Future Pandemics Research Articles

COVID-19 and protection measures adopted in rural amazon communities during the first months of the pandemic.

Motivation for the study. To document the evolution of COVID-19 in rural Amazonian populations, which are still little known. Main findings. COVID-19 spread rapidly through rural communities, initially spreading to mestizo hamlets and later affecting indigenous communities. Rural mortality varied by region and ethnicity. Social distancing was difficult, and travel to receive government vouchers contributed to contagion. Implications. Identifying the factors that contributed to contagion and the barriers to the adoption of protective measures in rural Amazonian populations will help to face future pandemics. To analyze the evolution of COVID-19 in rural populations of Loreto and Ucayali in the early stage of the pandemic. A community-level longitudinal observational study was conducted and based on two rounds of telephone surveys with local authorities of more than 400 indigenous and non-indigenous rural communities in Loreto and Ucayali, in July and August 2020. We collected information on cases and deaths by COVID-19 in their communities, protective measures adopted and if state assistance was received in the early stage of the pandemic. Descriptive statistics allowed us to evaluate the evolution of the pandemic after the initial outbreak and compare the trends of the two regions, as well as between indigenous and non-indigenous populations. In July 2020, COVID-19 had reached 91.5% of the communities, although deaths from COVID-19 were reported in 13.0% of the communities, with rural mortality being higher in Ucayali (0.111%) than in Loreto (0.047%) and in non-indigenous communities. By August, prevalence decreased from 44.0% to 32.0% of communities, but became more frequent in indigenous communities, and those in Ucayali. Traveling to the city to receive state bonuses and difficulties maintaining social distancing contributed to the spread. Our findings show the evolution of COVID-19 in rural communities and point to important areas of attention in future public policies, for the adoption of protective measures and reconsidering strategies for the distribution of assistance in the face of future pandemics. Motivation for the study. To document the evolution of COVID-19 in rural Amazonian populations, which are still little known. Main findings. COVID-19 spread rapidly through rural communities, initially spreading to mestizo hamlets and later affecting indigenous communities. Rural mortality varied by region and ethnicity. Social distancing was difficult, and travel to receive government vouchers contributed to contagion. Implications. Identifying the factors that contributed to contagion and the barriers to the adoption of protective measures in rural Amazonian populations will help to face future pandemics.

Decoding Pandemic Stress: Analysing Mental Health of Tea Workers in India

This research article aims to investigate the factors that affected the mental health of tea workers during the COVID-19 pandemic. The study provides essential insights into the psychological factors affecting tea workers during this critical time. Data were collected through semi-structured questionnaires from 532 tea workers in the north-eastern region of India. The collected data were analysed using confirmatory factor analysis and structural equation modelling approaches. The study found that all the factors investigated significantly impacted employee stress during the COVID-19 pandemic. However, safety perception and contagion risk were found to have the strongest influence on stress, followed by unknown and information overload, social exclusion and humiliation, monetary loss and job uncertainty, and quarantine and restraint. Additionally, the study confirms that stress at the onset of the COVID-19 pandemic can lead to depression among tea workers, which is also related to insomnia and relationship troubles. Investigating the various dimensions of COVID-19 stressors among tea workers is crucial for the government and management to understand the root causes of the problem. By understanding the contributing factors to mental health issues, we can develop appropriate interventions to support the well-being of tea workers, providing a blueprint for mitigating the potential adverse effects of future pandemics.

Experiences of mental health and poverty in high-income countries during COVID-19: A systematic review and meta-aggregation

Systematic reviews have been published that explore the experiences of living in poverty, yet there are no known studies that have synthesized the findings of research exploring the experiences of mental health and wellbeing of persons living in poverty during COVID-19. To address this gap, we conducted a systematic review and meta-aggregation of qualitative evidence using the method described by the Joanna Briggs Institute (JBI) following the PRISMA guidelines. Of 8391 titles and abstracts screened, we included 23 studies in our review and meta-aggregation. In conducting our meta-aggregation, we generated three synthesized findings: 1) magnification of inequities and marginalization during COVID-19; 2) difficulty accessing resources during the lockdown; and 3) the lockdown causing changes in mental health and wellbeing. The findings of this review suggest that persons living in poverty experienced increased difficulties with mental health and well-being during COVID-19. This was largely influenced by the presence of pandemic restrictions and increasing financial precarity that resulted in rising levels of psychosocial distress. Research regarding the plight of persons living in low income is needed to inform policy and practice for future pandemics in order to decrease the vulnerability of this population. Implementing evidence-informed policies and practices that mitigate the negative psychological effects of physical distancing restrictions on persons living in poverty are needed, and these can be identified through future research efforts.

