In the first of a new series, the leading Cambridge professor measures Covid-19’s impact

Behind the numbers: how to make sense of ‘excess’ deaths

10.1038/d41586-021-00055-6

Researchers are studying the sensory impact of the coronavirus, how long it lasts and what can be done to treat it.

COVID’s toll on smell and taste: what scientists do and don’t know

Critics of retired supreme court justice say QALYs measure not intended for public health debat

Experts unconvinced by Lord Sumption's lockdown ethics

t’s hard to know how many patients we’ve lost. On a regular ward, if there’s a death, you know about it. In our intensive care unit, we’re supposed to have around 30 beds, but coronavirus has forced us to increase our capacity to more than 80, so I have no idea what’s going on around me. I can also hear cardiac arrest bells from another unit, but I don’t know what proportion of the patients live or die.

This is what it's like to be an intensive care unit nurse right now

10.1101/2021.01.18.427166

SARS-CoV-2 501Y.V2, a novel lineage of the coronavirus causing COVID-19, contains multiple mutations within two immunodominant domains of the spike protein. Here we show that this lineage exhibits complete escape from three classes of therapeutically relevant monoclonal antibodies. Furthermore 501Y.V2 shows substantial or complete escape from neutralizing antibodies in COVID-19 convalescent plasma. These data highlight the prospect of reinfection with antigenically distinct variants and may foreshadow reduced efficacy of current spike-based vaccines.

SARS-CoV-2 501Y.V2 escapes neutralization by South African COVID-19 donor plasma

https://doi.org/10.1016/j.jhin.2020.12.022

The Covid-19 pandemic has caused untold disruption and enhanced mortality rates around the world. Understanding the mechanisms for transmission of SARS-CoV-2 is key to preventing further spread but there is confusion over the meaning of “airborne” whenever transmission is discussed. Scientific ambivalence originates from evidence published many years ago, which has generated mythological beliefs that obscure current thinking. This article gathers together and explores some of the most commonly held dogmas on airborne transmission in order to stimulate revision of the science in the light of current evidence. Six ‘myths’ are presented, explained, and ultimately refuted on the basis of recently published papers and expert opinion from previous work related to similar viruses. There is little doubt that SARS-CoV-2 is transmitted via a range of airborne particle sizes subject to all the usual ventilation parameters and human behaviour. Experts from specialties encompassing aerosol studies, ventilation, engineering, physics, virology and clinical medicine have joined together to present this review, in order to consolidate the evidence for airborne transmission mechanisms and offer justification for modern strategies for prevention and control of Covid-19 in healthcare and community.

Dismantling myths on the airborne transmission of severe acute respiratory syndrome coronavirus (SARS-CoV-2)

10.31234/osf.io/9d3yf

An important step when designing a study is to justify the sample size that will be collected. The key aim of a sample size justification is to explain how the collected data is expected to provide valuable information given the inferential goals of the researcher. In this overview article six approaches are discussed to justify the sample size in a quantitative empirical study: 1) collecting data from (an)almost) the entire population, 2) choosing a sample size based on resource constraints, 3) performing an a-priori power analysis, 4) planning for a desired accuracy, 5) using heuristics, or 6) explicitly acknowledging the absence of a justification. An important question to consider when justifying sample sizes is which effect sizes are deemed interesting, and the extent to which the data that is collected informs inferences about these effect sizes. Depending on the sample size justification chosen, researchers could consider 1) what the smallest effect size of interest is, 2) which minimal effect size will be statistically significant, 3) which effect sizes they expect (and what they base these expectations on), 4) which effect sizes would be rejected based on a confidence interval around the effect size, 5) which ranges of effects a study has sufficient power to detect based on a sensitivity power analysis, and 6) which effect sizes are plausible in a specific research area. Researchers can use the guidelines presented in this article to improve their sample size justification, and hopefully, align the informational value of a study with their inferential goals.

