Resurgence Of COVID-19 Research Articles

Vaccination as an alternative to non-drug interventions to prevent local resurgence of COVID-19

BackgroundWhile a COVID-19 vaccine protects people from serious illness and death, it remains a concern when and how to lift the high-cost and strict non-pharmaceutical interventions (NPIs). This study examined the joint effect of vaccine coverage and NPIs on the control of local and sporadic resurgence of COVID-19 cases.MethodsBetween July 2021 and January 2022, we collected the large-scale testing information and case number of imported COVID-19 patients from the website of the National Health Commission of China. A compartment model was developed to identify the level of vaccine coverage that would allow safe relaxation of NPIs, and vaccination strategies that can best achieve this level of coverage. We applied Monte Carlo simulation 50 000 times to remove random fluctuation effects and obtain fitted/predicted epidemic curve based on various parameters with 95% confidence interval at each time point.ResultsWe found that a vaccination coverage of 50.4% was needed for the safe relaxation of NPIs, if the vaccine effectiveness was 79.3%. The total number of incidence cases under the key groups firstly strategy was 103 times higher than that of accelerated vaccination strategy. It needed 35 months to fully relax NPIs if the key groups firstly strategy was implemented, and 27 months were needed with the accelerated vaccination strategy. If combined the two strategies, only 8 months are needed to achieve the vaccine coverage threshold for the fully relaxation of NPIs. Sensitivity analyses results shown that the higher the transmission rate of the virus and the lower annual vaccine supply, the more difficult the epidemic could be under control. When the transmission rate increased 25% or the vaccination effectiveness rate decreased 20%, 33 months were needed to reduce the number of total incidence cases below 1000.ConclusionsAs vaccine coverage improves, the NPIs can be gradually relaxed. Until that threshold is reached, however, strict NPIs are still needed to control the epidemic. The more transmissible SARS-CoV-2 variant led to higher resurgence probability, which indicates the importance of accelerated vaccination and achieving the vaccine coverage earlier.Graphical

ScienceWriters2021: Some Highlights for Science Editors et al

Although titled ScienceWriters, the annual conference of the National Association of Science Writers (NASW) and the Council for the Advancement of Science Writing (CASW) also has much to offer professionals in science editing and related realms. The following are highlights of some editorially related sessions of ScienceWriter2021, held September 28–October 8, 2021. Initially designed as a hybrid in-person and online event, with the in-person aspect in Boulder, CO, the conference was moved to online-only because of a resurgence of COVID-19. Science in a Fact-Free World: Applying Lessons from the COVID Crisis to Climate Communication By Caleb Hess A word cloud populates in real-time; near the center, words submitted most frequently appear in progressively larger fonts: Scared. Hopeless. Overwhelmed. These were the audience’s submissions when Katharine Hayhoe, chief scientist for the Nature Conservancy, asked for their one-word thoughts on climate change. Hayhoe’s presentation focused on the lessons gleaned from the COVID-19 pandemic about effective science communication. Specifically, it addressed how communication of politicized science can be reframed to appeal to cultural and political values. Failures in communicating about climate issues and COVID, Hayhoe stated, stem from relying excessively on data to sway people’s opinions. Instead, she said, values influence what information people are open to accepting more than data does. Hayhoe noted that in the United States, political affiliation, which signals values, is associated with the most polarization in individuals’ stances on popular issues. The most scientifically literate individuals, she said, are just better at “cherry picking” facts that fit their worldviews. This means […]

Structural and biochemical rationale for enhanced spike protein fitness in delta and kappa SARS-CoV-2 variants

The Delta and Kappa variants of SARS-CoV-2 co-emerged in India in late 2020, with the Delta variant underlying the resurgence of COVID-19, even in countries with high vaccination rates. In this study, we assess structural and biochemical aspects of viral fitness for these two variants using cryo-electron microscopy (cryo-EM), ACE2-binding and antibody neutralization analyses. Both variants demonstrate escape of antibodies targeting the N-terminal domain, an important immune hotspot for neutralizing epitopes. Compared to wild-type and Kappa lineages, Delta variant spike proteins show modest increase in ACE2 affinity, likely due to enhanced electrostatic complementarity at the RBD-ACE2 interface, which we characterize by cryo-EM. Unexpectedly, Kappa variant spike trimers form a structural head-to-head dimer-of-trimers assembly, which we demonstrate is a result of the E484Q mutation and with unknown biological implications. The combination of increased antibody escape and enhanced ACE2 binding provides an explanation, in part, for the rapid global dominance of the Delta variant.