Health System Resilience and Sustainability in India - Odisha's Strategies on Human Resources Management during COVID-19

Background: COVID-19 pandemic caused widespread loss of life, economic downturns, emotional distress and overwhelmed the public health delivery systems across the globe. Odisha was one of the few states in India that deployed proactive management of human resources in health (HRH) to fight the menace. This paper analyzes key decisions related to HRH during COVID-19. The findings aim to strengthen HRH practices to address future pandemics. Materials and Methods: We analyzed the structures, functions, and processes related to HRH management during the COVID-19, using a qualitative lens. Through purposive sampling, in-depth interviews were conducted with 20 key informants, including policymakers and state-level managers. Data were analyzed thematically to reflect upon the perspectives of key stakeholders, identify barriers and enablers, and document the decision-making dynamics. Results: Odisha strengthened its hospital infrastructure and capacity of health workforce through additional deployment and skill upgradation in a short period. Restriction of movements and strengthening the health system pillars led to considerable success. As COVID-19 cases surged in mid-2020, focus shifted to clinical treatment, active case finding and surveillance. Specific training modules were developed with guidance from the Ministry of Health, WHO, and UNICEF. A whole range of human resources were trained by both online and offline modes. Community-level training programs focused on enforcing COVID-appropriate behavior and management of vulnerable population. Infusion of technology enhanced the system’s capacity to deliver high quality training in a short period of time to a vast majority of stakeholders. Conclusion: The Odisha State Disaster Management Authority (OSDMA) and the National Health Mission (NHM) played critical roles in enhancing systems’ preparedness and institutionalizing such large-scale capacity building initiatives during periods of crisis. The state's approach in terms of scale, skill, and speed of human resources management could be a model for addressing future health crises.

Clinical characteristics and predictors of complications and mortality in hospitalized octogenarian patients with COVID-19: an ambispective study.

This study aimed to describe the clinical presentation of COVID-19 in hospitalized patients aged 80 or above and to identify predictors for death and complications throughout the epidemic waves of the disease. This was an observational, multicenter, ambispective study conducted between March 2020 and August 2021 using data collected in five centers from southern metropolitan area of Barcelona (COVID-MetroSud cohort). Patients were grouped based on the pandemic waves of inclusion in the registry. We conducted a descriptive analysis, followed by bivariate and multivariate analyses (binary logistic regression) to identify predictors of risk for death or complications. A total of 1192 patients (mean [SD] age 85.7 [4.22] years and 46.8% female) were included. The most frequently reported symptoms in all waves were fever (63.1%), cough (56.5%), dyspnea (48.2%), and asthenia (27.5%). Laboratory and radiological findings consistently showed abnormal bilateral chest X-ray results (72.5% of patients) and elevated inflammatory markers such as lactate dehydrogenase (mean [SD] 335 [188] U/L), C-reactive protein (CRP) (mean [SD] 110 [88.4] U/L), and ferritin (mean [SD] 842 [1561] U/L). Acute respiratory distress syndrome (43.7%), renal failure (19.2%), and delirium (17.5%) were the most frequent complications. The overall mortality rate was 41.4% and declined across the epidemic waves. Age, diabetes mellitus, heart failure, dyspnea, and higher baseline levels of creatinine were identified as risk factors for complications, while a higher Barthel index and presence of cough were found to be protective. Age, dyspnea, abnormal bilateral chest X-ray, CRP, and sodium were identified as risk factors for death. This study demonstrates the clinical presentation of COVID-19 (fever, cough, dyspnea, and asthenia) and the different risk factors for mortality and complications in octogenarian hospitalized patients throughout the pandemic. These findings could be highly valuable for managing future virus pandemics.

Attenuating mitochondrial dysfunction-derived reactive oxygen species and reducing inflammation: the potential of Daphnetin in the viral pneumonia crisis.