Sample Size Justification

10.1073/pnas.2005241118

Epidemic preparedness depends on our ability to predict the trajectory of an epidemic and the human behavior that drives spread in the event of an outbreak. Changes to behavior during an outbreak limit the reliability of syndromic surveillance using large-scale data sources, such as online social media or search behavior, which could otherwise supplement healthcare-based outbreak-prediction methods. Here, we measure behavior change reflected in mobile-phone call-detail records (CDRs), a source of passively collected real-time behavioral information, using an anonymously linked dataset of cell-phone users and their date of influenza-like illness diagnosis during the 2009 H1N1v pandemic. We demonstrate that mobile-phone use during illness differs measurably from routine behavior: Diagnosed individuals exhibit less movement than normal (1.1 to 1.4 fewer unique tower locations; P<3.2×10−3P<3.2×10−3<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>3.2</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>3</mml:mn></mml:mrow></mml:msup></mml:math>), on average, in the 2 to 4 d around diagnosis and place fewer calls (2.3 to 3.3 fewer calls; P<5.6×10−4P<5.6×10−4<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>5.6</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>4</mml:mn></mml:mrow></mml:msup></mml:math>) while spending longer on the phone (41- to 66-s average increase; P<4.6×10−10P<4.6×10−10<mml:math xmlns:mml="http://www.w3.org/1998/Math/MathML"><mml:mi>P</mml:mi><mml:mo>&lt;</mml:mo><mml:mn>4.6</mml:mn><mml:mo>×</mml:mo><mml:mn>1</mml:mn><mml:msup><mml:mrow><mml:mn>0</mml:mn></mml:mrow><mml:mrow><mml:mo>−</mml:mo><mml:mn>10</mml:mn></mml:mrow></mml:msup></mml:math>) than usual on the day following diagnosis. The results suggest that anonymously linked CDRs and health data may be sufficiently granular to augment epidemic surveillance efforts and that infectious disease-modeling efforts lacking explicit behavior-change mechanisms need to be revisited.

Cell-phone traces reveal infection-associated behavioral change

Full effects of Pfizer’s shots only kick in around a month after inoculation, but data from Israel shows there is a stark drop in infections even before that point

Israel sees 60% drop in hospitalizations for age 60-plus 3 weeks after 1st shot

So if you work somewhere already like this maybe suggest how to really run a WFH/mobile collaboration uni, and how we re-tool the physical meeting place we then in light of that? Maybe the philosophers already know this??

I think this is also a good question for science park or campus universities, or anywhere where the offices were mostly empty in August, even pre-COVID. Imperial had a buzz once; I’m afraid that we might not get it back, and wind up like those other places...

Follow-on question: if PhDs, PDRAs and academics all semi-virtualise except for lab work, then what should the space we now use for academic cellular offices and open plan offices look like? Can we entice people to come in by changing the spaces?

Question for post-COVID: will London STEM academics commute in beyond the bare minimum required? If not, can universities function as learning communities without physical presence? If yes, how, and does institutional identity survive, or just one big science network?

Novavax COVID-19 vaccine 89.3% effective

The NIHR-supported Novavax COVID-19 vaccine is 89.3% effective at preventing COVID-19, shown from interim analysis of its Phase III study data, including effectiveness against the new variants of concern.

NEW On average the rate of COVID infection is 1.9 x higher amongst primary and secondary teachers than the general population. For teaching assistants, the rate of COVID infection is three x higher in primary schools New figs @ons @MaryBoustedNEU