COVID-19 Resurgence in Iran, Lessons Learned

COVID-19 Resurgence in Iran, Lessons Learned

Projected resurgence of COVID-19 in the United States in July—December 2021 resulting from the increased transmissibility of the Delta variant and faltering vaccination

Projected resurgence of COVID-19 in the United States in July—December 2021 resulting from the increased transmissibility of the Delta variant and faltering vaccination

COVID-19 and a biased public mentality toward infection and vaccination: A case of unrealistic optimism and social comparisons between the vaccinated and unvaccinated

Unrealistic Optimism in the context of COVID-19 is described as the tendency to perceive peers as being more at risk of infection. To date, however, no research has proposed more specific comparisons. The present article not only replicates the most recent body of literature showing that people perceive themselves as less prone to COVID-19 infection than their peers, but fills the aforementioned gap by providing additional and more specific comparisons between those vaccinated and unvaccinated against COVID-19. Such comparisons may be crucial to curb the possibility of resurgence of COVID-19 by assessing how unvaccinated individuals perceive the probability of being infected by coronavirus. Some 622 Prolific—(un)vaccinated against COVID-19—users participated in an online quasi-experiment. Participants estimated the risk of COVID-19 infection for themselves, their peers or the average (un)vaccinated peer, which is a new addition to the literature. Results showed that there was an unrealistic optimism effect. Participants estimated their risk for infection as lower in comparison to others. Surprisingly, results showed that for unvaccinated people, vaccines seem to be an effective tool to reduce the risk of infection, but not for themselves.

Prioritizing COVID-19 Contact Tracing During a Surge Using Chatbot Technology.

When COVID-19 cases surge, identifying ways to improve the efficiency of contact tracing and prioritize vulnerable communities for isolation and quarantine support services is critical. During a fall 2020 COVID-19 resurgence in San Francisco, California, prioritization of telephone-based case investigation by zip code and using a chatbot to screen for case participants who needed isolation support reduced the number of case participants who would have been assigned for a telephone interview by 31.5% and likely contributed to 87.5% of Latinx case participants being successfully interviewed. (Am J Public Health. 2022;112(1):43-47. https://doi.org/10.2105/AJPH.2021.306563).

Telehealth to the Rescue During COVID-19: A Convergent Mixed Methods Study Investigating Patients' Perception.

Background: The onset of the pandemic necessitated abrupt transition to telehealth consultations. Although there is a few tools that gauge the patients' perception about their experiences, none of them are contextualized to an emergency in the Middle East and North Africa region. Accordingly, this study aims at developing and validating a tool to address this gap, and deploying it to assess the patients' perception of telehealth services during COVID-19 in Dubai, United Arab Emirates (UAE).Methods: A convergent mixed methods design was adapted. A random selection of 100 patients from Dubai, UAE were invited to participate. Qualitative and quantitative datasets were collected using a tailor-made survey. The qualitative data, collected through open-ended questions, was analyzed using multi-staged thematic analysis. As for the quantitative data, it captured the patients' extent of satisfaction, and was assessed using SPSS (with a series of descriptive and inferential analyses). The qualitative and quantitative findings were then merged via joint display analysis.Results: Out of the 100 patients that were randomly selected, 94 patients participated in this study. The reliability score of Cronbach's Alpha for the instrument was 98.9%. The percentage of the total average of satisfaction was 80.67%. The Principal Component Analysis showed that 88.1% of the variance can be explained by the instrument (p < 0.001). The qualitative data analysis expanded upon the quantitative findings enabling a better understanding of the patients' perception. Three themes, revolving around the quality of the patient telehealth experiences, surfaced: “Factors that worked to the benefit of the patients,” “Factors that the patients were not in favor of,” and “Opportunities for improvements as perceived by the patients.”Discussion: This study introduced a novel patient satisfaction with telehealth consultation survey contextualized to the COVID-19 times in Dubai, UAE. The participants were quite satisfied with the quality of their experience, however they suggested areas for improvement. Regional healthcare decision-makers can leverage the identified advantages and opportunities for improvement of telehealth. This will enable making informed decisions regarding the continuity of telehealth irrespective of how matters unfold in relation to the pandemic. It will also better prepare the healthcare sector for potential resurgence(s) of COVID-19 and/or the occurrence of other similar emergencies.

