title: COVID-19: A Socio-economic Perspective

text: AbstractThe recent outbreak of the COVID-19 or the coronavirus flu pandemic in the world threatens to derail the very existence of humankind The planet could only ignore the challenges posed by this flu strain to its peril This analysis seeks to locate the pandemic, its challenges and probable solutions within a socio-economic, political and medical sciences perspective The various dimensions of the viral disease ranging from its impact on human societies, body politic, health and economic realms have been discussed and analysed This perspective could be seen in the context of the ongoing debates on the nature and consequences of the crisis, as also the evolving dynamics of the same The article examines the current situation and also factors in any future changes A number of solutions have been offered for an effective tackling of this deadly disease, keeping in mind the global developments All in all, the crisis must serve as an important experience for the entire civilization and imparts lessons in health, social, political and economic spheres


title: Making sense of the U.S. COVID-19 pandemic response: A policy regime perspective

text: On March 26, 2020, 3 months after Chinese authorities admitted to a novel coronavirus outbreak and 10 weeks after the first infection was documented on American soil, the U.S. led the world in COVID-19 cases. While the State Department touted the U.S. as “leading the world’s humanitarian and health assistance response to the COVID-19 pandemic,” media accounts more often applied terms like “muddled” and “confused.” In this essay, we step back to consider what it takes to bring about swift and coordinated action in pandemic response, and what has impeded such a response thus far in U.S. efforts to address COVID-19. Informed by a policy regime perspective, we argue that the response has been handicapped by deficient political commitment and unclear goals, dysfunctional institutional dynamics—from bureaucratic silos to mismatched institutions, and inertia from partisan and economic interests. We conclude that the incoherence of the U.S. response to date has further eroded its already undermined legitimacy, and more importantly, has helped engender negative feedback that threatens the near-term durability of response measures, with grave consequences.


title: Universities urge U.S. leaders to boost science budgets by 15%, ease rules to cope with pandemic

text: The U S research community is urgently asking the White House and Congress to take steps aimed at keeping academic research afloat during the coronavirus pandemic Four organizations representing the nation’s major research institutions and medical schools today wrote to Congressional leaders, urging them to increase research spending at federal science agencies by some 15%, or $13 billion, in order to prevent students and researchers in all scientific disciplines from going broke, to help closed laboratories re-start once the pandemic eases, and to cover other unanticipated costs to the academic research enterprise


title: Getting to zero quickly in the 2019-nCov epidemic with vaccines or rapid testing

text: Any plan for stopping the ongoing 2019-nCov epidemic must be based on a quantitative understanding of the proportion of the at-risk population that needs to be protected by effective control measures in order for transmission to decline sufficiently and quickly enough for the epidemic to end. Using an SEIR-type transmission model, we contrasted two alternate strategies by modeling the proportion of the population that needs to be protected from infection by one-time vaccination (assuming 100% effectiveness) or by testing with isolation and treatment of individuals within six, 24, or 48 hours of symptom onset. If R is currently 2.2, vaccination at the herd immunity coverage of 55% would drive R just below 1, but transmission could persist for years. Over 80% of coverage is required to end the epidemic in 6 months with population-wide vaccination. The epidemic could be ended in just under a year if testing with isolation and treatment reached 80% of symptomatically infected patients within 24 hours of symptom onset (assuming 10% asymptomatic transmission). The epidemic could be ended in six months if testing with isolation and treatment reached 90% of symptomatic patients. If 90% of symptomatic patients could be tested within six hours of symptoms appearing, the epidemic could be ended in under four months.


title: Air Medical Evacuation of Nepalese Citizen During Epidemic of COVID-19 from Wuhan to Nepal

text: In December 2019, the world was disrupted by the news of a new strain of virus known as Novel Corona virus, taking lives of many in China Wuhan, the capital of Central China’s Hubei province is said to be the place where the outbreak started The city went on a lockdown as the disease spread rapidly After the lockdown, most countries like India and Bangladesh airlifted their citizens who were studying in Wuhan Similarly, Nepal also has many youth studying medicine in Wuhan Pleas for help from the students reached the government This was a first encounter of such experience for Nepal government With the help of Health Emergency Organizing committee, Epidemiology and Disease Control Division, Nepal Army Hospital, Nepal Police Hospital, Waste Management team, Nepal Ambulance service, Tribhuwan Airport and Royal Airlines the government of Nepal planned, organized and successfully brought back all the 175 students on 15 the February, 2019 from Wuhan, China The aim of the present article is to share the experience, the challenges faced and recommendations for future similar cases


title: A Mathematical Model Approach for Prevention and Intervention Measures of the COVID-19 Pandemic in Uganda

text: The human-infecting corona virus disease (COVID-19) caused by the novel severe acute respiratory syndrome corona virus 2 (SARS-CoV-2) was declared a global pandemic on March 11th, 2020. Current human deaths due to the infection have raised the threat globally with only 1 African country free of Virus (Lesotho) as of May 6th, 2020. Different countries have adopted different interventions at different stages of the outbreak, with social distancing being the first option while lock down the preferred option for flattening the curve at the peak of the pandemic. Lock down is aimed at adherence to social distancing, preserve the health system and improve survival. We propose a Susceptible-Exposed-Infected-Expected recoveries (SEIR) mathematical model to study the impact of a variety of prevention and control strategies Uganda has applied since the eruption of the pandemic in the country. We analyze the model using available data to find the infection-free, endemic/infection steady states and the basic reproduction number. In addition, a sensitivity analysis done shows that the transmission rate and the rate at which persons acquire the virus, have a positive influence on the basic reproduction number. On other hand the rate of evacuation by rescue ambulance greatly reduces the reproduction number. The results have potential to inform the impact and effect of early strict interventions including lock down in resource limited settings and social distancing


Abstract Purpose: Glucocorticoids are widely used to treat acute respiratory distress syndrome (ARDS) despite its use is highly controversial based on randomized controlled trials and meta-analyses. As type I interferons (IFNs) are our first line of defense against severe viral respiratory infections, we explored whether glucocorticoids interfere with IFN signaling and whether their use associates to outcome of IFN beta treatment of ARDS. Methods: We performed a propensity-matched post-hoc-analysis using data from the recent randomized INTEREST trial comparing IFN beta 1a to placebo in ARDS patients. Based on the results of these analyses we utilized human lung tissue and human pulmonary endothelial cell cultures to investigate the effect of hydrocortisone on IFN nuclear signaling and the protein transcription of CD73, a molecule responsible for vascular integrity. Results: We found that hydrocortisone reduces the production, and prevents the nuclear translocation of IRF9, that is required for IFN beta-dependent signaling of multiple IFN-induced genes. In addition, hydrocortisone inhibits IFN beta dependent upregulation of CD73 in human lung tissue. Additionally, we found that use of glucocorticoids with IFN beta 1a was independently associated with increased mortality (OR 5.4, 95% CI 2.1-13.9, P< 0.001) in the INTEREST-trial. Conclusions: Glucocorticoids inhibit type I IFN beta signaling and the upregulation of CD73 in human lung. This provides the mechanistic basis for the harmful association of glucocorticoids in IFN beta treated patients in the INTEREST-trial. Most importantly, it strongly speaks against the use of glucocorticoids in viral-induced ARDS such as in the currently expanding corona virus outbreak.


title: COVID-19: the key role of pulmonary capillary leakage. An observational cohort study

text: Background: COVID-19 induces progressive hypoxemic respiratory failure and acute respiratory distress syndrome, mostly due to a dysregulated inflammatory response. Since the first observations of COVID-19 patients, significant hypoalbuminemia was detected. This study aimed to investigate the hypothesis that hypoalbuminemia in COVID-19 patients is due to pulmonary capillary leakage and to test its correlation with indicators of respiratory function. Methods: 174 COVID-19 patients, 92 admitted to the Intermediate Medicine ward (IMW), and 82 to the Intensive Care Unit (ICU) at Luigi Sacco Hospital in Milan were included in this study. Findings: Serum albumin concentration was decreased in the whole cohort, with ICU patients displaying lower values than IMW patients [20 (18-23) vs 28 (24-33) g/L, p<0.0001]. Lower albumin values were found in patients belonging to a more compromised group (lower PaO2 to FiO2 ratio and worst chest X-ray findings). In a subset of 26 patients, analysis of bronchoalveolar lavage fluid (BALF) highlighted high protein concentrations, which were correlated to Interleukin-8 and Interleukin-10 BALF concentration. The length of hospitalisation [20 (15-29) vs 8 (5-14) days, p<0.0001] and death rate (52.4% vs 21.7%, p<0.0001) were higher in ICU than in IMW patients, while a strict relation between hypoalbuminemia and 30 day-survival was detected in the whole cohort. Electron microscopy examinations of eight out of ten autopsy lung tissues showed diffuse loosening of interendothelial junctional complex. Interpretation: The degree of hypoalbuminemia can be considered as a useful severity marker in hospitalised COVID-19 patients. Pulmonary capillary leak syndrome secondary to the hyperinflammatory state plays a key role in the pathogenesis of COVID-19 respiratory dysfunction and should be regarded as a therapeutic target.


title: Health Security Intelligence_ engaging across disciplines and sectors

text: This article introduces the Special Issue on Global Health Security. It provides an overview of the health security threat spectrum, tracing how perceptions of biological and health security threats have evolved in broad terms over the last century from deliberately introduced disease outbreaks to also incorporate natural disease outbreaks, unintended consequences of research, laboratory accidents, lack of awareness, negligence, and convergence of emerging technologies. This spectrum of threats has led to an expansion of the stakeholders and tools involved in intelligence gathering and threat assessments. The article argues that to strengthen global health security and health intelligence, the traditional state-based intelligence community must actively engage with non-security stakeholders and incorporate space for new sources of intelligence. The aim of the Special Issue is to contribute to the larger effort of developing a multidisciplinary, empirically informed and policy-relevant approach to intelligence-academia engagement in global health security that serves both the intelligence community and scholars from a broad range of disciplines.


