Ok, let's talk about pre-existing conditions now. The paper suggests that 3 of four deaths were in children with 'pre-existing conditions'. The most common pre-existing condition cited is 'neurological condition' which includes learning disabilities and mental health conditions.

If you consider only this year, this proportion is even higher >80%, which suggests that currently most deaths occurring within 28 days of a positive test have SARS-CoV-2 as a cause (direct or contributing cause)

By contrast with what the paper says which may have been true at the time, the vast majority of deaths with COVID-19 in children are very sadly due to COVID-19 now. There were 94+3=97 deaths in PHE 28 day data compared with 68 in the ONS which is 70% of with COVID being 'from'

These data are lagged, and concord very well with PHE data of COVID-19 deaths within 28 days of a positive test for recent waves, which means once data are backfilled, we have ~101 deaths in children up to now in England & Wales:

These are of course underestimates, because death registration gets backfilled & recent weeks are underestimated. This doesn't include the last 2 weeks where there have been deaths in children as per PHE data, at least some of which will be back filled in. They don't include PIMS

Unfortunately current ONS estimates, suggest a very very different picture - post-delta, and since mitigations have been mostly lifted in schools, which has meant mass infection in kids. ONS currently shows that 68 deaths till end of Oct from COVID-19 in 0-19 yr olds

ONS deaths 'involving COVID-19' include similar classification to what the review has produced- deaths directly due to COVID-19, and with COVID-19 as a contributor cause (also on the causal pathway). Both these would be attributable to COVID-19.

But what this goes to show is despite what may be a reasonably thorough, if subjective review of the evidence (as the nature of this will always be, even with death certification), it is not generalisable to the current data at all. And it suggests the ONS estimates are accurate.

These figures are roughly consistent to me with what they may have found, although I can't be completely sure because the exact date range isn't clear, the ONS doesn't provide data separately on PIMS-TS (which would've been underestimated by the ONS too), & the age range is diff.

The ONS data from the same period on deaths in 0-19 yr olds (0-18 yr olds not publicly available) "involving COVID-19" are 33 (if their end point is 28th Feb) for England and Wales.

In fact the authors note the difficulty in identifying PIMS-TS related deaths, because a diagnostic code for this was only generated in Nov 2020. Different codes were considered to represent this before, but it's very likely cases would've been missed at least early on.

For deaths from PIMS-TS, a multi-inflammatory syndrome that can occur after COVID-19, they relied on diagnoses being in the electronic record. Given this syndrome was only identified and described in April 2020, this would almost certainly have been underestimated.

It depended on a subjective review of case reports by 3 experts. All reviewers only agreed on only half of the cases they reviewed, indicating the really subjective nature of review. And consensus still could not be reached on 9 which needed further review.

"identifying whether SARS-CoV-2 was listed as 1a (the direct cause of death) on the Certificate of Cause of Death and whether the clinical course described was typical of SARS-CoV-2 infection." For the rest, a review was carried out to determine whether SARS-CoV-2 contributed.

The authors carried a review of 61 deaths in children who were positive for SARS-CoV-2/had PIMS-TS and come to the conclusion that only 25 were due to SARS-CoV-2. They conclude that only 25/61= 41% of all children who died 'with' COVID-19 died 'from' it.

The analysis is between March '20-Feb '21. Why is this important: -delta was not dominant -there were 3 lockdowns during this period None of this is relevant now with delta, no mitigations, the highest infection rates we've *ever* had in children (4-5% even post- half-term)

Ok, so worth really looking closely at the @NatureMedicine paper that's been cited widely on the impact of COVID-19 on children's deaths. This has several key limitations, and should not be cited in the way it is being

The Pfizer-BioNTech COVID-19 vaccine is associated with lower viral load in breakthrough infections, but this effect vanishes at 6 months after vaccination, according to a @NatureMedicine paper. A booster restores the reduction in viral load. https://go.nature.com/3mT9Y7V

