WHO's newly launched platform aims to combat misinformation around COVID-19. John Zarocostas reports from Geneva.WHO is leading the effort to slow the spread of the 2019 coronavirus disease (COVID-19) outbreak. But a global epidemic of misinformation—spreading rapidly through social media platforms and other outlets—poses a serious problem for public health. “We’re not just fighting an epidemic; we’re fighting an infodemic”, said WHO Director-General Tedros Adhanom Ghebreyesus at the Munich Security Conference on Feb 15.

In the second part of a special BMJ series, Brian Deer reveals a secret scheme to raise huge sums from a campaign, launched at a London medical school, that claimed links between MMR, autism, and bowel disease

This week we begin a special series of articles by the journalist Brian Deer. It focuses on what may seem a familiar story—the scare linking the MMR vaccine with autism, launched at a press conference in 1998 after the Lancet published a paper by Andrew Wakefield and colleagues describing 12 children with brain and bowel disease.

Twelve years after publishing a landmark study that turned tens of thousands of parents around the world against the measles, mumps and rubella (MMR) vaccine because of an implied link between vaccinations and autism, The Lancet has retracted the paper.

A national assessment of the efficacy of pertussis vaccination was made in 21 area health authorities in England. Notification rates for children given either three doses of diphtheria/tetanus/pertussis vaccine or diphtheria/tetanus vaccine were studied during the two and a half-year period January 1978-June 1980. A survey of home circumstances showed that the two vaccine groups could be validly compared. Home visits were made to assess the severity of the illness, the attack rates in home contacts, and to take pernasal swabs. Pertussis vaccination was found to be of outstanding value in preventing serious disease. Nevertheless, its effect in controlling whooping cough is limited by the fact that protection for home contacts is less satisfactory, and by the occurrence of mild cases in vaccinated children which may contribute to the spread of the disease.

Vaccines do not cause autism.You wouldn't know that if you'd ever used an Amazon Prime account to watch the 2016 documentary "Vaxxed: From Cover-Up to Catastrophe."Following criticism from Rep. Adam Schiff (D-CA), Amazon took down the documentary from its streaming video subscription service on March 1st.

In the first week after the first COVID-19 patient was reported in the Netherlands, we conducted a pre-registered momentary assessment study (7 surveys per day, 50 participants, 7 days) to study the dynamic relationship between individuals’ occupation with and worries about COVID-19 in daily life, and the moderating role of neuroticism in this relationship. At the group level, higher scores on occupation and worry co-occurred, and occupation predicted worry one hour later, but not vice versa. There were substantial individual differences in the magnitudes and directions of the effects. For instance, occupation with COVID-19 was related to increases in worry for some, but decreases in worry for others. Neuroticism did not predict any of these individual differences in the links between worry and occupation. This study suggests that it is important to go beyond group-level analyses and to account for individual differences in responses to COVID-19.

The European Union continues to export more vaccines than it administers, in data highlighting the risk of a backlash against the bloc’s governments amid setbacks that keep threatening to delay its own rollout.

As a result of the COVID-19 worldwide pandemic, the United States instituted various non-pharmaceutical interventions (NPIs) in an effort to slow the spread of the disease. Although necessary for public safety, these NPIs can also have deleterious effects on the economy of a nation. State and federal leaders need tools that provide insight into which combination of NPIs will have the greatest impact on slowing the disease and at what point in time it is reasonably safe to start lifting these restrictions to everyday life. In the present work, we outline a modeling process that incorporates the parameters of the disease, the effects of NPIs, and the characteristics of individual communities to offer insight into when and to what degree certain NPIs should be instituted or lifted based on the progression of a given outbreak of COVID-19. We apply the model to the 24 county-equivalents of Maryland and illustrate that different NPI strategies can be employed in different parts of the state. Our objective is to outline a modeling process that combines the critical disease factors and factors relevant to decision-makers who must balance the health of the population with the health of the economy.

Football fans will be allowed into stadiums from Wednesday and bars, restaurants and museums are reopening as Denmark takes a big foot forward in lifting its coronavirus restrictions. The big condition for Danes to take advantage of these new freedoms is that they must prove they are infection-free, by showing a coronapas or corona passport.

It was a beautiful August day, and I was on a socially distanced hike with friends along the Appalachian Trail. But instead of enjoying the scenery, I was distracted by my phone. It kept buzzing in my pocket as hundreds of Twitter notifications flooded in. I had been on Twitter for about a year, mainly tweeting about science. I enjoyed it, but none of my tweets ever got much traction—until that day. I was excited—and nervous. Was I ready to be Twitter famous?

Officials warn that falsified cards could endanger lives and undermine efforts to end the pandemic

Officials decided that strong action was needed to alert the public, doctors to unusual cases and their nonstandard treatment

Heneghan and colleagues’ systematic review, funded by WHO, published in March, 2021, as a preprint, states: “The lack of recoverable viral culture samples of SARS-CoV-2 prevents firm conclusions to be drawn about airborne transmission”.1 This conclusion, and the wide circulation of the review’s findings,is concerning because of the public health implications.If an infectious virus spreads predominantly through large respiratory droplets that fall quickly, the key control measures are reducing direct contact, cleaning surfaces, physical barriers, physical distancing, use of masks within droplet distance, respiratory hygiene,and wearing high-grade protection only for so-called aerosol-generating health-careprocedures. Such policies need not distinguish between indoors and outdoors, since a gravity-driven mechanism for transmission would be similar for both settings. But if an infectious virus is mainly airborne, an individual could potentially be infected when they inhale aerosols produced when an infected person exhales, speaks, shouts, sings, sneezes, or coughs. Reducing airborne transmission of virus requires measures to avoid inhalation of infectious aerosols, including ventilation, air filtration, reducing crowding and time spent indoors, use of masks whenever indoors, attention to mask quality and fit, and higher-grade protection for health-care staff and front-line workers.2 Airborne transmission of respiratory viruses is difficult to demonstrate directly.3 Mixed findings from studies that seek to detect viable pathogen in air are therefore insufficient grounds for concluding that a pathogen is not airborne if the totality of scientific evidence indicates otherwise. Decades of painstaking research, which did not include capturing live pathogens in the air, showed that diseases once considered to be spread by droplets are airborne.4 Ten streams of evidence collectively support the hypothesis that SARS-CoV-2 is transmitted primarily by the airborne route.

Many of those with medical conditions are concerned and nervous about the risk of leaving their homes

All adults to be eligible from 1 May, making jab available to at least 400 million more people

As safety concerns delay the use of two COVID-19 vaccines, Nature looks at the questions that scientists want answered.

COVID-19 has had negative repercussions on the entire global population. Despite there being a common goal that should have unified resources and efforts, there have been an overwhelmingly large number of clinical trials that have been registered that are of questionable methodological quality. As the final paper of this Series, we discuss how the medical research community has responded to COVID-19. We recognise the incredible pressure that this pandemic has put on researchers, regulators, and policy makers, all of whom were doing their best to move quickly but safely in a time of tremendous uncertainty. However, the research community's response to the COVID-19 pandemic has prominently highlighted many fundamental issues that exist in clinical trial research under the current system and its incentive structures. The COVID-19 pandemic has not only re-emphasised the importance of well designed randomised clinical trials but also highlighted the need for large-scale clinical trials structured according to a master protocol in a coordinated and collaborative manner. There is also a need for structures and incentives to enable faster data sharing of anonymised datasets, and a need to provide similar opportunities to those in high-income countries for clinical trial research in low-resource regions where clinical trial research receives considerably less research funding.