title: SimCOVID: An Open-Source Simulink-Based Program for Simulating the COVID-19 Epidemic

text: This paper presents an open-source computer simulation program developed for simulating, tracking and forecasting the COVID-19 outbreak. The program is built in Simulink with a block diagram display. The mathematical model used in this program is the SIR and SEIRD models represented by a set of differential-algebraic equations. It can be easily modified to develop new models for the problem. The program uses the outbreaks of China and Italy as test models. The infection and recovery rate functions are treated as constant, variable, or a combination of the two. In addition, an adaptive neuro-fuzzy inference system is employed and proposed to train the model and predict its output. The program showed good matching between the simulated and the reported cases and it predicts the final size of the Italy outbreak to be in the range 230,000 to 330,000 infection cases as of July 2020.


title: Evaluating the effect of public health intervention on the global-wide spread trajectory of Covid-19

text: As COVID-19 evolves rapidly, the issues the governments of affected countries facing are whether and when to take public health interventions and what levels of strictness of these interventions should be, as well as when the COVID-19 spread reaches the stopping point after interventions are taken. To help governments with policy-making, we developed modified auto-encoders (MAE) method to forecast spread trajectory of Covid-19 of countries affected, under different levels and timing of intervention strategies. Our analysis showed public health interventions should be executed as soon as possible. Delaying intervention 4 weeks after March 8, 2020 would cause the maximum number of cumulative cases of death increase from 7,174 to 133,608 and the ending points of the epidemic postponed from Jun 25 to Aug 22.


title: Evidence for probable aerosol transmission of SARS-CoV-2 in a poorly ventilated restaurant

text: Background: The role of aerosols in the transmission of SARS-CoV-2 remains debated. We analysed an outbreak involving three non-associated families in Restaurant X in Guangzhou, China, and assessed the possibility of aerosol transmission of SARS-CoV-2 and characterize the associated environmental conditions. Methods: We collected epidemiological data, obtained a video record and a patron seating-arrangement from the restaurant, and measured the dispersion of a warm tracer gas as a surrogate for exhaled droplets from the suspected index patient. Computer simulations were performed to simulate the spread of fine exhaled droplets. We compared the in-room location of subsequently infected cases and spread of the simulated virus-laden aerosol tracer. The ventilation rate was measured using the tracer decay method. Results: Three families (A, B, C), 10 members of which were subsequently found to have been infected with SARS-CoV-2 at this time, or previously, ate lunch at Restaurant X on Chinese New Year's Eve (January 24, 2020) at three neighboring tables. Subsequently, three members of family B and two members of family C became infected with SARS-CoV-2, whereas none of the waiters or 68 patrons at the remaining 15 tables became infected. During this occasion, the ventilation rate was 0.75-1.04 L/s per person. No close contact or fomite contact was observed, aside from back-to-back sitting by some patrons. Our results show that the infection distribution is consistent with a spread pattern representative of exhaled virus-laden aerosols. Conclusions: Aerosol transmission of SARS-CoV-2 due to poor ventilation may explain the community spread of COVID-19.


title: Understanding the Functional Properties of Lipid Heterogeneity in Pulmonary Surfactant Monolayers at the Atomistic Level

text: Pulmonary surfactant is a complex mixture of lipids and proteins lining the interior of the alveoli, and constitutes the first barrier to both oxygen and pathogens as they progress toward blood circulation. Despite decades of study, the behavior of the pulmonary surfactant is poorly understood on the molecular scale, which hinders the development of effective surfactant replacement therapies, useful in the treatment of several lung-related diseases. In this work, we combined all-atom molecular dynamics simulations, Langmuir trough measurements, and AFM imaging to study synthetic four-component lipid monolayers designed to model protein-free pulmonary surfactant. We characterized the structural and dynamic properties of the monolayers with a special focus on lateral heterogeneity. Remarkably, simulations reproduce almost quantitatively the experimental data on pressure–area isotherms and the presence of lateral heterogeneities highlighted by AFM. Quite surprisingly, the pressure–area isotherms do not show a plateau region, despite the presence of liquid-condensed nanometer–sized domains at surface pressures larger than 20 mN/m. In the simulations, the domains were small and transient, but they did not coalesce to yield a separate phase. The liquid–condensed domains were only slightly enriched in DPPC and cholesterol, and their chemical composition remained very similar to the overall composition of the monolayer membrane. Instead, they differed from liquid-expanded regions in terms of membrane thickness (in agreement with AFM data), diffusion rates, acyl chain packing, and orientation. We hypothesize that such lateral heterogeneities are crucial for lung surfactant function, as they allow both efficient packing, to achieve low surface tension, and sufficient fluidity, critical for rapid adsorption to the air–liquid interface during the breathing cycle.


title: Cluster of COVID-19 in northern France: A retrospective closed cohort study

text: Background: The Oise department in France has been heavily affected by COVID-19 in early 2020. Methods: Between 30 March and 4 April 2020, we conducted a retrospective closed cohort study among pupils, their parents and siblings, as well as teachers and non-teaching staff of a high-school located in Oise. Participants completed a questionnaire that covered history of fever and/or respiratory symptoms since 13 January 2020 and had blood tested for the presence of anti-SARS-CoV-2 antibodies. The infection attack rate (IAR) was defined as the proportion of participants with confirmed SARS-CoV-2 infection based on antibody detection. Blood samples from two blood donor centres collected between 23 and 27 March 2020 in the Oise department were also tested for presence of anti-SARS-CoV-2 antibodies. Findings: Of the 661 participants (median age: 37 years), 171 participants had anti-SARS-CoV-2 antibodies. The overall IAR was 25.9% (95% confidence interval (CI) = 22.6-29.4), and the infection fatality rate was 0% (one-sided 97.5% CI = 0-2.1). Nine of the ten participants hospitalised since mid-January were in the infected group, giving a hospitalisation rate of 5.3% (95% CI = 2.4-9.8). Anosmia and ageusia had high positive predictive values for SARS-CoV-2 infection (84.7% and 88.1%, respectively). Smokers had a lower IAR compared to non-smokers (7.2% versus 28.0%, P <0.001). The proportion of infected individuals who had no symptoms during the study period was 17.0% (95% CI = 11.2-23.4). The proportion of donors with anti-SARS-CoV-2 antibodies in two nearby blood banks of the Oise department was 3.0% (95% CI = 1.1-6.4). Interpretation: The relatively low IAR observed in an area where SARS-CoV-2 actively circulated weeks before confinement measures indicates that establishing herd immunity will take time, and that lifting these measures in France will be long and complex.


docid: dzfewoir

title: Characterization of a novel, low-cost, scalable vaporized hydrogen peroxide system for sterilization of N95 respirators and other COVID-19 related personal protective equipment.

text: Due to the virulence of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the pathogen responsible for the respiratory disease termed COVID-19, there has been a significant increase in demand for surgical masks and N95 respirators in medical clinics as well as within communities operating during the COVID-19 epidemic. Thus, community members, business owners, and even medical personnel have resorted to alternative methods for sterilizing face coverings and N95 respirators for reuse. While significant work has shown that vaporized hydrogen peroxide (VHP) can be used to sterilize N95 respirators, the cost and installation time for these sterilization systems limit their accessibility. To this end, we have designed and constructed a novel, cost-effective, and scalable VHP system that can be used to sterilize N95 respirators and other face coverings for clinical and community applications. N95 respirators inoculated with P22 bacteriophage showed a greater than 6-log10 reduction in viral load when sterilized in the VHP system for one 60-minute cycle. Further, N95 respirators treated with 20 cycles in this VHP system showed comparable filtration efficiency to untreated N95 respirators in a 50 to 200 nanometer particulate challenge filtration test. While a 23% average increase in water droplet roll-off time was observed for N95 respirators treated with 5 cycles in the sterilization, no breakdown in fluid resistance was detected. These data suggest that our VHP system is effective in sterilizing N95 respirators and other polypropylene masks for reuse. Relating to the present epidemic, deployment of this system reduces the risk of COVID-19 community transmission while conserving monetary resources otherwise spent on the continuous purchase of disposable N95 respirators and other face coverings. In summary, this novel, scientifically validated sterilization system can be easily built at a low cost and implemented in a wide range of settings.


title: Crushing coronavirus means ‘breaking the habits of a lifetime.’ Behavior scientists have some tips

text: With no vaccine or medication to cope with the novel coronavirus, people around the world have sought—or been ordered to seek—protection by changing the way they act in ways large and small, from their washing hands more frequently to avoiding almost all physical contact Now, government and industry leaders are turning to behavioral scientists for advice on how to persuade their citizens and workers to abide by such dramatic changes To beat the pandemic, we need “a more rapid change of behavior than I can think of in recent human history,” says Robb Willer, a sociologist at Stanford University He recently helped recruit more than 40 top behavioral scientists to summarize their field’s research on how to steer people into certain actions and how it might aid the response to the pandemic


title: Modelling the coronavirus disease (COVID-19) outbreak on the Diamond Princess ship using the public surveillance data from January 20 to February 20, 2020

text: The novel coronavirus disease 2019 (COVID-19) outbreak on the Diamond Princess ship has caused over 634 cases as of February 20, 2020. We model the transmission process on the ship with a stochastic model and estimate the basic reproduction number at 2.2 (95%CI: 2.1−2.4). We estimate a large dispersion parameter than other coronaviruses, which implies that the virus is difficult to go extinction. The epidemic doubling time is at 4.6 days (95%CI: 3.0−9.3), and thus timely actions were crucial. The lesson learnt on the ship is generally applicable in other settings.


