term Co-existence of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) with Antibody Response in Non-severe Coronavirus Disease 2019 (COVID-19) Patients

text: Severe acute respiratory syndrome coronavirus 2 infection causing coronavirus disease 2019 has spread worldwide. Whether antibodies are important for the adaptive immune responses against SARS-CoV-2 infection needs to be determined. Here, 26 cases of COVID-19 in Jinan, China, were examined and shown to be mild or with common clinical symptoms and no cases of severe symptoms were found among these patients. A striking feature of some patients is that SARS-CoV-2 could exist in patients who have virus-specific IgG antibodies for a very long period, with one case for up to 36 days. One COVID-19 patient who did not produce any SARS-CoV-2-bound IgG successfully cleared SARS-CoV-2 after 46 days of illness, revealing that without antibody-mediated adaptive immunity, innate immunity may still be powerful enough to eliminate SARS-CoV-2. Overall, this report may provide a basis for further analysis of both innate and adaptive immunity in SARS-CoV-2 clearance, especially in non-severe cases. This study also has implications for understanding the pathogenesis and treatment of SARS-CoV-2.


title: Basic Reproduction Rate and Case Fatality Rate of COVID-19: Application of Meta-analysis

text: Abstract Background: The outbreak of novel coronavirus disease of 2019 (COVID-19) has a wider geographical spread than other previous viruses such as Ebola and H1N1. The onset of disease and its transmission and severity has become a global concern. The policymakers have a serious concern for containing the spread and minimising the risk of death. Aim: This study aims to provide the estimates of basic reproduction rate (R0) and case fatality rate (CFR) which applies to a generalised population. Methods: A systematic review was carried out to retrieve the published estimates of reproduction rate and case fatality rate in peer-reviewed articles from PubMed MEDLINE database with defined inclusion and exclusion criteria in the period 15 December 2019 to 3 May 2020. The systematic review led to the selection of 24 articles for R0 and 17 articles for CFR. These studies used data from China and its provinces, other Asian countries such as Japan, Korea, the Philippines, and countries from other parts of the world such as Nigeria, Iran, Italy, Europe as a whole, France, Latin America, Turkey, the United Kingdom (UK), and the United States of America (USA). These selected articles gave an output of 30 counts of R0 and 29 counts of CFR which were used in a meta-analysis. A meta-analysis, with the inverse variance method, fixed- and random-effects model and the Forest plot, was performed to estimate the mean effect size or mean value of basic reproduction rate and case fatality rate. The Funnel plot is used to comprehend the publication bias. Results: We estimated the robust estimate of R0 at 3.11 (2.49-3.71) persons and the robust estimate of CFR at 2.56 (2.06-3.05) per cent after accounting for heterogeneity among studies, using the random-effects model. The regional subgroup analysis in a meta-analysis was significant for R0 but was not significant for CFR. The R0 values varied from 1.90 (1.06-2.74) persons to 3.83 (2.44-5.22) persons across the regions. The Funnel plot confirms that the selected studies are significant at one per cent level of significance. Conclusion: We found that one person is likely to infect two to three persons in the absence of any control measures, and around three per cent of the population are at the risk of death within one-and-a-half months from the onset of disease COVID-19 in a generalised population. The emergence of SARS-CoV-2 varies across regions, but the risk of death remains the same. Contribution: The estimates of R0 and CFR are independent of data from a particular region or time or a homogeneous population. These estimates are applicable to a generalised population. Therefore, the estimates of R0 and CFR are unequivocally applicable to developing country like India and its states or districts, in ambivalence. The assessments of R0 and CFR values across the developed nations make all of us aware of consequences of COVID-19, and hence these estimates are of crucial importance for government authorities for the practical implementation of strategies and control measures to contain the disease. Keywords: Covid-19, SARS-CoV-2, Reproduction Rate, Case Fatality Rate, Systematic Review, Meta-analysis


docid: pdqmwwuv

title: A mindful shift: an opportunity for mindfulness-driven tourism in a post-pandemic world

text: Many see the COVID-19 pandemic as a turning point for tourism, a chance to reflect on the pressing environmental and socio-economic concerns of the industry, and an opportunity to pinpoint a more desirable direction. However, for tourism to revive as a less impactful and more meaningful industry, more mindful consumers are needed to take factual benefits from the gravity of the current situation. Mindfulness as a practice of bringing a certain quality of attention to moment-by-moment experiences has become an important asset for individuals to cope with the problems of modern life. It is even seen as a significant driver of lifestyle change in Western societies, resulting in an increasing number of more conscious consumers and mindfulness-driven products and services. The COVID-19 pandemic is a wake-up call and opportunity for the tourism industry to embrace the mindfulness movement, trusting in its capacity to reflect on the current problems and to pave a new way forward towards more compassionate and meaningful tourism for both hosts and guests.


