December 1, 2020
Moderna says first injections of its vaccine could begin by December 21
“The country could see a surge upon a surge of new Covid-19 cases over the coming weeks. You know, we don’t want to frighten people, but that’s just the reality.”Dr. Fauci, director of the National Institute of Allergy and Infectious Diseases
“Closing the economy does not have to be all or nothing, doesn’t have to be total lockdown or full reopening.”Jure Leskovec, a computer scientist at Stanford University.
“Anyone over 65 years old who gathered for Thanksgiving and develops symptoms should be tested immediately because the available medications, as well as treatments, “work best very early in disease.”Dr. Deborah Birx, White House coronavirus coordinator
“We’re going to probably have by the end of this year, 30% of the U.S. population infected.”Dr. Scott Gottlieb, former FDA Commissioner
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Highlighted stories includes information we found interesting. An (!) indicates a story that includes new, promising/breakthrough or unexpected/surprising information. A (*) indicates information that may be useful in connection with your plans and preparations regarding the coronavirus and C19. And © indicates that a story contains information that may contradict or be inconsistent with other information.
1. Cases & Tests
3. Top 5 States in Cases, Deaths, Hospitalizations & Positivity
2. Covid triage tool helps flag riskiest cases
- One person in the room with you has C19. Here’s how long it takes to get infected. (!) (*)
- A Day-by-Day Breakdown of Coronavirus Symptoms Shows How The Disease Progresses (*)
- AI Analyzes Content of Nightmares, Finds C19 Infects Majority of Bad Dreams
K. Linked Stories
- Social Distancing Isn’t Enough to Prevent Infection – How to Detect C19 Super-Spreaders
- Most lungs recover after C19
- Air Quality Influences the Pandemic, Can Aggravate the Consequences of C19
- Can Vitamin D Supplements Prevent C19 or Reduce Symptoms?
- How the coronavirus reaches the brain
- Fourth Iteration of Adaptive C19 Treatment Trial Underway
- Tracking C19 Trends in Hard-Hit States Using Computational Models
- Sorting Out Viruses With Machine Learning: AI-Powered Nanotechnology May Lead to New Rapid C19 Tests
- Global Task Force to Investigate Origins of C19 Pandemic to “Ensure History Does Not Repeat”
- New C19 Research Provides Deep Insights Into Transmission and Mutation Properties of the coronavirus
- Governments urged to keep schools open
- Using age alone to determine if someone gets C19 intensive care treatment is not fair
- Safe ultraviolet light could be used to sterilise high-risk C19 environments
- Warwick scientists design model to predict cellular drug targets against C19
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A. Pandemic Headlines
(In no particular order)
- Millions of holiday travelers expected to accelerate COVID-19 surge
- CDC predicts grim COVID-19 death toll in December
- More than 100,000 deaths linked to C19 at long-term care facilities
- ‘Absolutely remarkable’: No one who got Moderna’s vaccine in trial developed severe COVID-19
- Moderna Applies For Emergency COVID Vaccine Approval In US & Europe as full results show 94% efficacy
- Moderna applied for emergency F.D.A. vaccine authorization and says first injections could begin by Dec. 21
- UK roll-out of Moderna vaccine could be ‘days away’
- Pfizer’s vaccine being flown into position on dry-ice packed United Airlines charter planes
- A ‘pandemic of mistrust’ could torpedo vaccination campaigns
- Dr. Fauci Confirms That Children Don’t Catch Or Transmit C19 In Large Numbers
- Fauci says it will be ‘months’ before children get COVID-19 vaccine
- Fauci on New York: ‘Close the bars and keep the schools open’
- US breaks record for daily C19 hospitalizations
- For health care workers, this surge of C19 is bringing burnover
- As Hospitals Fill With C19 Patients, Medical Reinforcements Are Hard To Find
- California Gov. Newsom Warns Of “Dramatic, Arguably Drastic” New Restrictions To Come As Hospitalizations Hit Record Highs
- NY Gov. Cuomo announces emergency hospital measures as New York enters ‘a new phase in the war against Covid
- Business closures, partial reopenings due to C19 could cost the US $3-$5 trillion
- “It’s Really Bad” – Almost One-Third Of Small Businesses In NY, NJ Have Closed
- Black Friday Foot Traffic Down More Than 52%
- Nearly 90 million workers weeks away from losing paid COVID leave
- Food Insecurity Increases Dramatically During Coronavirus Pandemic
- OPEC expected to cut oil production as COVID-19 reduces demand
- New York C19 positive test rate nears 4%, highest since May
- New York City reopening schools for special-education students and younger grades
- Vietnam confirms first COVID case in 89 days
- NY sees another 6,000+ new cases
- WHO: treat slowdown in cases with caution
- WHO Official Pushes Back On Chinese State Media Claims COVID-19 Originated In Europe
- New coronavirus lockdown still ‘on the table’ in NJ, Gov. Murphy says
- San Francisco imposes new COVID-19 lockdown measures
- NYC limits viewing times for Rockefeller Christmas tree
- Hong Kong orders civil servants to work from home
- California tops 15,000 cases
- France sees fewest new cases in nearly 2 months
- Germany’s Merkel says Germany can’t continue compensating companies for lost sales
- Hong Kong imposes new restrictions
- Turkey announces its strictest lockdown yet as it passes half a million cases
- Canada expands travel ban
- UK’s Prime Minister Johnson says tiered system will have ‘sunset’ date of Feb. 3
- Brits who refuse C19 vaccine may be denied entry to restaurants, bars
- After weeks of lockdown, cases in England drop 30%
- C19 has harmed poorest countries the most across Asia Pacific, says OECD
- Number of suicides in Japan over month span exceed deaths from COVID-19
- China demands recovering C19 patients wait six months before donating blood
- Malaria death toll to exceed C19’s in sub-Saharan Africa: WHO
- NJ indoor high-school, other youth sports put on hold till January
- Emergency department doctors ask: “Where did all the patients go?
- FDNY won’t require medics and firefighters to get new COVID-19 vaccine
- C19 shutdowns disproportionately affected low-income black households
- Young people’s anxiety levels doubled during first C19 lockdown
- Dozens protest outside LA health chief’s home over new C19 restrictions
- Killing The Future: COVID Madness Will Lead To Half A Million Fewer US Births In 2021
- “Absolutely Crazy” – Sub-Zero Freezer Demand Erupts Ahead Of Vaccine Distribution
- Newly-leaked documents reveal how China bungled COVID-19’s early days
- Kim Jong Un received experimental COVID-19 vaccine from China, analyst says
- LA County supervisor dines outdoors just hours after voting to ban the practice
- Shame on politicians who’ve fed anti-vax hysteria even amid a pandemic
- Asymptomatic Oklahoma health care workers with COVID-19 infection can continue to work
- TSA screens highest number of travelers since pandemic started
- New paint can kill germs, including C19, on all coated surfaces
- Hawaii seeks to be seen as remote workplace with a view
- Pope Francis cancels pre-Christmas ceremony due to C19
- New York City Ballet’s ‘The Nutcracker’ goes digital for 2020
- Digital COVID-19 ‘passport’ may take flight for airline travelers: report
- Staff at Oregon mink farm infected in C19 outbreak
- 155 arrested in London amid anti-lockdown protests
- Online holiday shopping explosion expected to cause shipping stress
- NBA unveils 134-page COVID-19 safety protocol for new season
- Coronavirus cancels Christmas markets in Europe
- Tequila bar applies to become church to skirt C19 lockdown rules
B. Numbers & Trends
Note: Unless otherwise noted, (i) all cases/deaths are confirmed cases/deaths that have been reported, (ii) all numbers reported in this update are as of the end of the most recent reporting period, and (iii) all changes reflect changes since the preceding day.
1. Cases & Tests
- Total Cases = 63,578,114
- New Cases (7 day average) = 575,029
- 7 day average of new cases has been declining since the peak on 11/25
- Since 11/25, the 7 day average has declined from 593,002 to 575,029, a decrease of 3%
- The decline in 7 day average since 11/25 is almost entirely due to the decline in the US 7 day average of new cases
US Cases & Testing:
- Total Cases = 13,920,038
- New Cases (7 day average) = 162,853
- Percentage of New Global Cases (7 day average) = 28.3%
- Total Number of Tests = 194,909,340
- Percentage of positive tests (7 day average) = 11.9%
- Although the 7 day average of new cases began to rapidly increase after 10/7, the 7 day average began to decrease at a rapid rate after the peak on 11/25
- Since 11/25, the 7 day average has declined from 179,943 to 162,853, a decrease of 9.5%
- Total Deaths = 1,473,457
- New Deaths (7 day average) = 10,168
- After increasing rapidly since 10/15, the 7 day average has decreased slightly since 11/26
- Total Deaths = 274,332
- New Deaths (7 day average) = 1,517
- Percentage of Global New Deaths = 14.9%
- 7 day average of new deaths began to rise rapidly on 11/2 until the 2nd peak on 11/25
- The 7 day average declined sharply from 1,713 on 11/25 to 1,481 on 11/29, a decrease 232 (or 13.5%), after which the 7 day average has increased by 36 to 1,517
3. Top 5 States in Cases, Deaths, Hospitalizations, ICU Patients & Positivity (11/30)
- After peaking at a positivity rate of 12.3% on 11/18, the US positivity rate continues to increase, but at a lower rate of 11.9%.
- ND still leads the nation at 54.5%, but the rate has dropped from 60.9% one week ago.
- Overall, 20 states reported lower positivity rates over the last seven days. Similar to what we saw in the Sunbelt states during the summer surge, falling positivity rates may be an early indicator that the cases are peaking.
- Four states (SD, ID, IA, KS) 7-day positivity rates greater than 40%.
- Six states (MO, NE, NV, WI, IN, UT) 7-day positivity rates greater than 30%.
- Only Five states (AL, PA, CO, MN, NH) had 7-day positivity rates greater than 20%.