Evaluating whether an intervention works when trialled in groups of individuals can pose complex challenges for clinical research. Cluster randomised controlled trials involve the random allocation of groups or clusters of individuals to receive an intervention, and they are commonly used in global health research. In this paper, we describe the potential reasons for the increasing popularity of cluster trials in low-income and middle-income countries. We also draw on key areas of global health research for an assessment of common trial planning practices, and we address their methodological shortcomings and pitfalls. Lastly, we discuss alternative approaches for population-level intervention trials that could be useful for research undertaken in low-income and middle-income countries for situations in which the use of cluster randomisation might not be appropriate.

In global health research, short-term, small-scale clinical trials with fixed, two-arm trial designs that generally do not allow for major changes throughout the trial are the most common study design. Building on the introductory paper of this Series, this paper discusses data-driven approaches to clinical trial research across several adaptive trial designs, as well as the master protocol framework that can help to harmonise clinical trial research efforts in global health research. We provide a general framework for more efficient trial research, and we discuss the importance of considering different study designs in the planning stage with statistical simulations. We conclude this second Series paper by discussing the methodological and operational complexity of adaptive trial designs and master protocols and the current funding challenges that could limit uptake of these approaches in global health research.

This paper shows the scale of global health research and the context in which we frame the subsequent papers in the Series. In this Series paper, we provide a historical perspective on clinical trial research by revisiting the 1948 streptomycin trial for pulmonary tuberculosis, which was the first documented randomised clinical trial in the English language, and we discuss its close connection with global health. We describe the current state of clinical trial research globally by providing an overview of clinical trials that have been registered in the WHO International Clinical Trial Registry since 2010. We discuss challenges with current trial planning and designs that are often used in clinical trial research undertaken in low-income and middle-income countries, as an overview of the global health trials landscape. Finally, we discuss the importance of collaborative work in global health research towards generating sustainable and culturally appropriate research environments.

The field of global health places a priority on improving health outcomes and achieving health equity for all people worldwide, with a specific focus on low-income and middle-income countries. Randomised clinical trials are a crucial tool for global health research. Although the quality of clinical trials has generally improved over time, their design has largely remained unchanged in global health research in the past seven decades, since the first randomised clinical trial was carried out. It is important to embrace new innovations in clinical trial methodologies that can help answer multiple research questions efficiently with a minimised sample size and trial duration, while also improving the ability of the local regions across low-income and middle-income countries to sustain research infrastructure and human resources for long-term gains. This Series shows the challenges in clinical trial research in global health and offers solutions that can optimise statistical efficiency and sustainability.

Increasingly strong evidence shows that the UK's vaccination programme is breaking the link between Covid-19 cases and deaths, scientists tracking the epidemic have said.

NSW Health reclassifies three coronavirus cases to locally-acquired after testing showed they shared same viral sequence as infected family next door

Concerns grow after sharp drop in numbers coming forward, with almost 15% of staff still unprotected

Using an electronic health records network we estimated the absolute incidence of cerebral venous thrombosis (CVT) in the two weeks following COVID-19 diagnosis(N=513,284),or influenza (N=172,742),or receipt of the BNT162b2 or mRNA-1273 COVID-19 vaccines(N=489,871).Theincidence of portal vein thrombosis (PVT) was also assessed in these groups, as well asthe baselineCVTincidence over a two-week period. The incidence of CVT after COVID-19 diagnosis was 39.0 per million people (95% CI, 25.2–60.2). This washigher thanthe CVT incidenceafter influenza (0.0 per million people, 95% CI 0.0–22.2, adjusted RR=6.73, P=.003) or after receiving BNT162b2 or mRNA-1273 vaccine (4.1 per million people, 95% CI 1.1–14.9, adjusted RR=6.36, P<.001). The relative risks were similar if a broader definition of CVT was used. For PVT, the incidence was 436.4 per million people (382.9-497.4) after COVID-19, 98.4 (61.4-157.6) after influenza, and 44.9 (29.7-68.0) after BNT162b2 or mRNA-1273. The incidence of CVT following COVID-19 was higher than the incidence observed across the entire health records network (0.41 per million people over any 2-week period). Laboratory test results, availablein a subsetof the COVID-19 patients,provide preliminary evidence suggestive of raised D-dimer, lowered fibrinogen, and an increased rate of thrombocytopenia in the CVT and PVT groups. Mortality was 20% and 18.8% respectively. These data show that the incidence of CVT issignificantly increased after COVID-19,andgreater than that observed with BNT162b2 and mRNA-1273 COVID-19 vaccines. The risk of CVT following COVID-19 is alsohigher than the latest estimate from the European Medicines Agency for theincidence associated withChAdOx1 nCoV-19 vaccine (5.0 per million people, 95% CI 4.3–5.8). Although requiring replication and corroboration, the present data highlight the risk of serious thrombotic events in COVID-19, and can help contextualizethe risks and benefits of vaccinationin this regard.

Italy, Spain and Belgium have joined other European countries in limiting the use of the Oxford/AstraZeneca vaccine to older age groups as the EU struggles to agree common guidelines to counter expected public hesitancy.

Surge testing has been expanded to four London boroughs as concern grows that the test and trace programme cannot contain a coronavirus variant that has shown increasing signs of vaccine resistance.

The P.1 lineage of the SARS-CoV-2 variant first observed in Brazil has driven a second wave of infections even in a region hit hard by the first wave.

In their seminal paper, Damialis and colleagues (2021, PNAS) report that, in early 2020, higher airborne pollen concentrations were related to higher COVID-19 infection rates. As a mechanism, the authors propose that “pollen exposure weakens the immunity … by diminishing the antiviral interferon response.” Although they assume an effect for the whole population, they speculate that it could be stronger for those with allergies. As a limitation, they acknowledge that they did not account for the countries’ testing strategies. As allergic people may be more likely to show symptoms that may be mistaken for those of COVID-19 (runny nose, headache, increased temperature), we explored whether people with allergies were more prone to get a rapid SARS-CoV-2 antigen test. Moreover, we assessed whether the test result was more likely to be positive among those with allergies.

The novel coronavirus has taken a catastrophic toll worldwide on physical and mental health. We focused on the psychosocial impact among students in Uruguay, a country relatively protected from the pandemic. Our study had three main aims : 1) describe in detail the impact among university students, 2) identify relationships between different dimensions and 3) highlight the factors determinant of mental distress. We designed a multi-dimensional questionnaire to investigate the perceived impact on the lives of students. The questionnaire was administered to 144 undergraduates in Uruguay online while the university was closed. 38-66% of students indicated increases in signs of anxiety, depression or sleep disturbances. Independently of other related factors, increases in substance use, impairments in social relationships, negative impacts of school closures, and personal economic worries explained 41% of variance in psychological distress. Findings are discussed in terms of policies for public health and future directions for research on mental health.

Psychologists worldwide are becoming increasingly concerned about the negative impact of the novel coronavirus (COVID-19) pandemic on adolescents’ mental health. However, compared to studies involving adults, research on adolescents is limited. To further understand adolescents’ mental health during the pandemic, the present study examined whether resilience, as a protective factor, buffers the relationship between the personality trait of environmental sensitivity and COVID-19-related distress. A total of 141 adolescents (53.7% women, Mage = 18.91 years, SDage = 0.82 years) living in urban Japan completed an online cross-sectional survey in October 2020. The results showed that sensitivity was positively, though weakly, correlated with COVID-19 stress and negatively correlated with resilience. Resilience was negatively correlated with COVID-19 stress. Mediation analysis showed that resilience buffered the negative relationship between sensitivity and COVID-19 stress, and its indirect effect was statistically significant, albeit close to zero. These results suggest that higher sensitivity is not necessarily a vulnerability factor, if resilience can be enhanced.

The UK government is reportedly considering vaccine passports as a way of bringing people back to offices and factories. Some countries are already using them, while others weigh up the risks and benefits. Where will we use them, who will need them and why are they so controversial?