title: Digital image processing with deep learning for automated cutting tool wear detection

text: Abstract Tool wear is a cost driver in the metal cutting industry. Besides costs for the cutting tools themselves, further costs appear - equipment downtime for tool changes, reworking of damaged surfaces, scrap parts or damages to the machine tool itself in the worst case. Consequently, tools need to be exchanged on a regular basis or at a defined tool wear state. In order to detect and monitor the tool wear state different approaches are possible. In this publication, a deep learning approach for image processing is investigated in order to quantify the tool wear state. In a first step, a Convolutional Neural Networks (CNN) is trained for cutting tool type classification. This works well with an accuracy of 95.6% on the test dataset. Finally, a Fully Convolutional Network (FCN) for semantic segmentation is trained on individual tool type datasets (ball end mill, end mill, drills and inserts) and a mixed dataset to detect worn areas on the microscopic tool images. The accuracy metric for this kind of task, Intersect over Union (IoU), is around 0.7 for all networks on the test dataset. This paper contributes to the perspective of a fully automated cutting tool wear analysis method using machine tool integrated microscopes in the scientific and industrial environment.


title: The Impact of COVID-19 on Medical Education

text: In the wake of the novel coronavirus (COVID-19) pandemic, it is abundantly clear to all the necessity of studying the pathology and widespread health consequences associated with the virus. However, what is much less clear is the impact of COVID-19 on medical education. Already, faculty and medical students are grappling with the changes that have been made and attempting to consolidate these with their plan of career development. Changes that may seem relatively minor in comparison to the global pandemic have the potential to be drastic turning points in the career progression of many. As not much is known regarding the long-lasting impact of COVID-19 on medical education, it is therefore also necessary to record and study the full impact of the changes being made. The path to entering a successful residency has been predictable for the last few years - do well on Step 1, give conference presentations, go the extra mile in clerkships and shadowing opportunities, and have meaningful non-academic extracurricular activities - all of which designed to best demonstrate a student's knowledge, persistence, collaborative spirit, and dedication to medicine. This trajectory has been changed with COVID-19 disrupting routines in hospitals, medical schools and beyond. The replacement of in-person classes with online equivalents is an obvious necessity at this time but creates a loss of collaborative experiences that has the potential to be a significant detriment to education. Likewise, the cancellation of clerkships, which are necessary for both skill acquisition as well as for relationship building, is a serious issue which students and medical schools must now resolve. Many medical students have also lost the opportunity for personal development through conference presentations. These presentations play a large role in distinguishing applicants during the residency application process, and therefore these lost opportunities have the potential to be a serious detriment to medical students’ career trajectory. While implementing technology to help resolve these issues is a unique way to help students to develop these skills, it is now necessary for medical students to demonstrate the same set of skills which they would have previously in a completely new and innovative manner. Persistence and adaptability during this time of challenge are attributes that medical students can demonstrate more readily. While every student has a personal story of how COVID-19 has impacted their education, there is no question that the impacts of COVID-19 will be felt on an extensive level. The panic in the community is palpable, and many are confused by how to proceed in the wake of COVID-19. This is no different for medical students and faculty and the questions that arise regarding medical education and their future careers.


title: The Prediction for the Outbreak of COVID-19 for 15 States in USA by Using Turning Phase Concepts as of April 10, 2020

text: Based on a new concept called Turning Period,the goal of this report is to show how we can conduct the prediction for the outlook in the different stages for the battle with outbreak of COVID-19 currently in US, in particular, to identify when each of top 15 states in USA (basically on their populations) is going to enter into the stage that the outbreak of COVID-19 is under the control by the criteria such as daily change of new patients is less than 10% smoothly. Indeed, based on the data of April 10, 2020 with the numerical analysis, we are able to classify 15 states of US into the following four different categories for the Prevention and Control of Infectious Diseases Today and the main conclusion are: First, staring around April 14, 20202, three states which are Washington State, Louisiana and Indiana are entering the stage that the outbreak of COVID-19 is under the control, which means daily change of new patients is less than 10% and the gamma is less than zero in general. Second, staring around April 15, 20202, two states which are New Jersey, and New York are entering the stage that the outbreak of COVID-19 is under the control, which means daily change of new patients is less than 10% and the gamma is less than zero in general. Third, staring around April 16, 20202, seven states which are California, Florida, Georgia (GA), Illinois, Maryland, Indiana, Michigan, and Pennsylvania are entering the stage that the outbreak of COVID-19 is under the control, which means daily change of new patients is less than 10% and the gamma is less than zero in general. Fourth, staring around April 17, 20202, three states which are Texas, Massachusetts, and Connecticut are entering the stage that the outbreak of COVID-19 is under the control, which means daily change of new patients is less than 10% and the gamma is less than zero in general. Finally, we want to reinforce that emergency risk management is always associated with the implementation of an emergency plan. The identification of the Turning Time Period is key to emergency planning as it provides a timeline for effective actions and solutions to combat a pandemic by reducing as much unexpected risk as soon as possible.


title: Where we are in fighting against COVID-19

text: On March 11, 2020, the World Health Organization announced the novel coronavirus disease (COVID-19) as a pandemic. Despite an increasing number of international attempts using maps to present and communicate COVID-19-related information in different organizations, most map products have only used the presentation function of maps. Against this backdrop, we offer an automatically daily-updated, color-blind-friendly, Tableau-based interactive dashboard to demonstrate where and how different countries are fighting against COVID-19. The dashboard allows users to specify countries they want to compare and aggregate relevant data on a daily, weekly, or monthly basis.