Amidst the global burden of viral pneumonia, mitigating the excessive inflammatory response induced by viral pneumonia has emerged as a significant challenge. Pneumovirus infections can lead to the persistent activation of M1 macrophages, culminating in cytokine storms that exacerbate pulmonary inflammation and contribute to the development of pulmonary fibrosis. Mitochondria, beyond their role as cellular powerhouses, are pivotal in integrating inflammatory signals and regulating macrophage polarization. Mitochondrial damage in alveolar macrophages is postulated to trigger excessive release of reactive oxygen species (ROS), thereby amplifying macrophage-mediated inflammatory pathways. Recent investigations have highlighted the anti-inflammatory potential of Daphnetin, particularly in the context of cardiovascular and renal disorders. This review elucidates the mechanisms by which viral infection-induced mitochondrial damage promotes ROS generation, leading to the phenotypic shift of alveolar macrophages towards a pro-inflammatory state. Furthermore, we propose a mechanism whereby Daphnetin attenuates inflammatory signaling by inhibiting excessive release of mitochondrial ROS, thus offering mitochondrial protection. Daphnetin may represent a promising pharmacological intervention for viral pneumonia and could play a crucial role in addressing future pandemics.

An investigation of the impact of ‘Living with COVID’ on workplace COVID-19 transmission risk, response and resilience - lessons learnt and future challenges

BackgroundPrevious research has highlighted links between occupation and risk of COVID-19 transmission and suggests that occupational risk is influenced by covariates including socio-economic status, and deprivation. This study examined the perspectives of local authority teams of how changes in policy and advice, as set out in the UK government report ‘Living with COVID,’ affected COVID-19 transmission risk, response and resilience in workplace settings in Greater Manchester, an area that was disproportionately affected by the pandemic.MethodsThe project, which took place between August and November 2022, undertook a mixed methods approach to incorporate wide-ranging reflections of changes following the publication of ‘Living with COVID’. Quantitative data was collected from local employers (n = 149) and employees (n = 397) using online surveys, and qualitative interview data was collected from Greater Manchester local authority teams (n = 19).ResultsThe research highlighted the inequitable impact of the pandemic on those already experiencing health inequalities, including people on more precarious employment contracts or those who were unable to work from home during the pandemic.The study found that the facilitators that helped local authorities to support employers to manage transmission included clear, detailed and timely national and local guidance, good communication, partnership working, funding, and timely access to data. Barriers to supporting employers included contradictory or confusing national guidance, structural inequalities, lack of funding, and delayed access to data. Interview participants reported that they were now utilising lessons learnt during the pandemic, along with the that partnerships developed, in order to tackle wider health issues and to prepare for future pandemics or health crises.ConclusionThe findings of the study, which concur with previously published research conducted as part of the PROTECT project, highlight the importance of active reflection on the lessons learned during the course of the pandemic. The study draws on PH and EH teams’ perspectives of managing COVID-19 transmission, in an area that was disproportionately affected by the pandemic, in order to add to our understanding of the best ways to ensure preparedness for future pandemics or health crises at a national level.

Roles of self-efficacy and self-control in the association between relative deprivation and psychological well-being among undergraduate students during COVID-19 pandemic

Prior research show that relative deprivation can decrease individuals’ psychological well-being. However, the underlying mechanism between relative deprivation and psychological well-being remains unclear. To explore the mediating effects of self-efficacy and self-control on the relationship between relative deprivation and psychological well-being. 426 undergraduate students submitted the online survey that assessed their psychological well-being, relative deprivation, self-efficacy and self-control. Students experienced high levels of psychological well-being, moderate to high levels of relative deprivation and moderate levels of self-efficacy and self-control. Parallel mediators of self-efficacy and self-control on the relationship between relative deprivation and psychological well-being were significant (each p < 0.01). This study explores the underlying mechanism between relative deprivation and psychological well-being by identifying the parallel mediators of self-efficacy and self-control. Effective interventions should be taken to alleviate students’ relative deprivation and promote their self-efficacy, self-control and psychological well-being during future pandemics.

"COVID-Collateral" Deaths.