No further delays in offering booster doses in countries experiencing a major resurgence of COVID-19

Covid booster shots should be proposed and recommended to all fully vaccinated individuals, considering antibody levels are waning over time and that the risk of being infected typically reappears after 6 months.

Epidemiological Characteristics of COVID-19 Resurgence in Areas Initially Under Control.

Objectives: To investigate the epidemiological characteristics and infection routes of new cases in order to provide information for preventing COVID-19 resurgence in areas initially under control.Methods: The information of new symptomatic and asymptomatic patients in Chinese mainland was collected. The location distribution, epidemic course, infection routes and patients' characteristics of outbreaks were described and analyzed.Results: There were 43 new outbreaks with 3,795 symptomatic patients in Chinese mainland from March 21, 2020 to June 13, 2021. These outbreaks mainly occurred in central, border and coastal port cities. The main infection route of first generation indigenous patients was contact with imported cases and contaminated goods or environments. The infection routes of secondary generation patients mainly included family transmission, indoor social gathering infection, nosocomial infection and other infection routes. Family transmission was the most common infection route, and indoor social gathering was the most important reason for the large-scale outbreaks.Conclusions: Strengthen the management of imported patients and staff in high-risk posts was the key point to avoid the first generation indigenous patients. Adequate family isolation, prompt management policies for indoor public place and monitor of population at risk of infection were key strategies for preventing COVID-19 resurgence in areas initially under control.

Impact of COVID-19 lockdown on self-harm and violence among patients presenting to the emergency department.

ImportanceConsidering the resurgence of COVID19 and the rapid spread of new and deadlier strains across the globe understanding the incidence and pattern of violence and self harm tendencies during this period might help in formulating better contingency plans for future lockdowns. A deeper look at the available data shows that there is a significant dearth of research into self-harm & violence during the COVID-19 pandemic.ObjectiveTo identify the incidence and sociodemographic characteristics of self-harm and violence during the COVID19 lockdown and compare with a control group from the previous year.DesignA cross-sectional retrospective observational study.SettingTertiary care teaching hospital.ParticipantsAll patients presenting to the emergency department (ED) with self harm and violence during the COVID-19 lockdown period between March 24–June 30, 2020 and March 24–June 30, 2019.ExposureThe COVID-19 lockdown period.Main outcome (s) and measure (s)The hypothesis being tested was formulated before the study. The null hypothesis tested was a decline in number of self-harm and violence cases during the lockdown.ResultsA total of 828 patients were analysed over both the time periods, out of which 30% (248) were females while 70% (580) were males. Increases in self-harm and violence were 12.71% and 95.32% respectively per 1000 ED admissions.A significant correlation was found between the COVID-19 lockdown and the increased incidence (X2 (1, N = 828) = 9.2, p < .05). An increase of violence by known individuals and between partners was seen. Intimate partner violence also increased to 7%. X2 (3, N = 662) = 21.03, p < .05. In the self harm dataset an increase in mortality, ICU admissions and decision to leave against medical advice was noted (X2 (4, N = 166) = 24.49, p < .05). Increase in the use of alcohol prior to acts of self harm and violence was noted.ConclusionsIncrease in the incidence of cases of self-harm and violence reported to the ED was noted during the lockdown period. Upgradation of health-care and law enforcement infrastructure maybe needed to deal with similar circumstances in a more efficient manner.Trial registration: N/A.