docid: icnqrpyg

title: Pathogenicity, tissue tropism and potential vertical transmission of SARSr-CoV-2 in Malayan pangolins

text: SARS-CoV-2 is having severe impact on public health at a global scale. Malayan pangolin SARS-CoV-2-related coronavirus (SARSr-CoV-2) is closely related to SARS-CoV-2. We show that CT scans of virus-positive pangolins reveal bilateral ground-glass opacities in lungs in similar manner to COVID-19 patients. The virus infected multiple organs in pangolins, with the lungs being the major target. Histological expression showed that ACE2 and TMPRSS2 are co-expressed with viral RNA. Transcriptome analysis revealed an inadequate interferon response, with different dysregulated chemokines and cytokines responses in pregnant and non-pregnant adults and fetuses. Viral RNA and protein were detected in three fetuses providing evidence for vertical virus transmission. In sum, our study identifies the biological framework of SARSr-CoV-2 in pangolins, revealing striking similarities to COVID-19 in humans.


title: Anticipating the novel coronavirus disease (COVID-19) pandemic

text: The infectious novel coronavirus disease COVID-19 outbreak has been declared as a public health emergency of international concern, and later as an epidemic. To date, this outbreak has infected more than one million people and killed over fifty thousand people across the world. In most countries, the COVID-19 incidence curve rises sharply in a short span of time, suggesting a transition from a disease free (or low-burden disease) equilibrium state to a sustained infected (or high-burden disease) state. Such a transition from one stable state to another state in a relatively short span of time is often termed as a critical transition. Critical transitions can be, in general, successfully forecasted using many statistical measures such as return rate, variance and lag-1 autocorrelation. Here, we report an empirical test of this forecasting on the COVID-19 data sets for nine countries including India, China and the United States. For most of the data sets, an increase in autocorrelation and a decrease in return rate predict the onset of a critical transition. Our analysis suggests two key features in predicting the COVID-19 incidence curve for a specific country: a) the timing of strict social distancing and/or lockdown interventions implemented, and b) the fraction of a nation's population being affected by COVID-19 at the time of implementation of these interventions. Further, using satellite data of nitrogen dioxide which is emitted predominantly as a result of anthropogenic activities, as an indicator of lockdown policy, we find that in countries where the lockdown was implemented early and strictly have been successful in reducing the extent of transmission of the virus. These results hold important implications for designing effective strategies to control the spread of infectious pandemics.


title: Detecting space-time clusters of COVID-19 in Brazil: mortality, inequality, socioeconomic vulnerability, and the relative risk of the disease in Brazilian municipalities

text: The first case of COVID-19 in South America occurred in Brazil on February 25th, 2020. By June 7th, 2020, there were 691,758 confirmed cases, 36,455 confirmed deaths, and a mortality rate of 5.3%. To assist with the establishment of measures for the strategic planning to combat the COVID-19 pandemic in Brazil, we present the first Brazilian geographic study with the aims to examine active hand emerging space-time clusters of COVID-19. We examine the associations between clusters and mortality rate, vulnerability, and social inequality. We used the prospective space-time scan statistic to detect daily COVID-19 clusters and examine the relative risk from February 25th-June 7th, 2020 in 5,570 Brazilian municipalities. We apply a Spearman statistic to measure correlation between the relative risk of each cluster and mortality rate, GINI index, and social inequality. We detected 11 emerging space-time clusters of COVID-19 occurring in all Brazilian regions, with seven of them with a relative risk greater than one, and the highest in the Amapa state in the northern region of Brazil. We observed a positive and significant correlation between the relative risk and mortality rate, Brazilian Social Vulnerability Index, and GINI Index. The results can be utilized to improve COVID-19 response and planning in all Brazilian states.


title: Clinical population genetic analysis of variants in the SARS-CoV-2 receptor ACE2

text: Purpose: SARS-CoV-2 infects cells via the human Angiotensin-converting enzyme 2 (ACE2) protein. The genetic variation of ACE2 function and expression across populations is still poorly understood. This study aims at better understanding the genetic basis of COVID-19 outcomes by studying association between genetic variation in ACE2 and disease severity in the Iranian population. Methods: We analyzed two large Iranian cohorts and several publicly available human population variant databases to identify novel and previously known ACE2 exonic variants present in the Iranian population and considered those as candidate variants for association between genetic variation and disease severity. We genotyped these variants across three groups of COVID-19 patients with different clinical outcomes (mild disease, severe disease, and death) and evaluated this genetic variation with regard to clinical outcomes. Results: We identified 32 exonic variants present in Iranian cohorts or other public variant databases. Among those, 11 variants are novel and have thus not been described in other populations previously. Following genotyping of these 32 candidate variants, only the synonymous polymorphism (c.2247G>A) was detected across the three groups of COVID-19 patients. Conclusion: Genetic variability of known and novel exonic variants was low among our COVID-19 patients. Our results do not provide support for the hypothesis that exonic variation in ACE2 has a sizeable impact on COVID-19 severity across the Iranian population.