docid: dyynuynl

title: An analysis of COVID-19 article dissemination by Twitter compared to citation rates

text: Background: The COVID-19 pandemic has resulted in over 1,000,000 cases across 181 countries worldwide. The global impact of COVID-19 has resulted in a surge of related research. Researchers have turned to social media platforms, namely Twitter, to disseminate their articles. The online database Altmetric is a tool which tracks the social media metrics of articles and is complementary to traditional, citation-based metrics. Citation-based metrics may fail to portray dissemination accurately, due to the lengthy publication process. Altmetrics are not subject to this time-lag, suggesting that they may be an effective marker of research dissemination during the COVID-19 pandemic. Objectives: To assess the dissemination of COVID-19 articles as measured by Twitter dissemination, compared to traditional citation-based metrics, and determine article characteristics associated with tweet rates. Methods: COVID-19 articles obtained from LitCovid published between January 1st to March 18th, 2020 were screened for inclusion. The following article characteristics were extracted independently, in single: Topic (General Info, Mechanism, Diagnosis, Transmission, Treatment, Prevention, Case Report, and Epidemic Forecasting), open access status (open access and subscription-based), continent of corresponding author (Asia, Australia, Africa, North America, South America, and Europe), tweets, and citations. A sign test was used to compare the tweet rate and citation rate per day. A negative binomial regression analysis was conducted to evaluate the association between tweet rate and article characteristics of interest. Results: 1328 articles were included in the analysis. Tweet rates were found to be significantly higher than citation rates for COVID-19 articles, with a median tweet rate of 1.09 (IQR 6.83) tweets per day and median citation rate of 0.00 (IQR 0.00) citations per day, resulting in a median of differences of 1.09 (95% CI 0.86-1.33, P < .001). 2018 journal impact factors were positively correlated with tweet rate (P < .001). The topics Diagnosis (P = .01), Transmission (P < .001), Treatment (P = .01), and Epidemic Forecasting (P < .001) were positively correlated with tweet rate, relative to Case Report. The following continents of the corresponding author were negatively correlated with tweet rate, Africa (P < .001), Australia (P = .03), and South America (P < .001), relative to Asia. Open access journals were negatively correlated with tweet rate, relative to subscription-based journals (P < .001). Conclusions: COVID-19 articles had significantly higher tweets rates compared to citation rates. This study further identified article characteristics that are correlated with the dissemination of articles on Twitter, such as 2018 journal impact factor, continent of the corresponding author, topic, and open access status. This highlights the importance of altmetrics in periods of rapidly expanding research, such as the COVID-19 pandemic to localize highly disseminated articles. Key words: COVID-19; Coronavirus; SARS-CoV-2; Altmetric; Twitter; Tweet; LitCovid; Citation; social media; research


title: Detection and molecular characterization of BCoVs circulating in central China based on the full-length spike gene/ Orta çin’de sığır koronavirusun tam uzunlukta spike genine dayalı tespiti ve moleküler karakterizasyonu

text: Bovine coronavirus (BCoV) is prevalent throughout the world and is an important aetiological agent of diarrhoea in new-born calves. However, little is known about the genetic diversity and molecular epidemiology of BCoV in China. In this study, a total of 127 faecal samples from diarrhoeic dairy calves from nine cities in Henan Province, Central China, were collected between 2017 and 2018 and evaluated by RT-PCR for the N gene. BCoV was detected in 15% (19/127) of calves. In addition, the full-length sequence of the S gene from 13 representative BCoV strains was obtained and analysed. Sequencing results for the full-length S gene showed 97.3-97.5% nucleotide (nt) identity and 96.3-96.8% amino acid (aa) identity with the classical Mebus strain. Phylogenetic analysis based on the full-length S gene showed that the BCoV strains in this study clustered with Vietnamese and Cuban BCoV strains on a large branch of the tree. These results enrich the molecular characterization of the Chinese BCoV strains and provide the first large-scale epidemiological examination of the prevalence of BCoV in diarrhoeic calves in Henan Province, Central China.


OMFS and ENT surgeons issue new COVID-19 PPE guidance


title: Liver injury is associated with severe Coronavirus disease 2019 (COVID‑19) infection: a systematic review and meta-analysis of retrospective studies

text: Aim: The Coronavirus disease 2019 (COVID-19) outbreak is a major threat to human beings. Lung injury has been reported as the major outcome of COVID-19 infection. However, liver damage has also been considered to occur in severe cases. Current meta-analysis of retrospective studies was done to summarize available findings on the association between liver injury and severity of COVID-19 infection. Methods: Online databases including PubMed, Scopus, Web of Science and Cochrane Library were searched to detect relevant publications up to 1 April 2020, using relevant keywords. To pool data, a fixed- or random-effects model was used depending on the heterogeneity between studies. Furthermore, publication bias test and sensitivity analysis were also done. Results: In total, 20 retrospective studies with 3,428 COVID-19 infected patients (severe cases = 1,455 and mild cases = 1,973), were included in this meta-analysis. Higher serum levels of Aspartate aminotransferase (weighted mean difference = 8.84 U/L, 95% CI = 5.97 to 11.71, P<0.001), Alanine aminotransferase (weighted mean difference = 7.35 U/L, 95% CI = 4.77 to 9.93, P<0.001), total Bilirubin (weighted mean difference = 2.30 mmol/L, 95% CI = 1.24 to 3.36, P<0.001) and lower serum levels of Albumin (weighted mean difference = -4.24 g/L, 95% CI = -6.20 to -2.28, P<0.001), were associated with a significant increase in the severity of COVID-19 infection. Conclusions: The incidence of liver injury seems to be higher in patients with severe COVID-19 infection. This finding could help physicians to identify patients with poor prognosis at an early stage.


title: Failed detection of the full-length genome of SARS-CoV-2 by ultra-deep sequencing from the recovered and discharged patients retested viral PCR positive

text: Over 10 percent of recovered and discharged patients retested positive for SARS-CoV-2, raising a public health concern whether they could be potential origins of infection. In this study, we found that detectable viral genome in discharged patients might only mean the presence of viral fragments, and could hardly form an infection origin for its extremely low concentration.


title: Predicting the mortality due to Covid-19 by the next month for Italy, Iran and South Korea; A simulation study

text: Aim: To estimate the number of confirmed cases and the rate of death and also to investigate the cause of death in Italy, Iran and South Korea in the next month. Background: Growing number of confirmed and deaths cases from the coronavirus worldwide, particularly in Italy, Iran and South Korea, has resulted concerns about the future of these countries and their deterioration. Also the European region is likely to face more casualties due to the delay in the virus reaching most of its regions and, of course, as the trend continues. Methods: We conducted a simulation in both current and ideal situation for the next month to predict the death rate and examine the reason for the difference in Italy, Iran and South Korea individually. If we assume the cultural and political factors and age pyramids distribution are similar across regions, the differences are mainly due either to the heavier health-care burden owing to the larger population or to the medical facilities diversities. Results: Our results for Italy showed higher death number, but the rate would be more for Iran. South Korea is also expected to have a smaller increase in the number of confirmed cases and deaths compared to Iran and Italy by the next month. Conclusion: Given the prevailing conditions around the world and the increasing number of casualties, it is essential that all countries, especially those with fewer days of involvement, shall do their best to avoid major losses and damages.


title: SARS-CoV-2 virus and antibodies in front-line Health Care Workers in an acute hospital in London: preliminary results from a longitudinal study

text: Abstract Background SARS-CoV-2 infection in Healthcare Workers (HCWs) is a public health concern during the pandemic. Little description has been made of their antibody response over time in the presence or absence detectable SARS-CoV-2 RNA and of symptoms. We followed a cohort of patient-facing HCWs at an acute hospital in London to measure seroconversion and RNA detection at the peak of the pandemic in London. Methods We enrolled 200 front-line HCWs between 26 March and 8 April 2020 and collected twice-weekly self-administered nose and throat swabs and monthly blood samples. Baseline and regular symptom data were also collected. Swabs were tested for SARS-CoV-2 RNA by polymerase chain reaction, and serum for IgM, IgA and IgG antibodies to the virus spike protein by enzyme-linked immunosorbent assay and flow cytometry. Findings We enrolled HCWs with a variety of roles who worked in areas where COVID-19 patients were admitted and cared for. During the first month of observation, 42/200 (21%) HCWs were PCR positive in at least one nose and throat swab. Only 8/42 HCW (19%) who were PCR positive during the study period had symptoms that met the current case definition. Of 181 HCWs who provided enrollment and follow-up blood samples, 82/181 (45.3%) were seropositive; 36/181 (19.9%) seroconverted during the study and 46/181 (25.4%) were seropositive at both time points. In 33 HCWs who had positive serology at baseline but were PCR negative, 32 remained PCR negative throughout follow-up. One HCW had a PCR positive swab six days after enrollment, likely representing a waning infection. Interpretation The extremely high seropositivity and RNA detection in this cohort of front-line HCWs who worked during the peak of the pandemic brings policies to protect staff and patients in the hospital environment into acute focus. Our findings have implications for planning for the expected second wave and for future vaccination roll out campaigns in similar settings. The further evidence of asymptomatic SARS-CoV-2 infection indicates that asymptomatic surveillance of HCWs is essential while our study sets the foundations to answer pertinent questions around the duration of protective immune response and the risk of re-infection.


title: MARKOVIAN RANDOM WALK MODELING AND VISUALIZATION OF THE EPIDEMIC SPREAD OF COVID-19

text: The epidemic spread of CoVID-19 has resulted in confirmed cases of viral respiratory illness in more than 1.4 million people around the world as of April 7th, 2020. However, different regions have experienced the spread of this disease differently. Here, we develop a Markovian random-walk spatial extension of a quarantine-enhanced SIR model to measure, visualize and forecast the effect of susceptible population density, testing rate, and social distancing and quarantine policies on epidemic spreading. The model is used to simulate the spread of CoVID-19 in the regions of Hubei, China; South Korea; Iran; and Spain. The model allows for evaluating the results of different policies both quantitatively and visually as means of better understanding and controlling the spread of the disease.


title: Estimating the Risks from COVID-19 Infection in Adult Chemotherapy Patients

text: The SARS-CoV-2 (COVID-19) novel coronavirus represents a significant health risk, particularly in older patients. Cancer is one of the leading causes of death in most rich countries, and delivering chemotherapy may be associated with increased risk in the presence of a pandemic infection. Estimating this risk is crucial in making decisions about balancing risks and benefits from administering chemotherapy. However, there are no specific data about chemotherapy risks per se. Here we develop a simple model to estimate the potential harms in patients undergoing chemotherapy during a COVID outbreak. We use age-related case fatality rates as a basis for estimating risk, and use previous data from risk of death during influenza outbreaks to estimate the additional risk associated with chemotherapy. We use data from randomised trials to estimate benefit across a range of curative and palliative settings, and address the balance of benefit against the risk of harm. We then use those data to estimate the impact on national chemotherapy delivery patterns.