10.31234/osf.io/yma8f

How will the world change as a result of the Covid-19 pandemic? What can people do to best adapt to the societal changes ahead? To answer these questions, over the course of the summer-fall 2020 we launched the World After COVID Project, interviewing more than 50 of the world’s leading scholars in the behavioral and social sciences, including fellows of national academies and presidents of major scientific societies. Experts independently shared their thoughts on what effects the COVID-19 pandemic will have on our societies and provided advice for successful response to new challenges and opportunities. Using mixed-method and natural language processing analyses, we distilled and analyzed these predictions and suggestions, observing a diversity of scenarios. Results also show that half of the experts approach their post-Covid predictions dialectically, highlighting both positive and negative features of the same prediction. Moreover, prosocial goals and meta-cognition—two chief tenants of the Common Wisdom model—were evident in their recommendations for how to cope with possible changes. The project provides a time capsule of experts’ predictions during major societal changes. We discuss implications for strengthening focus on prediction (vs. mere explanation) in psychological science as well as the value of uncertainty and dialecticism in forecasting.

Societal Change and Wisdom: Insights from the World after Covid Project

COVID curbed carbon emissions in 2020 — but not by much, and new data show global CO2 emissions have rebounded: https://go.nature.com/2XRpIv4

When the number of COVID-19 cases began to rise again in Manaus, Brazil, in December 2020, Nuno Faria was stunned. The virologist at Imperial College London and associate professor at the University of Oxford had just co-authored a paper in Science estimating that three-quarters of the city’s inhabitants had already been infected with SARS-CoV-2, the pandemic coronavirus—more than enough, it seemed, for herd immunity to develop. The virus should be done with Manaus. Yet hospitals were filling up again. “It was hard to reconcile these two things,” Faria says. He started to hunt for samples he could sequence to find out whether changes in the virus could explain the resurgence.

New coronavirus variants could cause more reinfections, require updated vaccines

Many states have launched their vaccination programs, which is both exciting and confusing. Who, where, when, how, many people are asking. There is confusion about the timing, who is eligible, where to sign up. In some cases, overwhelmed phone hotlines or websites. So, in an effort to inform and dispel myths, this week’s post is dedicating to bringing together some of the information I have read about or heard about so far.

Science Says Sunday – COVID-19 Vaccine Must-Knows: Before, During, After

Researchers in the Netherlands, the United States, and Belgium have presented early-stage clinical trial results demonstrating the safety and efficacy of Johnson & Johnson's vaccine candidate for coronavirus disease 2019 (COVID-19). Phase 1–2a interim results show that the vaccine is safe and immunogenic in both younger and older adults after just a single dose, thereby supporting evaluation in phase 3 trials.

Analysis supports phase 3 trials of Johnson & Johnson's COVID-19 vaccine

IN A bid to vaccinate as many people as fast as possible, the UK is taking an unorthodox strategy against covid-19. The country is eking out its vaccine supply by making most people wait three months to get their second dose of the two-shot regimen.

Is the UK right to delay the second dose of the covid-19 vaccines?

10.1056/NEJMoa2034201

BackgroundEfficacious vaccines are urgently needed to contain the ongoing coronavirus disease 2019 (Covid-19) pandemic of infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). A candidate vaccine, Ad26.COV2.S, is a recombinant, replication-incompetent adenovirus serotype 26 (Ad26) vector encoding a full-length and stabilized SARS-CoV-2 spike protein. MethodsIn this multicenter, placebo-controlled, phase 1–2a trial, we randomly assigned healthy adults between the ages of 18 and 55 years (cohort 1) and those 65 years of age or older (cohort 3) to receive the Ad26.COV2.S vaccine at a dose of 5×1010 viral particles (low dose) or 1×1011 viral particles (high dose) per milliliter or placebo in a single-dose or two-dose schedule. Longer-term data comparing a single-dose regimen with a two-dose regimen are being collected in cohort 2; those results are not reported here. The primary end points were the safety and reactogenicity of each dose schedule. ResultsAfter the administration of the first vaccine dose in 805 participants in cohorts 1 and 3 and after the second dose in cohort 1, the most frequent solicited adverse events were fatigue, headache, myalgia, and injection-site pain. The most frequent systemic adverse event was fever. Systemic adverse events were less common in cohort 3 than in cohort 1 and in those who received the low vaccine dose than in those who received the high dose. Reactogenicity was lower after the second dose. Neutralizing-antibody titers against wild-type virus were detected in 90% or more of all participants on day 29 after the first vaccine dose (geometric mean titer [GMT], 224 to 354) and reached 100% by day 57 with a further increase in titers (GMT, 288 to 488), regardless of vaccine dose or age group. Titers remained stable until at least day 71. A second dose provided an increase in the titer by a factor of 2.6 to 2.9 (GMT, 827 to 1266). Spike-binding antibody responses were similar to neutralizing-antibody responses. On day 14, CD4+ T-cell responses were detected in 76 to 83% of the participants in cohort 1 and in 60 to 67% of those in cohort 3, with a clear skewing toward type 1 helper T cells. CD8+ T-cell responses were robust overall but lower in cohort 3. ConclusionsThe safety and immunogenicity profiles of Ad26.COV2.S support further development of this vaccine candidate. (Funded by Johnson & Johnson and the Biomedical Advanced Research and Development Authority of the Department of Health and Human Services; COV1001 ClinicalTrials.gov number, NCT04436276. opens in new tab.)