Principals Strategies for Managing the Resurgence of Covid-19 in the Administration of Secondary Schools in Rivers State

The study investigated principals strategies for Covid-19 in the administration of secondary schools in Rivers State. Three research questions and three corresponding hypotheses guided the work. The study adopted the descriptive survey design. A sample size of 92 representing 30% drawn from a population of 276 principals using stratified sampling technique. A validated instrument titled principal’s strategies for managing the resurgence of Covid-19 questionnaire (PSMRCIQ) was used for data collection. The instrument yielded a reliability index of 0.87 using test re-test method. Mean and standard deviation were used to answer the research questions, while the z-test was used to test the hypotheses. The findings revealed that principals strategies for managing the resurgence of Covid-19 are; being vigilant in noticing sick students and staff, ensuring that social distancing and wearing of face mask are maintained, ensuring that all appropriate infection control measures are implemented and classes are not over crowed. It was recommended that Rivers State government should ensure that secondary schools are provided with preventive measures and health workers. And principals should also ensure that schools are comply and obey all preventive measure and classes should not also be overcrowded.

Effectiveness of a third dose of the BNT162b2 mRNA COVID-19 vaccine for preventing severe outcomes in Israel: an observational study

BackgroundMany countries are experiencing a resurgence of COVID-19, driven predominantly by the delta (B.1.617.2) variant of SARS-CoV-2. In response, these countries are considering the administration of a third dose of mRNA COVID-19 vaccine as a booster dose to address potential waning immunity over time and reduced effectiveness against the delta variant. We aimed to use the data repositories of Israel's largest health-care organisation to evaluate the effectiveness of a third dose of the BNT162b2 mRNA vaccine for preventing severe COVID-19 outcomes.MethodsUsing data from Clalit Health Services, which provides mandatory health-care coverage for over half of the Israeli population, individuals receiving a third vaccine dose between July 30, 2020, and Sept 23, 2021, were matched (1:1) to demographically and clinically similar controls who did not receive a third dose. Eligible participants had received the second vaccine dose at least 5 months before the recruitment date, had no previous documented SARS-CoV-2 infection, and had no contact with the health-care system in the 3 days before recruitment. Individuals who are health-care workers, live in long-term care facilities, or are medically confined to their homes were excluded. Primary outcomes were COVID-19-related admission to hospital, severe disease, and COVID-19-related death. The third dose effectiveness for each outcome was estimated as 1 – risk ratio using the Kaplan-Meier estimator.Findings1 158 269 individuals were eligible to be included in the third dose group. Following matching, the third dose and control groups each included 728 321 individuals. Participants had a median age of 52 years (IQR 37–68) and 51% were female. The median follow-up time was 13 days (IQR 6–21) in both groups. Vaccine effectiveness evaluated at least 7 days after receipt of the third dose, compared with receiving only two doses at least 5 months ago, was estimated to be 93% (231 events for two doses vs 29 events for three doses; 95% CI 88–97) for admission to hospital, 92% (157 vs 17 events; 82–97) for severe disease, and 81% (44 vs seven events; 59–97) for COVID-19-related death.InterpretationOur findings suggest that a third dose of the BNT162b2 mRNA vaccine is effective in protecting individuals against severe COVID-19-related outcomes, compared with receiving only two doses at least 5 months ago.FundingThe Ivan and Francesca Berkowitz Family Living Laboratory Collaboration at Harvard Medical School and Clalit Research Institute.