23/ TRANSLATIONS: if interested in translating the comics, pls complete agreement in folder below, & send it to @ChiaWang8 at chiawang@mail.nsysu.edu.tw: Translation to Indonesian, Thai, Dutch, and Sinhala is already underway. Help for others needed https://drive.google.com/drive/folders/1g32z0LrxjcWYet2n6BFNYuzDsRvmNfdm

22/ A powerpoint version can be downloaded from this folder from @chiawang (it is the file that ends in "pptx"): https://drive.google.com/drive/folders/1g32z0LrxjcWYet2n6BFNYuzDsRvmNfdm

21/ And for people more inclined to learn about the details, check out the literature references etc., this thread explains the @ScienceMagazine paper in more detail:Quote Tweet

20/ If you want to download all the comic images at once, they are available in this folder: https://drive.google.com/drive/u/0/folders/1Qz69bmqQ7qhrMYcWBuPsfsmFlMmASVfz

19/ There are many requests to translate to other languages. So far they are only in English, but I am inquiring if we can make the editable files available, will post here if so.

18/ More information: - Our scientists'FAQs: http://bit.ly/FAQ-A - @ScienceMagazine review: https://science.org/doi/10.1126/science.abd9149… - @TheLancet paper: https://thelancet.com/article/S0140-6736(21)00869-2/fulltext… - @ScienceMagazine paradigm shift paper: https://science.org/doi/full/10.1126/science.abg2025… - Transmission estimator:

17/ How to stop airborne transmission? - Keep distance (helps but not enough by itself) - Ventilation, filtration (+UV in some cases) - Masks w/ attention to fit to the face - Avoid indoor crowding

16/ Plexiglas barriers may trap higher concentrations of aerosols! (and INCREASE, rather than decrease, transmission of the virus)

15/ Surface disinfection CANNOT block airborne transmission (and is a waste of time and money):

14/ Why did so many people get infected despite mask wearing? (not wearing it tight to the face, or low quality filter)

13/ Crowding indoors is a key element for superspreading events

12/ ACE2 is the cell entry receptor that binds and guides SARS-CoV-2 to invade cells

11/ Virus-laden aerosols can enter and deposit in the bronchiolar and alveolar regions of the lungs (also in the nose and upper respiratory tract):

10/ Solar radiation and artificial UV light disable aerosols by damaging their genetic material. (But ventilation and/or filters are preferable to artificial UV whenever possible)

9/ Filters work well to remove infectious aerosols from the air (commercial HEPA or cheaper fan + filter like Corsi-Rosenthal box):

8/ Racing with time: how long do infectious viruses survive in aerosols?

7/ Virus-containing aerosols are impacted by airflow and ventilation

6/ How long can virus-containing aerosols linger in the air?

5/ What is the main difference between aerosols and droplets?

4/ How can aerosols infect through airborne transmission? (by inhalation)

3/ So what are aerosols?

2/ The cast of characters: aerosols & droplets

1/ AIRBORNE TRANSMISSION OF RESPIRATORY VIRUSES: THE COMIC VERSION Supplementary multimedia prepared by lead author @ChiaWang8 to our recent @ScienceMagazine peer-reviewed paper https://science.org/doi/10.1126/science.abd9149… @kprather88 @linseymarr @zeynep @Lakdawala_Lab @zeynep

NEW Viewpoint by @Erik_Klok_MD, @MPaiMD, Menno Huisman & @ProfMakris discussing the epidemiology, pathophysiology, and optimal diagnostic and therapeutic management of vaccine-induced immune thrombotic thrombocytopenia #VITT #COVID19Vaccine https://thelancet.com/journals/lanhae/article/PIIS2352-3026(21)00306-9/fulltext