Mayors expect their residents to spend more time outdoors after being inspired to do so amid the coronavirus pandemic, but few leaders are looking to incorporate pandemic-fueled changes to those spaces into long-term plans, according to a survey report of 130 mayors from 38 states released Wednesday. Three out of four respondents to the Menino Survey of Mayors from Boston University said they expect residents to spend more time outside at open spaces compared to before the pandemic, and around two-thirds said they think residents will spend more time biking and walking. Despite that trend, just over a third of mayors said they do not expect to see changes made to outdoor spaces during the pandemic — like expanded outdoor dining and infrastructure — last long-term due to budgetary constraints. But planning parks and open space with an equity lens is expected to endure, with 52% saying they believe the quality of parks vary across neighborhoods.

Previous research suggests that people with specific fears may use their subjective experience of anxiety to infer the presence of danger – a process known as ex-consequentia reasoning. While existing research validates the presence of ex-consequentia reasoning among fearful individuals, there are contextual factors that may moderate such emotional inferences. One would expect that even fearful people can acknowledge a difference in the trustworthiness of the intuitive thoughts and feelings of a fearful person relative to an expert in a fear-relevant situation. We investigated whether the expertise of characters described in vignettes about fear of heights and spiders modulated the extent to which fearful and non-fearful participants believed it was appropriate for the character to infer the presence of danger from their emotional reactions. Bayesian ordinal regression and a multiverse analytic approach were used to ensure inferences were not sensitive to particular analytic choices. Consistent with our expectations, fearful and non-fearful participants were more likely to agree that an expert character should listen to their intuitive thoughts and feelings about a situation than a fearful character. Tentatively, we suggest that people’s metacognitive awareness about the relative validity of fear-related thoughts and feelings might be leveraged to help reduce ex-consequentia reasoning.

In response to the COVID-19 pandemic, some smokers have experienced increased motivation to quit smoking, due to the higher risk of severe COVID-19 infection. However, this is not found across all smokers, and the motivation to quit appears dependent upon factors such as fear of COVID-19 and perceived risk from COVID-19. In the current investigation, specific COVID-19 risk beliefs were measured to isolate which beliefs predicted the motivation to quit smoking, these being the perceived severity of COVID-19 and perceived probability of COVID-19 infection. UK based smokers (N = 243) completed an online survey between September and October 2020, in which they reported their current motivation to quit smoking, fear of COVID-19, and their beliefs about how severe COVID-19 infection would be and how probable COVID-19 infection was. The only significant predictor of the motivation to quit smoking was the perceived probability of COVID-19 infection. This positive relationship remained when controlling for the general perceived probability and severity of other smoking related health conditions, suggesting a COVID-19-specific effect. Further, fear of COVID-19 only indirectly related to an increase in motivation to quit, when mediated through perceived probability of COVID-19 infection. The result places the perceived probability of COVID-19 infection as a central predictor of motivation to quit during the pandemic. Based on this evidence, messaging to smokers aiming to facilitate smoking cessation during the pandemic should focus on the highly contagious nature of the virus, to increase the motivation to quit.

Former prime minister says group should commit to global vaccine drive and slams UK’s foreign aid cut

Prime minister’s comments come after border worker diagnosed last week said to have missed two vaccine appointments

Cases of SARS-CoV-2 infection in Manaus, Brazil, resurged in late 2020, despite previously high levels of infection. Genome sequencing of viruses sampled in Manaus between November 2020 and January 2021 revealed the emergence and circulation of a novel SARS-CoV-2 variant of concern. Lineage P.1, acquired 17 mutations, including a trio in the spike protein (K417T, E484K and N501Y) associated with increased binding to the human ACE2 receptor. Molecular clock analysis shows that P.1 emergence occurred around mid-November 2020 and was preceded by a period of faster molecular evolution. Using a two-category dynamical model that integrates genomic and mortality data, we estimate that P.1 may be 1.7–2.4-fold more transmissible, and that previous (non-P.1) infection provides 54–79% of the protection against infection with P.1 that it provides against non-P.1 lineages. Enhanced global genomic surveillance of variants of concern, which may exhibit increased transmissibility and/or immune evasion, is critical to accelerate pandemic responsiveness.

Inhaling budesonide found to shorten recovery for over-65s, and over-50s with underlying conditions

App was to have been updated before English lockdown easing, but firms objected to data-sharing changes

The director general of the health authority said he “would not hesitate” to use this vaccine if Denmark’s Covid-19 situation was in a worse position.

Let's talk about the background risk of CVST (cerebral venous sinus thrombosis) versus in those who got J&J vaccine. We are going to focus in on women ages 20-50. We are going to compare the same time period and the same disease (CVST). DEEP DIVE KEY NUMBERS!

In this series, we discuss diving into some of the broader impacts of COVID-19. This week, we talk about the effects of the pandemic on education.

After ~10 months of relative quiescence we've started to see some striking evolution of SARS-CoV-2 with a repeated evolutionary pattern in the SARS-CoV-2 variants of concern emerging from the UK, South Africa and Brazil. 1/19

Ben Wakana@benwakana46Replying to @benwakana46"Institutions CAN BE TRUSTED to look out for the public interest." -@celinegounder

Céline Gounder, MD, ScM, FIDSA@celinegounderWith all due respect to @NateSilver538, he is not an expert on the psychology of vaccine confidence. He is a poll aggregator and political pundit. He is not an infectious disease specialist, epidemiologist, vaccinologist, virologist, immunologist, or behavioral scientist.

Improving indoor ventilation and air quality will help us all to stay safeOver a year into the covid-19 pandemic, we are still debating the role and importance of aerosol transmission for SARS-CoV-2, which receives only a cursory mention in some infection control guidelines.12

This study explored the effect knowledge of antibody status has on compliance with transmission reducing behaviours (TRBs). Participants (n=82) comprised of NHS Lothian staff and individuals enrolled in the BioResource study with community diagnosed and treated SARS-CoV-2 infections. They completed a baseline health beliefs questionnaire, provided blood samples for antibody testing and received result 2-4 weeks later. Around 2-4 weeks later, participants completed follow-up health belief questionnaires. The questionnaire was designed based on the constructs of the Health Belief Model, the most prominent framework for understanding why individuals may or may not act in the face of a threat. Fifty-six participants completed the follow-up health belief questionnaires. Knowledge of antibody status did not affect compliance with TRBs. Increased perceived benefits, cues to action and self-efficacy, and decreased perceived barriers, to comply with TRBs was significantly associated with higher compliance. No significant correlation was found between measures of susceptibility or severity and compliance with TRBs. Interventions to increase perceived benefits, cues to action and self-efficacy, and decrease barriers, to engaging in TRBs should be explored.

Prof Marie Scully identified correct diagnostic test at University College London hospital after seeing rare side-effect in patient Coronavirus – latest updates See all our coronavirus coverage Sarah BoseleyTue 13 Apr 2021 15.50 BSTLast modified on Tue 13 Apr 2021 21.50 BST1,5681568Marie Scully was alarmed and puzzled. “It didn’t make sense,” she said. The consultant haematologist at University College London hospital (UCLH) had seen patients with blood clots in the brain and low platelets before and, although it was unusual, she always knew why. But there was no reason for the condition of the young woman in her 30s she was treating in early March.“Now when you have blood clots in the brain like that there’s always a cause, and it was difficult to pinpoint the cause,” said Prof Scully. “It didn’t fit our normal diagnostic boxes, let’s say. She was a young woman with cerebral venous sinus thrombosis, and she had a low platelet count.”