Study Design: This observational study focuses on select cases where death may have been related to COVID-related fears or the unintended consequences of protocols or public health mandates imposed during the COVID-19 pandemic. Objective: The objective of this study is to highlight examples of "COVID-collateral" deaths for the expressed purpose of preventing similar deaths in the future. Methods: The study represents a retrospective observational study from the case work at an academically-based regional medical examiners' office. Cases were selected based on identification of deaths that may have been related to COVID-19 fears, mandates or policies. Results: Six cases of COVID-collateral deaths are highlighted in this report, including cases where fear or isolation related to COVID-19 infection resulted in untreated exacerbation of an underlying disease/condition with eventual death, as well as cases where COVID-related psychological/mental stress or isolation played a role in suicide. Conclusions: Medical examiners/coroners should be aware of these cases if future pandemics or similar events occur, so that more thorough and accurate data regarding such deaths can be gathered. Public health officials, the medical community, and the general public also need to be aware of such cases so that appropriate preventive strategies can be employed.

Anaesthesia healthcare workers' interactions with COVID-19-positive and -suspect patients: A multi-site observational study from Queensland, Australia.

Occupationally acquired COVID-19 is a hazard for healthcare workers (HCWs). In four hospitals of the Metro North Hospitals and Health Service in Queensland, Australia, we invited HCWs to report the nature of any anaesthesia interactions with COVID-19-positive and COVID-19-suspect patients. This was to assist workforce planning in future pandemics. Data collection consisted of three phases; 1) participating HCWs recorded details of episodes of care (EOCs) with COVID-19-positive or COVID-19-suspect patients; 2) these HCWs were invited to complete a follow-up survey about their own health status regarding COVID-19 infections; 3) electronic health records were used to assess patient demographics, infectious status and outcomes. Between 21 March 2020 and 17 May 2022, 63 anaesthesia HCWs reported 90 EOCs with 67 unique patients. The median (interquartile range (IQR)) age of the HCWs was 40.5 years (34-46); 55% (34/62) were male, 62% (39/63) were consultants and 21% (13/63) were registrars. The median (IQR) age of patients was 39 (28-63) years. Personal protective equipment (PPE) was deemed to be appropriate by the HCWs in (86/88) 98% of the EOCs. Twenty-four HCWs (38%) responded to a follow-up survey. Of 12 HCWs who subsequently tested positive to COVID-19, only four had cared for a COVID-19-positive patient in the two weeks prior to their diagnosis. Most responding HCWs perceived they contracted COVID-19 in the community, experiencing mild illness. We found relatively low COVID-19 case numbers, high PPE use and low transmission of COVID-19 within the hospital setting.

The value of using COVID-19 antibody tests as a potential approach to prioritize vaccination delivery.

The highly contagious novel COVID-19 virus has demonstrated a great challenge for healthcare workers (HCWs) worldwide. One of these challenges is the availability of vaccines in some countries or societies, especially in the early stages of the pandemic. This study aims to determine the level of natural immunity against COVID-19 infection among HCWs exposed to COVID-19 at the early stages of the pandemic and build a model to determine the groups that can benefit more from the scarce vaccination resources. This study took place between January and March 2021, after the first waves of the COVID-19 pandemic, before spreading the variants of concern, such as the UK variant (Alpha B.1.1.7), and before starting the vaccine campaigns. This cross-sectional study collected serum samples from 251 vulnerable HCWs. The samples were tested for IgG antibodies against COVID-19 using commercial kits. The demographics and clinical characteristics of the participants were recorded using face-to-face interviews. COVID-19 IgG antibodies were detected in more than 40% of HCWs before vaccination. Those HCWs should have less priority than those without COVID-19 IgG. The seroprevalence of COVID-19 was higher in male HCWs and among nurses. There was no association between the participants' immunity and smoking status or different blood groups. Most HCWs reported being infected with the virus during the first wave, mainly at the end of 2020. A limited number of HCWs reported infections between January 2021 and March 2021. All HCWs eventually received the COVID-19 vaccine, ignoring being previously infected. The reported results emphasize the value of using immunity tests to prioritize the groups that may benefit the most from the limited vaccines, especially in developing countries with scarce resources where those with COVID-19 IgG antibodies should have less priority for the COVID-19 vaccine. The present results indicate that up to 40% of the delivered vaccines to HCWs who had COVID-19 antibodies could be prioritized more wisely in future pandemics.