title: Personal protective equipment (PPE) in a pandemic: Approaches to PPE preservation for South African healthcare facilities

text: Personal protective equipment (PPE) is key to protecting healthcare workers from COVID-19 infection, but the pandemic has disrupted supply chains globally and necessitated rapid review of the scientific evidence for PPE re-use In South Africa, where the COVID-19 epidemic is still developing, healthcare facilities have a short window of opportunity to improve PPE supply chains, train staff on prudent PPE use, and devise plans to track and manage the inevitable increases in PPE demand This article discusses the available PPE preservation strategies and addresses the issue of decontamination and re-use of N95 respirators as a last-resort strategy for critical shortages during the pandemic


title: Uncanny similarity of unique inserts in the 2019-nCoV spike protein to HIV-1 gp120 and Gag

text: This paper has been withdrawn by its authors. They intend to revise it in response to comments received from the research community on their technical approach and their interpretation of the results. If you have any questions, please contact the corresponding author.


title: Comparison of Four Molecular In Vitro Diagnostic Assays for the Detection of SARS-CoV-2 in Nasopharyngeal Specimens

text: The novel human coronavirus SARS-CoV-2 was first discovered in the city of Wuhan, Hubei province, China, causing an outbreak of pneumonia in January 2020. As of April 10, 2020, the virus has rapidly disseminated to over 200 countries and territories, causing more than 1.6 million confirmed cases of COVID-19 and 97,000 deaths worldwide. The clinical presentation of COVID-19 is fairly non-specific, and symptoms overlap with other seasonal respiratory infections concurrently circulating in the population. Further, it is estimated that up to 80% of infected individuals experience mild symptoms or are asymptomatic, confounding efforts to reliably diagnose COVID-19 empirically. To support infection control measures, there is an urgent need for rapid and accurate molecular diagnostics to identify COVID-19 positive patients. In the present study, we have evaluated the analytical sensitivity and clinical performance of four SARS-CoV-2 molecular diagnostic assays granted Emergency Use Authorization by the FDA using nasopharyngeal swabs from symptomatic patients. This information is crucial for both laboratories and clinical teams, as decisions on which testing platform to implement are made.


title: Role of tool-substrate gap in the micro-holes formation by electrochemical discharge machining

text: Abstract Electrochemical discharge machining (ECDM) is an efficient micro-machining technique for fabricating hard to machine materials such as glass, alumina, zirconia, etc. Glass based substrates have many applications in the field of MEMS and microfluidic systems. The tool-substrate gap is one of the important process parameters which affects ECD machining characteristics such as micro-feature overcut, width, depth, etc. The reported work investigates the effect of the tool-substrate gap on the ECD machining performance with NaOH and KOH electrolytes. A tapered tool with 130 µm average tip size was used to create blind micro-holes in glass substrate with varying tool-substrate gap and machining time. Numerical and experimental results showed a similar decreasing trend of the depth of blind holes as the tool-substrate gap increases. Higher overcut was observed in the case of a tool-substrate gap of 20 µm in the NaOH electrolyte and 10 µm in the KOH electrolyte. The maximum tool-substrate gap up to which machining happened was observed to be 60 µm and 30 µm in the case of the NaOH and KOH electrolytes, respectively. Tool wear was found to be higher when the tool was in physical contact and when the NaOH electrolyte was used for a machining duration of 60s.


title: Structural analysis of SARS-CoV-2 and predictions of the human interactome

text: Specific elements of viral genomes regulate interactions within host cells. Here, we calculated the secondary structure content of >2500 coronaviruses and computed >100000 human protein interactions with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). We found that the 3’ and 5’ are the most structured elements in the viral genome and the 5’ has the strongest propensity to associate with human proteins. The domain encompassing nucleotides 23000 – 24000 is highly conserved both at the sequence and structural level, while the region upstream varies significantly. These two sequences code for a domain of the viral protein Spike S that interacts with the human receptor angiotensin-converting enzyme 2 (ACE2) and has the potential to bind sialic acids. Our predictions indicate that the first 1000 nucleotides in the 5’ can interact with proteins involved in viral RNA processing such as double-stranded RNA specific editases and ATP-dependent RNA-helicases, in addition to other high-confidence candidate partners. These interactions, previously reported to be also implicated in HIV, reveal important information on hostvirus interactions. The list of transcriptional and post-transcriptional elements recruited by SARS-CoV-2 genome provides clues on the biological pathways associated with gene expression changes in human cells.


title: A socio-technical transitions perspective for assessing future sustainability following the COVID-19 pandemic

text: This policy brief argues that the COVID-19 pandemic exposes the fractures in the contemporary global socio-technical order and offers the prospects of several different alternative futures. The policy brief explores the pandemic through the lens of the multi-level perspective on socio-technical transitions. The pandemic is framed as a meta-transition event at the landscape level of unprecedented scale, pace, and pervasiveness such that it permeates all socio-technical regimes simultaneously. The prospects for the future are then defined on a matrix that compares the strength of civil society and that of economic structures. The result is four distinct scenarios that are linked to contemporary discourses on socio-economic futures: business as usual; managed transition; chaotic transition; and managed degrowth. The scenarios are presented as a starting point for policy discussion and the engagement of societal actors to define social and economic possibilities for the future, and the implications that the different futures would have for ecological burdens. It is concluded that the COVID 19 pandemic can act as a catalytic event in which the legitimacy and efficacy of existing economic and political structures will be challenged and reshaped, and hence is an opportunity to redefine the ecological burdens our activities create.


News: 10 Lessons for COVID-19 ED Operations


title: Whole Genome Sequencing of SARS-CoV-2: Adapting Illumina Protocols for Quick and Accurate Outbreak Investigation During a Pandemic

text: The COVID-19 pandemic spread very fast around the world. A few days after the first detected case in South Africa, an infection started a large hospital outbreak in Durban, KwaZulu-Natal. Phylogenetic analysis of SARS-CoV-2 genomes can be used to trace the path of transmission within a hospital. It can also identify the source of the outbreak and provide lessons to improve infection prevention and control strategies. In this manuscript, we outline the obstacles we encountered in order to genotype SARS-CoV-2 in real-time during an urgent outbreak investigation. In this process, we encountered problems with the length of the original genotyping protocol, reagent stockout and sample degradation and storage. However, we managed to set up three different library preparation methods for sequencing in Illumina. We also managed to decrease the hands on library preparation time from twelve to three hours, which allowed us to complete the outbreak investigation in just a few weeks. We also fine-tuned a simple bioinformatics workflow for the assembly of high-quality genomes in real-time. In order to allow other laboratories to learn from our experience, we released all of the library preparation and bioinformatics protocols publicly and distributed them to other laboratories of the South African Network for Genomics Surveillance (SANGS) consortium.


title: Clinical Characteristics of Recurrent-positive Coronavirus Disease 2019 after Curative Discharge: a retrospective analysis of 15 cases in Wuhan China

text: In China, the patients with previously negative RT-PCR results again test positive during the post-discharge isolation period. We aimed to determine the clinical characteristics of these recurrent-positive patients. We retrospectively reviewed the data of 15 recurrent-positive patients and 107 control patients with non-recurrent, moderate COVID-19 treated in Wuhan, China. Clinical data and laboratory results were comparatively analyzed. We found that recurrent-positive patients had moderate disease. The rate of recurrent-positive disease in our hospital was 1.87%. Recurrent-positive patients were significantly younger (43(35-54) years) than control patients (60(43-69) years) (P=0.011). The early LOS (length of stay in hospital before recurrence) was significantly longer in recurrent-positive patients (36(34-45) days) than in control patients (15(7-30) days) (P =0.001). The time required for the first conversion of RT-PCR results from positive to negative was significantly longer in recurrent-positive patients (14(10-17) days) than in control patients (6(3-9) days) (P =0.011). Serum COVID-19 antibody levels were significantly lower in recurrent-positive patients than in control patients (IgM: 13.69 {+/-} 4.38 vs. 68.10 {+/-} 20.85 AU/mL, P = 0.015; IgG: 78.53 {+/-} 9.30 vs. 147.85 {+/-} 13.33 AU/mL, P < 0.0001). Recurrent-positive patients were younger than control patients. The early LOS (length of stay in hospital before recurrence) was significantly longer in recurrent-positive group than that in control group. COVID-19 IgM/IgG antibody levels were significantly lower in recurrent-positive group than those in control group, which might explain why the virus RNA RT-PCR was positive after the initial clinical cure(with three times of virus RNA RT-PCR negative). The virus might not be fully eliminated because of the lower IgG level and their later replicating might result in recurrent-positive virus RNA RT-PCR.


COVID Operation Theatre- Advisory and Position Statement of Indian Society of Anaesthesiologists (ISA National)


title: Understanding the Mosaic of COVID-19: A Review of the Ongoing Crisis

text: In late 2019, a queer type of pneumonia emerged in Wuhan city in the central part of China. On investigation, it was found to be caused by the coronavirus. Human coronaviruses were discovered in the 1960s. There are a total of seven types of coronaviruses that infect humans: 229E and NL63 are the alpha coronaviruses; OC43, HKU1, MERS-CoV, and SARS-CoV are beta coronaviruses, and SARS-CoV-2 or COVID-19 is a novel coronavirus. COVID-19 surfaced in China at the culmination of the year 2019. The pandemic then fanned out rapidly, involving Italy, Japan, South Korea, Iran, and the rest of the world.


title: Optimization of Microbiological Laboratory Detection Strategy for Patients in A Designated Hospital Treating Novel Coronavirus Pneumonia in Anhui Province

text: Novel coronavirus pneumonia (NCP) is an emerging, highly contagious community acquired pneumonia (CAP) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). Highly efficient and accurate microbiological laboratory assay is essential to confirm the SARS-CoV-2 infection, rule out other pathogens that can cause CAP, and monitor secondary infections. Here, we enrolled and provide microbiological analysis for 129 suspected and 52 transferred confirmed NCP patients hospitalized in the First Affiliated Hospital of University of Science and Technology of China (USTC) from Jan 21 to Feb 29, 2020. By analyzing the dual swab samples (sputum and pharyngeal) from 129 suspected patients with realtime RT-PCR, we confirmed 33 SARS-CoV-2 infections, with two co-infection cases with adenovirus or rhinovirus. We also used multiplex PCR to detect 13 common respiratory tract pathogens in 96 non-NCP patients, and found that 30 patients (31.25%) were infected with at least one respiratory tract pathogen that may cause CAP. Further, we performed bacterial and fungal cultures as well as fungal serologic tests and found that there is no secondary bacterial/fungal infections in confirmed NCP patients. Our studies suggest that, during the epidemic of NCP in Anhui province, there was a certain proportion of infection and co-infection of other common pathogens of CAP, and the secondary bacterial and fungal infection is not detectable in NCP patients. In comparison with SARS-CoV-2 detection alone, this optimized strategy combining multiple pathogen detection for identification of NCP and other CAP patients as well as cultures and serologic tests for confirmed patients increases the diagnosis efficiency and facilitates the personalized medication.