10.1016/S0140-6736(21)02282-0

Fears of adverse effects of COVID-19 vaccination on fertility have affected vaccine uptake in some communities. Despite the absence of supporting evidence for such a risk, low biological plausibility, and preliminary data supporting the safety of mRNA vaccines in pregnancy,1Shimabukuro TT Kim SY Myers TR et al.Preliminary findings of mRNA COVID-19 vaccine safety in pregnant persons.N Engl J Med. 2021; 384: 2273-2282Crossref PubMed Scopus (94) Google Scholar,  2Kharbanda EO Haapala J DeSilva M et al.Spontaneous abortion following COVID-19 vaccination during pregnancy.JAMA. 2021; (published online Sept 8.)https://doi.org/10.1001/jama.2021.15494Crossref Scopus (0) Google Scholar,  3Zauche LH Wallace B Smoots AN et al.Receipt of mRNA COVID-19 vaccines and risk of spontaneous abortion.N Engl J Med. 2021; 385: 1533-1535Crossref PubMed Google Scholar this claim has become widespread, and it has been challenged by WHO.4WHOCoronavirus disease (COVID-19): vaccines safety.https://www.who.int/news-room/q-a-detail/coronavirus-disease-(covid-19)-vaccines-safetyDate: Feb 19, 2021Date accessed: September 2, 2021Google Scholar Vaccine hesitancy during pregnancy, or among women of childbearing age, could have substantial public health consequences because infection with SARS-CoV-2 during pregnancy is a risk factor for severe maternal illness and complications.5Mullins E Hudak ML Banerjee J et al.Pregnancy and neonatal outcomes of COVID-19: coreporting of common outcomes from PAN-COVID and AAP-SONPM registries.Ultrasound Obstet Gynecol. 2021; 57: 573-581Crossref PubMed Scopus (26) Google Scholar,  6Vousden N Bunch K Morris E et al.The incidence, characteristics and outcomes of pregnant women hospitalized with symptomatic and asymptomatic SARS-CoV-2 infection in the UK from March to September 2020: a national cohort study using the UK Obstetric Surveillance System (UKOSS).PLoS One. 2021; 16e0251123Crossref PubMed Scopus (13) Google Scholar

Fertility rates and birth outcomes after ChAdOx1 nCoV-19 (AZD1222) vaccination

Research letter reports fertility rates and birth outcomes after ChAdOx1 nCoV-19 vaccination: fertility unaffected; no increased risk of miscarriage and no instances of stillbirth in women vaccinated before pregnancy in global clinical trials. https://hubs.li/H0-N6Hq0

10.1016/S1473-3099(21)00676-9

The SARS-CoV-2 pandemic is now better controlled in settings with access to fast and reliable testing and highly effective vaccination rollouts. Several studies have found that people who recovered from COVID-19 and tested seropositive for anti-SARS-CoV-2 antibodies have low rates of SARS-CoV-2 reinfection. There are still looming questions surrounding the strength and duration of such protection compared with that from vaccination.

Protective immunity after recovery from SARS-CoV-2 infection

Eighty-five percent of people in Singapore eligible for coronavirus vaccines are fully vaccinated, and 18 percent have received booster shots.But the Singaporean government said Monday that it will no longer cover the medical costs of people “unvaccinated by choice,” who make up the bulk of remaining new coronavirus cases and covid-19 hospitalizations in the city-state.

People ‘unvaccinated by choice’ in Singapore no longer can receive free covid-19 treatment

10.1126/science.abd9149 PREVIOUS ARTICLEAdvances and challenges in time-resolved macromolecular crystallographyPrevious

AbstractThe COVID-19 pandemic has revealed critical knowledge gaps in our understanding of and a need to update the traditional view of transmission pathways for respiratory viruses. The long-standing definitions of droplet and airborne transmission do not account for the mechanisms by which virus-laden respiratory droplets and aerosols travel through the air and lead to infection. In this Review, we discuss current evidence regarding the transmission of respiratory viruses by aerosols—how they are generated, transported, and deposited, as well as the factors affecting the relative contributions of droplet-spray deposition versus aerosol inhalation as modes of transmission. Improved understanding of aerosol transmission brought about by studies of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection requires a reevaluation of the major transmission pathways for other respiratory viruses, which will allow better-informed controls to reduce airborne transmission.