Sustaining effective COVID-19 control in Malaysia through large-scale vaccination

IntroductionAs of 3rd June 2021, Malaysia is experiencing a resurgence of COVID-19 cases. In response, the federal government has implemented various non-pharmaceutical interventions (NPIs) under a series of Movement Control Orders and, more recently, a vaccination campaign to regain epidemic control. In this study, we assessed the potential for the vaccination campaign to control the epidemic in Malaysia and four high-burden regions of interest, under various public health response scenarios. MethodsA modified susceptible-exposed-infectious-recovered compartmental model was developed that included two sequential incubation and infectious periods, with stratification by clinical state. The model was further stratified by age and incorporated population mobility to capture NPIs and micro-distancing (behaviour changes not captured through population mobility). Emerging variants of concern (VoC) were included as an additional strain competing with the existing wild-type strain. Several scenarios that included different vaccination strategies (i.e. vaccines that reduce disease severity and/or prevent infection, vaccination coverage) and mobility restrictions were implemented. ResultsThe national model and the regional models all fit well to notification data but underestimated ICU occupancy and deaths in recent weeks, which may be attributable to increased severity of VoC or saturation of case detection. However, the true case detection proportion showed wide credible intervals, highlighting incomplete understanding of the true epidemic size. The scenario projections suggested that under current vaccination rates complete relaxation of all NPIs would trigger a major epidemic. The results emphasise the importance of micro-distancing, maintaining mobility restrictions during vaccination roll-out and accelerating the pace of vaccination for future control. Malaysia is particularly susceptible to a major COVID-19 resurgence resulting from its limited population immunity due to the country’s historical success in maintaining control throughout much of 2020.

SARS-CoV-2 RNA surveillance in large to small centralized wastewater treatment plants preceding the third COVID-19 resurgence in Bangkok, Thailand

Wastewater surveillance for SARS-CoV-2 RNA has been a successful indicator of COVID-19 outbreaks in populations prior to clinical testing. However, this has been mostly conducted in high-income countries, which means there is a dearth of performance investigations in low- and middle-income countries with different socio-economic settings. This study evaluated the applicability of SARS-CoV-2 RNA monitoring in wastewater (n = 132) to inform COVID-19 infection in the city of Bangkok, Thailand using CDC N1 and N2 RT-qPCR assays. Wastewater influents (n = 112) and effluents (n = 20) were collected from 19 centralized wastewater treatment plants (WWTPs) comprising four large, four medium, and 11 small WWTPs during seven sampling events from January to April 2021 prior to the third COVID-19 resurgence that was officially declared in April 2021. The CDC N1 assay showed higher detection rates and mostly lower Ct values than the CDC N2. SARS-CoV-2 RNA was first detected at the first event when new reported cases were low. Increased positive detection rates preceded an increase in the number of newly reported cases and increased over time with the reported infection incidence. Wastewater surveillance (both positive rates and viral loads) showed strongest correlation with daily new COVID-19 cases at 22–24 days lag (Spearman's Rho = 0.85–1.00). Large WWTPs (serving 432,000–580,000 of the population) exhibited similar trends of viral loads and new cases to those from all 19 WWTPs, emphasizing that routine monitoring of the four large WWTPs could provide sufficient information for the city-scale dynamics. Higher sampling frequency at fewer sites, i.e., at the four representative WWTPs, is therefore suggested especially during the subsiding period of the outbreak to indicate the prevalence of COVID-19 infection, acting as an early warning of COVID-19 resurgence.

Predicting High-Risk Groups for COVID-19 Anxiety Using AdaBoost and Nomogram: Findings from Nationwide Survey in South Korea

People living in local communities have become more worried about infection due to the extended pandemic situation and the global resurgence of COVID-19. In this study, the author (1) selected features to be included in the nomogram using AdaBoost, which had an advantage in increasing the classification accuracy of single learners and (2) developed a nomogram for predicting high-risk groups of coronavirus anxiety while considering both prediction performance and interpretability based on this. Among 210,606 adults (95,287 males and 115,319 females) in South Korea, 39,768 people (18.9%) experienced anxiety due to COVID-19. The AdaBoost model confirmed that education level, awareness of neighbors/colleagues’ COVID-19 response, age, gender, and subjective stress were five key variables with high weight in predicting anxiety induced by COVID-19 for adults living in South Korean communities. The developed logistic regression nomogram predicted that the risk of anxiety due to COVID-19 would be 63% for a female older adult who felt a lot of subjective stress, did not attend a middle school, was 70.6 years old, and thought that neighbors and colleagues responded to COVID-19 appropriately (classification accuracy = 0.812, precision = 0.761, recall = 0.812, AUC = 0.688, and F-1 score = 0.740). Prospective or retrospective cohort studies are required to causally identify the characteristics of anxiety disorders targeting high-risk COVID-19 anxiety groups identified in this study.