- In total, 42 states have 7-day positivity rates greater than 5% (-3 since 11/23)
- Hospitalizations in the US have increased to 96,039, up 11.9% since 11/23. While hospitalizations are still increasing, the weekly percentage increase on 11/24 was 14.5%.
- 27 states have had increases of hospitalized patients of more than 10% since 11/23. On 11/24, 31 states had +10% gains
- 30 states have more than 1,000 hospitalized patients (+3 since 11/24)
- Nine states saw decreases in the number of hospitalized patients (HI, IA, ND, MO, NE, WI, SD, IL, KS). (+4 since 11/24)
- ICU Patients in the US have increased to 18,545 up from 16,895 (+ 9.8%) since 11/23. ICU patients have increased, but the weekly percentage increase has fallen from 15.3% on 11/24
- 16 states have seen the number of ICU patients increase by more than 10% since 11/24 (-10 since 11/24)
- 30 states have more than 100 patients in ICU, (unch states since 11/24)
- 10 states (HI, IA, WI, ND, KS, OK, MI, MO, SD, MT) saw decreases in the number of ICU patients since 11/17 (+5 since 11/24)
4. U.S. Cases Fall, but Officials Warn of Dire Weeks to Come
The U.S. added fewer C19 cases than in previous days, but hospitalizations hit another record, following a Thanksgiving holiday that was the busiest travel period in the country since the pandemic began.
What to Know
- Moderna planned to ask health regulators to authorize its Covid-19 vaccine.
- Health workers treating Covid patients and nursing-home residents are expected to be the first people to receive vaccines in the U.S.
- U.S. hospitalizations due to C19 rose to 93,000, an all-time high.
- California Gov. Gavin Newsom warned of possible new stay-at-home orders, while New York Gov. Andrew Cuomo ordered hospitals to prepare for a new surge.
- Health experts urged Americans to take preventative steps after gathering or traveling for Thanksgiving.
Current US Trends
- The number of coronavirus-related hospitalizations in the U.S. once again hit a record high, with more than 93,000 people admitted as of Sunday, according to the Covid Tracking Project.
- And health officials warned the situation could worsen in the weeks following Thanksgiving. Dr. Anthony Fauci, the U.S. government’s top infectious-disease expert, said the country could experience a “surge upon a surge” of new cases.
- The U.S. reported 138,903 new confirmed infections for Sunday, according to data compiled by Johns Hopkins University. That is down from 155,596 a day before and the record 205,557 reported on Friday. Sunday’s figure was also a week-over-week decline, down from 142,734 on Nov. 22.
- Weekends often lead to a decline in reported cases, as fewer doctors’ offices and testing sites are open. Thanksgiving was expected to amplify that effect on data across the U.S., with cases projected to fall in the days following the holiday before surging as the backlog of tests makes its way through local and state reporting systems.
5. 50 to 100 million people in the US may have had C19
- Some 53 million people in the U.S. likely had had C19 by the end of September, according to a modeling estimate from researchers at the Centers for Disease Control and Prevention. Roughly 6.9 million infections had been confirmed within that time period, suggesting that roughly one in every eight cases was identified.
- The CDC estimates are also in line with studies that have looked at blood samples for disease-fighting antibodies as a sign of a person’s past infection and arrived at similar conclusions: Many more people have had C19 in the U.S. than have been reported, but the majority of people is still at risk.
- “This indicates that approximately 84% of the U.S. population has not yet been infected, and thus most of the country remains at risk, despite already high rates of hospitalization,” the authors wrote.
- The report, posted online on Wednesday by the academic journal Clinical Infectious Diseases, doesn’t include data from the past two months, when the pandemic has raged the strongest across many places in the U.S. [NOTE: Some estimates indicate that up to 100 million people may have had C19 based on today’s number of cases.]
- Since the onset of the pandemic, public-health authorities have suspected that the U.S. is failing to capture a large amount of cases, due to both the inability of testing to keep up with the spread of the disease throughout most of the pandemic and the proportion of people who have little to no symptoms. Researchers have attempted to suss out just how many people have been infected by the novel virus, both through antibody surveys and various modeling studies.
- In the report published Wednesday, the researchers broke down the confirmed cases by age, location and when the case was reported. They then adjusted those caseloads based on factors such as the potential for false-negative test results, lacking testing in an area, hospital surveillance and survey data, or the estimated rates of asymptomatic cases.
- The researchers estimated that roughly 16% of the U.S. population had been infected with the virus through September, ranging from 9% to 31% across different locations. More cases went unreported among younger people, especially children, the report says. Case reporting has improved over time, particularly among those younger cohorts, as the capacity to test for the virus has grown. The biggest leaps in the ability to find cases occurred in the spring and summer.
- In June, CDC Director Robert Redfield said the country was capturing roughly 10% of cases through May, and the current report estimates that 13% of cases were captured through the end of September.
- On Nov. 24, another study from the CDC published in JAMA Internal Medicine estimated that fewer than 1% to 23% of people in the U.S. had antibodies, depending on the location, after looking at more than 177,000 patient blood samples collected between July 27 and Sept. 24. In 42 out of 49 jurisdictions, the estimated prevalence was less than 10%. It is still unknown how long antibodies might last post-infection, among other limitations.
C. New Scientific Findings & Research
1. Chemical compounds in foods can inhibit a key coronavirus enzyme
- Chemical compounds in foods or beverages like green tea, muscadine grapes and dark chocolate can bind to and block the function of a particular enzyme, or protease, in the coronavirus (SARS-CoV-2), according to a new study by plant biologists at North Carolina State University.
- Proteases are important to the health and viability of cells and viruses, says De-Yu Xie, professor of plant and microbial biology at NC State and the corresponding author of the study. If proteases are inhibited, cells cannot perform many important functions – like replication, for example.
- “One of our lab’s focuses is to find nutraceuticals in food or medicinal plants that inhibit either how a virus attaches to human cells or the propagation of a virus in human cells,” Xie said.
- In the study, the NC State researchers performed both computer simulations and lab studies showing how the so-called “main protease” (Mpro) in the SARS-CoV-2 virus reacted when confronted with a number of different plant chemical compounds already known for their potent anti-inflammatory and antioxidant properties.
- “Mpro in SARS-CoV-2 is required for the virus to replicate and assemble itself,” Xie said. “If we can inhibit or deactivate this protease, the virus will die.”
- Computer simulations showed that the studied chemical compounds from green tea, two varieties of muscadine grapes, cacao powder and dark chocolate were able to bind to different portions of Mpro.
- “Mpro has a portion that is like a ‘pocket’ that was ‘filled’ by the chemical compounds,” Xie said. “When this pocket was filled, the protease lost its important function.”
- In vitro lab experiments completed by Yue Zhu, an NC State Ph.D. student in Xie’s lab, showed similar results. The chemical compounds in green tea and muscadine grapes were very successful at inhibiting Mpro’s function; chemical compounds in cacao powder and dark chocolate reduced Mpro activity by about half.
- “Green tea has five tested chemical compounds that bind to different sites in the pocket on Mpro, essentially overwhelming it to inhibit its function,” Xie said. “Muscadine grapes contain these inhibitory chemicals in their skins and seeds. Plants use these compounds to protect themselves, so it is not surprising that plant leaves and skins contain these beneficial compounds.”
2. None of the Coronavirus Mutations Appear to Increase Transmissibility
- The analysis of virus genomes from over 46,000 people with C19 from 99 countries is published today (November 25, 2020) in Nature Communications.
- First and corresponding author Dr. Lucy van Dorp (UCL Genetics Institute) said: “The number of SARS-CoV-2 genomes being generated for scientific research is staggering. We realized early on in the pandemic that we needed new approaches to analyze enormous amounts of data in close to real time to flag new mutations in the virus that could affect its transmission or symptom severity.
- “Fortunately, we found that none of these mutations are making C19 spread more rapidly, but we need to remain vigilant and continue monitoring new mutations, particularly as vaccines get rolled out.”
- Coronaviruses like SARS-CoV-2 are a type of RNA virus, which can all develop mutations in three different ways: by mistake from copying errors during viral replication, through interactions with other viruses infecting the same cell (recombination or reassortment), or they can be induced by host RNA modification systems which are part of host immunity (e.g. a person’s own immune system).
- Most mutations are neutral, while others can be advantageous or detrimental to the virus. Both neutral and advantageous mutations can become more common as they get passed down to descendant viruses.
- The research team from UCL, Cirad and the Université de la Réunion, and the University of Oxford, analyzed a global dataset of virus genomes from 46,723 people with C19, collected up until the end of July 2020.
- The researchers have so far identified 12,706 mutations in SARS-CoV-2. For 398 of the mutations, there is strong evidence that they have occurred repeatedly and independently. Of those, the researchers honed in on 185 mutations which have occurred at least three times independently during the course of the pandemic.
- To test if the mutations increase transmission of the virus, the researchers modeled the virus’s evolutionary tree, and analyzed whether a particular mutation was becoming increasingly common within a given branch of the evolutionary tree — that is, testing whether, after a mutation first develops in a virus, descendants of that virus outperform closely-related SARS-CoV-2 viruses without that particular mutation.
- The researchers found no evidence that any of the common mutations are increasing the virus’s transmissibility. Instead, they found most common mutations are neutral for the virus. This includes one mutation in the virus spike protein called D614G, which has been widely reported as being a common mutation that may make the virus more transmissible. The new evidence finds that this mutation is in fact not associated with significantly increasing transmission.
- The researchers found that most of the common mutations appear to have been induced by the human immune system, rather than being the result of the virus adapting to its novel human host. This situation is in contrast with another analysis by the same team of what happened when SARS-CoV-2 later jumped from humans into farmed minks.
- Dr. van Dorp said: “When we analyzed virus genomes sourced from mink, we were amazed to see the same mutation appearing over and again in different mink farms, despite those same mutations having rarely been observed in humans before.”