Coronavirus disease 2019 (COVID-19) pandemic burst and its relevant consequences in dental practice


Teleaudiology: Strategies, considerations during a crisis and beyond


docid: ftbnmwet

title: Monitoring the Covid-19 epidemics in Italy from mortality data

text: The mortality data can be used as an alternative source to monitor the status of Covid-19. We have studied a dataset including deaths up to the fourth week of April. There is a large excess, more pronounced at the beginning of the pandemic, showing a difference in age and gender compared to the Covid-19-confirmed cases. The study indicates that mortality information can be used to provide a less biased time profile of the pandemic.


title: Assessing the impact of reduced travel on exportation dynamics of novel coronavirus infection (COVID-19)

text: The impact of the drastic reduction in travel volume within mainland China in January and February 2020 was quantified with respect to reports of novel coronavirus (COVID-19) infections outside China. Data on confirmed cases diagnosed outside China were analyzed using statistical models to estimate the impact of travel reduction on three epidemiological outcome measures: (i) the number of exported cases, (ii) the probability of a major epidemic, and (iii) the time delay to a major epidemic. From 28 January to 7 February 2020, we estimated that 226 exported cases (95% confidence interval: 86, 449) were prevented, corresponding to a 70.4% reduction in incidence compared to the counterfactual scenario. The reduced probability of a major epidemic ranged from 7% to 20% in Japan, which resulted in a median time delay to a major epidemic of two days. Depending on the scenario, the estimated delay may be less than one day. As the delay is small, the decision to control travel volume through restrictions on freedom of movement should be balanced between the resulting estimated epidemiological impact and predicted economic fallout.


docid: qcgttpqq

title: County-Level Proportions of Black and Hispanic populations, and Socioeconomic Characteristics in Association with Confirmed COVID-19 Cases and Deaths in the United States

text: Objectives. The objective of this study was to investigate potential county-level disparities among racial/ethnic and economic groups in COVID-19 burden which was measured using confirmed cases and deaths in 100,000 population. Design. Secondary data analysis Using county-level data for 3,142 US counties was conducted in 2020. Hierarchical linear regression and concentration curve analyses were performed. The combined association of COVID-19 cases and deaths was examined separately by sociodemographic and economic characteristics of the county population. Data from the American Community Survey (ACS) 5-year estimates (2014-2018), Area Health Resources File (AHRF) 2018-2019, and 2020 COVID-19 data from Johns Hopkins University were used in this study. Results. After adjusting for covariates, US counties with a higher proportion of the black population, and a higher proportion of adults with less than high school diploma had disproportionately higher COVID-19 cases and deaths ({beta}>0, p<0.05). A higher proportion of the Hispanic population was associated with higher confirmed cases ({beta}= 1.03, 95% CI= 0.57-1.5), and higher housing cost to household income ratio was associated with higher deaths ({beta}= 3.74, 95% CI= 2.14-5.37). This can potentially aggravate the existing health disparities among these population groups. Conclusions. Identification of disproportionately impacted population groups can pave the way towards narrowing the disparity gaps and guide policymakers and stakeholders in designing and implementing population group-specific interventions to mitigate the negative consequences of COVID-19 pandemic.


title: Demonstration of four entities of appendicitis in China through studying cluster/outbreak

text: Objective: To differentiate different entities of appendicitis through studying cluster/outbreak, ascertain common setting of cluster/outbreak, and provide the epidemiological evidences of infectious etiology of appendicitis. Background: Differential diagnosis and management for perforated appendicitis and non-perforated appendicitis and the infectious etiology of appendicitis are current hot topics. Methods: Field investigation for Tibetan students were carried out and reports published in English and Chinese medical journals were reviewed. Results: The literature review included 473 patients in 7 cluster/outbreaks of appendicitis in 6 provinces and autonomous regions. All the clusters/outbreaks occurred in group living units. We found two classic entities of appendicitis with natural history from non perforated appendicitis to perforated appendicitis and two entities of non-perforated appendicitis . In classic entities, one may represent majority of sporadic patients and the other may represent partial sporadic patients with obvious gastrointestinal manifestation. In entities of non-perforated appendicitis, one was identical to features of sporadic non-perforated appendicitis and the other one is identical to the following Tibetan students and associated with Fusobacterium. The field investigation for 120 Tibetan students with appendicitis showed that the resected appendices exhibited diffuse or focal hemorrhages and infiltration by eosinophils and by lymphocytes. Most patients had normal body temperature, white blood cell count and neutrophil count. This is a new entity of appendicitis. The clusters/outbreaks of appendicitis showed the features of infectious disease in epidemiology. The entity of perforated appendicitis was not found. Conclusion: Studying cluster/outbreak is a good method to differentiate different entities of appendicitis and infectious etiology.


title: Defining the Pandemic at the State Level: Sequence-Based Epidemiology of the SARS-CoV-2 virus by the Arizona COVID-19 Genomics Union (ACGU)

text: In December of 2019, a novel coronavirus, SARS-CoV-2, emerged in the city of Wuhan, China causing severe morbidity and mortality. Since then, the virus has swept across the globe causing millions of confirmed infections and hundreds of thousands of deaths. To better understand the nature of the pandemic and the introduction and spread of the virus in Arizona, we sequenced viral genomes from clinical samples tested at the TGen North Clinical Laboratory, provided to us by the Arizona Department of Health Services, and at Arizona State University and the University of Arizona, collected as part of community surveillance projects. Phylogenetic analysis of 79 genomes we generated from across Arizona revealed a minimum of 9 distinct introductions throughout February and March. We show that >80% of our sequences descend from clades that were initially circulating widely in Europe but have since dominated the outbreak in the United States. In addition, we show that the first reported case of community transmission in Arizona descended from the Washington state outbreak that was discovered in late February. Notably, none of the observed transmission clusters are epidemiologically linked to the original travel-related cases in the state, suggesting successful early isolation and quarantine. Finally, we use molecular clock analyses to demonstrate a lack of identifiable, widespread cryptic transmission in Arizona prior to the middle of February 2020.


title: PC-FACS May 2020 for July 2020 Issue

text: PC-FACS (Fast Article Critical Summaries for Clinicians in Palliative Care) provides hospice and palliative care clinicians with concise summaries of the most important findings from more than 100 medical and scientific journals. If you have colleagues who would benefit from receiving PCFACS, please encourage them to join the AAHPM at aahpm.org. Comments from readers are welcomed at pcfacs@aahpm.org.


Basismaßnahmen zur Wiederbelebung Erwachsener: COVID-19-Leitlinien des European Resuscitation Council


title: Influence of cutting fluid application frequency on the surface quality of micromilled slots on Inconel 718 alloy

text: Abstract Micromilling is a machining process defined by its low dimensions. In general, it is defined by the cutting tool diameter that must vary between 1 µm and 1000 µm. This process is used mostly in molds, medical applications and Micro-Electromechanical Systems (MEMS), where high quality parts are required in terms of geometry, which are absent of defects and possess smooth surfaces. However, there exist hurdles that need to be crossed in order to achieve these high-quality parts, most frequently surface roughness and the presence of burrs. For such phenomena, one common solution is the appliance of cutting fluids. To this end, some research studies have been developed, these have placed their focus upon the different composition of cutting fluid, which is applied with different pressures and at different rates. The application of cutting fluid can be made through pulses, as this is a common configuration for the MQL fluid supplier. The frequency of pulses defines the volume of cutting fluid applied and consequently affects the results. In this sense, this study aims to evaluate the influence of the frequency of cutting fluid application over the final part of the cutting process. The results demonstrated that for the difficult to cut Inconel 718, if a low frequency of fluid, delivered by MQL, is applied, the final piece will not be homogeneous, as well as leaving parts with a low surface quality and higher burr formation.


title: COVID-19, City Lockdown, and Air Pollution: Evidence from China

text: The rapid spread of COVID-19 is a global public health challenge. To prevent the escalation of its transmission, China locked down one-third of its cities and strictly restricted human mobility and economic activities. Using timely and comprehensive air quality data in China, we show that these counter-COVID-19 measures led to remarkable improvement in air quality. Within weeks, the Air Quality Index and PM2.5 concentrations were brought down by 25%. The effects are larger in colder, richer, and more industrialized cities. We estimate that such improvement would avert 24,000 to 36,000 premature deaths from air pollution on a monthly basis.