Interim Results of a Phase 1–2a Trial of Ad26.COV2.S Covid-19 Vaccine

10.31234/osf.io/nqgbx

Purpose: Intimate Partner Violence (IPV) is an urgent matter, and a global concern for several countries across the world highlighted high numbers and percentages also before the beginning of the Covid-19 pandemic. Further, international states and organizations have claimed an increase in IPV numbers during the COVID-19 pandemic, raising awareness of the potential causes and providing urgent recommendations and guidelines to follow for the containment and possible interventions. Based on these priorities, this review aims to explore and analyze the existing scientific literature on the association and consequences of COVID-19 on Domestic Violence and to sum up the strategies and recommendations for clinicians and health care workers. Methods: The electronic databases of PubMed, Scopus and Science of Direct were searched. Papers published between 2019 and 2020, written in English and having as main focus the domestic violence during the COVID-19 pandemic, were included. Results: At the final stage, 60 articles were included and analyzed. Results pointed three pre-determined categories: the course, the dynamics, the recommendations and an adjunctive category DV and disasters. Conclusions: Since COVID-19 is responsible for a spike in DV cases, it is essential to implement specific and shared assessment strategies and targeted interventions in order to prevent the adverse outcomes of IPV.

IPV and COVID-19: A systematic review of the literature

10.31234/osf.io/zx6va

We investigated the impacts of the COVID-19 pandemic on the modality of cognitive assessments (in-person versus remote assessments). We created a web-based questionnaire with 34 items and collected data from 114 respondents from a range of health care professions and settings. We established the proportion of cognitive assessments which were face-to-face or via video or telephone conferencing, both pre- and post-March 2020. Further, we asked respondents about the assessment tools used and perceived barriers, challenges and facilitators for the remote assessment of cognition. In addition, we asked questions specifically about the use of the Oxford Cognitive Screen. We found that the frequency of assessing cognition was stable compared to pre-pandemic levels. Use of telephone and video conferencing cognitive assessments increased by 10% and 18% respectively. Remote assessment increased accessibility to participants and safety but made observing the subtleties of behaviour during test administration difficult. The respondents called for an increase in the availability of standardised, validated, and normed remote assessments. We conclude that the pandemic has not been detrimental to the frequency of cognitive assessments. In addition, a shift in clinical practice to include remote cognitive assessments is clear and wider availability of validated and standardised remote assessments is necessary.