- Lead author Professor Francois Balloux (UCL Genetics Institute) added: “We may well have missed this period of early adaptation of the virus in humans. We previously estimated SARS-CoV-2 jumped into humans in October or November 2019, but the first genomes we have date to the very end of December. By that time, viral mutations crucial for the transmissibility in humans may have emerged and become fixed, precluding us from studying them.”
- It is only to be expected that a virus will mutate and eventually diverge into different lineages as it becomes more common in human populations, but this does not necessarily imply that any lineages will emerge that are more transmissible or harmful.
- Dr. van Dorp said: “The virus seems well adapted to transmission among humans, and it may have already reached its fitness optimum in the human host by the time it was identified as a novel virus.”
- The researchers caution that the imminent introduction of vaccines is likely to exert new selective pressures on the virus to escape recognition by the human immune system. This may lead to the emergence of vaccine-escape mutants. The team stressed that the computational framework they developed should prove useful for the timely identification of possible vaccine-escape mutations.
- Professor Balloux concluded: “The news on the vaccine front looks great. The virus may well acquire vaccine-escape mutations in the future, but we’re confident we’ll be able to flag them up promptly, which would allow updating the vaccines in time if required.”
3. Researchers Discover How the Coronavirus Reaches the Brain of C19 Patients
- It is now recognized that C19 is not a purely respiratory disease. In addition to affecting the lungs, the coronavirus (SARS-CoV-2) can impact the cardiovascular system, the gastrointestinal tract and the central nervous system. More than 1 in 3 people with C19 report neurological symptoms such as loss of, or change in, their sense of smell or taste, headaches, fatigue, dizziness, and nausea. In some patients, the disease can even result in stroke or other serious conditions.
- Until now, researchers had suspected that these manifestations must be caused by the virus entering and infecting specific cells in the brain. But how does SARS-CoV-2 get there? Under the joint leadership of Dr. Helena Radbruch of Charité’s Department of Neuropathology and the Department’s Director, Prof. Dr. Frank Heppner, a multidisciplinary team of researchers has now traced how the virus enters the central nervous system and subsequently invades the brain.
- As part of this research, experts from the fields of neuropathology, pathology, forensic medicine, virology and clinical care studied tissue samples from 33 patients (average age 72) who had died at either Charité or the University Medical Center Göttingen after contracting C19. Using the latest technology, the researchers analyzed samples taken from the deceased patients’ olfactory mucosa and from four different brain regions. Both the tissue samples and distinct cells were tested for SARS-CoV-2 genetic material and a ‘spike protein’ which is found on the surface of the virus.
- The team provided evidence of the virus in different neuroanatomical structures which connect the eyes, mouth and nose with the brain stem. The olfactory mucosa revealed the highest viral load. Using special tissue stains, the researchers were able to produce the first-ever electron microscopy images of intact coronavirus particles within the olfactory mucosa. These were found both inside nerve cells and in the processes extending from nearby supporting (epithelial) cells. All samples used in this type of image-based analysis must be of the highest possible quality. To guarantee this was the case, the researchers ensured that all clinical and pathological processes were closely aligned and supported by a sophisticated infrastructure.
- “These data support the notion that SARS-CoV-2 is able to use the olfactory mucosa as a port of entry into the brain,” says Prof. Heppner. This is also supported by the close anatomical proximity of mucosal cells, blood vessels and nerve cells in the area.
- “Once inside the olfactory mucosa, the virus appears to use neuroanatomical connections, such as the olfactory nerve, in order to reach the brain,” adds the neuropathologist. “It is important to emphasize, however, that the C19 patients involved in this study had what would be defined as severe disease, belonging to that small group of patients in whom the disease proves fatal. It is not necessarily possible, therefore, to transfer the results of our study to cases with mild or moderate disease.”
- The manner in which the virus moves on from the nerve cells remains to be fully elucidated. “Our data suggest that the virus moves from nerve cell to nerve cell in order to reach the brain,” explains Dr. Radbruch. She adds: “It is likely, however, that the virus is also transported via the blood vessels, as evidence of the virus was also found in the walls of blood vessels in the brain.” SARS-CoV-2 is far from the only virus capable of reaching the brain via certain routes. “Other examples include the herpes simplex virus and the rabies virus,” explains Dr. Radbruch.
- The researchers also studied the manner in which the immune system responds to infection with SARS-CoV-2. In addition to finding evidence of activated immune cells in the brain and in the olfactory mucosa, they detected the immune signatures of these cells in the cerebral fluid. In some of the cases studied, the researchers also found tissue damage caused by stroke as a result of thromboembolism (i.e. the obstruction of a blood vessel by a blood clot).
- “In our eyes, the presence of SARS-CoV-2 in nerve cells of the olfactory mucosa provides good explanation for the neurologic symptoms found in C19 patients, such as a loss of the sense of smell or taste,” explains Prof. Heppner. “We also found SARS-CoV-2 in areas of the brain which control vital functions, such as breathing. It cannot be ruled out that, in patients with severe C19, presence of the virus in these areas of the brain will have an exacerbating impact on respiratory function, adding to breathing problems due to SARS-CoV-2 infection of the lungs. Similar problems might arise in relation to cardiovascular function.”
4. Type O blood linked to lower C19 risk
- A large study adds to evidence that people with type O or Rh−negative blood may be at slightly lower risk from the new coronavirus.
- Among 225,556 Canadians who were tested for the virus, the risk for a C19 diagnosis was 12% lower and the risk for severe C19 or death was 13% lower in people with blood group O versus those with A, AB, or B, researchers reported on Tuesday in Annals of Internal Medicine.
- People in any blood group who were Rh-negative were also somewhat protected, especially if they had O-negative blood. People in these blood type groups may have developed antibodies that can recognize some aspect of the new virus, coauthor Dr. Joel Ray of St. Michael’s Hospital in Toronto told Reuters.
- “Our next study will specifically look at such antibodies, and whether they explain the protective effect,” Ray said. Whether or how this information might influence C19 prevention or treatment is still unclear.
5. Vitamin D fails to help in severe C19 cases
- Low levels of vitamin D have been linked to higher risk for severe C19, but high vitamin D levels do not fix the problem. Increasing vitamin D levels in critically ill patients did not shorten their hospital stay or lower their odds of being moved to intensive care, needing mechanical ventilation, or dying, doctors in Brazil found.
- They randomly gave 240 patients hospitalized with severe C19 either a single high dose of vitamin D3 or a placebo. Only 6.7% of patients in the vitamin D group had “deficient” levels of the nutrient, compared to 51.5% of patients in the placebo group, but there was no difference in the outcomes, according to a paper posted on medRxiv ahead of peer review.
- The same was true when the researchers focused on the 116 patients with vitamin D deficiency before the treatment. The authors say theirs is the first randomized trial of its kind to show that vitamin D supplementation “is ineffective to improve hospital length of stay or any other clinical outcomes among hospitalized patients with severe C19.”
6. Triggers of C19 “cytokine storm” identified
- A form of inflammatory cell death called panoptosis triggers the storm of cytokines, or inflammatory proteins, that causes critical illness in C19, researchers say. During panoptosis, “cells spew out their contents instead of neatly packaging them away” as happens during routine cell death, Thirumala-Devi Kanneganti of St. Jude Children’s Research Hospital told Reuters.
- Neighboring cells see the debris, including cytokines, as a sign of danger, and respond by secreting more cytokines, allowing the cytokine storm to build, said Kanneganti. Her team identified a synergy between two cytokines, TNF-alpha and IFN-gamma, as the cause of panoptosis in C19. Mice given TNF-alpha and IFN-gamma developed the symptoms and organ damage of C19 and died rapidly, Kanneganti said.
- Treatment with antibodies that neutralize these two cytokines protected the mice from death, not just from C19 but also from other life-threatening illnesses involving cytokine storms, such as sepsis, her team reported in Cell. Trials are needed to test these treatments in humans, Kanneganti said.
7. People with asthma 30% less likely to contract C19
- People with asthma could be as much as 30% less likely to contract the coronavirus, according to Israeli research that was accepted for publication in a peer-reviewed journal.
- “COVID-19 susceptibility in bronchial asthma,” which is slated to be published in the Journal of Allergy and Clinical Immunology this month and which The Jerusalem Post reviewed, shows that contrary to what has been assumed by many medical professionals up until now, people with bronchial asthma are less likely to get C19.
- The findings were not dependent on age, gender or socioeconomic status.
- There are three hypotheses for why asthma patients might not catch COVID, explained Dr. Eugene Merzon, head of the Department of Managed Care in Leumit Health Services, who helped lead the study.
- The first is physical: Respiratory allergy is associated with significant reductions in angiotensin-converting enzyme 2 (ACE2) receptors in the lungs, the protein that provides the entry point for C19 to hook into and infect human cells.
- The second is sociological: People with asthma are more likely to suffer from severe cases of C19. As such, said Merzon, they are more likely to adhere to Health Ministry instructions, including wearing masks, social distancing and maintaining good hygiene.
- Finally, treatment for asthma with inhaled corticosteroids (ICSs) could reduce the likelihood of getting the virus.
- Merzon explained that most people with chronic asthma use inhalers. Studies have shown that ICS use might reduce replication of C19.
- “The recommendation is that these patients make sure they continue taking their medication” during the pandemic, Merzon said. The paper also advised that in general, physicians should continue to treat asthma according to existing asthma guidelines and recommendations.
- Until now, bronchial asthma has not been adequately assessed in relation to coronavirus disease, the authors wrote in their paper.
- This research was a retrospective, population-based, cross-sectional study that utilized data from Leumit’s nationwide health fund database of 725,000 members. It specifically included all health fund enrollees who had been tested for C19 from February 1 to June 30, 2020 – some 37,569 people, including 2,266 who tested positive.
