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.

10.18564/jasss.4585

Modeling COVID-19 for Lifting Non-Pharmaceutical Interventions

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.

Coronapas: The passport helping Denmark open up after Covid

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?

As a Ph.D. student, sharing my perspective on social media felt scary—but it’s worth it

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.

10.1016/S2214-109X(20)30542-8

How COVID-19 has fundamentally changed clinical research in global health

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.

10.1016/S2214-109X(20)30541-6

The role and challenges of cluster randomised trials for global health

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.

10.1016/S2214-109X(20)30540-4

Randomised trials at the level of the individual

10.1016/S2214-109X(20)30539-8

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.

Urgently seeking efficiency and sustainability of clinical trials in global health

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.

Clinical Trials in Global Health

10.31234/osf.io/2qya8

Despite continued transmission of SARS-CoV-2 and sustained recommendations to wear protective face coverings, many people remained reluctant to comply throughout the early months of the pandemic. In the present study we surveyed an international cohort of participants on three different occasions from July to August, 2020 (N = 695) to examine the relative contribution of several factors in explaining variation in mask wearing behavior across a range of routine and leisure activities. We examine the role of COVID-19 prevalence, perceived risk of infection, COVID-19 related stress, demographics, time orientation, and several mask wearing attitudes and intentions. We find that COVID-19-related stress and the intention to protect oneself were reliably associated with more mask wearing across contexts, while other factors, such as anxiety caused by others’ mask wearing and the intention to wear masks to protect others, were context dependent. We discuss potential avenues for future research on possible positive and negative indirect effects of COVID-19-related stress, time orientation, and political orientation with regard to mask wearing behavior.

Mask wearing behavior across routine and leisure activities during COVID-19

Nurses getting ready to vaccinate 16+ at Career. Thank you to our nurses for keeping our community safe.

High school vaccinations begin today in New Haven!

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

Gordon Brown calls for G7 to act on Covid vaccine ‘apartheid’

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

Ardern tells New Zealand border staff: get Covid vaccine now or be redeployed

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.

10.1126/science.abh2644

Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil

“Genomics and epidemiology of the P.1 SARS-CoV-2 lineage in Manaus, Brazil” - P.1 may be 1.7–2.4-fold more transmissible - previous (non-P.1) infection provides 54–79% of the protection against infection with P.1 that it provides against non-P.1 lineages https://science.sciencemag.org/content/early/2021/04/13/science.abh2644.full

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

10.1136/bmj.n657

Covid-19: a disaster five years in the making

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

Kati Kariko Helped Shield the World From the Coronavirus

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

Has the Era of Overzealous Cleaning Finally Come to an End?

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.

Canada is likely to exceed the U.S. infection rate in the coming days

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

Slovakia Offers a Lesson in How Rapid Testing Can Fight COVID

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.

More Contagious Virus Variant Is Now Dominant in U.S., C.D.C. Chief Says

Taking care with self-care during COVID-19: Affect-behavior associations during early stages of the pandemic

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.

10.31234/osf.io/eycmj

This pandemic teaches us the value of truly open science

10.1136/bmj.n898

Covid-19, open science, and the CVD-COVID-UK initiative

"These data represent a remarkable research resource and illustrate how covid-19 has fostered open science" @jsross119 @BHFDataScience

U.K. variant now dominant form of COVID in US ⁦@CDCDirector⁩ As predicted B.1.1.7 is now the predominant SARS-CoV-2 strain in the US. Let’s remember it is much more transmissible and likely also more severe. Vaccines do cover it. ⁦@ajc

The same approaches that work against SARS-CoV-2 work against variants like B.1.1.7: Mask Avoid indoor gatherings Socialize outdoors And, reinforces the need to continue to scale-up vaccine administration to all 16+.

.@SecBlinken: Stopping COVID-19 is the Biden-Harris Administration’s number one priority. Otherwise, the coronavirus will keep circulating in our communities, threatening people’s lives and livelihoods, holding our economy back.

One year ago today: The WHO strongly asserts that COVID-19 is not airborne, and that the most effective way to prevent spread is frequent handwashing.

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.

10.1016/S2214-109X(21)00026-7

Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis

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.