In the United States, the COVID-19 pandemic became an unconventional vehicle to advance partisan rhetoric and antagonism. Using data available at the individual- (Study 1; N = 4,220), county- (Study 2; n = 3,046), and state-level (n = 49), we found that partisanship and political orientation was a robust and strong correlate of mask use. Political conservatism and Republican partisanship were related to downplaying the severity of COVID-19 and perceiving masks as being ineffective that, in turn, were related to lower mask use. In contrast, we found that counties with majority Democrat partisanship reported greater mask use, controlling for various socioeconomic and demographic factors. Lastly, states with strong cultural collectivism reported greater mask use while those with strong religiosity reported the opposite. States with greater Democrat partisanship and strong cultural collectivism subsequently reported lower COVID-19 deaths, mediated by greater mask use and lower COVID-19 cases, in the five months following the second wave of COVID-19 in the US during the Summer of 2020. Nonetheless, more than the majority for Democrats (91.58%), Republicans (77.52%), and third-party members (82.48%) reported using masks. Implications for findings are discussed.

The stories you hold on to will be colored by your own experience—but also by the experiences of those around you.

We are starting to vaccinate our way out of the pandemic, but we shouldn't let that make us complacent about the underlying problems, writes Graham Lawton

We need to suppress the level of SARS-CoV-2 in as many humans as possible as quickly as possible

The SARS-CoV-2 variant B.1.1.7 was first identified in December, 2020, in England. We aimed to investigate whether increases in the proportion of infections with this variant are associated with differences in symptoms or disease course, reinfection rates, or transmissibility.

Judgments differ from decisions. Judgments are more abstract, decontextualized and bear fewer consequences for the agent. In pursuit of experimental control, psychological experiments on bias create a simplified, bare-bone representation of social behavior. These experiments resemble conditions in which people judge others, but not how they make real-world decisions.

The FDA and CDC should worry less about sins of commission and more about sins of omission.

Humans learn about the world by collectively acquiring information, filtering it, and sharing what we know. Misinformation undermines this process. The repercussions are extensive. Without reliable and accurate sources of information, we cannot hope to halt climate change, make reasoned democratic decisions, or control a global pandemic. Most analyses of misinformation focus on popular and social media, but the scientific enterprise faces a parallel set of problems—from hype and hyperbole to publication bias and citation misdirection, predatory publishing, and filter bubbles. In this perspective, we highlight these parallels and discuss future research directions and interventions.

The SARS-CoV-2 pandemic has been raging for over a year, creating global detrimental impact. The BNT162b2 mRNA vaccine has demonstrated high protection levels, yet apprehension exists that several variants of concerns (VOCs) can surmount the immune defenses generated by the vaccines. Neutralization assays have revealed some reduction in neutralization of VOCs B.1.1.7 and B.1.351, but the relevance of these assays in real life remains unclear. Here, we performed a case-control study that examined whether BNT162b2 vaccinees with documented SARS-CoV-2 infection were more likely to become infected with B.1.1.7 or B.1.351 compared with unvaccinated individuals. Vaccinees infected at least a week after the second dose were disproportionally infected with B.1.351 (odds ratio of 8:1). Those infected between two weeks after the first dose and one week after the second dose, were disproportionally infected by B.1.1.7 (odds ratio of 26:10), suggesting reduced vaccine effectiveness against both VOCs under different dosage/timing conditions. Nevertheless, the B.1.351 incidence in Israel to-date remains low and vaccine effectiveness remains high against B.1.1.7, among those fully vaccinated. These results overall suggest that vaccine breakthrough infection is more frequent with both VOCs, yet a combination of mass-vaccination with two doses coupled with non-pharmaceutical interventions control and contain their spread.

Pediatricians should be vigilant, experts said, after the release of the largest U.S. study of the syndrome, MIS-C, that can strike young people weeks after their coronavirus infection.

The prediction, based on modelling at University College London (UCL), was reported on by the Telegraph this morning.   Prof Paul Hunter, Professor in Medicine, The Norwich School of Medicine, University of East Anglia, said: “I am quite sceptical of the conclusions reported by the Dynamic Causal Modelling group at UCL that we will reach herd immunity on 9th April. For any infection herd immunity can only be said to have been achieved if a sufficient proportion of the population have acquired immunity either from immunization or natural infection to bring the R value below 1 that the disease with ultimately disappear. But for herd immunity to really happen that immunity has to last. At present we do not know how long the immunity generated by immunization will last nor what impact the emergence and spread of new variants will have on vaccine effectiveness.

Many scientists critical of University College London Covid-19 forecast as ‘over-confident and over-optimistic’

Political appointees also tried to blunt scientific findings they deemed unfavorable to Trump, according to new documents from House probe.

FacebookTwitterLinkedInWhatsAppMORE THAN a billion doses of covid-19 vaccine have been made. Now comes the hard part: ensuring every country in the world has access to them. Can distribution be made more equitable? Alok Jha and Natasha Loder are joined by Edward Carr, The Economist’s deputy editor, and Sondre Solstad, senior data journalist.With Seth Berkley of GAVI, the Vaccine Alliance, and John Nkengasong, director of the Africa Centres for Disease Control and Prevention. Runtime: 40 min

Chinese vaccines “don’t have very high protection rates,” said the director of the China Centers for Disease Control.

One of the biggest obstacles in America's race to vaccinate against the coronavirus has been that substantial proportions of certain groups choose not to vaccinate.

Three-quarters of population could be fully immunised by first week in August, according to forecasts

The covid-19 pandemic is not a one-off extraordinary event but the culmination of a five year unravelling of progress in global health, writes Peter Hotez

Collaborating with devoted colleagues, Dr. Kariko laid the groundwork for the mRNA vaccines turning the tide of the pandemic.

Suspension of face-to-face instruction in schools during the COVID-19 pandemic has led to concerns about consequences for students’ learning. So far, data to study this question have been limited. Here we evaluate the effect of school closures on primary school performance using exceptionally rich data from The Netherlands (n ≈ 350,000). We use the fact that national examinations took place before and after lockdown and compare progress during this period to the same period in the 3 previous years. The Netherlands underwent only a relatively short lockdown (8 wk) and features an equitable system of school funding and the world’s highest rate of broadband access. Still, our results reveal a learning loss of about 3 percentile points or 0.08 standard deviations. The effect is equivalent to one-fifth of a school year, the same period that schools remained closed. Losses are up to 60% larger among students from less-educated homes, confirming worries about the uneven toll of the pandemic on children and families. Investigating mechanisms, we find that most of the effect reflects the cumulative impact of knowledge learned rather than transitory influences on the day of testing. Results remain robust when balancing on the estimated propensity of treatment and using maximum-entropy weights or with fixed-effects specifications that compare students within the same school and family. The findings imply that students made little or no progress while learning from home and suggest losses even larger in countries with weaker infrastructure or longer school closures.

When vaccines are in limited supply, expanding the number of people who receive some vaccine, such as by halving doses or increasing the interval between doses, can reduce disease and mortality compared with concentrating available vaccine doses in a subset of the population. A corollary of such dose-sparing strategies is that the vaccinated individuals may have less protective immunity. Concerns have been raised that expanding the fraction of the population with partial immunity to SARS-CoV-2 could increase selection for vaccine-escape variants, ultimately undermining vaccine effectiveness. We argue that, although this is possible, preliminary evidence instead suggests such strategies should slow the rate of viral escape from vaccine or naturally induced immunity. As long as vaccination provides some protection against escape variants, the corresponding reduction in prevalence and incidence should reduce the rate at which new variants are generated and the speed of adaptation. Because there is little evidence of efficient immune selection of SARS-CoV-2 during typical infections, these population-level effects are likely to dominate vaccine-induced evolution.