- Asthma was found in 153 or 6.75% of C19 positive patients and in 3,388 or 9.62% of those who tested negative.
- Previous epidemiological reports from China and Italy revealed that few patients with C19 had asthma, the paper notes. Asthma was reported in 9% of hospitalized patients with C19 in New York and 14% in the United Kingdom, the authors added.
- “However, all these prevalence data were derived from the C19 inpatient population,” the researchers explained. “Therefore, the prevalence of asthma may be different in outpatient patients with C19.”
- Moreover, they said that in previous severe acute respiratory syndrome outbreaks, such as SARS in 2003, patients with asthma appeared to be less susceptible to the coronavirus infection, which also uses ACE2 as an entry receptor. However, “reported entry receptors for most other coronaviruses do not include ACE2 and they exacerbate asthma upon infection.”
- Going forward, Merzon said the study could play a role in helping personalize recommendations for different cohorts of the public with preexisting conditions and allow health professionals to better differentiate between those patients who are at higher and lower risk of contracting the virus, rather than just of those experiencing severe symptoms.
D. Vaccines & Testing
1. FDA authorizes ‘new generation’ of C19 antibody test
- The FDA on Wednesday authorized a C19 antibody test that is being touted as a “new generation” of diagnostics with the ability to measure the degree of someone’s immune response to the coronavirus.
- Kantaro Biosciences said its COVID-SeroKlir test determines the specific level of C19 neutralizing antibodies in a person’s system, CNBC reported.
- “We think that our test is really one of the first in a new generation of antibody tests that provide much more meaningful information to individuals and clinicians on whether an individual’s been infected and developed an immune response,” said Dr. Erik Lium, chief commercial innovation officer at Mt. Sinai, which launched Kantaro Biosciences with Renalytix.
- The FDA has previously approved tests that estimate the number of antibodies, but not neutralizing ones, the outlet reported.
- Neutralizing antibodies bind to a virus to block infection, though the FDA has warned that more research is needed to determine how much protection they provide from the coronavirus.
- Lium said the test could help facilitate these studies.
- “It’s going to broadly enable studies of immunity and the relationship between immunity and the level of antibodies that an individual has,” Lium told the outlet.
- Test sensitivity is the ability to correctly identify the presence of antibodies and test specificity is the ability to correctly determine there aren’t any — which means Kantaro’s diagnostic is nearly 100% accurate.
- People will need to provide a blood sample for the test, which is processed in a clinical laboratory, CNBC reported.
- Through a partnership with Bio-Techne, 10 million tests will be manufactured each month, the outlet reported.
- “With this [emergency use authorization] in hand, we are ready to immediately supply this best-in-class serologic assay to clinicians across the U.S.,” Bio-Techne CEO Chuck Kummeth said in a statement.
- “We anticipate that COVID-SeroKlir will play an increasingly important role in the decision making of healthcare providers and policymakers and are prepared to scale up to meet additional demand.”
2. Covid triage tool helps flag riskiest cases
- As hospitals again run out of intensive-care beds, doctors just gained a new triage tool to help them decide how to prioritize medical treatment.
- A Swiss firm called Abionic SA started selling a blood test in Europe that it says can help hospitals more quickly pinpoint patients at risk of a severe form of C19. The method can be performed on a droplet of blood, and gives results in five minutes.
- A low score can allow physicians to shift patients from intensive care to the general ward — or discharge them.
- This kind of technology could be vital until vaccines are widely deployed. Intensive-care units filled up in the most recent surge of infections across Europe and hospitals in the U.S. Midwest are now also struggling. Ward occupancy has come down slightly in France and Belgium, but Sweden is at its highest level since June.
- Hospitals typically use age and medical history to single out high-risk patients — a blunt tool as C19 turns out to overwhelm healthy young people as well. A triage score known as AIFELL, for instance, uses six criteria that include an altered sense of smell, inflammation and fever to assess risk.
- An ideal test would find younger people at higher risk and older people at lower risk, two populations that defy common generalizations.
- Abionic’s tool uses a biomarker called pancreatic stone protein, which is secreted by the pancreas in response to stress from a systemic infection and can signal organ dysfunction. It’s already been used to gauge the risk of developing sepsis.
- Triage can also let doctors better deploy scarce treatments, such as the antibody cocktail developed by drugmakers Regeneron Pharmaceuticals Inc. and Roche Holding AG. Since the medicine appears to be more effective early on in an infection, it would be better to swiftly pinpoint patients who are at higher risk, Chief Executive Officer Severin Schwan said in an interview with Bloomberg News last week.
Source: Bloomberg Coronavirus Daily
E. Improved & Potential Treatments
1. New Therapy for Flu May Help in Fight Against C19, HIV, and Many Other Pathogenic Viruses
- In an average year, more than 2 million people in the United States are hospitalized with the flu, and 30,000 to 80,000 of them die from the flu or related complications.
- The Purdue team’s work is detailed in Nature Communications and uses a targeted therapy approach against the virus infections.
- “We target all of the antiviral drugs we develop specifically to virus-infected cells,” said Philip S. Low, the Purdue Ralph C. Corley Distinguished Professor of Chemistry. “That way, we treat the diseased cells without harming healthy cells. We use this capability to deliver immune-activating drugs selectively into flu-infected cells. There is also the potential that this therapy will prove efficacious in people infected with C19.”
- The flu virus, like many other pathogenic viruses, exports its proteins into its host cell surface and then buds off nascent viruses in the process of spreading to adjacent host cells. Because these exported viral proteins are not present in the membranes of healthy host cells, the Purdue team has exploited the presence of viral proteins in infected cells by designing homing molecules that target drugs specifically to virus-infected cells, thereby avoiding the collateral toxicity that occurs when antiviral drugs are taken up by uninfected cells.
- “We chose to start our tests with influenza virus because the results can often be applied to other enveloped viruses,” Low said. “Our lab tests show that our process works in influenza infected mice that are inoculated with 100 times the lethal dose of virus.”
- Low said the new therapy may prove effective against other pathogenic virus infections such as hepatitis B, HIV and respiratory syncytial virus (RSV).
2. Doctors Save the Lives of C19 Patients by Using Existing Treatment Earlier
- The lives of patients hospitalized with C19 are being saved by doctors who are using an existing medical treatment at an earlier stage.
- Dr. Luigi Sedda of Lancaster University analyzed the results from the team at Wrightington, Wigan and Leigh Teaching Hospitals NHS Trust (WWL). Their research has now been published in the prestigious medical journal BMJ Respiratory Open.
- He said: “We show that Continuous Positive Airway Pressure (CPAP) in the first days of hospitalization seems to save between 10% to 20% of patients. However, it is important to underline that this was a pilot study with a small sample size, although comforting evidence is starting to emerge elsewhere.”
- According to NHS England, 96% of people who died with Covid had at least one serious health condition and the majority are over the age of 80.
- The team led by Dr. Abdul Ashish used the CPAP machines on patients with C19 admitted to the Royal Albert Edward Infirmary in Wigan.
- In the case of patients with severe acute respiratory syndrome, C19 may cause the lungs to swell and collapse. Using CPAP treatment, which is often used at home to help people with sleep problems, helps to keep the lungs open and makes breathing easier.
- The research conducted by the team showed how CPAP treatment can be delivered effectively in a ward setting, with low resources both across the country and worldwide where intensive care bed availability is limited.
- The research has so far helped almost a hundred patients at the Royal Albert Edward Infirmary.
- Consultant Respiratory Physician Dr. Ashish said: “When you use CPAP early in the admission it stops the patient getting worse, therefore avoiding invasive ventilation techniques. As CPAP is readily available and can be used in a ward setting, we have demonstrated that, when used early, it can be very effective way of treating severe C19 pneumonia.
- “We are one of the early adopters of ward based CPAP in the North West and have developed local protocols and pathways by modifying our existing CPAP machines to deliver good outcomes for our patients.”
- The researchers also found that the early use of CPAP potentially reduces lung damage during the worst of the C19 infection and allows the patient to recover from the inflammatory effects. However, when used later, CPCP does not prevent lung damage thus leading to additional inflammation and a reduction in survival chances.
- Dr. Martin Farrier, Associate Medical Director, said: “”We are at the forefront of developing care for C19 patients and have developed a very effective treatment strategy for our population who develop lung failure following C19 infection. The people of Wigan can be sure that they are going to get the best care at WWL because we have helped to develop the best care.”
- He praised Dr. Luigi Sedda and his team at Lancaster University.
- “This collaboration with Lancaster University has been remarkable and allowed us to deliver high quality research.
3. Patient outcomes suggest high efficacy of Hydroxychloroquine in early treatments
- The recent serious outbreak of C19 has affected (November 13, 2020) 53,796,098 people worldwide, resulting in 37,555,669 recovered, 1,310,250 deaths, and a large number of open cases. It has required urgent medical treatments for numerous patients. No clinically active vaccines or antiviral agents are available for C19.
- According to several studies, Chloroquine (CQ) and Hydroxychloroquine (HCQ) have shown promises as Covid19 antiviral especially when administered with Azithromycin (AZM). However, there is significant controversy. Many countries are limiting the use of CQ/HCQ, while others are accepting this therapeutical option. A new paper addresses whether Chloroquine (CQ) and Hydroxychloroquine (HCQ) are helpful in C19 infection by analyzing the latest published literature on the subject while applying the scientific method.
- Papers in favor, or against, this therapeutical option are both reviewed. Bias by a conflict of interest is also taken into account. The rationale behind this use is clear.
- CQ/HCQ is effective against C19 in-vitro and in-vivo laboratory studies. Therapy in C19 infected patients with CQ/HCQ is supported by evidence of trials and field experiences from multiple sources. The relevant works are reviewed. The presence or absence of conflict of interest is weighed against the conclusions. CQ/HCQ has been used with success in mild cases or medium severity cases.