10.1111/eci.13554

Reconciling estimates of global spread and infection fatality rates of COVID‐19: an overview of systematic evaluations

How do COVID-19 skeptics use public health data and social media to advocate for reopening the economy and against mask mandates?We studied half a million tweets, over 41,000 visualizations, and spent six months lurking in anti-mask Facebook groups.Here’s what we found.

The Data Visualizations Behind COVID-19 Skepticism

Interesting visualisation of COVID-related data sharing on Twitter: http://vis.mit.edu/covid-story/#dashboard… via @OYCar

2103.12847

The median voter theorem has long been the default model of voter behavior and candidate choice. While contemporary work on the distribution of political opinion has emphasized polarization and an increasing gap between the "left" and the "right" in democracies, the median voter theorem presents a model of anti-polarization: competing candidates move to the center of the ideological distribution to maximize vote share, regardless of the underlying ideological distribution of voters. These anti-polar results, however, largely depend on the "singled-peakedness" of voter preferences, an assumption that is rapidly loosing relevance in the age of polarization. This article presents a model of voter choice that examines three potential mechanisms that can undermine this finding: a relative cost of voting that deters voters who are sufficiently indifferent to both candidates, ideologically motivated third-party alternatives that attract extreme voters, and a bimodal distribution of voter ideology. Under reasonable sets of conditions and empirically observed voter opinion distributions, these mechanisms can be sufficient to cause strategically-minded candidates to fail to converge to the center, or to even become more polarized than their electorate.

Polarization, Abstention, and the Median Voter Theorem

Over the last few decades, social scientists have experienced the causal revolution, the replication crisis, and, now in just a matter of months, another epoch: the era of coronavirus disease 2019 (COVID-19) research. According to Google Scholar, roughly 3.55 million COVID-19–related articles have appeared to date. That amounts to about 9,726 articles per day, or, roughly, one article every 9 seconds. Many of these articles are in the social sciences—that is, concerned not directly with medical outcomes but rather with COVID-19’s impact on social, behavioral, and economic outcomes.

10.1073/pnas.2104155118

Opinion: Past is future for the era of COVID-19 research in the social sciences

THE UK’s controversial decision to increase the time between covid-19 vaccine doses has been thrust back under the spotlight after the US hasn’t followed suit, amid warnings that the strategy may backfire. However, the UK is no longer alone in its decision, with Canada and Germany both choosing to follow a similar plan.

US refuses to extend time between coronavirus vaccine doses

Lack of transparency on Oxford-developed vaccine fuel for European and US caution

Brexit blinds Britain to AstraZeneca’s blunders

A specific form of severe cerebral venous thrombosis associated with platelet deficiency (thrombocytopenia) and bleeding has been identified in seven cases (as of 15 March 2021) in temporal association with vaccination with COVID-19 Vaccine AstraZeneca.

FAQ – Temporary suspension of COVID-19 vaccine AstraZeneca

It's been 100 days since the first dose of the SARS2-CoV vaccine was given in the UK, and 24.8 million people have received their first dose since. That is pretty amazing.

The aim of the article is to determine the predictors of mental health among Polish society. Research was conducted after the first wave of the pandemic. Due to such an approach, it was possible to determine whether secondary effects of the pandemic have impact on mental health, apart from socio-demographic and psychological factors. In order to gather the research material, the CAWI on-line survey method was applied and carried out within the framework of the Ariadna Research Panel on the sample of 1079 Poles aged 15 and over. The FCV-19S scale, which is used to measure the fear of COVID-19 was applied in the measurement. It is a verified diagnostic instrument used to measure mental health in a lot of countries. The results of a hierarchical regression analysis have shown that the factors which increase the level of fear of COVID-19 are demographic, social and psychological features as well as attitudes towards the pandemic. The results of research indicate the significance of social context in the analysis and explanation of the effects of disasters and cataclysms

10.31234/osf.io/89cnw

PREDICTORS OF MENTAL HEALTH AFTER THE FIRST WAVE OF THE COVID-19 PANDEMIC IN POLAND

Our letter in the Times. ‘We request that the government urgently and openly share the scientific evidence, data and modelling it is using to inform its decision on the #Covid_19 public health interventions’ @richardhorton1 @miriamorcutt @devisridhar @drannewilson @PWGTennant