A given event has many causes, but people intuitively view some causes as more important than others. Models of causal judgment have been evaluated in controlled laboratory experiments, but they have yet to be tested in complex real-world settings. Here, we provide such a test, in the context of the 2020 U.S. presidential election. Across tens of thousands of simulations of possible election outcomes, we computed, for each state, an adjusted measure of the correlation between a Biden victory in that state and a Biden election victory. These effect size measures accurately predicted the extent to which U.S. participants (N=207, pre-registered) viewed victory in a given state as having caused Biden to win the presidency. This supports the theory that people intuitively select as causes of an outcome the factors with the largest average causal effect on that outcome across possible counterfactual worlds.

This week, the C.D.C. acknowledged what scientists have been saying for months: The risk of catching the coronavirus from surfaces is low.

The assumption that we would fare better than our neighbours to the south held true through much of the pandemic's first year. Not anymore.

One of the country’s top epidemiologists explains how population-wide use of rapid antigen tests—in combination with other measures—helped get its outbreak under control

The B.1.1.7 variant, first identified in Britain, is now the source of most new coronavirus infections in the United States, the director of the Centers for Disease Control and Prevention said.

Although evidence exists for a feedback loop between positive affect and self-care behaviors, it is unclear if findings generalize to the COVID-19 pandemic. A 10-day daily diary was completed by 324 adult participants in the United States during spring 2020 when national stay-at-home orders were in effect. We hypothesized a reciprocal within-person process whereby positive affect increased self-care behaviors (Aim 1) and self-care behaviors increased positive affect (Aim 2). Lagged analyses for Aim 1 indicated that greater negative affect, rather than positive affect, predicted increased self-care behaviors from one day to the next day. For Aim 2, concurrent analyses, but not lagged analyses, indicated self-care behaviors was associated with more positive affect and less negative affect afterwards. We discuss the ways negative affect might function differently than normal during stressful environments and conclude self-care behaviors continue to have only a short-term (within a day) impact on positive and negative affect.

As COVID-19 cases resulting from infection with SARS-CoV-2 variants accumulate in the US and around the world, one question looms large: How well do the COVID-19 vaccines developed so far protect against these novel coronavirus spinoffs? “The virus is telling us it’s going to throw out a lot of mutations,” infectious disease specialist Jesse Goodman, MD, MPH, who, as then-chief scientist at the US Food and Drug Administration (FDA), led the agency’s response to the H1N1 influenza A pandemic, said in an interview. “Even if we don’t have a critical situation right at the moment…there’s a realistic possibility that variants will continue to evolve that have potential to avoid vaccine immunity.” That’s to be expected, Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases (NIAID), told JAMA Editor in Chief Howard Bauchner, MD, in a February 3 podcast. Regardless of the platform on which the vaccine is based, Fauci said, “you still have a fixed immunogen and a virus that’s changing. Sooner or later, you’re going to get a mutant that evades that.”

As the pandemic limited our lives, people engaged in their favorite activities; either in alternative ways or while disregarding the restrictions. These major activities and our engagement in these activities of life are considered to have a significant impact on our mental health. Thus, this study aimed to examine the relationship between two types of passion (harmonious passion and obsessive passion), fear of COVID-19 (emotional fear responses, symptomatic expressions of fear), and mental distress. To this end, 322 Japanese participants completed an online questionnaire. The results showed that harmonious passion (HP) was positively related to emotional fear responses and negatively to mental distress. On the other hand, obsessive passion (OP) was positively associated with symptomatic expressions of fear and negatively with mental distress. Symptomatic expressions of fear have a stronger positive relationship with mental distress than emotional fear reactions. This study evidenced that HP is a protective factor against pandemics as it improves mental health while appropriately recognizing fear of COVID-19. Focusing on different types of passion may prove effective in improving mental health amidst the pandemic.

France has told under-55s to abandon the AstraZeneca jab for their second dose and have another vaccine instead.

A viral video on Facebook includes a number of false and misleading claims about the Covid-19 pandemic.  The video consists of a woman recommending a publication in New Zealand called The Real News, which she summarises and reads from. There are a number of false or misleading claims in this video. This article considers some of them. There are  many other claims included in the video that we have not checked, which may or may not be true. 

We must act now to prevent a further widening in wellbeing between poor and rich

No really. Just look at the numbers.

This pandemic teaches us the value of truly open science

To assess the impact of anti-vaccine movements that targeted pertussis whole-cell vaccines, we compared pertussis incidence in countries where high coverage with diphtheria-tetanus-pertussis vaccines (DTP) was maintained (Hungary, the former East Germany, Poland, and the USA) with countries where immunisation was disrupted by antivaccine movements (Sweden, Japan, UK, The Russian Federation, Ireland, Italy, the former West Germany, and Australia). Pertussis incidence was 10 to 100 times lower in countries where high vaccine coverage was maintained than in countries where immunisation programs were compromised by anti-vaccine movements. Comparisons of neighbouring countries with high and low vaccine coverage further underscore the efficacy of these vaccines. Given the safety and cost-effectiveness of whole-cell pertussis vaccines, our study shows that, far from being obsolete, these vaccines continue to have an important role in global immunisation.

In 1873—4 Sweden suffered its last smallpox epidemic. The disease broke out in epidemic proportions in Stockholm late in the autumn of 1873. The medical corps in the capital city had long been concerned about what they regarded as the failure of the vaccination programme and warned the authorities about the prospects of an epidemic if the disease, which was raging Europe, reached the city. Stockholm was less well protected than the rest of the country, partially because the vaccination system had broken down there. However, there was also resistance to vaccination in various social classes. While some resistance may have been on religious grounds, some reflected the uncertainty that had arisen about the effectiveness of vaccination when the protection proved to be less than lifelong. Publicists also distributed literature emphasizing the right of individuals to make their own decisions rather than being coerced by society. The liberal social policy of the day was reflected in more restrictive policies that shifted responsibility from the collective to the private spheres. Not until faced by a crisis in the form of an epidemic did the municipal government act.

The British Vaccination Act of 1840 was the first incursion of the state, in the name of public health, into traditional civil liberties. The activities of today's propagandists against immunisations are directly descended from, indeed little changed from, those of the anti-vaccinationists of the late nineteenth century, say Robert Wolfe and Lisa Sharp Much attention has been given on the internet to the “anti-vaccination” movement—using vaccination in its wider sense of “any immunisation”—and its possible harmful effects on uptake rates of immunisations. Many observers believe that the movement is something new and a consequence of concerns arising from the large number of immunisations now given, but concern over vaccination began shortly after the introduction of smallpox vaccination and has continued unabated ever since. Methods of disseminating information have changed since the 19th century, but the concerns and activities of anti-vaccination movements in the United Kingdom and their counterparts in the United States have changed little since then. The historian Martin Kaufman, writing about anti-vaccination movements in 19th and early 20th century America, concluded his paper with this comment, “With the improvements in medical practice and the popular acceptance of the state and federal governments' role in public health, the anti-vaccinationists slowly faded from view, and the movement collapsed.”1 We hope that a brief historical examination of anti-vaccination sentiments will give medical professionals a better sense of perspective about the groups opposing immunisations and their arguments.

In spring 2010, the Institute of Medicine’s Preparedness Forum organized three workshops to discuss and examine the vaccination campaign. The workshops were held in Raleigh, North Carolina (April 15); Austin, Texas (April 27); and Seattle, Washington (May 11). They were organized by a planning committee that included representatives from relevant federal agencies and state and local public health authorities and associations. The workshops were designed to facilitate a series of conversations focused on the following objectives: Examine innovative efforts used to distribute and administer vaccine and discuss how they may inform future efforts; Examine how jurisdictions and providers interpreted and applied the Centers for Disease Control and Prevention's Advisory Committee on Immunization Practices (CDC/ACIP) recommendations for use of 2009 H1N1 vaccine; Highlight successful approaches used by jurisdictions to develop and use innovative partnerships with traditional and non-traditional partners, such as community groups and the private sector; and Discuss strategies used to collect, monitor, evaluate, and use data during the 2009 H1N1 vaccination campaigns.For each area, participants discussed lessons learned and challenges that arose during the vaccination campaigns and identified strategies to address these challenges for future emergency vaccination programs and other medical countermeasures dispensing campaigns.