Dose prediction of lopinavir/ritonavir for 2019-novel coronavirus (2019-nCoV) infection based on mathematic modeling


title: Epidemiological investigation and intergenerational clinical characteristics of 24 COVID-19 patients associated with supermarket cluster

text: Objective: To analyze the epidemiological and intergenerational clinical characteristics of COVID-19 patients associated with cluster, so as to understand the rules of the patients associated with cluster of this outbreak and provide help for the prevention and control of COVID-19. Methods: All close contacts of the patient were screened since the first supermarket employee with COVID-19 was identified. A retrospective analysis was made on the epidemiological and clinical characteristics of the confirmed cases admitted to the designated hospitals for centralized treatment. The patients were divided into two groups according to the first generation (supermarket employees, group A) and the second or third generation (family members or friends of supermarket employees, group B), and the similarities and differences between the two groups were compared. Results: A total of 24 COVID-19 patients were diagnosed, with an average age of 48{+/-}1.73 years. The mean duration from onset to release form quarantine was 21.04{+/-}6.77 days, and the onset time was concentrated in 5-11 days after the first patient was diagnosed. Among all the patients, 23 patients were moderate, among which 7 patients (29.17%) were asymptomatic. Symptoms of symptomatic patients were cough (75.00%), low fever (62.50%), shortness of breath (41.67%), sore throat (25.00%), gastrointestinal symptoms (25.00%), fatigue (20.83%), etc. Biochemical examination on admission showed that the white blood cell count < 4.010x9/L (29.17%) and the lymphocyte count <1.1x109/L (58.33%). The lymphocyte count of 50.00% of the patients was [≤]0.6x109/L. On admission, chest CT showed pneumonia (100%) with bilateral infiltration (75.00%). Treatment: antiviral drug (100%), Chinese medicine (100%), common oxygen therapy (45.83%). There were 11 cases in group A (first generation, 11 cases) and 13 cases in group B (second generation, 11 cases; third generation, 2 cases). In group B, there were more males, from onset to admission later, more patients had underlying diseases, and more patients were treated with albumin (P<0.05). However, there was no statistical difference between the two groups in other clinical indicators, including the duration from onset to release form quarantine(P>0.05). There was no improvement in granulocyte count in all patients, as well as in groups A and B, between admission and release from quarantine(P>0.05). Conclusion: The clinical characteristics of COVID-19 patients associated with cluster were similar to those of other COVID-19 patients, but there were some special features. The severity of the disease was similar and there was intergenerational spread. There was no difference in clinical characteristics between generations. Asymptomatic infections occurred in a proportion of patients and could cause spread.


Italian politics in 2019 and their legacy: reactions to the coronavirus


title: Serology-informed estimates of SARS-COV-2 infection fatality risk in Geneva, Switzerland

text: The infection fatality risk (IFR) is the average number of deaths per infection by a pathogen and is key to characterizing the severity of infection across the population and for specific demographic groups. To date, there are few empirical estimates of IFR published due to challenges in measuring infection rates. Outside of closed, closely surveilled populations where infection rates can be monitored through viral surveillance, we must rely on indirect measures of infection, like specific antibodies. Representative seroprevalence studies provide an important avenue for estimating the number of infections in a community, and when combined with death counts can lead to robust estimates of the IFR. We estimated overall and age-specific IFR for the canton of Geneva, Switzerland using age-stratified daily case and death incidence reports combined with five weekly population-based seroprevalence estimates. From February 24th to June 2nd there were 5'039 confirmed cases and 286 reported deaths within Geneva (population of 506'765). We inferred age-stratified (5-9, 10-19, 20-49, 50-65 and 65+) IFRs by linking the observed number of deaths to the estimated number of infected individuals from each serosurvey. We account for the delays between infection and seroconversion as well as between infection and death. Inference is drawn in a Bayesian framework that incorporates uncertainty in seroprevalence estimates (supplement). Of the 286 reported deaths caused by SARS-CoV-2, the youngest person to die was 31 years old. Infected individuals younger than 50 years experienced statistically similar IFRs (range 0.00032-0.0016%), which increases to 0.14% (95% CrI 0.096-0.19) for those 50-64 years old to 5.6% (95% CrI 4.3-7.4) for those 65 years and older (supplement). After accounting for demography and age-specific seroprevalence, we estimate a population-wide IFR of 0.64% (95% CrI 0.38-0.98). Our results are subject to two notable limitations. Among the 65+ age group that died of COVID-19 within Geneva, 50% were reported among residents of assisted care facilities, where around 0.8% of the Geneva population resides. While the serosurvey protocol did not explicitly exclude these individuals, they are likely to have been under-represented. This would lead to an overestimation of the IFR in the 65+ age group if seroprevalence in this institutionalized population was higher than in the general population (supplement). Further, our IFR estimates are based on current evidence regarding post-infection antibody kinetics, which may differ between severe and mild infections. If mild infections have significantly lower and short-lived antibody responses, our estimates of IFR may be biased upwards. Estimates of IFR are key for understanding the true pandemic burden and for weighing different risk reduction strategies. The IFR is not solely determined by host and pathogen biology, but also by the capacity of health systems to treat severe cases. Despite having among the highest per capita incidence in Switzerland, Geneva's health system accommodated the influx of cases needing intensive care (peak of 80/110 ICU-beds including surge capacity) while maintaining care quality standards. As such, our IFR estimates can be seen as a best-case scenario with respect to health system capacity. Our results reveal that population-wide estimates of IFR mask great heterogeneity by age and point towards the importance of age-targeted interventions to reduce exposures among those at highest risk of death.