Airborne transmission of respiratory viruses

10.1016/S0140-6736(21)02226-1

SummaryBackgroundIn the USA, COVID-19 vaccines became available in mid-December, 2020, with adults aged 65 years and older among the first groups prioritised for vaccination. We estimated the national-level impact of the initial phases of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older.MethodsWe analysed population-based data reported to US federal agencies on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 50 years and older during the period Nov 1, 2020, to April 10, 2021. We calculated the relative change in incidence among older age groups compared with a younger reference group for pre-vaccination and post-vaccination periods, defined by the week when vaccination coverage in a given age group first exceeded coverage in the reference age group by at least 1%; time lags for immune response and time to outcome were incorporated. We assessed whether the ratio of these relative changes differed when comparing the pre-vaccination and post-vaccination periods.FindingsThe ratio of relative changes comparing the change in the COVID-19 case incidence ratio over the post-vaccine versus pre-vaccine periods showed relative decreases of 53% (95% CI 50 to 55) and 62% (59 to 64) among adults aged 65 to 74 years and 75 years and older, respectively, compared with those aged 50 to 64 years. We found similar results for emergency department visits with relative decreases of 61% (52 to 68) for adults aged 65 to 74 years and 77% (71 to 78) for those aged 75 years and older compared with adults aged 50 to 64 years. Hospital admissions declined by 39% (29 to 48) among those aged 60 to 69 years, 60% (54 to 66) among those aged 70 to 79 years, and 68% (62 to 73), among those aged 80 years and older, compared with adults aged 50 to 59 years. COVID-19 deaths also declined (by 41%, 95% CI –14 to 69 among adults aged 65–74 years and by 30%, –47 to 66 among those aged ≥75 years, compared with adults aged 50 to 64 years), but the magnitude of the impact of vaccination roll-out on deaths was unclear.InterpretationThe initial roll-out of the US COVID-19 vaccination programme was associated with reductions in COVID-19 cases, emergency department visits, and hospital admissions among older adults.FundingNone.

Estimating the early impact of the US COVID-19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older: an ecological analysis of national surveillance data

New research Article @TheLancet: Estimating the early impact of the US #COVID19 vaccination programme on COVID-19 cases, emergency department visits, hospital admissions, and deaths among adults aged 65 years and older https://thelancet.com/journals/lancet/article/PIIS0140-6736(21)02226-1/fulltext… #VaccinesWork

WHO has granted emergency use listing (EUL) to #COVAXIN® (developed by Bharat Biotech), adding to a growing portfolio of vaccines validated by WHO for the prevention of #COVID19.

10.1038/s41562-021-01217-2

During the COVID-19 pandemic, conspiracy theorists have exploited the provisional nature of scientific consensus and the realities of how science is conducted to paint scientists and public health leaders as malign actors. Download PDF

How conspiracists exploited COVID-19 science

Conspiracy theorists during the pandemic have exploited the provisional nature of scientific consensus and the realities of how science is conducted to paint scientists and health leaders as malign actors, according to a @NatureHumBehav Comment article. https://go.nature.com/3q1JB1I

10.1016/S1473-3099(21)00691-5

Pregnant women are vulnerable to COVID-19, with increased risk of more severe illness and pregnancy complications, particularly if infected during the third trimester.1Allotey J Stallings E Bonet M et al.Clinical manifestations, risk factors, and maternal and perinatal outcomes of coronavirus disease 2019 in pregnancy: living systematic review and meta-analysis.BMJ. 2020; 370m3320Crossref PubMed Scopus (16) Google Scholar Based on prior experience with vaccines in pregnancy, and with no hypothesised mechanisms for fetal harm, similar efficacy and side-effects to the non-pregnant population were anticipated with vaccination against SARS-CoV-2 in pregnancy. Current, albeit limited, data support this; no major safety signals were observed in animal reproductive toxicology studies or with post-marketing surveillance. However, until recently, there was little consensus regarding routine vaccination in pregnancy, and vaccine hesitancy in pregnant women remains high.2Skjefte M Ngirbabul M Akeju O et al.COVID-19 vaccine acceptance among pregnant women and mothers of young children: results of a survey in 16 countries.Eur J Epidemiol. 2021; 36: 197-211Crossref PubMed Scopus (25) Google Scholar

COVID-19 vaccination in pregnancy—number needed to vaccinate to avoid harm

Local outlets may lack audience size, but they can can provide a veneer of legitimacy to fringe groups, experts say

How anti-vaxxers and ivermectin advocates have co-opted US local news

(CNN)Join Big Bird, Elmo and Rosita for "The ABCs of Covid Vaccines: A CNN/Sesame Street Townhall for Families" this Saturday at 8:30 a.m. ET, hosted by CNN's Dr. Sanjay Gupta and Erica Hill. What questions do you or your kids have about Covid-19 vaccines? Share them below.