PM warns of ‘bumpy’ winter while data ‘issue’ blamed for 16,000-case backlog pushing numbers to record high

Report on the uptake of seasonal influenza vaccine in frontline health care workers (HCWs) during the 2019 to 2020 influenza vaccination programme in England.

Report on the uptake of influenza vaccine in eligible GP patient groups during the 2019 to 2020 influenza vaccination programme in England.

A targeted immunisation programme may offer some protection, but it will not deliver ‘life as normal’

Vaccine passports for covid-19 are likely to become a “feature of our lives”, according to a UK government review of the scheme, despite mounting political opposition to making proof of vaccination a condition of entry to workplaces, shops and venues.

Abstract BackgroundWhile risk of outdoor transmission of respiratory viral infections is hypothesized to be low, there are limited data on SARS-CoV-2 transmission in outdoor compared to indoor settings.MethodsWe conducted a systematic review of peer-reviewed papers indexed in PubMed, EMBASE, and Web of Science and preprints in Europe PMC through 12 August 2020 that described cases of human transmission of SARS-CoV-2. Reports of other respiratory virus transmission were included for reference.ResultsFive identified studies found a low proportion of reported global SARS-CoV-2 infections occurred outdoors (<10%) and the odds of indoor transmission was very high compared to outdoors (18.7 times; 95% confidence interval, 6.0–57.9). Five studies described influenza transmission outdoors and 2 adenovirus transmission outdoors. There was high heterogeneity in study quality and individual definitions of outdoor settings, which limited our ability to draw conclusions about outdoor transmission risks. In general, factors such as duration and frequency of personal contact, lack of personal protective equipment, and occasional indoor gathering during a largely outdoor experience were associated with outdoor reports of infection.ConclusionsExisting evidence supports the wide-held belief that risk of SARS-CoV-2 transmission is lower outdoors but there are significant gaps in our understanding of specific pathways.

A 200,000-dose order of Russia’s Sputnik V vaccine that triggered a political crisis in Slovakia should not be administered yet because of incomplete or inaccurate information from the manufacturer, the national medicines agency has said.

Adults under 30 should be offered an alternative vaccine instead of the AstraZeneca jab if there is one available in their area and they are healthy and not at high risk of Covid, the UK government’s vaccination advisory body has said.The recommendation from the joint committee on vaccines and immunisation (JCVI) is broadly in line with the thinking in Europe, where some countries have already opted to restrict the Oxford/AstraZeneca vaccine to older groups following concerns about rare events of blood clots allied to low platelets.Overall, the risks from Covid for older people are far higher and they will be encouraged to have the vaccine, which has been proven to be safe and effective in millions of people. In the UK, up to 31 March, there were 79 reports of these rare blood clots with low platelets – some but not all of them in the brain – and 19 deaths, among more than 20m AstraZeneca jabs.

New international study reveals one in every 13 COVID-related deaths results in a child under 18 years of age losing a parent.

Americans are inundated by news about the staggering half-million lives that have been lost to covid-19. But the story is bigger than just who dies. Each death casts a shadow on those left behind.For every 13 covid-19 deaths, one child under the age of 18 loses a parent. In research published by JAMA Pediatrics, we estimate that about 40,000 children in the United States have lost a parent to covid-19 since February 2020. Three-quarters of those children were adolescents, and one quarter were children younger than 10.

The scale of COVID-19 mortality in the United States, including among prime-age adults, merits efforts to continuously track how many children are affected by parental death. Children who lose a parent are at elevated risk of traumatic grief, depression, poor educational outcomes, and unintentional death or suicide, and these consequences can persist into adulthood.1 Sudden parental death, such as that occurring owing to COVID-19, can be particularly traumatizing for children and leave families ill prepared to navigate its consequences. Moreover, COVID-19 losses are occurring at a time of social isolation, institutional strain, and economic hardship, potentially leaving bereaved children without the supports they need.

Background: How SARS-CoV-2 infectivity varies with viral load is incompletely understood. Whether rapid point-of-care antigen lateral flow devices (LFDs) detect most potential transmission sources despite imperfect sensitivity is unknown. Methods: We combined SARS-CoV-2 testing and contact tracing data from England between 01-September-2020 and 28-February-2021. We used multivariable logistic regression to investigate relationships between PCR-confirmed infection in contacts of community-diagnosed cases and index case viral load, S gene target failure (proxy for B.1.1.7 infection), demographics, SARS-CoV-2 incidence, social deprivation, and contact event type. We used LFD performance to simulate the proportion of cases with a PCR-positive contact expected to be detected using one of four LFDs. Results: 231,498/2,474,066 (9%) contacts of 1,064,004 index cases tested PCR-positive. PCR-positive results in contacts independently increased with higher case viral loads (lower Ct values) e.g., 11.7%(95%CI 11.5-12.0%) at Ct=15 and 4.5%(4.4-4.6%) at Ct=30. B.1.1.7 infection increased PCR-positive results by ~50%, (e.g. 1.55-fold, 95%CI 1.49-1.61, at Ct=20). PCR-positive results were most common in household contacts (at Ct=20.1, 8.7%[95%CI 8.6-8.9%]), followed by household visitors (7.1%[6.8-7.3%]), contacts at events/activities (5.2%[4.9-5.4%]), work/education (4.6%[4.4-4.8%]), and least common after outdoor contact (2.9%[2.3-3.8%]). Contacts of children were the least likely to test positive, particularly following contact outdoors or at work/education. The most and least sensitive LFDs would detect 89.5%(89.4-89.6%) and 83.0%(82.8-83.1%) of cases with PCR-positive contacts respectively. Conclusions: SARS-CoV-2 infectivity varies by case viral load, contact event type, and age. Those with high viral loads are the most infectious. B.1.1.7 increased transmission by ~50%. The best performing LFDs detect most infectious cases.

Europe’s drug regulator has denied it has already established a causal connection between the Oxford/AstraZeneca vaccine and a rare blood clotting syndrome, after a senior official from the agency said there was a link.

However, less has been mentioned about how vaccine passports may generate or compound inequalities; those who are unable to get a vaccine may be limited in their participation in public, social, and economic life. Currently, there are many groups who are unable to get a vaccine; those who can’t for health reasons; younger population groups, with most national vaccination campaigns basing distribution on age as the key predictor of risk; and anyone in a LMIC which do not have purchase agreements with pharmaceutical firms, or have only managed to procure enough for a small percentage of their population through the COVAX mechanism, and therefore will be many years before a widespread national rollout is possible. Requiring a vaccine passport will exclude these groups—and if history of public health has told us anything, excluding people based on their health status is dangerous, and ethically reprehensible. 

Scientists and researchers managed to produce vaccines to protect against COVID-19. Vaccine candidates have recently been approved in some countries and are in the approval process in others, yet misinformation about the safety and effects of any future vaccine is already threatening its rollout. In this report, we catalogue the top myths about a COVID-19 vaccine that have appeared in NewsGuard’s ratings of more than 6,000 news and information sites worldwide.

Intense pressures on the already overstretched NHS are being exacerbated by the tens of thousands of health staff who are sick with long Covid, doctors and hospital bosses say.At least 122,000 NHS personnel have the condition, the Office for National Statistics disclosed in a detailed report that showed 1.1 million people in the UK were affected by the condition. That is more than any other occupational group and ahead of teachers, of whom 114,000 have it.