- No randomized controlled trial has however been conducted to support the safety and efficacy of CQ/HCQ and AZM for C19.
- Prophylaxis with CQ/HCQ is more controversial, but generally not having side effects, and supported by pre-clinical studies.
- The mechanism of action against C19 is unclear. More research is needed to understand the mechanisms of actions CQ/HCQ have against C19 infection, and this requires investigations with nanoscale imaging of viral infection of host cells.
- Most of the published works indicate CQ/HCQ is likely effective against C19 infection, almost 100% in prophylaxis and mild to medium severity cases, and 60% in late infection cases.
- The percentage of positive outcomes is larger if works conducted under a probable conflict of interest are excluded from the list.
- Outcomes suggest high efficacy of CQ/HCQ in early treatments and lower efficacy and controversial results only for late treatment.
- Statistically, 100% of early treatment studies are positive, late treatment studies are mixed with 70% positive effects, 78% of pre-exposure prophylaxis studies are positive, and 100% of post-exposure prophylaxis studies also report positive effects.
F. Concerns & Unknowns
1. Cancer survivors at higher risk of hospitalization and dying from flu (and possibly other respiratory diseases such C19)
- Survivors from a wide range of cancers are more likely than people in the general population to be hospitalised or die from seasonal influenza even several years after their cancer diagnosis, according to new data published in EClinicalMedicine.
- Given that flu and C19 are both epidemic respiratory viruses with broadly similar risk factors, the findings suggest that cancer survivors are also likely to be at raised risk of severe C19 outcomes.
- With over two million cancer survivors in the UK, the researchers say their results highlight that this group may need to be prioritized for vaccination against both diseases.
- In the first large study of its kind looking at this issue, researchers from the London School of Hygiene & Tropical Medicine (LSHTM), analysed medical records from 1990 to 2014 of more than 630,000 people in the UK, including over 100,000 survivors of a range of cancers.
- Comparing the rates of influenza hospitalization and death between cancer survivors and the cancer-free population, the researchers found that the risk of these outcomes was more than 9 times higher in survivors from lymphomas, leukaemia, and multiple myeloma, compared to those with no prior cancer. Crucially, this raised risk persisted for at least 10 years after cancer diagnosis. Despite the risks being raised compared to the general population, the absolute risks of developing severe flu were still relatively low, with about 1 in 1000 survivors of these types of cancer hospitalized with flu each year.
- Survivors from other types of cancer also had more than double the risk of severe influenza outcomes for up to five years from diagnosis.
- These findings persisted even after accounting for other suspected risk factors such as old age, smoking, socioeconomic status, body mass index and other illnesses.
- The researchers also found that cancer survivors were more likely to have other diseases that are associated with increased risk of severe C19 outcomes, such as heart disease, diabetes, respiratory disease and kidney disease.
- According to Gov.uk, to date 199,881 patients have been admitted to hospital in the UK with C19, and there have been 63,873 C19 recorded deaths. Age is by far the most important factor determining the absolute risk of developing severe C19, with some studies estimating around 20% of individuals aged over 80 years old require hospitalization, compared with less than 1% of people aged under 30.
- Current guidance on who should be considered vulnerable to C19 is largely based on policies developed for previous epidemic respiratory viruses like influenza. In such guidance, cancer survivors with no recent immunosuppressing treatment are not considered high-risk. However, findings from this new study – combined with other recent UK data showing that cancer survivors had a raised risk of dying from C19- suggests that cancer survivors should be included as a vulnerable group for C19 and influenza management policies.
- Helena Carreira, one of the lead authors of the study and Research Fellow at LSHTM, said: “We knew that people with cancer are at high risk of severe outcomes from these epidemic viruses soon after diagnosis, but we found that this increased risk also continues for several years after diagnosis. This means that vaccination and other preventative strategies are important considerations for the much broader population of longer-term cancer survivors.”
- Professor Krishnan Bhaskaran, senior author of the study and Professor of Statistical Epidemiology at LSHTM, said: “These findings have an immediate relevance as we enter the winter period: we have a flu vaccine available, and the likelihood of a C19 vaccine in the near future. Understanding how vaccination should be prioritized to protect the most vulnerable will be crucial over the next few months.”
- The authors acknowledge limitations of their study, including that it is not certain that risk factors for severe influenza will have the same associations with C19; and a lack of data on cancer treatments that patients had received.
2. C19 patients with diabetes or heart disease are more likely to die
- Cholesterol may be helping the coronavirus to infect human cells by acting as a taxi service, new lab studies reveal.
- The findings may explain why people with metabolic conditions such as diabetes and cardiovascular disease, who often have elevated cholesterol levels, make up a disproportionate number of patients who develop severe C19 symptoms.
- Researchers found that the coronavirus (SARS-CoV-2) can stick to cholesterol molecules as they bind to their regular cell receptor, called SR-B1.
- This helps to position the pathogen so that its spike protein can bond with the ACE2 receptor, which allows it to infect the cell.
- This graphic shows how cholesterol may be hijacked by SARS-CoV-2 to aid the infection of human cells. The virus binds to cholesterol and when cholesterol then attaches to its SR-B1 receptor on the surface of human cells, it brings the virus with it, which allows it to latch onto ACE2 allowing it to infect cells
- A study published in Nature Metabolism by researchers at the Chinese Academy of Military Medical Sciences looked at the role of ‘good’ cholesterol, otherwise known as high-density lipoproteins (HDL), in coronavirus infection.
- The study looked specifically at the SR-B1 receptor, which connects with cholesterol molecules and is found on cells throughout the human body, including in the lungs, where coronavirus targets.
- SARS-CoV-2 cannot exploit this receptor directly, the study found, but it can take advantage of the process of cholesterol connecting to SR-B1 in order to infiltrate cells.
- The viral spike on the coronavirus — the same one which latches on to ACE2 — has two sections, dubbed subunit one and subunit 2.
- In their experiments, the Chinese scientists found subunit one can attach to cholesterol. This means when the cholesterol naturally migrates to its receptor, it brings the coronavirus to the cell surface as well.
- Researchers state this ‘enhances viral uptake’ and the cholesterol receptor ‘facilitates SARS-CoV-2 entry into ACE2-expressing cells by augmenting virus attachment’.
- The researchers then discovered that by blocking SR-B1 and neutralizing it, this inhibits infection.
- They say that targeting the SR-B1 receptor could be a potential avenue for future treatments.
- ‘The results of our study demonstrate that SR-B1 facilitates SARS-CoV-2 cellular attachment, entry and infection,’ the researchers explain in their paper.
- ‘Thus… SR-B1 might represent a therapeutic target to limit SARS-CoV-2 infection.’
- This would likely benefit people with specific comorbidities more than others. People with heart disease and diabetes, who are most likely to have elevated HDL levels, are among those who would benefit the most.
- ‘Cardiovascular disease and diabetes are associated with an increased risk of severe C19,’ the researchers write.
- ‘Approximately half of patients with C19 have chronic underlying diseases, mainly cardiovascular and cerebrovascular diseases and diabetes.
- ‘In addition, increased C19 mortality has been observed in patients with obesity or diabetes.’
- NHS data from April reveals almost a third (29%) of coronavirus patients had heart disease and nearly a fifth (19%) were diabetic.
- A previous study from the NHS and Imperial College found patients with Type 2 diabetes are twice as likely to die from C19 and type 1 diabetics are three and a half times more likely to die.
3. How lockdown may lead to “avoidable harm” for the health of under 16s
- Decreases in hospital attendances and admissions amid fears of C19 may result in avoidable harm for under 16s say researchers, who warn against the “unintended consequences of pandemic control measures”.
- Research led by Dr Rachel Isba from Lancaster University, Dr Rachel Jenner from Royal Manchester Children’s Hospital, and Dr Marc Auerbach from Yale University analysed attendances and admissions to Paediatric Emergency Departments (PED) at the Royal Manchester Children’s Hospital in the UK and Yale New Haven Children’s Hospital in the US.
- The Royal Manchester Children’s Hospital, part of Manchester University NHS Foundation Trust is the largest and busiest children’s hospital in the UK and the PED sees approximately 50,000 patients per year. The PED at Yale New Haven Children’s Hospital sees over 38,000 patients per year. Both hospitals are in geographical areas that went into “lockdown” on March 23, 2020.
- The international team compared the differences between weekly attendances and admissions (via the PED) from January 1, 2020, to May 20, 2020 compared with the same period in 2019.
- Following lockdown, they found “a striking decrease” in the number of children and young people attending the PED at both hospitals.
- Despite this, after lockdown they were up to 60% more likely to be admitted to hospital in 2020 compared to the same period in 2019, suggesting they may have been more unwell by the time they attended hospital.
- The researchers said: “These observations likely reflect both a genuine decrease in need (e.g., fewer viral infections) but also an increase in delayed and unmet need. Children and adolescents presenting later on in their illness are more likely to have a negative outcome.”
- “Although the direct effects of C19 currently appear to be less severe in children and adolescents, only time will reveal the indirect negative impacts on this age group, including deaths, because of delayed Paediatric Emergency Department presentation.”
- They said that fear of C19 was likely to have been a factor in the reduced numbers of under 16s attending hospital PEDs.
- “Although not explored here, contributing factors are likely to include the parent or caregiver’s fear of the virus, resulting in higher personal thresholds for needing to attend, and will need to be addressed proactively in case of future lockdowns.
- “Those with responsibility for making and communicating decisions around lockdown need to be aware of the unintended consequences of pandemic control measures. As a minimum, there needs to be clear and consistent messaging around when it is appropriate to take an ill or injured child to hospital–emphasizing that a PED visit can be made safely — delivered at the start of any future periods of lockdown.”
4. Infected after holiday to Europe, pregnant Singapore mum gives birth to baby with C19 antibodies
- A “dramatic” pregnancy brought on by getting C19 when she was pregnant ended in tears of joy when Mrs Celine Ng-Chan, 31, gave birth to her second child earlier this month.