Impact of visitation restrictions in neonatal intensive care units during the COVID-19 pandemic on parents in northern Hokkaido, Japan.

Medical institutions restricted visitation to neonatal intensive care units (NICUs) during the coronavirus disease (COVID-19) pandemic. Therefore, this study aimed to investigate the impact of COVID-19 NICU visitor restrictions on parents. We conducted a questionnaire of 378 parents of infants who were hospitalised for more than 1 week at two NICUs in our area and discharged between 1 April 2020 and 31 March 2022. While the visiting rules for NICUs during this period varied depending on the phase of the COVID-19 epidemic, generally, only parents were allowed to visit the NICUs for a few hours daily. A total of 157 parents (A University Hospital (AMUH), n = 79; AK General Hospital (AKGH), n = 78) responded to the survey (41.3% response rate), with 40% stating that their emotions towards their infants were affected by restrictions due to the COVID-19 pandemic. Parents' feelings towards their infants were influenced by mode of delivery, parity, duration of hospitalisation and opportunities to visit the NICU. More than 70% of respondents felt stressed due to COVID-19 restrictions, and anxiety and emotional stress related to visitor restrictions were significantly affected by the number and duration of visits and allowability of family member visits. Parents felt that the restrictions had a negative impact on breastfeeding, overall infant care and infant-family bonding. As parents felt an impact on the bond with their infant during visitation restrictions, it is essential for facilities to implement measures to protect infant-family bonding during potential future pandemics.

Reconciling market and moral logics on a minimum wage: Supermarket work in Australia during the first two years of the SARS-COV-2 pandemic

Essential workers generate and maintain basic services that populations must receive, without interruption, to sustain a healthy, functional society. When SARS-COV-2 spread around the world, mundane low-paid work in essential non-healthcare industries such as supermarkets, became high risk, makeshift and unpredictable. Drawing on recent scholarship in the sociology of work, we conducted 32 interviews to capture how supermarket workers in Australia navigated the trade-offs and moral choices entailed in performing essential roles in non-health settings during a pandemic. We found that, as key assumptions about the resilience of globalised modernity and its supporting systems were tested, supermarket workers found themselves at the centre of experiments and public debates about the effectiveness and appropriateness of different infection control measures. Compensating for a lack of preparedness by governments and corporations, they were forced to accept, and then tasked with resolving inconsistencies between the political economy of low paid work and the moral economy of social provision. Given the experiences of those who found themselves in essential roles outside healthcare, there is an urgent need to reconceptualize what ‘successful’ pandemic preparedness and response entails. Reflecting on their experiences, these workers told us that expressions of solidarity and concern, from those not sharing their position of biological and financial precarity, were of little value. Drawing on the market logics that define their employment as essential and replaceable, the workers we spoke to observed that fair renumeration for risks and better protections were the most important considerations in recasting how societies prepare for future pandemics.

Uptake, Acceptability, and Results of SARS-CoV-2 Antigen Rapid Diagnostic Testing in Community Settings in Cameroon.

Mass gathering event restrictions were part of mitigation measures during the COVID-19 pandemic that were lifted as prevalence decreased and after vaccination rollout. We explored SARS-CoV-2 antigen rapid diagnostic test acceptability and positivity in community settings in Cameroon. In August-October 2022, community workers sensitized and referred individuals for COVID-19 testing to nearby testing points in Douala and Yaoundé. Participants consented to SARS-CoV-2 antigen rapid diagnostic testing, a survey, or both components. We describe the positivity rate, COVID-19-related history, and Likert-scale testing perceptions. Factors associated with testing acceptance were analyzed using logistic regression. Overall, 20.5% (2,449/11,945) of sensitized individuals visited testing points, and 1,864 (76.1%) were enrolled; 50.6% accepted the survey and testing (46.0% accepted survey only). Seven (0.7%) of 1,006 individuals tested positive. Most (71.8%; 1,292/1,800) considered community testing more accessible than hospital-based testing. Individuals accepting versus refusing testing differed in perceived COVID-19 risk (67%, 49%; P <0.001), belief in accurate test results (79%, 47%; P <0.001), and ability to test easily (96%, 55%; P <0.001). Males (adjusted odds ratio [aOR]: 1.26 [1.04-1.53]) and those over 50 years (aOR: 1.9 [1.4-2.7]), with symptoms (aOR: 1.80 [1.30-2.50]), and at least partial vaccination (aOR: 0.76 [0.58-0.99]) were significantly associated with test acceptance. Refusal reasons included lack of perceived need for testing (33.8%) and testing discomfort (26.3%). Although community-based testing was generally perceived as important, actual testing uptake was low. In future pandemics, community testing should be optimized by addressing misinformation, offering alternative testing modalities for greater comfort, creating demand, and tailoring approaches to maximize testing uptake.