Ontario is entering another lockdown, mere weeks after restrictions lifted. Undoubtedly, we opened too early. The number of COVID-19 patients admitted to hospital when we eased restrictions in February was 10 times what they were when we reopened in the summer.

The COVID-19 pandemic has caused a decrease in both material resources (e.g., jobs, access to healthcare), and socio-psychological resources, triggered by social distancing and lockdowns. It is established that perceived resource scarcity creates a mindset that affects cognitive abilities, including decision-making. Given the importance of social norms compliance in the current climate, we investigated whether perceived material and socio-psychological scarcity experienced during the pandemic predicted cooperation, measured using two Public Good Games (PGGs), where participants contributed money or time (i.e., hours indoors contributed to shorten the lockdown). Material scarcity had no relationship with cooperation. Scarcity of socio-psychological wellbeing (e.g., connecting with family) predicted increased cooperation in both PGGs, suggesting that missing social contact fosters prosociality. On the other hand, perceived scarcity of freedom (e.g., limited movement) predicted decreased willingness to spend time indoors to shorten the lockdown. These results may have implications for message framing when aiming to increase cooperation.

In this article, we provide a toolbox of resources and nudges for those who are interested in advancing open scientific practice. Open Science encompasses a range of behaviours that aim to include the transparency of scientific research and how widely it is communicated. The paper is divided into seven sections, each dealing with a different stakeholder in the world of research (researchers, students, departments and faculties, universities, academic libraries, journals, and funders). With two frameworks in mind — EAST and the Pyramid of Culture Change — we describe the influences and incentives that sway behaviour for each of these stakeholders, we outline changes that can foster Open Science, and suggest actions and resources for individuals to nudge these changes. In isolation, a small shift in one person’s behaviour may appear to make little difference, but when combined, these small shifts can lead to radical changes in culture. We offer this toolbox to assist individuals and institutions in cultivating a more open research culture.

Study Objectives. This study examined associations between average and intraindividual trajectories of stress, sleep duration, and sleep quality in college students before and after transitioning to online learning due to the COVID-19 pandemic. Methods. Two hundred and one first-year college students answered twice-weekly questionnaires assessing stress exposure, sleep duration, and sleep quality from January until May, 2020 (N= 4,278 unique observations). Results. Multilevel growth modeling revealed that prior to distance learning, student stress was increasing and sleep duration and quality were decreasing. After transitioning online, students’ stress immediately and continuously decreased; sleep quality initially increased but decreased over time; and sleep duration increased but then plateaued for the remainder of the semester. Days with higher stress than typical for that student were associated with lower sleep quality, and higher average stress exposure was linked with shorter sleep duration and lower sleep quality. Specific demographics (e.g., females) were identified as at-risk for stress and sleep problems. Conclusions. Although remote learning initially alleviated college students’ stress and improved sleep, these effects plateaued, and greater exposure to academic, financial, and interpersonal stressors predicted worse sleep on both daily and average levels. Environmental stressors may particularly dictate sleep quality during times of transition, but changes in learning modalities may mitigate short-term detrimental health outcomes, even during a developmental period with considerable stress vulnerability. Future studies should examine the longer-term implications of these trajectories on mental and physical health.

The UK’s medicines regulatory body has said that no decision has been made on any regulatory action relating to the Oxford/AstraZeneca vaccine following reports it is considering restricting use of the vaccine in younger people.

Covid-19 has brought many changes: we must learn to embrace the good and learn from the bad

The CDC's sweeping COVID-19 response has involved teams deployed to trace outbreaks in vulnerable communities, consultations with hospitals and schools to mitigate transmission, embeds and trainings with state and local health departments, coordinating vaccine distribution, and major efforts to wrangle data from disparate sources to paint a clear picture of the pandemic's trajectory. For much of the pandemic, the work has been largely invisible to the public. The agency was sidelined and contradicted by the Trump administration, leading to mixed messaging on topics such as mask use, school reopenings and testing.

Health care agencies around the world recommended behavioral measures regarding hygiene and physical distancing to manage the COVID-19 pandemic. The current research sheds light on the interplay of psychological factors related to compliance and well-being during the pandemic. We do so by presenting a complex psychological network based on a large-scale survey (N = 6093). In total, participants were invited five times to complete this survey over a period of approximately 10 weeks (April 23th – June 30th 2020). The third and fifth wave included interventions aimed at influencing the psychological networks. We found that 1) compliance and well-being during the pandemic seemed connected through negative emotions and therefore were related factors and 2) trust in authorities influenced support for behavioral measures, which is in turn associated with compliance during the COVID-19 pandemic. Furthermore, the network structure was used to design multiple interventions, aimed at psychological variables varying in their relative importance for the network. The interventions significantly affected the variables the intervention was aimed at as well as other variables in the networks. The effects of interventions on variables related to the aim of the interventions were partially explained by the network structure. The results suggest that the network structure can be an important source of information for designing effective interventions aimed at influencing the public’s psychological systems in relation to pandemics.

In most European countries, the first wave of the COVID-19 pandemic (spring 2020) led to the imposition of physical distancing rules, resulting in a drastic and sudden reduction of real-life social interactions. Even people not directly affected by the virus itself were impacted in their physical and/or mental health, as well as in their financial security, by governmental lockdown measures. We investigated if the combination of these events had changed people’s appraisal of social scenes by testing 241 participants recruited mainly in Italy, Austria, and Germany in an online, pre-registered study conducted about 50 days after the beginning of the COVID-19 outbreak in Europe. Images depicting individuals alone, in small groups (up to four people) and in large groups (more than seven people) were rated in terms of valence, arousal, and perceived physical distance. Pre-pandemic normative ratings were obtained from a validated database (Kurdi et al., 2017). Several self-report measures were also taken, and condensed into four factors through factor analysis. All images were rated as more arousing compared to the pre-pandemic period, and the greater the decrease in real-life physical interactions reported by participants, the higher the ratings of arousal. As expected, only images depicting large gatherings of people were rated less positively during, compared to before, the pandemic. These ratings of valence were however moderated by a factor that included participants’ number of days in isolation, relationship closeness, and perceived COVID-19 threat. Higher scores on this factor were associated with more positive ratings of images of individuals alone and in small groups, suggesting an increased appreciation of safer social situations, such as intimate and small-group contacts. The same factor was inversely related to the perceived physical distance between individuals in images of small and large groups, suggesting an impact of lockdown measures and contagion-related worries on the representation of interpersonal space. These findings point to rapid and compelling psychological and social consequences of the lockdown measures imposed during the COVID-19 pandemic on the perception of social groups. Further studies should assess the long-term impact of such events as typical everyday life is restored.

The coronavirus vaccine developed by Pfizer and its German partner BioNTech protects against symptomatic Covid for up to six months, an updated analysis of clinical trial data has found.In a statement released on Thursday, the companies reported efficacy of 91.3% against any symptoms of the disease in participants assessed up to six months after their second shot. The level of protection is only marginally lower than the 95% achieved soon after vaccination.