Investigating the Impacts of COVID-19 Pandemic on Assessment of Cognition: a Web-based Questionnaire Study

10.31234/osf.io/xuefh

As the United States continues to be ravaged by COVID-19, it becomes increasingly important to implement effective public health campaigns to improve personal behaviors that help control the spread of the virus. To design effective campaigns, research is needed to understand the current mitigation intentions of the general public, diversity in those intentions, and theoretical predictors of them. COVID-19 campaigns will be particularly challenging because mitigation involves myriad, diverse behaviors. This study takes a person-centered approach to investigate data from a survey (N = 976) of Pennsylvania adults. Latent class analysis revealed five classes of mitigation: one marked by complete adherence with health recommendations (34% of the sample), one by complete refusal (9% of the sample), and three by a mixture of adherence and refusal. Statistically significant covariates of class membership included relatively negative injunctive norms, risk due to essential workers in the household, personal knowledge of someone who became infected with COVID-19, and belief that COVID-19 was a leaked biological weapon. Additionally, trait reactance was associated with non-adherence while health mavenism was associated with adherence. These findings may be used to good effect by local healthcare providers and institutions, and also inform broader policy-making decisions regarding public health campaigns to mitigate COVID-19.

Optimizing COVID-19 Health Campaigns: A Person-Centered Approach

10.31234/osf.io/xtu3f

Fear is an evolutionary adaptive emotion that serves to protect the organism from harm. Once a threat diminishes, fear should also dissipate as otherwise fear may become chronic and pathological. While threat (i.e., number of infections, hospitalizations and deaths) during the ongoing COVID-19 pandemic has substantially varied over time, it remains unclear whether fear has followed a similar pattern. To examine the development of fear of COVID-19 and investigate potential predictors for chronic fear, we conducted a large online longitudinal study (N = 2000) using the Prolific platform. Participants represented unselected residents of 34 different countries. The Fear of the Coronavirus Questionnaire (FCQ) and several other demographic and psychological measures were completed monthly between March and August 2020. Overall, we find that fear steadily decreased after a peak in April 2020. Additional analyses showed that elevated fear was predicted by region (i.e., North America), anxious traits, and media use.

Pandemic panic? Results of a 6-month longitudinal study on fear of COVID-19

10.31234/osf.io/mtces

The 2019 coronavirus (COVID-19) pandemic has made the world seem unpredictable. During such crises we can experience concerns that others might be against us, culminating perhaps in paranoid conspiracy theories. Here, we investigate paranoia and belief updating in an online sample (N=1,010) in the United States of America (U.S.A). We demonstrate the pandemic increased individuals’ self-rated paranoia and rendered their task-based belief updating more erratic. Local lockdown and reopening policies, as well as culture more broadly, markedly influenced participants’ belief-updating: an early and sustained lockdown rendered people’s belief updating less capricious. Masks are clearly an effective public health measure against COVID-19. However, state-mandated mask wearing increased paranoia and induced more erratic behaviour. Remarkably, this was most evident in those states where adherence to mask wearing rules was poor but where rule following is typically more common. This paranoia may explain the lack of compliance with this simple and effective countermeasure. Computational analyses of participant behaviour suggested that people with higher paranoia expected the task to be more unstable, but at the same time predicted more rewards. In a follow-up study we found people who were more paranoid endorsed conspiracies about mask-wearing and potential vaccines – again, mask attitude and conspiratorial beliefs were associated with erratic task behaviour and changed priors. Future public health responses to the pandemic might leverage these observations, mollifying paranoia and increasing adherence by tempering people’s expectations of other’s behaviour, and the environment more broadly, and reinforcing compliance.

Paranoia and Belief Updating During a Crisis

10.31234/osf.io/ygz37

In the context of a recent outbreak of the coronavirus disease (COVID-19), the present study investigated the buffering effect of grit on the relationship between fear of COVID-19 and psychological distress. The data were collected from 224 Japanese participants (98 females; mean age = 46.56, SD = 13.41) in July 2020. The measures used in this study included the Fear of COVID-19 Scale (FCV-19S), Short Grit Scale, and Depression, Anxiety, and Stress Scale 21 (DASS). The results of mediation analyses revealed significant indirect effects of consistency of interest, a major component of grit, on psychological distress; we also found non-significant indirect effects of perseverance of effort, another major component of grit, on psychological distress. These results suggest that consistency of interest buffers the psychological distress induced by fear of COVID-19. Based on these results, it can be concluded that individuals with higher consistency of interest are less likely to experience worsening of their mental health, even if they experience fear of COVID-19 during the pandemic.