What questions do your kids have about the Covid-19 vaccine?

10.31234/osf.io/6s28u

During the COVID-19 pandemic social consequences in day-to-day decisions might not have been salient to the decider and thus egoistic. How can prosocial intentions be increased? In an experimental vignette study with N = 206, we compared the likelihood that parents send sick children to kindergarten after four interventions (general information about COVID-19, empathy, reflection of consequences via mental simulation, and control group). Independent of the intervention, empathic concern with individuals who were affected by COVID-19 and the salience of social consequences were high. The reported likelihood of sending a sick child to kindergarten was somewhat reduced in the control group and even more reduced in the reflection and empathy group, but not in the information group.

Keeping the kids home: Increasing concern for others in times of crisis

10.31234/osf.io/4yme9

Coronavirus Disease 2019 broke out in China at the end of 2019 and spread rapidly around the world. In response, many countries have adopted social distancing and lockdown measures. But restrictive measures resulted in many unwanted psychological consequences, including mental fatigue. Mental fatigue in turn is very likely to cause psychopathological disorders and cognitive malfunctions. A cognitive ability that is likely to be affected by mental fatigue is reasoning, while high reasoning ability is a prerequisite for compliance with restrictive measures. The present study aims to explore the association between mental fatigue and reasoning under the impact of long-term restrictive measures. The findings indicated that mental fatigue correlates negatively with cognitive reflection, while it has no significant association with general reasoning. The results also showed that mental fatigue correlates positively with the misperception of the preventive measures and negatively with the incomprehension of the restrictive measures. The implications of the results have been discussed.

Association of Mental Fatigue due to Long-term Restrictive Measures with Reasoning: A COVID-19 Study

10.31234/osf.io/q4bd2

There is widespread concern about fake news and other misinformation circulating on social media. In particular, many argue that the context of social media itself may make people particularly susceptible to the influence of false claims. Here, we test that claim by asking whether simply considering whether to share news on social media reduces people’s ability to identify truth versus falsehood. In a large online experiment (N=3,157 Americans quota-matched to the national distribution of age, gender, ethnicity, and geographic region) examining COVID-19 and political news, we find support for this possibility. Compared to a baseline where participants judged only the accuracy of each headline, we observed worse truth discernment when participants also indicated their sharing intentions. Conversely, sharing discernment was substantially higher when participants also rated accuracy, relative to a baseline where sharing intentions were elicited without rating accuracy. These results suggest people may be particularly vulnerable to believing false claims on social media due to fundamental features of these platforms – which is particularly concerning given that it is hard to imagine social media without sharing.

Social Media Sharing Reduces Truth Discernment

10.31234/osf.io/e3kv9

Trust in automation, is of concern in computer science and cognitive systems engineering, as well as the popular media (e.g., Chancey et al., 2015; Hoff and Bashir 2015; Hoffman et al., 2009; Huynh et al., 2006; Naone, 2009; Merritt and Ilgen, 2008; Merritt et al. 2013, 2015a; Pop et al. 2015; Shadbolt, 2002; Wickens et al. ,2015; Woods and Hollnagel 2006). Trust is of particular concern as more AI systems are being developed and tested (Schaefer et al., 2016).

Measuring Trust in the XAI Context

Health leaders agree that a world without COVID-19 will not be possible until everyone has equal access to vaccines. More than 4.6 million people have died from the virus since it swept across the globe from the beginning of 2020, but it’s expected that the rate of people dying will slow if more people are vaccinated. 