Asymptomatic COVID-19 Adult Outpatients identified as Significant Viable SARS-CoV-2 Shedders

Differential kinetics of RNA loads and infectious viral levels in the upper respiratory tract between asymptomatic and symptomatic SARS-CoV-2 infected adult outpatients remain unclear limiting recommendations that may guide clinical management, infection control measures and occupational health decisions. In the present investigation, 496 (2.8%) of 17,911 French adult outpatients were positive for an upper respiratory tract SARS-CoV-2 RNA detection by a quantitative RT-PCR assay, of which 180 (36.3%) were COVID-19 asymptomatic. Of these adult asymptomatic viral shedders, 75% had mean to high RNA viral loads (Ct values < 30) which median value was significantly higher than that observed in symptomatic subjects (P = 0.029), and 50.6% were positive by cell culture assays of their upper respiratory tract specimens. Our findings indicate that COVID-19 asymptomatic adult outpatients are significant viable SARS-CoV-2 shedders in their upper respiratory tract playing a major potential role as SARS-CoV-2 transmitters in various epidemiological transmission chains, promoting COVID-19 resurgence in populations.

Understanding the effectiveness of government interventions against the resurgence of COVID-19 in Europe

European governments use non-pharmaceutical interventions (NPIs) to control resurging waves of COVID-19. However, they only have outdated estimates for how effective individual NPIs were in the first wave. We estimate the effectiveness of 17 NPIs in Europe’s second wave from subnational case and death data by introducing a flexible hierarchical Bayesian transmission model and collecting the largest dataset of NPI implementation dates across Europe. Business closures, educational institution closures, and gathering bans reduced transmission, but reduced it less than they did in the first wave. This difference is likely due to organisational safety measures and individual protective behaviours—such as distancing—which made various areas of public life safer and thereby reduced the effect of closing them. Specifically, we find smaller effects for closing educational institutions, suggesting that stringent safety measures made schools safer compared to the first wave. Second-wave estimates outperform previous estimates at predicting transmission in Europe’s third wave.

Mobility data to aid assessment of human responses to extreme environmental conditions

Mobility data to aid assessment of human responses to extreme environmental conditions

Antecedents of patients Covid-19 management outcomes

Background: Effective Covid-19 management calls for clear understanding of determinants of possible outcomes. The likelihood of mortality or extent of recovery are the only two eventual outcomes. Examining influences of exposure, effect multiplier, moderating, and confounding factors in Covid-19 management is key to safeguarding human life and protecting livelihoods. Method: An assessment of covid-19 resurgence preparedness was conducted in Lake Region Economic Bloc Counties of Kenya. Data on cumulative cases, mortality, vaccination, oxygen flow per minute, and ages of infected was collected. Mortality is taken as the response variable where cumulative cases is exposure variable, vaccination as moderating variable, oxygen flow rate as effect multiplier, and age taken as a confounding factor. Age frequency is used as a categorical variable and divided in three groups: 0-19, 20-49, and 50 < years. A multiple logistic regression model is formulated, fitted, and estimated. Finally, an outcome predictive model is fitted. Findings: Adjusting for all variables, the likelihood of mortality after being infected is 5.3%, (1.053:95% CI, 1.03 - 3.34). A patient is 27%, (95% CI, 7% -33%) more likely to succumb to Covid-19 because of insufficient oxygen compared to a patient without critical oxygen need. Unvaccinated patient is 1.27 times (95% CI, 1.14 -6.26) more likely to die of Covid-19 compared to the vaccinated. A patient aged (20-49) years is 21%, (95% CI, 2% -30.4%) more likely to succumb to Covid-19 compared to one aged (0-19) years. Lastly, a patient aged 50 years and older is 47%, (95% CI, 3% - 56%) more likely to succumb to Covid-19 compared to one in (0-19) years age bracket.