title: Role of Drugs Affecting the Renin-Angiotensin-Aldosterone System on Susceptibility and Severity of COVID-19: A Large Case-Control Study from Zheijang Province, China.

text: Background. Medical editorials have suggested that angiotensin converting enzyme inhibitors (ACEIs) and angiotensin receptor blockers (ARBs) should not be given to people with arterial hypertension during the coronavirus disease 2019 (COVID-19) pandemic because of a potential increased risk of worse clinical outcomes and that calcium channel blockers (CCBs) should be used as an alternative. Methods Using a cohort of 610 COVID-19 cases and 48,667 population-based controls from Zheijang, China we have tested the role of usage of ACEIs, ARBs, CCBs and other medications on risk and severity of COVID 19. Analyses were adjusted for age, sex and BMI and for presence of relevant comorbidities. Findings: Higher BMI, diabetes and cardio/ cerebrovascular disease as independent risk factors for the development of COVID-19. Individuals with hypertension taking CCBs had significantly increased risk [odds ratio (OR)= 1.67 (95% CI 1.2-2.9)) of manifesting symptoms of COVID-19 whereas those taking ARBs and diuretics had significantly lower disease risk (OR=0.24; 95%CI 0.17-0.34 and OR=0.32; 95%CI 0.19-0.57 respectively). Other antihypertensive drugs were not associated with increased risk of severe or critical form of the infection. Use of glucocorticoids was significantly associated with a severe/critical form of COVID-19 (OR= 7.56; 95%CI 1.17-48.93). Interpretation: we found no evidence to alter ARBs or ACEIs therapy in the context of the pandemic. Patients on corticosteroids with COVID-19 are at higher risk of developing a severe form of COVID-19and therefore should be monitored closely.


title: COVID-19 in London, a Case Series Demonstrating Late Improvement in Survivors

text: Objective To determine whether the trajectories of survivors and non-survivors are different in patients admitted to intensive care in London. Design In this case series of 15 survivors and 16 non-survivors, data from admission to discharge was collected and aligned to lowest PaO2/FiO2 ratio where aggregation and trends were demonstrated. Setting Single centre case-series in London, Intensive Care. Participants All non-survivors were included (n=16). A biased set of survivors (n=15) who were demonstrated an unexpected and rapid recovery after a prolonged period of mechanical ventilatory support. Results Respiratory failure trajectories of survivors and non-survivors were similar once aligned indicating, from a respiratory function perspective, it is difficult to identify survivors from non-survivors with some survivors improving late in their disease (day 20 - 30 from symptom onset) Non-survivors are admitted earlier in their disease (p < 0.05) and had worse organ failure requirements prior to the nadir of their respiratory funciton (p < 0.05) compard to survivors. Conclusion Analysis of multiple factors fails to differentiate between survivors and non-survivors. Even when faced with multiorgan failure, perseverance until discharge must be advocated as late improvements do occur in survivors.


docid: tjjuokec

title: Priority Setting of Ventilators in the COVID-19 Pandemic from the public's perspective

text: Background: Ventilator allocation plan for public health crisis should be developed through recognizing the values of society and engaging the general public. This study was conducted to assess the Iranian citizens' attitude about a number of principles and criteria for allocation of ventilators in current COVID-19 epidemic. Materials and Methods: An electronic self-administered questionnaire was publicly distributed through social networks of Telegram and WhatsApp to perform this cross-sectional study. The questionnaire consisted of 11 statements about the selection and prioritization of patients for the use of a ventilator. Results: 1262 persons, including 767 citizens and 495 health care providers participated in this study. More than 95% of participants agreed upon the necessity to avoid discrimination and avoid prioritization according to patients' gender, economic and political status. While 40.9% of citizens and 49.6% of healthcare workers believed that a ventilator can be disconnected from a patient with a poor prognosis to help a patient who has a better prognosis (P-value=0.13), 34.3% of people and 29.6% of healthcare workers believed that the earlier admitted patients have the right to receive the device even if the likeliness of his/her survival is less than the next patient (P-value=0.009). Conclusions: This study showed that people accept maximizing health benefits as a measure of ventilator allocation in the pandemic of COVID-19. At the same time, periodic evaluation of patients and disconnecting the device from a patient that no longer benefits from ICU services require its scientific and ethical basis to be brought in public discourse.