COVID vaccines: Widening inequality and millions vulnerable

Richer countries must wake up and see the bigger Covid picture

The Guardian view on global vaccine inequality: unwise as well as unethical

Poor countries will bear the brunt of both tolls

Vaccine inequality will cost money as well as lives

As lockdowns ease in New South Wales, Victoria and the ACT, and people return to work and socialising, many of us will be mixing more with others, even though a section of the community is still unvaccinated.

Your unvaccinated friend is roughly 20 times more likely to give you COVID

Thanks @MKushel and others for helping bring their voices front and center in the conversation. Highly recommend this piece. (3/3) cc: @KellyMDoran @JessieGaeta @vineet_chopra @gregggonsalves

This during a time when so many people have turned their backs on this vulnerable population (Or are actively trying to destroy their lives @Kim_Janey and @bostonpolice). We have a CIVIC RESPONSIBILITY to help ppl experiencing homelessness. (2/3)

A study in @JournalGIM by @MKushel found "the majority of participants [who experienced #homelessness] expressed a positive inclination toward vaccine acceptability, citing...CIVIC RESPONSIBILITY." (1/3)

10.1007/s11606-021-07161-1

BackgroundHomeless-experienced populations are at increased risk of exposure to SARS-CoV-2 due to their living environments and face an increased risk of severe COVID-19 disease due to underlying health conditions. Little is known about COVID-19 testing and vaccination acceptability among homeless-experienced populations.ObjectiveTo understand the facilitators and barriers to COVID-19 testing and vaccine acceptability among homeless-experienced adults.DesignWe conducted in-depth interviews with participants from July to October 2020. We purposively recruited participants from (1) a longitudinal cohort of homeless-experienced older adults in Oakland, CA (n=37) and (2) a convenience sample of people (n=57) during a mobile outreach COVID-19 testing event in San Francisco.ParticipantsAdults with current or past experience of homelessness.ApproachWe asked participants about their experiences with and attitudes towards COVID-19 testing and their perceptions of COVID-19 vaccinations. We used participant observation techniques to document the interactions between testing teams and those approached for testing. We audio-recorded, transcribed, and content analyzed all interviews and identified major themes and subthemes.Key ResultsParticipants found incentivized COVID-19 testing administered in unsheltered settings and supported by community health outreach workers (CHOWs) to be acceptable. The majority of participants expressed a positive inclination toward vaccine acceptability, citing a desire to return to routine life and civic responsibility. Those who expressed hesitancy cited a desire to see trial data, concerns that vaccines included infectious materials, and mistrust of the government.ConclusionsParticipants expressed positive evaluations of the incentivized, mobile COVID-19 testing supported by CHOWs in unsheltered settings. The majority of participants expressed a positive inclination toward vaccination. Vaccine hesitancy concerns must be addressed when designing vaccine delivery strategies that overcome access challenges. Based on the successful implementation of COVID-19 testing, we recommend mobile delivery of vaccines using trusted CHOWs to address concerns and facilitate wider access to and uptake of the COVID vaccine.

COVID-19 Testing and Vaccine Acceptability Among Homeless-Experienced Adults: Qualitative Data from Two Samples

Freedom Day gave Covid-19 the freedom to spread again. Now, in the face of expert opinion, the prime minister drags his feet over the return of tougher restrictions.

Is Boris Johnson’s Covid response wilfully negligent or fatally complacent?

The government, ignoring the science, talks of freedom. But true liberty comes from cutting infections so people feel safe