Staring down the barrel of COVID-19


title: Simulating the Spread of Epidemics in China on the Multi-layer Transportation Network: Beyond the Coronavirus in Wuhan

text: Based on the SEIR model and the modeling of urban transportation networks, a general-purpose simulator for the spread of epidemics in Chinese cities is built. The Chinese public transportation system between over 340 prefectural-level cities is modeled as a multi-layer bi-partite network, with layers representing different means of transportation (airlines, railways, sail routes and buses), and nodes divided into two categories (central cities, peripheral cities). At each city, an open-system SEIR model tracks the local spread of the disease, with population in- and out-flow exchanging with the overlying transportation network. The model accounts for (1) different transmissivities of the epidemic on different transportation media, (2) the transit of inbound flow at cities, (3) cross-infection on public transportation vehicles due to path overlap, and the realistic considerations that (4) the infected population are not entering public transportation and (5) the recovered population are not subject to repeated infections. The model could be used to simulate the city-level spread in China (and potentially other countries) of an arbitrary epidemic, characterized by its basic reproduction number, incubation period, infection period and zoonotic force, originated from any Chinese prefectural-level city(s), during the period before effective government interventions are implemented. Flowmaps are input into the system to trigger inter-city dynamics, assuming different flow strength, determined from empirical observation, within/between the bi-partite divisions of nodes. The model is used to simulate the 2019 Coronavirus epidemic in Wuhan; it shows that the framework is robust and reliable, and simulated results match public city-level datasets to an extraordinary extent.


title: Transmission of Respiratory Infectious Diseases between Neighboring Cities using Agent-based Model and Compartmental Model

text: We formulate an agent-based model and a compartmental model (SEIR) that simulate the spread of a respiratory infectious disease between two neighboring cities. We consider preventive measures such as implementation of social distancing and lockdown in a city, as well as the effect of protective gears or practices. The chance of travelling to another city and within the city during lockdown, and initial percentage of exposed and infected individuals on both cities influence the increase in the number of newly-infected individuals on both models. Our simulations show that (i) increase in exposed individuals results in increase in number of new infections, hence the need for increased testing-isolation efforts; (ii) protection level of 75-100% effectiveness impedes disease transmission; (iii) travelling within city or to other city can be an option given that strict preventive measures (e.g., non-pharmaceutical interventions) are observed; and (iv) the ideal set-up for neighboring cities is to implement lockdown when there is high risk of disease local transmission while individuals observe social distancing, maximizing protective measures, and isolating those that are exposed. The results of the agent-based and compartmental models show similar qualitative dynamics; the differences are due to different spatio-temporal heterogeneity and stochasticity. These models can aid decision makers in designing infectious disease-related policies to protect individuals while continuing population movement.


title: An international comparison of the second derivative of COVID-19 deaths after implementation of social distancing measures

text: This work compares deaths for confirmed COVID-19 cases in China to eight other countries, Italy, Spain, France, USA, UK, Germany, Netherlands and South Korea. After implementing varying intensities and timing of social distancing measures, several appear to be converging onto the decline in the daily growth rate of deaths, or relative second derivative of total deaths, seen in China after the implementation an aggressive social distancing policy. By calculating future trajectories in these countries based on the observed Chinese fatality statistics, an estimate of the total deaths and maximum daily death rates over a defined period of time is made. Our lower bound estimate for the United Kingdom based on the real data approximates the lower bound estimate of the recent modelling study of Ferguson et al. [1]. These results suggest there may be a threshold of effective public health intervention. Our method of viewing the data may be helpful in monitoring the course of the epidemic, judging the effectiveness of implementation, and monitoring the relaxation of social distancing.


title: A Highly Immunogenic Measles Virus-based Th1-biased COVID-19 Vaccine

text: The COVID-19 pandemic is caused by severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2) and has spread world-wide with millions of cases and hundreds of thousands of deaths to date. The gravity of the situation mandates accelerated efforts to identify safe and effective vaccines. Here, we generated measles virus (MeV)-based vaccine candidates expressing the SARS-CoV-2 spike glycoprotein (S). Insertion of the full-length S protein gene in two different MeV genomic positions resulted in modulated S protein expression. The variant with lower S protein expression levels was genetically stable and induced high levels of effective Th1-biased antibody and T cell responses in mice after two immunizations. In addition to neutralizing IgG antibody responses in a protective range, multifunctional CD8+ and CD4+ T cell responses with S protein-specific killing activity were detected. These results are highly encouraging and support further development of MeV-based COVID-19 vaccines. Author Contributions CH performed research, analyzed data, and wrote the paper; CS performed research and analyzed data; AA performed research and analyzed data; AE performed research and analyzed data; SM performed research, analyzed data, and wrote the paper; MH developed the bioinformatics pipeline and analyzed data; BS contributed new reagents and concepts; MDM designed and supervised research, analyzed data and wrote the paper; all authors read, corrected and approved the final manuscript. Significance Statement The COVID-19 pandemic has caused hundreds of thousands of deaths, yet. Therefore, effective vaccine concepts are urgently needed. In search for such a concept, we have analysed a measles virus-based vaccine candidate targeting SARS-CoV-2. Using this well known, safe vaccine backbone, we demonstrate here induction of functional immune responses in both arms of adaptive immunity with the desired immune bias. Therefore, occurrence of immunopathologies such as antibody-dependent enhancement or enhanced respiratory disease is rather unlikely. Moreover, the candidate still induces immunity against the measles, recognized as a looming second menace, when countries are entrapped to stop routine vaccination campaigns in the face of COVID-19. Thus, a bivalent measles-based COVID-19 vaccine could be the solution for two significant public health threats.


title: Pandemics, transformations and tourism: be careful what you wish for

text: Disease outbreaks and pandemics have long played a role in societal and economic change However, the nature of such change is selective, meaning that it is sometimes minimal and, at other times, a


title: Time delay epidemic model for COVID-19

text: A time delay epidemic model is presented for the spread of the Coronavirus 2019 (COVID-19) in China. The time delay effects affect infected individuals. Monte Carlo simulation is performed to estimate the transmission and recovery rates. The basic reproduction number is estimated in terms of the average infected ratio. This ratio can be used to monitor the policy performance of disease control during the spread of the disease.


docid: ortraqpz

title: List of Credits

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title: Co-occurrence of SARS-CoV-2 and Respiratory Pathogens in the Frail Elderly

text: Background: Elderly SARS-CoV-2 patients are associated with higher hospitalization and mortality. Co-infection is critical in the severity of respiratory diseases. It is largely understudied for SARS-CoV-2. Methods: Between March 24th and April 27th, 2020, nasopharyngeal and oropharyngeal swabs from 3,348 patients from nursing homes and assisted living facilities in 22 states in the US were tested by Capstone Healthcare for SARS-CoV-2, 24 other respiratory viruses, and 8 respiratory bacteria. Total nucleic acid was extracted with MagMAXTM Viral/Pathogen Ultra nucleic acid isolation kit. SARS-Co-V-2 was detected with the CDC 2019-novel coronavirus (2019-nCoV) diagnostic panel. Total nucleic acid was pre-amplified before analysis for other respiratory pathogens with Taqman OpenArrayTM Respiratory Tract Microbiota Plate. Results: Patients mean age was 76.9 years. SARS-CoV-2 was detected in 1,413 patients (42.2%). Among them, 1,082 (76.6%) and 737 (43.7%) patients were detected with at least one bacterium or another virus, respectively. SARS-CoV-2-positive patients were more likely to have bacterial co-occurrences (76.6%) than SARS-CoV-2-negative patients (70.0%) (p<0.0001). The most common co-occurring bacteria were Staphylococcus aureus and Klebsiella pneumonia, detected in 55.8% and 40.1% SARS-CoV-2-positive patients, respectively. Staphylococcus aureus was associated with SARS-CoV-2, with higher detection rates in SARS-CoV-2-positive patients (55.8%) than SARS-CoV-2-negative patients (46.2%) (p<0.0001). Human herpes virus 6 (HHV6) also was common and associated with SARS-CoV-2, with higher detection rates in SARS-CoV-2-positive patients (26.6%) than SARS-CoV-2-negative patients (19.1%) (p<0.0001). Conclusions: SARS-CoV-2-positive patients are more likely to be positive for certain respiratory bacteria and viruses. This observation may help explain high hospitalization and mortality rates in older patients.


title: A Social Network Model of the COVID-19 Pandemic

text: In the COVID-19 coronavirus pandemic, currently vaccines and specific anti-viral treatment are not yet available. Thus, preventing viral transmission by case isolation, quarantine, and social distancing is essential to slowing its spread. Here we model social networks using weighted graphs, where vertices represent individuals and edges represent contact. As public health measures are implemented, connectivity in the graph decreases, resulting in lower effective reproductive numbers, and reduced viral transmission. For COVID-19, model parameters were derived from the coronavirus epidemic in China, validated by epidemic data in Italy, then applied to the United States. We calculate that, in the U.S., the public is able to contain viral transmission by limiting the average number of contacts per person to less than 7 unique individuals over each 5 day period. This increases the average social distance between individuals to 10 degrees of separation.


title: Capsaicin and its analogues impede nocifensive response of Caenorhabditis elegans to noxious heat

text: Capsaicin is the most abundant pungent molecule identified in red chili peppers, and it is widely used for food flavoring, in pepper spray for self-defense devices and recently in ointments for the relief of neuropathic pain. Capsaicin and several other related vanilloid compounds are secondary plant metabolites. Capsaicin is a selective agonist of the transient receptor potential channel, vanilloid subfamily member 1 (TRPV1). After exposition to vanilloid solution, C. elegans wild type (N2) and mutants were placed on petri dishes divided in quadrants for heat stimulation. Thermal avoidance index was used to phenotype each tested C. elegans experimental groups. The data revealed for the first-time that capsaicin can impede nocifensive response of C. elegans to noxious heat (32°C – 35°C) following a sustained exposition. The effect was reversed 6h post capsaicin exposition. Additionally, we identified the capsaicin target, the C. elegans transient receptor potential channel OCR-2. Further experiments also undoubtedly revealed anti-nociceptive effect for capsaicin analogues, including ginger (Zingiber officinale) and turmeric (Curcuma longa) secondary metabolites.


title: COVID-19 Outcomes in 4712 consecutively confirmed SARS-CoV2 cases in the city of Madrid.

text: There is limited information describing features and outcomes of patients requiring hospitalization for COVID19 disease and still no treatments have clearly demonstrated efficacy. Demographics and clinical variables on admission, as well as laboratory markers and therapeutic interventions were extracted from electronic Clinical Records (eCR) in 4712 SARS-CoV2 infected patients attending 4 public Hospitals in Madrid. Patients were stratified according to age and stage of severity. Using multivariate logistic regression analysis, cut-off points that best discriminated mortality were obtained for each of the studied variables. Principal components analysis and a neural network (NN) algorithm were applied. A high mortality incidence associated to age >70, comorbidities (hypertension, neurological disorders and diabetes), altered vitals such as fever, heart rhythm disturbances or elevated systolic blood pressure, and alterations in several laboratory tests. Remarkably, analysis of therapeutic options either taken individually or in combination drew a universal relationship between the use of Cyclosporine A and better outcomes as also a benefit of tocilizumab and/or corticosteroids in critically ill patients. We present a large Spanish population-based study addressing factors influencing survival in current SARS CoV2 pandemic, with particular emphasis on the effectivity of treatments. In addition, we have generated an NN capable of identifying severity predictors of SARS CoV2. A rapid extraction and management of data protocol from eCR and artificial intelligence in-house implementations allowed us to perform almost real time monitoring of the outbreak evolution.