Covid 19 – pandemic in India


title: FakeCovid -- A Multilingual Cross-domain Fact Check News Dataset for COVID-19

text: In this paper, we present a first multilingual cross-domain dataset of 5182 fact-checked news articles for COVID-19, collected from 04/01/2020 to 15/05/2020. We have collected the fact-checked articles from 92 different fact-checking websites after obtaining references from Poynter and Snopes. We have manually annotated articles into 11 different categories of the fact-checked news according to their content. The dataset is in 40 languages from 105 countries. We have built a classifier to detect fake news and present results for the automatic fake news detection and its class. Our model achieves an F1 score of 0.76 to detect the false class and other fact check articles. The FakeCovid dataset is available at Github.


title: Estimated inequities in COVID-19 infection fatality rates by ethnicity for Aotearoa New Zealand

text: There is limited evidence as to how COVID-19 infection fatality rates (IFR) may vary by ethnicity. We combine demographic and health data for ethnic groupings in Aotearoa New Zealand with international data on IFR for different age groups to estimate inequities in IFR by ethnicity. We find that, if age is the dominant factor determining IFR, estimated IFR for Māori is around 50% higher than non-Māori. If underlying health conditions are more important than age per se, then estimated IFR for Māori is more than 2.5 times that of New Zealand European, and estimated IFR for Pasifika is almost double that of New Zealand European. IFRs for Māori and Pasifika are likely to be increased above these estimates by racism within the healthcare system and other inequities not reflected in official data. IFR does not account for differences among ethnicities in COVID-19 incidence, which could be higher in Māori and Pasifika as a result of crowded housing and higher inter-generational contact rates. These factors should be included in future disease incidence modelling. The communities at the highest risk will be those with elderly populations, and Māori and Pasifika communities, where the compounded effects of underlying health conditions, socioeconomic disadvantage, and structural racism result in imbricated risk of contracting COVID-19, becoming unwell, and death.


title: Mental health service activity during COVID-19 lockdown: South London and Maudsley data on working age community and home treatment team services and mortality from February to mid-May 2020

text: The lockdown and social distancing policy response to the COVID-19 pandemic in the UK has a potentially important impact on provision of mental healthcare; however, there has been relatively little quantification of this. Taking advantage of the Clinical Record Interactive Search (CRIS) data resource with 24-hourly updates of electronic mental health records data, this paper describes daily caseloads and contact numbers (face-to-face and virtual) for home treatment teams (HTTs) and working age adult community mental health teams (CMHTs) from 1st February to 15th May 2020 at the South London and Maudsley NHS Trust (SLaM), a large mental health service provider for 1.2m residents in south London. In addition daily deaths are described for all current and previous SLaM service users over this period and the same dates in 2019. In summary, the CMHT sector showed relatively stable caseloads and total contact numbers, but a substantial shift from face-to-face to virtual contacts, while HTTs showed the same changeover but reductions in caseloads and total contacts (although potentially an activity rise again during May). Number of deaths for the two months between 16th March and 15th May were 2.4-fold higher in 2020 than 2019, with 958 excess deaths.


title: Outbreak dynamics of COVID-19 in Europe and the effect of travel restrictions

text: For the first time in history, on March 17,2020, the European Union closed all its external borders to contain the spreading of the coronavirus 2019, COVID-19. Throughout two past months, governments around the world have implemented massive travel restrictions and border control to mitigate the outbreak of this global pandemic. However, the precise effects of travel restrictions on the outbreak dynamics of COVID-19 remain unknown. Here we combine a global network mobility model with a local epidemiology model to simulate and predict the outbreak dynamics and outbreak control of COVID-19 across Europe. We correlate our mobility model to passenger air travel statistics and calibrate our epidemiology model using the number of reported COVID-19 cases for each country. Our simulations show that mobility networks of air travel can predict the emerging global diffusion pattern of a pandemic at the early stages of the outbreak. Our results suggest that an unconstrained mobility would have significantly accelerated the spreading of COVID-19, especially in Central Europe, Spain, and France. Ultimately, our network epidemiology model can inform political decision making and help identify exit strategies from current travel restrictions and total lockdown.


title: A time delay dynamic system with external source for the local outbreak of 2019-nCoV

text: How to model the 2019 CoronaVirus (2019-nCov) spread in China is one of the most urgent and interesting problems in applied mathematics. In this paper, we propose a novel time delay dynamic system with external source to describe the trend of local outbreak for the 2019-nCoV. The external source is introduced in the newly proposed dynamic system, which can be considered as the suspected people travel to different areas. The numerical simulations exhibit the dynamic system with the external source is more reliable than the one without it, and the rate of isolation is extremely important for controlling the increase of cumulative confirmed people of 2019-nCoV. Based on our numerical simulation results with the public data, we suggest that the local government should have some more strict measures to maintain the rate of isolation. Otherwise the local cumulative confirmed people of 2019-nCoV might be out of control.


title: Age separation dramatically reduces COVID-19 mortality rate in a computational model of a large population

text: COVID-19 pandemic has caused a global lock down in many countries throughout the world. Faced with a new reality, and until a vaccine or efficient treatment is found, humanity must figure out ways to keep economy going on one hand, yet keep the population safe on the other hand, especially those that are susceptible to this virus. Here we use a network simulation, with parameters that were drawn from what is known about the virus, to explore 5 different scenarios of partial lock down release. We find that separating age groups by reducing interactions between age groups, protects the general population and reduces mortality rates. Furthermore, addition of new connections within the same age group to compensate for the lost connections outside the age group, still has a strong beneficial influence and reduces the total death toll by 66%. While complete isolation from society may be the most protective scenario for the elderly population, it would have an emotional and possibly cognitive impact that might outweigh its benefit. We therefore propose creating age-related social recommendations or even restrictions, thereby allowing social connections but still strong protection for the older population.