Covid measures give us choice. They are not restrictions on British life

10.1016/S0140-6736(21)02276-5

SummaryBackgroundEngland's COVID-19 roadmap out of lockdown policy set out the timeline and conditions for the stepwise lifting of non-pharmaceutical interventions (NPIs) as vaccination roll-out continued, with step one starting on March 8, 2021. In this study, we assess the roadmap, the impact of the delta (B.1.617.2) variant of SARS-CoV-2, and potential future epidemic trajectories.MethodsThis mathematical modelling study was done to assess the UK Government's four-step process to easing lockdown restrictions in England, UK. We extended a previously described model of SARS-CoV-2 transmission to incorporate vaccination and multi-strain dynamics to explicitly capture the emergence of the delta variant. We calibrated the model to English surveillance data, including hospital admissions, hospital occupancy, seroprevalence data, and population-level PCR testing data using a Bayesian evidence synthesis framework, then modelled the potential trajectory of the epidemic for a range of different schedules for relaxing NPIs. We estimated the resulting number of daily infections and hospital admissions, and daily and cumulative deaths. Three scenarios spanning a range of optimistic to pessimistic vaccine effectiveness, waning natural immunity, and cross-protection from previous infections were investigated. We also considered three levels of mixing after the lifting of restrictions.FindingsThe roadmap policy was successful in offsetting the increased transmission resulting from lifting NPIs starting on March 8, 2021, with increasing population immunity through vaccination. However, because of the emergence of the delta variant, with an estimated transmission advantage of 76% (95% credible interval [95% CrI] 69–83) over alpha, fully lifting NPIs on June 21, 2021, as originally planned might have led to 3900 (95% CrI 1500–5700) peak daily hospital admissions under our central parameter scenario. Delaying until July 19, 2021, reduced peak hospital admissions by three fold to 1400 (95% CrI 700–1700) per day. There was substantial uncertainty in the epidemic trajectory, with particular sensitivity to the transmissibility of delta, level of mixing, and estimates of vaccine effectiveness.InterpretationOur findings show that the risk of a large wave of COVID-19 hospital admissions resulting from lifting NPIs can be substantially mitigated if the timing of NPI relaxation is carefully balanced against vaccination coverage. However, with the delta variant, it might not be possible to fully lift NPIs without a third wave of hospital admissions and deaths, even if vaccination coverage is high. Variants of concern, their transmissibility, vaccine uptake, and vaccine effectiveness must be carefully monitored as countries relax pandemic control measures.FundingNational Institute for Health Research, UK Medical Research Council, Wellcome Trust, and UK Foreign, Commonwealth and Development Office.

Non-pharmaceutical interventions, vaccination, and the SARS-CoV-2 delta variant in England: a mathematical modelling study

Many countries have seen sharp falls in the number of measles cases as a result of covid-19 controls, but the pandemic has also interrupted immunisation programmes

Australia has had zero measles in 2021 due to covid-19 border closure

10.1140/epjds/s13688-021-00306-6

Finding the origin location of an infectious disease outbreak quickly is crucial in mitigating its further dissemination. Current methods to identify outbreak locations early on rely on interviewing affected individuals and correlating their movements, which is a manual, time-consuming, and error-prone process. Other methods such as contact tracing, genomic sequencing or theoretical models of epidemic spread offer help, but they are not applicable at the onset of an outbreak as they require highly processed information or established transmission chains. Digital data sources such as mobile phones offer new ways to find outbreak sources in an automated way. Here, we propose a novel method to determine outbreak origins from geolocated movement data of individuals affected by the outbreak. Our algorithm scans movement trajectories for shared locations and identifies the outbreak origin as the most dominant among them. We test the method using various empirical and synthetic datasets, and demonstrate that it is able to single out the true outbreak location with high accuracy, requiring only data of 𝑁=4N=4N=4 individuals. The method can be applied to scenarios with multiple outbreak locations, and is even able to estimate the number of outbreak sources if unknown, while being robust to noise. Our method is the first to offer a reliable, accurate out-of-the-box approach to identify outbreak locations in the initial phase of an outbreak. It can be easily and quickly applied in a crisis situation, improving on previous manual approaches. The method is not only applicable in the context of disease outbreaks, but can be used to find shared locations in movement data in other contexts as well.

Finding disease outbreak locations from human mobility data

Estimates based on viral evolution forecast a 50% risk 17 months after a first infection without measures such as masking and vaccination.

COVID reinfections likely within one or two years, models propose

Nearly everyone in Iran has been infected by the coronavirus at some point during the covid-19 pandemic, and some have caught the virus more than once, but the country still hasn’t achieved herd immunity. Instead, Iran is seeing a punishing new wave of deaths driven by the delta variant.

Nearly every person in Iran seems to have had covid-19 at least once