title: The majority of male patients with COVID-19 present low testosterone levels on admission to Intensive Care in Hamburg, Germany: a retrospective cohort study.

text: Background. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) continues to spread worldwide and pose a major public health burden. There is increasing evidence that men are more likely to die from SARS-CoV-2 infection than women. However, underlying factors that mediate the observed sex bias in coronavirus disease 2019 (COVID-19) remain unknown. Methods. In this retrospective cohort, we included COVID-19 patients who were admitted to an Intensive Care Unit at the University Hospital Hamburg-Eppendorf, Germany. We obtained demographic data of all patients who were discharged or had died by 29th April 2020. We systematically analyzed sex hormones as well as cytokine and chemokine responses in male and female patients with laboratory-confirmed SARS-CoV-2 infections upon hospital admission. We used uni- and multivariable linear regression methods to identify potential risk factors for disease severity in males and females. Findings. All enrolled patients (n=45; n=35 males and n=10 females) presented comorbidities with hypertension being the most common (45.7% in males; 40% in females), followed by cancer (35% in males; 40% in females), obesity (34.3% in males and 30% in females), type II diabetes (25.7% in males and 20% in females) and chronic heart diseases (8.6% in males and 0% in females). We detected that the vast majority of male COVID-19 patients present low testosterone (68.6%) and low dihydrotestosterone (48.6%) levels. In contrast, most female COVID-19 patients have elevated testosterone levels (60%) without alterations in dihydrotestosterone levels. Both, female and male COVID-19 patients may present elevated estradiol levels (45.7% in males and 40% in females). Disease severity defined by SOFA score correlates with elevated cytokine responses (e.g. IL-6) in males and IL-2 in females. In male COVID-19 patients, testosterone levels negatively correlate with inflammatory IL-2 and IFN-{gamma}, whereas estradiol levels positively correlate with the inflammatory cytokine IL-6. Vice versa, in female COVID-19 patients, testosterone levels positively correlate with inflammatory cytokines (e.g. IL-6). Interpretation. We here show that critically ill male COVID-19 patients suffer from severe testosterone and dihydrotestosterone deficiencies. Both androgens are required to mount antiviral immune responses to combat infection in males.


docid: rlsdznmv

title: Monitoring Disease Transmissibility of 2019 Novel Coronavirus Disease in Zhejiang, China

text: We monitored the transmissibility of 2019 novel coronavirus disease in Zhejiang accounting the transmissions from imported cases. Even though Zhejiang is one of the worst-affected provinces, an interruption of disease transmission (i.e. instantaneous reproduction numbers <1) was observed in early/mid-February after an early social-distancing response to the outbreak.


title: Structural analysis of the SARS-CoV-2 methyltransferase complex involved in coronaviral RNA cap creation

text: COVID-19 pandemic is caused by the SARS-CoV-2 virus that has several enzymes that could be targeted by antivirals including a 2’-O RNA methyltransferase (MTase) that is involved in the viral RNA cap formation; an essential process for RNA stability. This MTase is composed of two nonstructural proteins, the nsp16 catalytic subunit and the activating nsp10 protein. We have solved the crystal structure of the nsp10-nsp16 complex bound to the pan-MTase inhibitor sinefungin in the active site. Based on the structural data we built a model of the MTase in complex with RNA that illustrates the catalytic reaction. A structural comparison to the Zika MTase revealed low conservation of the catalytic site between these two RNA viruses suggesting preparation of inhibitors targeting both these viruses will be very difficult. Together, our data will provide the information needed for structure-based drug design.


title: Neutrophilia and NETopathy as Key Pathologic Drivers of Progressive Lung Impairment in Patients With COVID-19

text: There is an urgent need for new therapeutic strategies to contain the spread of the novel coronavirus disease 2019 (COVID-19) and to curtail its most severe complications. Severely ill patients experience pathologic manifestations of acute respiratory distress syndrome (ARDS), and clinical reports demonstrate striking neutrophilia, elevated levels of multiple cytokines, and an exaggerated inflammatory response in fatal COVID-19. Mechanical respirator devices are the most widely applied therapy for ARDS in COVID-19, yet mechanical ventilation achieves strikingly poor survival. Many patients, who recover, experience impaired cognition or physical disability. In this review, we argue the need to develop therapies aimed at inhibiting neutrophil recruitment, activation, degranulation, and neutrophil extracellular trap (NET) release. Moreover, we suggest that currently available pharmacologic approaches should be tested as treatments for ARDS in COVID-19. In our view, targeting host-mediated immunopathology holds promise to alleviate progressive pathologic complications of ARDS and reduce morbidities and mortalities in severely ill patients with COVID-19.


title: Neuropilin-1 is a host factor for SARS-CoV-2 infection

text: SARS-CoV-2 is the causative agent of COVID-19, a coronavirus disease that has infected more than 6.6 million people and caused over 390,000 deaths worldwide1,2. The Spike (S) protein of the virus forms projections on the virion surface responsible for host cell attachment and penetration. This viral glycoprotein is synthesized as a precursor in infected cells and, to be active, must be cleaved to two associated polypeptides: S1 and S2(3,4). For SARS-CoV-2 the cleavage is catalysed by furin, a host cell protease, which cleaves the S protein precursor at a specific sequence motif that generates a polybasic Arg-Arg-Ala-Arg (RRAR) C-terminal sequence on S1. This sequence motif conforms to the C-end rule (CendR), which means that the C-terminal sequence may allow the protein to associate with cell surface neuropilin-1 (NRP1) and neuropilin-2 (NRP2) receptors5. Here we demonstrate using immunoprecipitation, site-specific mutagenesis, structural modelling, and antibody blockade that, in addition to engaging the known receptor ACE2, S1 can bind to NRP1 through the canonical CendR mechanism. This interaction enhances infection by SARS-CoV-2 in cell culture. NRP1 thus serves as a host factor for SARS-CoV-2 infection, and provides a therapeutic target for COVID-19.


title: A Poorly Understood Disease? The Unequal Distribution of Excess Mortality Due to COVID-19 Across French Municipalities

text: While COVID-19 was already responsible for more than 500,000 deaths worldwide as of July 3, 2020, very little is known on the socio-economic heterogeneity of its impact on mortality. In this paper, we combine several administrative data sources to estimate the relationship between mortality due to COVID-19 and poverty at a very local level (i.e. the municipality level) in France, one of the most severely hit country in the world. We find strong evidence of an income gradient in the impact of the pandemic on mortality: it is twice as large in the poorest municipalities compared to other municipalities. We then show that both poor housing conditions and higher occupational exposure are likely mechanisms. Overall, these mechanisms accounts for up to 60% of the difference observed between rich and poor municipalities.


docid: nmpppztq

title: Epidemiology of CoVID-19 and predictors of recovery in the Republic of Korea

text: Background: The recent CoVID-19 pandemic has emerged as a threat to global health. Though current evidence on the epidemiology of the disease is emerging, very little is known about the predictors of recovery. We describe the epidemiology of confirmed CoVID-19 patients in Republic of Korea and identify predictors of recovery. Materials and methods: Using publicly available data for confirmed CoVID-19 cases from the Korea Centers for Disease Control and Prevention from January 20, 2020 to April 30, 2020, we undertook descriptive analyses of cases stratified by sex, age group, place of exposure, date of confirmation and province. Correlation was tested among all predictors (sex, age group, place of exposure and province) with the Pearsons correlation coefficient. Associations between recovery from CoVID-19 and predictors were estimated using a multivariable logistic regression model. Results: Majority of the confirmed cases were females (56 percent), from 20-29 age group (24.3 percent), and primarily from three provinces Gyeongsangbuk (36.9 percent), Gyeonggi (20.5 percent) and Seoul (17.1 percent). Case fatality ratio was 2.1 percent and 41.6 percent cases recovered. Older patients, patients from certain provinces such as Daegu, Gyeonggi, Gyeongsangbuk, Jeju, Jeollabuk and Jeollanam, and those contracting the disease from healthcare settings had lower recovery. Conclusions: Our study adds to the very limited evidence base on potential predictors of recovery among confirmed CoVID-19 cases. We call additional research to explore the predictors of recovery and support development of policies to protect the vulnerable patient groups.


docid: jeufhpkq

title: Massive and rapid COVID-19 testing is feasible by extraction-free SARS-CoV-2 RT-qPCR

text: Coronavirus disease 2019 (COVID-19) is caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). The most widely used method of COVID-19 diagnostics is a reverse transcription quantitative polymerase chain reaction (RT-qPCR) assay, detecting the presence of SARS-CoV-2 RNA in patient samples, typically from nasopharyngeal swabs. The RNA extraction is a major bottleneck in current COVID-19 testing, in terms of turn-around, logistics, component availability and cost, which delays or completely precludes COVID-19 diagnostics in many settings. Efforts to simplify the current methods are important, as increased diagnostic availability and efficiency is expected to benefit patient care and infection control. Here, we describe methods to circumvent RNA extraction in COVID-19 testing by performing RT-qPCR directly on heat-inactivated subject samples as well as samples lysed with readily available detergents. Our data, including cross-comparisons with clinically diagnosed patient samples, suggest that direct RT-qPCR is a viable option to extraction-based COVID-19 diagnostics. We argue that significant savings in terms of time and cost can be achieved by embracing RNA-extraction-free protocols, that feeds directly into the established PCR-based testing pipeline. This could aid the expansion of COVID-19 testing.


title: Effects of mobility and multi-seeding on the propagation of the COVID-19 in Spain

text: Assessing the impact of mobility on epidemic spreading is of crucial importance for understanding the effect of policies like mass quarantines and selective re-openings. High mobility between areas contribute to the importation of cases, affecting the spread of the disease. While many factors influence local incidence and making it more or less homogeneous with respect to other areas, the importance of multi-seeding has often been overlooked. Multi-seeding occurs when several independent (non-clustered) infected individuals arrive at a susceptible population. This can give rise to autonomous outbreaks that impact separate areas of the contact (social) network. Such mechanism has the potential to boost local incidence and size, making control and tracing measures less effective. In Spain, the high heterogeneity in incidence between similar areas despite the uniform mobility control measures taken suggests that multi-seeding could have played an important role in shaping the spreading of the disease. In this work, we focus on the spreading of SARS-CoV-2 among the $52$ Spanish provinces, showing that local incidence strongly correlates with mobility occurred in the early-stage weeks from and to Madrid, the main mobility hub and where the initial local outbreak unfolded. These results clarify the higher order effects that mobility can have on the evolution of an epidemic and highlight the relevance of its control.