The proposed WHO Pandemic Agreement: Ambitious progress or business as usual?

The World Health Organization (WHO)’s proposal for a Pandemic Agreement, released in April 2024, at first blush, seems laudable (WHO 2024a). The failure of governments to coordinate a response to COVID-19, as implored by the WHO and the United Nations (UN) at the beginning of the pandemic, underlines the urgent need for reform in the global governance of pandemics. This editorial considers: how has the Agreement progressed to date? And will it adequately prepare societies to tackle future pandemics?

Simulating the effect of counterfactual changes in religious tourism on economic growth in Saudi Arabia

PurposeThe literature has well-documented the positive economic effects of both leisure and religious tourism. However, certain events, such as the COVID-19 pandemic and others, can impair the positive effect. Hence, the purpose of this study is to simulate the effect of counterfactual changes in religious tourism on Saudi Arabia’s economic growth during the MATAF expansion project and the COVID-19 pandemic.Design/methodology/approachThe study employs novel dynamic autoregressive distributed lag (DARDL) and kernel-based regularised least squares (KRLS) estimation techniques to analyse data spanning 1970–2022.FindingsThe results refuted the positive effect of spiritual tourism, especially during the two events. The simulation results show that a shock in predicted religious tourism will lower economic growth marginally in the short term but substantially in the long run.Practical implicationsThe Saudi Arabian government should prioritise strategic infrastructural development such as expanding roads, airports and renovating worship centres during periods of low demand to promote economic growth through religious tourism. This will allow for the accommodation of a growing number of pilgrims without disrupting religious activities. In addition, it is imperative for the government to engage in international cooperation with other governments to proactively avert future pandemics such as the COVID-19 pandemic.Originality/valueEven though many studies have examined the effect of religious tourism on economic growth, to the best of our knowledge, this study is the first one that simulates the effect of counterfactual changes in religious tourism on economic growth during the MATAF expansion project and the COVID-19 pandemic.

Higher Affinity Enables More Accurate Detection of SARS-CoV-2 in Human Saliva Using Aptamer-Based Litmus Test.

Many aptamers have been generated by systematic evolution of ligands by exponential enrichment (SELEX) to recognize spike proteins of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2&ek), some of which have been engineered into dimeric and trimeric versions for enhanced affinity for diagnostic applications. However, no studies have been conducted to compare the utilities of monomeric, dimeric and trimeric aptamers in diagnostic assays with real clinical samples to answer the question of what levels of affinity an aptamer must have for accurate clinical diagnostics. Herein, we carried out a comparative study with two monomeric aptamers MSA1 and MSA5, one dimeric aptamer and two homotrimeric aptamers constructed with MSA1 and MSA5, with affinity varying by 1000-fold. Using a colorimetric sandwich assay to analyze 48 human saliva samples, we found that the trimeric aptamer assay (Kd≈10 pM) can identify the SARS-CoV-2 infection much more accurately than the dimeric aptamer assay (Kd≈100 pM) and monomeric aptamer assay (Kd≈10,000 pM). Based on the experimental data, we theoretically predict the levels of affinity an aptamer needs to possess to achieve 80-100 % sensitivity and 100 % specificity. The findings from this study highlight the need for deriving very high affinity aptamers to enable highly accurate detection of viral infection for future pandemics.