- To the private tutor’s relief, her son, Aldrin, was not only born free of C19, he even has antibodies against the virus, according to his paediatrician.
- Mrs Ng-Chan is one of a few women in Singapore who were infected with the coronavirus during their pregnancies to have given birth so far.
- She said: “It’s very interesting. His paediatrician said my C19 antibodies are gone but Aldrin has C19 antibodies.
- “My doctor suspects I have transferred my C19 antibodies to him during my pregnancy.”
- The Sunday Times understands Aldrin’s antibodies suggest that he has immunity to the virus.
- Weighing 3.5 kg at birth, he was born on Nov 7 at the National University Hospital (NUH), and looked exactly like his elder sister, Aldrina, 2, at her birth, Mrs Ng-Chan added.
- “I have always wanted a boy as I resonate very well with boys, having three younger brothers in my family,” she said.
- Mrs Ng-Chan said her pregnancy was a dramatic one, as she, her mother and her daughter all contracted C19 after returning from a family holiday to Europe in March. Her husband and father, who were on the trip as well, escaped infection.
- Mrs Ng-Chan’s mother, Madam Choy Wai Chee, 58, came close to death.
- The office manager was hospitalised for four months and spent 29 days on a life support machine.
- Mrs Ng-Chan and Aldrina were only mildly ill and were discharged from hospital after 2.5 weeks.
- When she was diagnosed with C19, Mrs Ng-Chan was 10 weeks pregnant.
- She said: “I wasn’t worried that Aldrin would get C19 as I read that the transmission risk (from mother to the fetus) is very low.”
- She was also aware of another couple, Natasha and Pele Ling, who were expecting their first child when they both fell ill with C19 in March.
- Mrs Ling, a 29-year-old speech and language therapist, tested positive for the coronavirus in her 36th week of pregnancy in March.
- She gave birth to Boaz on April 26 at the NUH. Baby Boaz was possibly the first baby born in Singapore with C19 antibodies.
- It is not known how many babies in Singapore have been born to women who had C19 while they were pregnant.
- Chairman of the obstetrics and gynaecology division at KK Women’s and Children’s Hospital (KKH), Associate Professor Tan Hak Koon, told The Straits Times that the number of pregnant women infected with C19 under the hospital’s care is “very low”, and none has as yet given birth.
- Prof Tan said guidelines published by the Royal College of Obstetricians and Gynaecologists in the United Kingdom in October said current evidence suggests that transmission of C19 from a pregnant woman to her baby during pregnancy or birth is uncommon.
- Current evidence also shows that whether the newborn infant catches C19 from his mother is not affected by the mode of delivery, feeding choice such as breast or bottle feeding, or if the mother and baby stayed in the same room after delivery.
- At NUH, a spokesman said that babies born to women who have recovered from C19 are assessed comprehensively by a team of doctors.
- Generally, invasive testing for C19 would not be required in a healthy asymptomatic baby if the mother had had C19 earlier in her pregnancy and had completely recovered and subsequently tested negative for C19, like Mrs Ng-Chan.
- Without specifying numbers, the spokesman added that maternal and umbilical cord blood is processed using the standard polymerase chain reaction, and so far all the mother-newborn pairs have tested negative.
- Mrs Ng-Chan said she was filled with joy and gratitude over the new addition to her family.
- “My pregnancy and birth was smooth sailing despite being diagnosed with C19 in my first trimester, which is the most unstable stage of the pregnancy. I’m very blessed to have Aldrin and he came out very healthy,” she said.
- “I feel relieved my C19 journey is finally over now.”
G. The Road Back?
1. Coronavirus shutdowns don’t need to be all or nothing
- We were warned this might happen.
- While millions stayed home last spring, looking to summer for respite from the virus, experts worried that an even larger fall surge was around the corner.
- We’ve rounded that corner. As cases and hospitalizations reach record levels across Europe and the United States, leaders are being forced to make hard decisions about what to shut down and when. In the United States, President-elect Joe Biden has made clear that he won’t call for a national lockdown, but more targeted shutdowns at the state or local level are on the table. And in fact, many regions are already rolling out more targeted approaches, focusing on crowded spaces like restaurants, bars, or schools.
- European countries began rolling out new restrictions in October, and in the United States many governors and city officials are beginning to partially clamp down. Public schools in New York City were closed on November 19; Minnesota has shuttered bars and restaurants for a month starting November 20; California officials enacted curfews between 10 p.m. and 5 a.m. in certain counties through December 21.
- Whether these fine-tuned restrictions will work remains to be seen. But scientists have been studying what worked and what didn’t in the early months of the pandemic, revealing some promising approaches. New research suggests that focusing on closing or reducing capacity at transmission hot spots while keeping less risky parts of the economy open can curb exponential rises in cases, while minimizing harm to the economy.
- “We don’t need to fully shelter in place to slow transmission,” says Lauren Ancel Meyers, a mathematical biologist at the University of Texas at Austin. But these sharper approaches work only if governments set clear guidelines and people follow them, she says. Even the smartest interventions will be overwhelmed if enacted too late amidst rampant transmission within a community.
- Here’s a closer look at what may work, and what doesn’t.
Don’ts: What didn’t work
- In hindsight, some of the measures enacted in the earliest days of the pandemic did little to quell it. Temperature checks and deep cleaning of public surfaces emerged as two largely ineffective measures in a global analysis published November 16 in Nature Human Behavior.
- Early on, “no one had a clue as to how to stop the spread of the virus,” says Peter Klimek, a data scientist at the Medical University of Vienna in Austria. Instead, countries threw the kitchen sink at the virus, enacting many measures simultaneously.
- Klimek and his colleagues used statistical techniques to try to disentangle which measures worked and which didn’t. In 56 different countries, including the United States, they assessed how more than 6,000 different interventions affected infection rates in the weeks after enactment. What they found comports with what we’ve since learned about the virus and how it spreads.
- Temperature checks, at border crossing or airports, aren’t especially effective because people are often contagious well before symptom onset (SN: 4/15/20). Deep cleaning public places such as subway cars seemed prudent early on, but evidence suggests that touching shared surfaces isn’t a big driver of transmission events, Klimek says. Instead, the coronavirus spreads most easily through the air (SN: 7/7/20)
Do: Target transmission hot spots
- Given the ease of airborne spread, interventions that targeted transmission hot spots — crowded indoor spaces — worked best, especially cancelling small gatherings of up to 50 people. “Basically this includes the closure of bars, restaurants, cafes, having people work from home if possible, and bans on family celebrations like weddings, funerals,” Klimek says.
- Limits on large gatherings, stay-at-home orders and travel restrictions proved effective too, along with increasing access to personal protective equipment and educating the public about risk management.
- These measures were more effective when enacted sooner, the researchers found. For instance, responding to a rise in cases quickly by cancelling small gatherings and restricting some travel, but keeping schools open, slowed the spread as much as if all three measures were enacted two weeks later when cases were much higher, Klimek says.
- “Countries that are facing difficult situations right now likely waited too long,” Klimek says. “It’s better to act sooner and act more decisively.”
- Part of the hesitancy to act early stems from a fear of the economic consequences of shutdowns. But scientists are trying to chart paths that minimize those economic costs while still controlling the virus.
- “If we can identify economic sectors that contribute most to transmission and least to gross domestic product, then those our prime candidates to close down,” says Katharina Hauck, a health economist at Imperial College London. “You get the biggest impact on transmission and the least damage to GDP.”
- To identify those sectors, Hauck and her colleagues simulated the effects of more targeted restrictions on disease spread and the economy in the United Kingdom, drawing on both economics and epidemiology. Using detailed survey data on people’s levels of contact, and thus transmission, at different sorts of businesses and residences, the researchers projected the effects of restricting different sectors.
- A widespread shutdown that maintains only essential services across 63 economic sectors, but leaves schools and universities open, would keep C19 hospitalizations within capacity, according to the report released November 16. Such a blunt shutdown would cost the United Kingdom 229 billion pounds (about $306 billion U.S. dollars) in lost GDP over the next six months, compared with hypothetically leaving the economy open but allowing hospitals to be overwhelmed.
- A fully open scenario would send 68,000 people to the hospital at the height of the surge, compared with the United Kingdom’s peak of around 18,000 C19 patients hospitalized in April, the researchers say. But letting the virus burn through a population unabated could have unforeseen and drastic economic consequences, in addition to leading to many more deaths.
- Alternatively, more targeted restrictions focused on high contact sectors like restaurants, retail shops, and entertainment venues could keep hospitals functional while allowing schools and universities to remain mostly open, along with manufacturing centers, construction, financial services and agriculture. Such a scenario cost the United Kingdom only 26 billion pounds (about $35 billion) in lost GDP, compared with keeping everything open.
- “Our study shows how we might fine-tune closures of the economy and save both lives and livelihoods,” Hauck says. England and much of Europe are in the midst of a more fine-tuned approach this fall, with restaurants and cafes closed in many countries but schools remaining largely open. There are preliminary signs these measures are turning the tide. Daily case counts in France, for instance, have fallen nearly 70 percent, from a weekly rolling average of over 54,868 on November 8 to 16,722 on November 25.
Do: Reduce crowding
- Could similarly targeted restrictions work in the United States?
- Simply limiting capacity at key transmission hot spots, such as restaurants, may be enough to curtail exponential spread in some cities, according to an analysis published November 10 in Nature. “Closing the economy does not have to be all or nothing, doesn’t have to be total lockdown and full reopening,” says Jure Leskovec, a computer scientist at Stanford University.
- Leskovec and his colleagues turned to cell phone mobility data from some 98 million Americans across 10 large metro areas, including Chicago, New York City, Atlanta and Washington D.C. This database allowed the researchers to “visualize” these people as particles, whose location is updated each hour as they move from their homes to places like restaurants, grocery stores and gyms. The researchers excluded schools and workplaces from their analysis.