docid: vqhdewhs

title: Development and validation of an automated radiomic CT signature for detecting COVID-19

text: Background : The coronavirus disease 2019 (COVID-19) outbreak has reached pandemic status. Drastic measures of social distancing are enforced in society and healthcare systems are being pushed to and over their limits. Objectives : To develop a fully automatic framework to detect COVID-19 by applying AI to chest CT and evaluate validation performance. Methods : In this retrospective multi-site study, a fully automated AI framework was developed to extract radiomics features from volumetric chest CT exams to learn the detection pattern of COVID-19 patients. We analysed the data from 181 RT-PCR confirmed COVID-19 patients as well as 1200 other non-COVID-19 control patients to build and assess the performance of the model. The datasets were collected from 2 different hospital sites of the CHU Liege, Belgium. Diagnostic performance was assessed by the area under the receiver operating characteristic curve (AUC), sensitivity and specificity. Results : 1381 patients were included in this study. The average age was 64.4 and 63.8 years with a gender balance of 56% and 52% male in the COVID-19 and control group, respectively. The final curated dataset used for model construction and validation consisted of chest CT scans of 892 patients. The model sensitivity and specificity for detecting COVID-19 in the test set (training 80% and test 20% of patients) were 78.94% and 91.09%, respectively, with an AUC of 0.9398 (95% CI: 0.875-1). The negative predictive value of the algorithm was found to be larger than 97%. Conclusions : Benchmarked against RT-PCR confirmed cases of COVID-19, our AI framework can accurately differentiate COVID-19 from routine clinical conditions in a fully automated fashion. Thus, providing rapid accurate diagnosis in patients suspected of COVID-19 infection, facilitating the timely implementation of isolation procedures and early intervention.


title: Characteristics of lymphocyte subsets and cytokines in peripheral blood of 123 hospitalized patients with 2019 novel coronavirus pneumonia (NCP)

text: Background: To explore the cellular immunity and cytokines status of NCP patients and to predict the correlation between the cellular immunity levels, cytokines and the severity of patients. Methods: 123 NCP patients were divided into mild and severe groups. Peripheral blood was collected, lymphocyte subsets and cytokines were detected. Correlation analysis was performed on the lymphocyte subsets and cytokines, and the differences between the indexes of the two groups were analyzed. Results: 102 mild and 21 severe patients were included. Lymphocyte subsets were reduced in two groups. The proportion of CD8 + T reduction in the mild and severe group was 28.43% and 61.9%, respectively; The proportion of B cell reduction was 25.49% and 28.57%; The proportion of NK cell reduction was 34.31% and 47.62%; The detection value of IL-6 was 0 in 55.88% of the mild group, mild group has a significantly lower proportion of patients with IL-6 higher than normal than severe group; There was no significant linear correlation between the lymphocyte subsets and cytokines, while significant differences were noticed between the two groups in CD4 + T, CD8 + T, IL-6 and IL-10. Conclusions: Low levels of CD4+T and CD8+T are common in severe NCP. IL-6 and IL-10 levels were higher in severe patients. T cell subsets and cytokines can be used as one of the basis for predicting the transition from mild to severe. Large number of samples are still needed to confirm the "warning value" of CD4 + T, CD8 + T IL-6 and IL-10.


title: A Preliminary Assessment of Novel Coronavirus (COVID-19) Knowledge and Perceptions in Nigeria

text: This study assessed knowledge and perceptions about COVID-19 among the general public in Nigeria during the initial week of the pandemic lockdown in the country. From March 28 to April 4, 2020, this cross-sectional survey used an anonymous online questionnaire to collect data from respondents within Nigeria. Purposive and snowball sampling techniques were used to recruit 1357 respondents, aged 15-70 years, from 180 cities and towns within Nigeria. Study data were analyzed using descriptive statistics. Approximately more than half (57.02%) of the respondents were male with a high level of education (48.86% bachelor degree or higher). Approximately half of the respondents (46.94%) opined that COVID-19 was a biological weapon designed by the Chinese government. About 94% of the respondents identified contact with airborne droplets via breathing, sneezing, or coughing as the most common mode of transmission; most respondents associated COVID-19 with coughing (81.13%), shortness of breath (73.47%) and fever (62.79%). Regular hand washing and social distancing were selected by most respondents (94.25%) as a way of preventing infection whereas 11.86% reported consuming gins, garlic, ginger, herbal mixtures and African foods/soups as preventive measures against COVID-19. The majority of the respondents (91.73%) thought COVID-19 is deadly, and most respondents (84.3%) got 4 or more answers correctly. It was also observed that the traditional media (TV/Radio) is the most common source of health information about COVID-19 (93.5%). Findings revealed that Nigerians have relatively high knowledge, mostly derived from traditional media, about COVID-19. Their perceptions of COVID-19 bear implications across public health initiatives, compliance with precautionary behavior as well as bilateral relations with foreign nations. Evidence-based campaign should be intensified to remove misconceptions and promote precautionary measures.


Chest CT versus RT-PCR for the Detection of COVID-19: Systematic Review and Meta-Analysis


Perinatal outcomes in critically ill pregnant women with COVID-19


TB Prevalence Correlation to Covid- 19 Mortality Tareef Fadhil Raham * Abstract Back ground : Latent TB disease reflect a state of persistent immune response to stimulation by Mycobacterium tuberculois . TB infection lead to latent TB disease in 90-95 % while 5-10 % of individuals develop active TB disease when compared to BCG , BCG is 60% effective against the development of active TB. Studies done to test association of BCG with covid-19 morbidity and mortality and it was thought that BCG have preventive effects due to presumed non specific anti viral effects in this study we test association between prevalent of TB which reflects about 90-95 % of corresponding latent TB infection with covid 19 mortality. Materials and methods : countries divided into 5 groups according to BCG following status : No vaccination at all no previous BCG group , no current but had BCG in past (one or more), 1 current BCG with previous booster (s) , just 1 BCG now no previous booster (s) and more than 1 BCG setting now. covid -19 deaths taken as it is on these are tested against TB prevalence 2018. Results: Slop values have significant influences between TB prevalence and covid -19 deaths among all tested groups and are reversed in just 1 BCG now no previous booster (s) group P<0.01 coefficient (0.30751) ,1 current BCG with previous booster (s) P<0.01 coefficient (0.63662) , and more than 1 BCG setting now group P<0.05 with coefficient of (0.61580). While no vaccination at all no previous BCG group shows Compound model linear regression P<0.05 coefficient ( 97.45%)and No current but had BCG in past (one or more) group shows Cubic model P<0.01, coefficient (66.098%) The overall slope value is highly significant and reverse influence at P<0.01, as well as highly significant relationship coefficient (0.36749). The linear regression model obtained in logarithmic mode for all tested sample and being inverse in countries with more than 1 BCG setting at this time and countries with 1 current BCG with previous booster (s) furthermore linear regression model is logarithmic in countries with just 1 BCG now and no previous booster (s) . Conclusion: TB prevalence is strongly associated with covid-19 mortality and being more sever in absence of BCG vaccine . Recommendations: Early interventions might be considered based on the supportive evidence at this timewhich include BCG vaccination ,review of current latent TB programs. Key words :TB prevalence, covid- 19 mortality ,BCG * consultant pediatrician ; DCH and Arabic Board;MOH Iraq tareeffadhil@yahoo.com (00964)7901584338


docid: glnuktps

title: CoViD-19 Epidemic in India and Projections: Is Relief in Sight?

text: Background: Projection of cases and deaths in an epidemic such as CoViD-19 is hazardous and the early projections were way-off the actual pattern. However, we now have actual data for more than 50 consecutive days in India that can be effectively used for projection. Methods: We closely track the trend and use the same pattern for projection. We call this Empirical Model. We also fit a Theoretical Model based on a Gamma function on the pattern of some of the previous epidemics. Results: The Empirical Model predicts the peak around the fourth week of May and the near end of the epidemic by the end of June 2020. The maximum number of active cases is likely to be nearly 75,000 during the second week of June. This would mean a peak demand of nearly 15,000 beds and nearly 4000 ventilators. The case-fatality based on those who have reached an outcome was nearly 10% in the first week of May and is likely to remain at this level for some time. Theoretical Model projected a peak of nearly 2500 new cases per day in the second week of May that seems to have been already breached. This model predicts the near end of the epidemic by the middle of July 2020.


False-negative from screening for COVID-19 at international border post: Estimated magnitude


title: COVID-19 in a Designated Infectious Diseases HospitalOutside Hubei Province,China

text: Background A new type of novel coronavirus infection (COVID-19) occurred in Wuhan, Hubei Province. Previous investigations reported patients in Wuhan city often progressed into severe or critical and had a high mortality rate.The clinical characteristics of affected patients outside the epicenter of Hubei province are less well understood. Methods All confirmed COVID-19 case treated in the Third People's Hospital of Shenzhen,from January 11, 2020 to February 6, 2020, were included in this study. We analyzed the epidemiological and clinical features of these cases to better inform patient management in normal hospital settings. Results Among the 298 confirmed cases, 233(81.5%) had been to Hubei while 42(14%) had not clear epidemiological history. Only 192(64%) cases presented with fever as initial symptom. The lymphocyte count decreased in 38% patients after admission. The number (percent) of cases classified as non-severe and severe was 240(80.6%) and 58(19.4%) respectively. Thirty-two patients (10.7%) needed ICU care. Compared to the non-severe cases, severe cases were associated with older age, underlying diseases, as well as higher levels of CRP, IL-6 and ESR. The median (IRQ) duration of positive viral test were 14(10-19). Slower clearance of virus was associated with higher risk of progression to severe clinical condition. As of February 14, 2020, 66(22.1%) patients were discharged and the overall mortality rate remains 0. Conclusions In a designated hospital outside the Hubei Province, COVID-19 patients were mainly characterized by mild symptoms and could be effectively manage by properly using the existing hospital system.