Interest consistency can buffer the effect of COVID-19 fear on psychological distress

The coronavirus situation represents both a health crisis and a communications emergency – especially as we enter the vaccination phase. With a significant minority expressing a degree of hesitancy about receiving a coronavirus vaccine, clear and effective communication about the benefits and risks (or lack of) will undoubtedly be important for maximising uptake. At the same time, many familiar communication challenges – such as convincing people of the need to limit social contact, to wear face coverings, and to wash their hands – will be just as important for much of 2021 as they were in 2020. Perhaps more so, if the vaccine rollout is accompanied by a sense of complacency about taking basic precautions.

As vaccines start rolling out, here’s what our research says about communication and coronavirus

It’s three from three as far as positive outcomes from COVID vaccine trials are concerned but Monday’s announcement from AstraZeneca and Oxford University, at a first glance, may not seem to be as exciting as those from Pfizer and BioNTech, and Moderna. Furthermore, the figures are a bit of a head scratcher, so let’s look at them in more detail.

A Dose (or more) of Positivity - Reading into AstraZeneca's Interim Analysis Results

Despite the efficacy of approved vaccines, the number of people who intend to get immunised against COVID-19 is down in many countries, making the sought-after ‘herd immunity’ more complicated to reach

What is vaccine hesitancy and why do so many people have it?

A Wisconsin pharmacist convinced the world was “crashing down” told police he tried to ruin hundreds of doses of coronavirus vaccine, because he believed the shots would mutate people’s DNA, according to court documents released on Monday.

US pharmacist who tried to ruin Covid vaccine doses is a conspiracy theorist, police say

Government ministers should stop politicising the Covid-19 vaccine by boasting about being the first to license it, the head of a leading research group has said. Heidi Larson, the director of the London-based Vaccine Confidence Project (VCP), said the government should instead focus on building support for the jab or it will lose the confidence and trust of the British people.

Vaccine expert tells ministers: 'Stop boasting and get public onboard'

Even as vaccines for the disease are being held up as the last hope for a return to normalcy, misinformation about them is spreading.

We Don’t Even Have a COVID-19 Vaccine, and Yet the Conspiracies Are Here

The COVID-19 vaccines furthest along in clinical trials are the fastest to make, but they are also the hardest to deploy.

Vaccine Chaos Is Looming

The Trump administration spurred development of a vaccine; the Biden administration has to persuade Americans to take it.

The Lame-Duck Vaccine

The initial results of the AstraZeneca/Oxford vaccine trials were unexpected and confusing, but there’s more data to come.

The Long Haul of Vaccine Results Is Just Beginning

A year of scientific uncertainty is over. Two vaccines look like they will work, and more should follow.

The End of the Pandemic Is Now in Sight

Scientists now have better tests and treatments, and are forging a clear pathway out of this global ordeal

It's not just the vaccine. There are many causes for hope in the fight against Covid

Two Arab nations have become the first countries to approve a Chinese COVID-19 vaccine, a significant boost for China’s plans to roll out its vaccines worldwide. The United Arab Emirates (UAE) approved a vaccine developed by Chinese state-owned Sinopharm on 9 December, and Bahrain followed days later. But researchers say a lack of public data on the safety and efficacy of the vaccine could hinder the company’s plans to distribute the vaccine in a range of other countries.

Arab nations first to approve Chinese COVID vaccine — despite lack of public data

The Pfizer–BioNTech vaccine has passed safety and efficacy tests — but researchers still have many questions about how this and other vaccines will perform as they’re rolled out to millions of people.

The UK has approved a COVID vaccine — here’s what scientists now want to know