title: Over view for the truth of COVID -19 pandemic: A guide for the Pathologists, Health care workers and community’

text: Pakistan is in the grip of COVID-19, due to severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) since 26 February 2020, and the number of infected people and mortality is rising gradually. The health workers, doctors, pathologists and laboratory staff are front line fighters who are facing the risk. Few things are important for public and health workers, human behavior is at the core of preparedness and response i.e, personal protective measures, (handwashing, face masks, respiratory etiquette, surface and objects cleansing), social distancing and travel measures because the virus spreads through the respiratory channels, eyes, nose and mouth. While working in the Pathology labs, use the personal protection equipment (PPE), during the work in the duty. Avoiding the over duties and long shifts. It is good to keep the immune system healthy by taking a healthy balanced diet, vitamin supplements, and a night of proper sleep. It is also important to avoid taking food during duties and avoid making close contact without wearing safety dress.


title: Never Let a Crisis Go To Waste: Implementing Virtual Innovations during the COVID-19 Pandemic for a Better Tomorrow in Healthcare

text: Abstract The coronavirus disease (COVID-19) pandemic has necessitated adjustments within our healthcare infrastructure, many of which have been virtually mediated, in order to facilitate preservation of patient care, education, and research. In this commentary, we discuss how these virtual innovations can be applied to improve healthcare delivery in the post-COVID-19 era.


title: Computational analysis of microRNA-mediated interactions in SARS-CoV-2 infection

text: MicroRNAs (miRNAs) are post-transcriptional regulators of gene expression found in more than 200 diverse organisms. Although it is still not fully established if RNA viruses could generate miRNAs, there are examples of miRNA like sequences from RNA viruses with regulatory functions. In the case of Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2), there are several mechanisms that would make miRNAs impact the virus, like interfering with viral replication, translation and even modulating the host expression. In this study, we performed a machine learning based miRNA prediction analysis for the SARS-CoV-2 genome to identify miRNA-like hairpins and searched for potential miRNA-based interactions between the viral miRNAs and human genes and human miRNAs and viral genes. Overall, 950 hairpin structured sequences were extracted from the virus genome and based on the prediction results, 29 of them could be precursor miRNAs. Targeting analysis showed that 30 viral mature miRNA-like sequences could target 1,367 different human genes. PANTHER gene function analysis results indicated that viral derived miRNA candidates could target various human genes involved in crucial cellular processes including transcription, metabolism, defense system and several signaling pathways such as Wnt and EGFR signalings. Protein class-based grouping of targeted human genes showed that host transcription might be one of the main targets of the virus since 96 genes involved in transcriptional processes were potential targets of predicted viral miRNAs. For instance, basal transcription machinery elements including several components of human mediator complex (MED1, MED9, MED12L, MED19), basal transcription factors such as TAF4, TAF5, TAF7L and site-specific transcription factors such as STAT1 were found to be targeted. In addition, many known human miRNAs appeared to be able to target viral genes involved in viral life cycle such as S, M, N, E proteins and ORF1ab, ORF3a, ORF8, ORF7a and ORF10. Considering the fact that miRNA-based therapies have been paid attention, based on the findings of this study, comprehending mode of actions of miRNAs and their possible roles during SARS-CoV-2 infections could create new opportunities for the development and improvement of new therapeutics.


title: Coronavirus Disease-19: The First 7,755 Cases in the Republic of Korea

text: We report the first 7,755 patients with confirmed COVID-19 in Korea as of March 12(th), 2020. A total of 66 deaths have been recorded, giving a case fatality proportion of 0.9%. Older people, and those with comorbidities were at a higher risk of a fatal outcome. The highest number of cases of COVID-19 were in Daegu, followed by Gyeongbuk. This summary may help to understand the disease dynamics in the early phase of the COVID-19 outbreaks, and may therefore, guide future public health measures.


Survey Pinpoints Adverse Effects of COVID-19 Pandemic on Cancer Care


title: Cell cycle-gated feedback control mediates desensitization to interferon stimulation

text: Cells use sophisticated molecular circuits to interpret and respond to extracellular signal factors, such as hormones and cytokines, which are often released in a temporally varying fashion. In this study, we focus on type I interferon (IFN) signaling in human epithelial cells and combine microfluidics, time-lapse microscopy, and computational modeling to investigate how the IFN-responsive regulatory network operates in single cells to process repetitive IFN stimulation. We found that IFN-α pretreatments lead to opposite effects, priming versus desensitization, depending on the input durations. These effects are governed by a regulatory network composed of a fast-acting positive feedback loop and a delayed negative feedback loop, mediated by upregulation of ubiquitin-specific peptidase 18 (USP18). We further revealed that USP18 upregulation can only be initiated at the G1 and early S phases of cell cycle upon the treatment onset, resulting in heterogeneous and delayed induction kinetics in single cells. This cell cycle gating provides a temporal compartmentalization of feedback control processes, enabling duration-dependent desensitization to repetitive stimulations. Moreover, our results, highlighting the importance of IFN dynamics, may suggest time-based strategies for enhancing the effectiveness of IFN pretreatment in clinical applications against viruses, such as SARS-CoV-2.