- From this starting point, they built a statistical model, tweaking variables that control how easily a virus can jump from particle to particle (in effect, person to person) in different situations until the model closely matched the actual case counts in these 10 cities from March to May, even as these cities enacted social distancing measures.
- “From an epidemiological standpoint the model is quite simple, but it shows the power of mobility in spreading the virus,” Leskovec says. That simplicity also allowed the researchers to simulate different reopening strategies, seeing how restricting mobility at different locations influenced the spread of disease.
- Overall, most predicted infections occurred at a small number of places. In Chicago, for instance, their analyses found that 85 percent of infections occurred at just 10 percent of places outside the home, including restaurants and fitness centers. But 80 percent of those infections could be prevented by capping the maximum occupancy at any given time to 20 percent of normal. Leskovec says that these businesses still retain 60 percent of overall visitors, by their estimation, but the visits were more spread out so fewer people clustered together at any given time. “For the price of 40 percent of visitors, we’re preventing 80 percent of infections,” he says.
- Limiting occupancy is especially important in lower-income neighborhoods, the researchers found. Residents of these neighborhoods socially distance less due to work-related demands (SN: 11/11/20), and Leskovec’s analysis predicted higher infection rates at particular spots. “A single trip to the grocery store is twice as dangerous for a low-income person than a high-income person” in eight of the 10 metro areas, Leskovec says. “Low-income families go to stores that are more densely packed than richer families, and they stay longer,” Leskovec says.
- Limiting capacity at these often crowded locations, or creating other ways of distributing food in these neighborhoods, might start to ameliorate C19’s stark racial and ethnic health disparities (SN: 4/10/20).
Do: Act early
- While targeted shutdowns can work, these more precise tools are only effective if enacted before community spread takes off. “You have to tap on the brakes at the first indication that things are taking an alarming turn,” says Meyers, the mathematical biologist. “If intensive care units start reaching capacity, then it’s time to slam on the brakes,” with longer, more restrictive measures.
- In the United States, many regions may have already passed the optimal moment to start tapping the brakes with less restrictive measures, Meyers says. “The key pressure points for reducing transmission, like restrictions on indoor dining, are also some of the hardest things to get enacted.” But for every day that social distancing measures are delayed, cities need on average two and a half more days of restrictions to contain an outbreak, Meyers and colleagues report in Emerging Infectious Diseases in September.
- “Waiting a week to act not only means that things probably look worse in terms of hospitalizations, but it also might mean that we have to lock down for two and a half extra weeks longer,” Meyers says. “So even though we’re trying to avoid that sort of economic cost up front, it may come back to bite us.”
H. Innovation & Technology
1. Google’s DeepMind AI cracks 50-year-old riddle in major scientific breakthrough
- Artificial intelligence has helped to solve a 50-year-old riddle that could lead to faster virus treatments and medicinal discoveries.
- The “protein folding problem” has baffled scientists for decades because there are so many different types of proteins and they can be found in all living organisms.
- Coronavirus is related to the way proteins function as well as other diseases like dementia and cancer.
- A big problem with proteins is the fact it’s very difficult to map out their 2D structures.
- Google-owned artificial lab DeepMind is now claiming its AlphaFold program has solved the issue and can predict many protein shapes.
- This is a very impressive achievement considering there is around 200 million known proteins in the world.
- The London-based AI company says its system can identify a protein shape in a matter of days.
- Scientists from the 14th Community Wide Experiment on the Critical Assessment of Techniques for Protein Structure Prediction (CASP14) also worked on the project.
- They’ve been trying to solve the protein riddle since 1994.
- Chair of CASP14 Dr. John Moult said: “Proteins are extremely complicated molecules and their precise three-dimensional structure is key to the many roles they perform, for example the insulin that regulates sugar levels in our blood and the antibodies that help us fight infections.”
- “Even tiny rearrangements of these vital molecules can have catastrophic effects on our health, so one of the most efficient ways to understand disease and find new treatments is to study the proteins involved.”
- “There are tens of thousands of human proteins and many billions in other species, including bacteria and viruses, but working out the shape of just one requires expensive equipment and can take years.”
- The scientists have said there is still more work to be done and will be submitting a paper containing their current research for review.
- Their findings could go on to change scientific research as we know it.
2. Physicist creates N95-type respirators using cotton candy machine
- Mahesh Bandi, a physicist with the Nonlinear and Non-equilibrium Physics Unit, OIST Graduate University, Onna, Okinawa, has found a way to produce N95-type respirator filters that is less expensive and quicker than conventional approaches. In his paper published in Proceedings of the Royal Society A, he describes the technique he developed and how well his filters performed.
- As the pandemic has worn on, scientists have found that mask wearing can reduce the spread of C19. Unfortunately, cloth masks are far from foolproof. Research has shown that to prevent infection, people need to wear an N95 respirator—a face mask that has electrocharged filters that attract and hold viruses, preventing them from passing through. Such respirators are expensive, difficult to manufacture and are in short supply. In this new effort, Bandi has found a way to make a filter as effective as those used in N95 respirators but that can be produced quickly and cheaply.
- The technique involves heating ordinary plastics such as bottles or shopping bags and then putting them into an ordinary cotton candy machine (also known as a candy floss machine). The machine spins the plastic into a material that is similar to cotton candy (a mesh), which is also electrocharged by the spinning. Bandi then cuts the resulting material into small squares and then bolsters their electrostatic charge by placing them close to the vent of a common air ionizer.
- Bandi tested his filters by placing several inside of surgical masks. He found the filters worked very well, but the masks were not a viable option. He then designed his own mask to allow easy insertion and removal of the filters (each mask requires three) and used a 3-D printer to produce the result. Rigorous testing (which included microscopic inspections and comparisons with N95 filters) showed the filters to be as effective at preventing inhalation of SARS-CoV-2 viruses as standard N95-type respirators.
- Bandi does not say if he has plans to set up manufacturing centers for the masks—it appears he is simply publishing the idea as a way to allow others to do so.
3. Grabbing C19 and Other Viruses Out of Thin Air
- The future could hold portable and wearable sensors for detecting viruses and bacteria in the surrounding environment. But we’re not there yet. Scientists at Tohoku University have been studying materials that can change mechanical into electrical or magnetic energy, and vice versa, for decades. Together with colleagues, they published a review in the journal Advanced Materials about the most recent endeavors into using these materials to fabricate functional biosensors.
- “Research on improving the performance of virus sensors has not progressed much in recent years,” says Tohoku University materials engineer Fumio Narita. “Our review aims to help young researchers and graduate students understand the latest progress to guide their future work for improving virus sensor sensitivity.”
- Piezoelectric materials convert mechanical into electrical energy. Antibodies that interact with a specific virus can be placed on an electrode incorporated onto a piezoelectric material. When the target virus interacts with the antibodies, it causes an increase in mass that decreases the frequency of the electric current moving through the material, signaling its presence. This type of sensor is being investigated for detecting several viruses, including the cervical-cancer-causing human papilloma virus, HIV, influenza A, Ebola and hepatitis B.
- Magnetostrictive materials convert mechanical into magnetic energy and vice versa. These have been investigated for sensing bacterial infections, such as typhoid and swine fever, and for detecting anthrax spores. Probing antibodies are fixed onto a biosensor chip placed on the magnetostrictive material and then a magnetic field is applied. If the targeted antigen interacts with the antibodies, it adds mass to the material, leading to a magnetic flux change that can be detected using a sensing ‘pick-up coil’.
- Narita says that developments in artificial intelligence and simulation studies can help find even more sensitive piezoelectric and magnetostrictive materials for detecting viruses and other pathogens. Future materials could be coilless, wireless, and soft, making it possible to incorporate them into fabrics and buildings.
- Scientists are even investigating how to use these and similar materials to detect SARS-CoV-2 in the air. This sort of sensor could be incorporated into underground transportation ventilation systems, for example, in order to monitor virus spread in real time. Wearable sensors could also direct people away from a virus-containing environment.
- “Scientists still need to develop more effective and reliable sensors for virus detection, with higher sensitivity and accuracy, smaller size and weight, and better affordability, before they can be used in home applications or smart clothing,” says Narita. “This sort of virus sensor will become a reality with further developments in materials science and technological progress in artificial intelligence, machine learning, and data analytics.”
I. Projections & Our (Possible) Future
1. Dip in C19 testing over Thanksgiving could show false decline in spread
- A dip in COVID testing over the holidays may result in the false perception that the spread of the virus is slowing, experts warn.
- “I just hope that people don’t misinterpret the numbers and think that there wasn’t a major surge as a result of Thanksgiving, and then end up making Christmas and Hanukkah and other travel plans,” said Dr. Leana Wen, a professor at George Washington University and an emergency physician.
- Testing numbers are typically lower on Saturdays and Sundays, and a long holiday weekend for Thanksgiving is likely to increase the typical lag.
- Already, the number of tests and new positive cases has declined significantly. As of Friday, positive case numbers had dropped by about a third, according to Johns Hopkins University.
- About 1.2 million people were tested Thursday, down from 2 million per day a few days before Thanksgiving — a record high as the number of people seeking reassurance before the holidays flooded testing centers.
J. Practical Tips & Other Useful Information
1. One person in the room with you has C19. Here’s how long it takes to get infected
- Keep six feet of distance. Issued by the CDC and adopted by many businesses, it’s the guideline that most of us have lived by during C19.
- But as the climate has turned cold and some of us have moved indoors, John Bush, a professor of applied mathematics at MIT, calls such a rule of thumb “dangerous” and “overly simplistic.” Because when you’re inside, microscopic droplets are trapped right alongside you in a confined space, and standing six feet away from someone doesn’t stop the coronavirus (SARS-CoV-2) from floating in the air of your living room where you can potentially inhale it.