Biothermodynamic analysis of the Dengue virus: Empirical formulas, biosynthesis reactions and thermodynamic properties of antigen-receptor binding and biosynthesis

After the experience with the COVID-19 pandemic, WHO has issued a warning about the possible causes of future pandemics. One such causative agent is the Dengue virus. Until now, we have had information mostly on biological properties of the Dengue virus and very little information about its chemical and thermodynamic properties. To be better prepared for a potential Dengue pandemic, the goal of this paper is to chemically and thermodynamically characterize the Dengue virus, as well as to describe the biophysical basis of the virus-host interactions of the Dengue virus. To that goal, the empirical formula was determined, as well as biosynthesis reactions and thermodynamic properties of antigen-receptor binding and thermodynamic properties of biosynthesis and multiplication of the Dengue virus. A model was developed of virus-host interactions between the Dengue virus and its host tissues, based on nonequilibrium thermodynamics.

Higher Affinity Enables More Accurate Detection of SARS‐CoV‐2 in Human Saliva Using Aptamer‐Based Litmus Test

AbstractMany aptamers have been generated by systematic evolution of ligands by exponential enrichment (SELEX) to recognize spike proteins of the severe acute respiratory syndrome coronavirus 2 (SARS‐CoV‐2&amp;ek), some of which have been engineered into dimeric and trimeric versions for enhanced affinity for diagnostic applications. However, no studies have been conducted to compare the utilities of monomeric, dimeric and trimeric aptamers in diagnostic assays with real clinical samples to answer the question of what levels of affinity an aptamer must have for accurate clinical diagnostics. Herein, we carried out a comparative study with two monomeric aptamers MSA1 and MSA5, one dimeric aptamer and two homotrimeric aptamers constructed with MSA1 and MSA5, with affinity varying by 1000‐fold. Using a colorimetric sandwich assay to analyze 48 human saliva samples, we found that the trimeric aptamer assay (Kd≈10 pM) can identify the SARS‐CoV‐2 infection much more accurately than the dimeric aptamer assay (Kd≈100 pM) and monomeric aptamer assay (Kd≈10,000 pM). Based on the experimental data, we theoretically predict the levels of affinity an aptamer needs to possess to achieve 80–100 % sensitivity and 100 % specificity. The findings from this study highlight the need for deriving very high affinity aptamers to enable highly accurate detection of viral infection for future pandemics.

Cost of COVID-19 vaccine delivery in nine States in Nigeria via the U.S. Government Initiative for Global Vaccine Access

BackgroundIn 2022, the U.S. Centers for Disease Control and Prevention collaborated with implementing partners, African Field Epidemiology Network and Sydani Group, to support COVID-19 vaccination efforts in Nigeria. To characterize the costs of COVID-19 vaccination, this study evaluated financial costs per dose for activities implemented to support the intensification campaign for COVID-19 vaccination.MethodsThis retrospective evaluation collected secondary data from existing expenditure and programmatic records on resource utilization to roll out COVID-19 vaccination during 2022. The study included incremental financial costs of the activities implemented to support an intensification campaign for COVID-19 vaccination across nine states and six administrative levels in Nigeria from the perspective of the external donor (U.S. Government). Costs for vaccines and injection supplies, transport of vaccines, and any economic costs, including government in-kind contributions, were not included. All costs were converted from Nigerian Naira to 2022 U.S. Dollars (US$).ResultsThe estimated financial delivery cost of the COVID-19 vaccination intensification campaign was US$0.84 per dose (total expenditure of US$6.29 million to administer 7,461,971 doses). Most of the financial resources were used for fieldwork activities (86%), followed by monitoring and supervision activities (8%), coordination activities (5%), and training-related activities (1%). Labor (58%) and travel (37%) were the resource inputs that accounted for the majority of the cost, while shares of other resource inputs were marginal (1% for each). Most labor costs (79%) were spent on payments for mass vaccination campaign teams, including pay-for-performance incentives. By administrative level, the largest share of costs (46%) was for pay-for-performance incentives at the community, health facility, or campus levels combined, followed by local government area level (24%), community level only (15%), state level (9%), national level (3%), campus level only (1%), and health facility level only (< 1%).ConclusionsFindings from the evaluation can help to inform resources needed for vaccination activities to respond to future outbreaks and pandemics in resource-limited settings, particularly to reach new target populations not regularly included in routine childhood immunization delivery.