BackgroundA rapidly increasing number of serological surveys for antibodies to SARS-CoV-2 have been reported worldwide. We aimed to synthesise, combine, and assess this large corpus of data.MethodsIn this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, and five preprint servers for articles published in English between Dec 1, 2019, and Dec 22, 2020. Studies evaluating SARS-CoV-2 seroprevalence in humans after the first identified case in the area were included. Studies that only reported serological responses among patients with COVID-19, those using known infection status samples, or any animal experiments were all excluded. All data used for analysis were extracted from included papers. Study quality was assessed using a standardised scale. We estimated age-specific, sex-specific, and race-specific seroprevalence by WHO regions and subpopulations with different levels of exposures, and the ratio of serology-identified infections to virologically confirmed cases. This study is registered with PROSPERO, CRD42020198253.Findings16 506 studies were identified in the initial search, 2523 were assessed for eligibility after removal of duplicates and inappropriate titles and abstracts, and 404 serological studies (representing tests in 5 168 360 individuals) were included in the meta-analysis. In the 82 studies of higher quality, close contacts (18·0%, 95% CI 15·7–20·3) and high-risk health-care workers (17·1%, 9·9–24·4) had higher seroprevalence than did low-risk health-care workers (4·2%, 1·5–6·9) and the general population (8·0%, 6·8–9·2). The heterogeneity between included studies was high, with an overall I2 of 99·9% (p<0·0001). Seroprevalence varied greatly across WHO regions, with the lowest seroprevalence of general populations in the Western Pacific region (1·7%, 95% CI 0·0–5·0). The pooled infection-to-case ratio was similar between the region of the Americas (6·9, 95% CI 2·7–17·3) and the European region (8·4, 6·5–10·7), but higher in India (56·5, 28·5–112·0), the only country in the South-East Asia region with data.InterpretationAntibody-mediated herd immunity is far from being reached in most settings. Estimates of the ratio of serologically detected infections per virologically confirmed cases across WHO regions can help provide insights into the true proportion of the population infected from routine confirmation data.

Background Estimates of community spread and infection fatality rate (IFR) of COVID‐19 have varied across studies. Efforts to synthesize the evidence reach seemingly discrepant conclusions. Methods Systematic evaluations of seroprevalence studies that had no restrictions based on country and which estimated either total number of people infected and/or aggregate IFRs were identified. Information was extracted and compared on eligibility criteria, searches, amount of evidence included, corrections/adjustments of seroprevalence and death counts, quantitative syntheses and handling of heterogeneity, main estimates, and global representativeness. Results Six systematic evaluations were eligible. Each combined data from 10‐338 studies (9‐50 countries), because of different eligibility criteria. Two evaluations had some overt flaws in data, violations of stated eligibility criteria, and biased eligibility criteria (e.g. excluding studies with few deaths) that consistently inflated IFR estimates. Perusal of quantitative synthesis methods also exhibited several challenges and biases. Global representativeness was low with 78‐100% of the evidence coming from Europe or the Americas; the two most problematic evaluations considered only 1 study from other continents. Allowing for these caveats, 4 evaluations largely agreed in their main final estimates for global spread of the pandemic and the other two evaluations would also agree after correcting overt flaws and biases. Conclusions All systematic evaluations of seroprevalence data converge that SARS‐CoV‐2 infection is widely spread globally. Acknowledging residual uncertainties, the available evidence suggests average global IFR of ~0.15% and ~1.5‐2.0 billion infections by February 2021 with substantial differences in IFR and in infection spread across continents, countries, and locations.

By mid March, 2021, vaccination against COVID-19 using the ChAdOx1 nCoV-19 (AZD1222) vaccine from Oxford–AstraZeneca1Ramasamy MN Minassian AM Ewer KJ et al.Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial.Lancet. 2021; 396: 1979-1993Summary Full Text Full Text PDF PubMed Scopus (55) Google Scholar,  2Voysey M Costa Clemens SA Madhi SA et al.Single-dose administration and the influence of the timing of the booster dose on immunogenicity and efficacy of ChAdOx1 nCoV-19 (AZD1222) vaccine: a pooled analysis of four randomised trials.Lancet. 2021; 397: 881-891Summary Full Text Full Text PDF PubMed Scopus (3) Google Scholar was paused in a number of European countries due to reports of thromboembolic events in vaccinated individuals.3Wise J Covid-19: European countries suspend use of Oxford-AstraZeneca vaccine after reports of blood clots.BMJ. 2021; 372: n699Crossref PubMed Scopus (0) Google Scholar According to the European Medicines Agency (EMA), 30 cases of thromboembolic events (predominantly venous) had been reported by March 10, 2021, among the approximately 5 million recipients of the Oxford–AstraZeneca COVID-19 vaccine in the European Economic Area.3Wise J Covid-19: European countries suspend use of Oxford-AstraZeneca vaccine after reports of blood clots.BMJ. 2021; 372: n699Crossref PubMed Scopus (0) Google Scholar The EMA subsequently stated that “The number of thromboembolic events in vaccinated people is no higher than the number seen in the general population”.4European Medicines AgencyCOVID-19 Vaccine AstraZeneca: PRAC investigating cases of thromboembolic events - vaccine's benefits currently still outweigh risks - update.https://www.ema.europa.eu/en/news/covid-19-vaccine-astrazeneca-prac-investigating-cases-thromboembolic-events-vaccines-benefitsDate: March 11, 2021Date accessed: March 22, 2021Google Scholar To inform the ongoing discussion on the safety of the Oxford–AstraZeneca COVID-19 vaccine, we analysed nationwide population-based data from Denmark to estimate the natural incidence of venous thromboembolism.5

From the start of the COVID-19 pandemic, rheumatologists have been inundated with questions and concerns from their patients about whether their rheumatic disease, or the drugs they use to treat them, might increase their risk of COVID-19. With COVID-19 vaccination programmes now underway in many countries, patients' concerns have shifted toward questions about the vaccines and whether they are safe for them to receive. The short answer is yes.

In this issue of The Lancet Public Health, a series of papers present different aspects of the COVID-19 pandemic in France. In their nationwide epidemiological study, Jean Gaudart and colleagues analysed COVID-19 incidence, morbidity, mortality, and factors potentially associated with the first wave of infections in France. For Gaudart and colleagues, the country “could absorb the shock, thanks to a strong hospital system and a national lockdown”. In another study, Thomas Roederer and colleagues focused their analysis on one of the most vulnerable groups in society and assessed seroprevalence and risk factors in homeless people relocated to emergency shelters. They noted high exposure to SARS-CoV-2 and high asymptomatic seroprevalence. Living in crowded conditions was the strongest factor associated with exposure, underscoring the importance of providing safe, uncrowded accommodation, alongside adequate testing and public health information to this vulnerable population. The study by Michaël Schwarzinger and colleagues investigated COVID-19 vaccine acceptance and its determinants, such as vaccine characteristics or place of vaccination. Although most determinants were hypothetical at the time the study was done (July, 2020), such analyses are particularly important in a country where vaccine confidence has been persistently low. They estimated that 30% of adults were likely to refuse vaccination outright. Latest data from the CoviPrev survey suggest that this proportion has decreased from 32% in December, 2020, to 21% in February, 2021.

We are living in extraordinary times. 2021 brings the covid-19 mortality to >2 million deaths worldwide and to >100,000 deaths in the UK. Steely eyed scientists are finding themselves the topic of political debate, independent government advisors are accused of succumbing to political pressures, and academics (particularly women) are subjected to vitriolic abuse on Twitter. 

So far this month, according to government data, about 2,030 Brazilians aged 30 to 39 have died from Covid, more than double the number recorded in January. Among those in their 40s, there have been 4,150 fatalities in March, up from 1,823 in January, and for those 20-29, deaths jumped to 505 from 242.

NEW BRUNSWICK, N.J., March 29, 2021 /PRNewswire/ -- Janssen Pharmaceutica NV, one of the Janssen Pharmaceutical Companies of Johnson & Johnson (NYSE: JNJ) (the Company), has entered into an agreement with the African Vaccine Acquisition Trust (AVAT) to make available up to 220 million doses of its single-shot COVID-19 vaccine candidate to African Union's 55 member states with delivery beginning in the third quarter of 2021. AVAT also has the potential to order an additional 180 million doses, for a combined total of up to 400 million doses through 2022. The availability of the vaccine candidate is subject to its successful approval or authorization by the national regulatory authorities of AU member states.

These last few months of waiting can feel agonizing. But there are steps you can take to manage the anxiety.