title: Tissue-specific tolerance in fatal Covid-19

text: Successful host defence against a pathogen can involve resistance or tolerance, with implications for prioritising either antimicrobial or immunomodulatory therapeutic approaches. Hyper-inflammation occurs in Covid-19 and is associated with worse outcomes. The efficacy of dexamethasone in preventing mortality in critical Covid-19 suggests that inflammation has a causal role in death. Whether this deleterious inflammation is primarily a direct response to the presence of SARS-CoV-2 requiring enhanced resistance, or an independent immunopathologic process necessitating enhanced tolerance, is unknown. Here we report an aberrant immune response in fatal Covid-19, principally involving the lung and reticuloendothelial system, that is not clearly topologically associated with the virus, indicating tissue-specific tolerance of SARS-CoV-2. We found that inflammation and organ dysfunction in fatal Covid-19 did not map to the widespread tissue and cellular distribution of SARS-CoV-2 RNA and protein, both between and within tissues. A monocyte/myeloid-rich vasculitis was identified in the lung, along with an influx of macrophages/monocytes into the parenchyma. In addition, stereotyped abnormal reticulo-endothelial responses (reactive plasmacytosis and iron-laden macrophages) were present and dissociated from the presence of virus in lymphoid tissues. Our results support virus-independent immunopathology being one of the primary mechanisms underlying fatal Covid-19. This supports prioritising pathogen tolerance as a therapeutic strategy in Covid-19, by better understanding non-injurious organ-specific viral tolerance mechanisms and targeting aberrant macrophage and plasma cell responses.


title: Quantifying early COVID-19 outbreak transmission in South Africa and exploring vaccine efficacy scenarios

text: Background: COVID-19 has emerged and spread at great speed globally and has presented one of the greatest public health challenges in modern times with no proven cure or vac-cine. Africa is still early in this epidemic, therefore the spectrum of disease severity is not yet clear. Methods: We used a mathematical model to fit to the observed cases of COVID-19 in South Africa to estimate the basic reproductive number and critical vaccination coverages to con-trol the disease for different hypothetical vaccine efficacy scenarios. We also estimated the percentage reduction in effective contacts due to the social distancing measures imple-mented. Results: Early model estimates show that COVID-19 outbreak in South Africa had a basic reproductive number of 2.95 (95% credible interval [CrI] 2.83-3.33). A vaccine with 70% effi-cacy had the capacity to contain COVID-19 outbreak but at very higher vaccination cover-age 94.44% (95% Crl 92.44-99.92%) with a vaccine of 100% efficacy requiring 66.10% (95% Crl 64.72-69.95%) coverage. Social distancing measures put in place have so far reduced the number of social contacts by 80.31% (95% Crl 79.76-80.85%). Conclusions: Findings suggest a highly efficacious vaccine would have been required to con-tain COVID-19 in South Africa. Therefore, the current social distancing measures to reduce contacts will remain key in controlling the infection in the absence of vaccines and other therapeutics.


title: Prediction of the coronavirus epidemic prevalence inquarantine conditions based on an approximate calculation model

text: A calculation model for predicting the spread of the COVID-19 epidemic under quarantine conditions is proposed. The obtained simple analytical ratios allow estimating the factors determining the intensity of the infection spread, including changing requirements for quarantine severity. The presented method of forecasting allows to calculate both the total number of infected persons and the number of active infections. Comparison of the results of calculations according to the proposed model with the statistics for a number of cities shows their satisfactory qualitative and quantitative compliance. The proposed simple model can be useful in preliminary assessment of possible consequences of changing quarantine conditions.


Neurology Journals Adapt in the Time of COVID-19


title: Monoclonal Antibodies for the Coronavirus

text: Antibodies as a therapy Let’s have a look at what is (in my opinion) probably our best shot at a reasonably short-term targeted therapy against the COVID-19 epidemic: the possibility of using monoclonal antibodies


title: Pre-existing immunity provides a barrier to airborne transmission of influenza viruses

text: Human-to-human transmission of influenza viruses is a serious public health threat, yet the precise role of immunity from previous infections on the susceptibility to airborne viruses is still unknown. Using human seasonal influenza viruses in a ferret model, we examined the roles of exposure duration and heterosubtypic immunity on influenza transmission. We found that airborne transmission of seasonal influenza strains is abrogated in recipient animals with pre-existing non-neutralizing immunity, indicating that transmissibility of a given influenza virus strain should be examined in the context of ferrets that are not immunologically naïve.


title: COVID-19 outbreak and endoscopy: Considerations in patients encountered in a foregut surgery practice

text: Severe acute respiratory syndrome coronavirus has become a critical challenge to global health. Since the arrival of coronavirus disease 2019 in the United States, several government agencies and professional societies have issued guidelines to healthcare systems and medical providers. Endoscopy is a substantial portion of the practice of many general surgeons in the United States. With upper endoscopy, manipulation of the upper aerodigestive tract can turn the droplets to an aerosolized form and increase the likelihood of transmission and therefore is considered a high-risk procedure. In this article we review some aspects of the coronavirus disease 2019 outbreak that are relevant to practice of surgical endoscopy. The emphasis of this communication is on the mode of transmission, previous experiences during other coronavirus outbreaks and society guidelines. We then highlight the changes that we have made to our practice to incorporate these factors to improve the safety of patients, health care providers, and community as a whole.