- So are any of us safe indoors during the C19 era? Can we go to a grocery store? Can we meet with a loved one? Bush, alongside his MIT colleague Martin Z. Bazant, has answered that question with a complex mathematical model, which simulates the fluid dynamics of virus-loaded respiratory droplets in any space, from a cozy kitchen to a gigantic concert hall.
- And because the equation is far too complicated for most people to understand, they turned their findings into a free online tool. Go to this website, and you can create your own custom scenario to judge C19 risks for yourself.
- The tool assumes one person in a room with you has C19. Then, it hands you an incredible amount of control to tweak the variables at play. These variables include details about the building: What’s the square footage? What’s the height of the ceiling? How about the HVAC system—is it a standard domestic furnace or does it have a fancy HEPA filter? What’s the humidity? Is a window open? The variables also include all sorts of details about human behavior: How many other people are there with you? Are they wearing masks? Cotton or surgical? Do they wear masks properly or pull them down their face a bit? Are they whispering or singing?
- At first glance, all of these controls might seem overwhelming. (And they are!) But the payoff is worth it. Because the tool gives you a very clear answer of how long how many people can safely be in a space together.
- Let’s try an example. You just enjoyed Thanksgiving dinner in a typical 20-foot-by-20-foot dining room with a group of 10 people. People talked normally. Nobody was wearing masks since they were eating. The air was of average humidity.
- “Based on this model, it should be safe for this room to have: 10 people for 18 minutes.” If you had simply followed a six-foot distance guideline and worn a mask, as the CDC suggests, these guests would be safe hanging out indefinitely. Which is clearly nonsensical.
- “But what if they were wearing masks?” you ask. Good question. Let’s assume no one ate and instead talked through coarse cotton masks. Cotton masks bought them two more minutes of safety. Opening the windows to increase ventilation helps more. It buys another six minutes.
- However, upgrading from coarse cotton masks to surgical masks increased the number to a whopping two hours. But with a catch: If those surgical masks are worn improperly by half of the people—say, the masks fit loosely or the wearers’ noses are sticking out—the safe time plummets back down to 32 minutes. Human factors matter a lot.
- It’s a demonstration that wearing masks properly does help. After working on the source math behind this tool, Bush concludes that we absolutely should because it’s the most “dramatic” effect he noticed; it moves the needle in any circumstance, buying you precious minutes to stay safe. However, masks are not hazmat suits. They cannot overcome the reality of being in a small space with other people.
- To prove the point, let’s make that dining room bigger. In fact, let’s stretch it into a 180,000-square-foot Walmart. And let’s fill it with 1,000 people who are good about wearing their coarse cotton masks. The only other variable I’m changing is that the air is probably a bit drier than in your home.
- In these conditions, the tool says people should be safe for 68 minutes—if only one person has C19.
- As you can see, more space helps people stay safe. Just keep this in mind: Where I live, around Chicago, as many as one in 15 people currently have C19, so as many as 66 people in that Walmart could have C19 out of 1,000. Here, we run into a shortcoming of the tool. It models a single sick person in a space, not what happens when real infection rates hit what they are now. And there’s no way to tweak it accordingly.
- Obviously this is just a model. It’s a simulation—researchers’ best guess of how our world works. It isn’t perfect and cannot guarantee your safety in any situation. But after using this MIT tool for over an hour, I went from feeling comforted to feeling like things are even less safe than I thought. The model seems to suggest that, when we’re stuck indoors during the peak of a pandemic, the only way to “stay safe out there” is to try to not go out there—or let anyone in—at all.
2. A Day-by-Day Breakdown of Coronavirus Symptoms Shows How The Disease Progresses
- As doctors observe a growing number of coronavirus patients, they have identified a few patterns in how typical symptoms progress.
- As many as 40% of coronavirus cases are asymptomatic, according to the Centres for Disease Control and Prevention. And 20% of symptomatic cases become severe or critical.
- Among patients who develop symptoms, a fever and cough are usually the first to arrive. They’re often followed by a sore throat, headache, muscle aches and pains, nausea, or diarrhoea (though in severe cases, gastrointestinal issues can appear earlier in the course of an infection).
- Patients with severe infections tend to develop difficulty breathing – one of the virus‘ hallmark symptoms – around five days after symptoms start.
- But symptoms generally don’t appear right after a person has been infected. The virus’ median incubation period is about four to five days, according to the Centres for Disease Control and Prevention.
- During that time, an infected person likely won’t yet know they’re sick, but evidence shows they could transmit the virus during the presymptomatic phase.
A day-by-day breakdown
- After observing thousands of patients during China’s outbreak earlier this year, hospitals there identified a pattern of symptoms among C19 patients:
- Day 1: Symptoms start off mild. Patients usually experience a fever, followed by a cough. A minority may have had diarrhoea or nausea one or two days before this, which could be a sign of a more severe infection.
- Day 3: This is how long it took, on average, before patients in Wenzhou were admitted to the hospital after their symptoms started. A study of more than 550 hospitals across China also found that hospitalized patients developed pneumonia on the third day of their illness.
- Day 5: In severe cases, symptoms could start to worsen. Patients may have difficulty breathing, especially if they are older or have a preexisting health condition.
- Day 7: This is how long it took, on average, for some patients in Wuhan to be admitted to the hospital after their symptoms started. Other Wuhan patients developed shortness of breath on this day.
- Day 8: By this point, patients with severe cases will have most likely developed shortness of breath, pneumonia, or acute respiratory distress syndrome (ARDS), an illness that may require intubation. ARDS is often fatal.
- Day 9: Some Wuhan patients developed sepsis, an infection caused by an aggressive immune response, on this day.
- Days 10-11: If patients have worsening symptoms, this is the time in the disease’s progression when they’re likely to be admitted to the ICU. These patients probably have more abdominal pain and appetite loss than patients with milder cases.
- Day 12: In some cases, patients don’t develop ARDS until nearly two weeks after their illness started. One Wuhan study found that it took 12 days, on average, before patients were admitted to the ICU. Recovered patients may see their fevers resolve after 12 days.
- Day 16: Patients may see their coughs resolve on this day, according to a Wuhan study.
- Day 17-21: On average, people in Wuhan either recovered from the virus and were discharged from the hospital or passed away after 2.5 to 3 weeks.
- Day 19: Patients may see their shortness of breath resolve on this day, according to a Wuhan study.
- Day 27: Some patients stay in the hospital for longer. The average stay for Wenzhou patients was 27 days.
- Just because patients leave the hospital, though, doesn’t mean their symptoms are fully gone. Some coronavirus patients report having symptoms for months, including chest pain, shortness of breath, nausea, heart palpitations, and loss of taste and smell.
- People who got sick and were never hospitalized can have lingering symptoms, too.
- A July report from CDC researchers found that among nearly 300 symptomatic patients, 35 percent had not returned to their usual state of health two to three weeks after testing positive.
- Patients who felt better after a few weeks said their symptoms typically resolved four to eight days after getting tested. Loss of taste and smell usually took the longest to get back to normal, they said: around eight days, on average.
3. AI Analyzes Content of Nightmares, Finds C19 Infects Majority of Bad Dreams
- C19 has turned 2020 into a nightmare for many people, as they struggle with health problems, economic uncertainty and other challenges. Now a team of researchers in Finland has evidence that the pandemic really is a bad dream. In a paper published in Frontiers in Psychology, scientists used artificial intelligence to help analyze the dream content of close to a thousand people and found that the novel coronavirus had infected more than half of the distressed dreams reported.
- The researchers crowdsourced sleep and stress data from more than 4,000 people during the sixth week of the C19 lockdown in Finland. About 800 respondents also contributed information about their dreams during that time — many of which revealed a shared anxiety about the pandemic.
- “We were thrilled to observe repeating dream content associations across individuals that reflected the apocalyptic ambience of C19 lockdown,” said lead author Dr. Anu-Katriina Pesonen, head of the Sleep & Mind Research Group at the University of Helsinki. “The results allowed us to speculate that dreaming in extreme circumstances reveal shared visual imagery and memory traces, and in this way, dreams can indicate some form of shared mindscape across individuals.”
- “The idea of a shared imagery reflected in dreams is intriguing,” she added.
- Pesonen and her team transcribed the content of the dreams from Finnish into English word lists and fed the data into an AI algorithm, which scanned for frequently appearing word associations. The computer built what the researchers called dream clusters from the “smaller dream particles” rather than entire dreams.
- Eventually, 33 dream clusters or themes emerged. Twenty of the dream clusters were classified as bad dreams, and 55% of those had pandemic-specific content. Themes such as failures in social distancing, coronavirus contagion, personal protective equipment, dystopia, and apocalypse were rated as pandemic specific.
- For example, word pairs in a dream cluster labeled “Disregard of Distancing” included mistake-hug, hug-handshake, handshake-restriction, handshake-distancing, distancing-disregard, distancing-crowd, crowd-restriction, and crowd-party.
- “The computational linguistics-based, AI-assisted analytics that we used is really a novel approach in dream research,” Pesonen said. “We hope to see more AI-assisted dream research in future. We hope that our study opened the development towards that direction.”
- The study also offered some insights into the sleep patterns and stress levels of people during the pandemic lockdown. For instance, more than half of respondents reported sleeping more than before the period of self-quarantine, though 10% had a harder time falling asleep and more than a quarter reported more frequent nightmares.
- Not surprisingly, more than half of study participants reported increases in stress levels, which were more closely linked to patterns like fitful sleep and bad dreams. Those most stressed-out also had more pandemic-specific dreams. The research could provide valuable insights for medical experts who are already assessing the toll the coronavirus is having on mental health. Sleep is a central factor in all mental health issues, according to Pesonen.
- “Repeated, intense nightmares may refer to post-traumatic stress,” she explained. “The content of dreams is not entirely random, but can be an important key to understanding what is the essence in the experience of stress, trauma and anxiety.”