How the Hell Did It Get This Bad? Timothy Caulfield Battles the Infodemic, March 3

Key PointsQuestion  Was statewide school closure associated with decreased incidence and mortality for coronavirus disease 2019 (COVID-19)?Findings  In this US population–based time series analysis conducted between March 9, 2020, and May 7, 2020, school closure was associated with a significant decline in both incidence of COVID-19 (adjusted relative change per week, −62%) and mortality (adjusted relative change per week, −58%). In a model derived from this analysis, it was estimated that closing schools when the cumulative incidence of COVID-19 was in the lowest quartile compared with the highest quartile was associated with 128.7 fewer cases per 100 000 population over 26 days and with 1.5 fewer deaths per 100 000 population over 16 days.Meaning  There was a temporal association between statewide school closure and lower COVID-19 incidence and mortality, although some of the reductions may have been related to other concurrent nonpharmaceutical interventions.

10.1001/jama.2020.14348

Association Between Statewide School Closure and COVID-19 Incidence and Mortality in the US

LONDON, Sept 1 (Reuters) - As many as 1 in 7 children may have symptoms linked to the coronavirus months after testing positive for COVID-19, the authors of an English study on long COVID in adolescents said on Wednesday.

English study finds long COVID affects up to 1 in 7 children months after infection

The U.S. production company that runs RT's American operations has received more than $100 million in Russian government funding since 2016, according to public filings, the largest subsidy of any recipient in the United States of so-called "foreign agent" funding from any country over that period.

RT America Received More Than $100 Million In Russian Government Funding Since 2017, Filings Show

Welcome and thank you for standing by. At this time, all participants are in a listen only mode until the question and answer portion of today’s call. During that time, if you would like to ask a question, please press star one. Today’s conference is being recorded. If you have any objections, you may disconnect this time. We now would like to turn the meeting over to Benjamin Haynes. You may now begin.

Transcript for CDC Media Telebriefing: COVID-19 Vaccination and Pregnancy

A rapid evidence briefing

The effectiveness of vaccination against long COVID

NEW: FDA approves Pfizer and Moderna vaccine booster shots for all adults in the U.S.

In this workshop, we kickstarted the process of developing a manifesto that establishes the need for collective intelligence in science communication and identifies the tools and methods necessary for its success.

SciBeh Virtual Workshop 2021: Science Communication as Collective Intelligence

Please note that due to the impact of this COVID-19 pandemic, all meeting participants will be joining this advisory committee meeting via an online teleconferencing platform. The online web conference meeting will be available at the following:  10/14 - Day 1  Youtube: https://youtu.be/BhlshZ7Lkr0External Link Disclaimer Yorkcast: https://fda.yorkcast.com/webcast/Play/feeef31603f54d6fb06189e7fb3074651dExternal Link Disclaimer   10/15 - Day 2 Youtube: https://youtu.be/c-H40GrvWz4External Link Disclaimer Yorkcast: https://fda.yorkcast.com/webcast/Play/619cf18fbc6c4c598c7ee996e029bcf61d

Vaccines and Related Biological Products Advisory Committee October 14-15, 2021 Meeting Announcement

10.1136/bmj.327.7429.1459

Objectives To determine whether parachutes are effective in preventing major trauma related to gravitational challenge.Design Systematic review of randomised controlled trials.Data sources: Medline, Web of Science, Embase, and the Cochrane Library databases; appropriate internet sites and citation lists.Study selection: Studies showing the effects of using a parachute during free fall.Main outcome measure Death or major trauma, defined as an injury severity score > 15.Results We were unable to identify any randomised controlled trials of parachute intervention.Conclusions As with many interventions intended to prevent ill health, the effectiveness of parachutes has not been subjected to rigorous evaluation by using randomised controlled trials. Advocates of evidence based medicine have criticised the adoption of interventions evaluated by using only observational data. We think that everyone might benefit if the most radical protagonists of evidence based medicine organised and participated in a double blind, randomised, placebo controlled, crossover trial of the parachute.

Parachute use to prevent death and major trauma related to gravitational challenge: systematic review of randomised controlled trials

Nearly one-third of US parents are opposed to vaccinating their kids against Covid – so one-time vaccine skeptics are helping families find evidence-based answers

‘The only logical choice’: anti-vaxxers who changed their minds on Covid vaccines

STOCKHOLM, Jan 13 (Reuters) - Sweden hit a new daily record for COVID-19 cases on Thursday, with figures likely to continue to increase rapidly over the next couple of weeks before peaking at the end of January, the country's health agency said on Thursday

EuropeSweden sets new record of COVID cases, sees peak at end of January

Key PointsQuestion  How has COVID-19 vaccine hesitancy changed among Black and White individuals in the US since vaccines became publicly available?Findings  This survey study of 1200 US adults found that COVID-19 vaccine hesitancy decreased more rapidly among Black individuals than among White individuals since December 2020. A key factor associated with this pattern seems to be the fact that Black individuals more rapidly came to believe that vaccines were necessary to protect themselves and their communities.Meaning  This study suggests that ongoing efforts to increase vaccine uptake among Black individuals in the US should attend to a range of vaccination barriers beyond vaccine hesitancy.

10.1001/jamanetworkopen.2021.44470

Changes in COVID-19 Vaccine Hesitancy Among Black and White Individuals in the US

Overlooking the potential for airborne transmission of SARS-CoV-2 leaves Australia vulnerable to outbreaks

10.5694/mja2.51131

Australia must act to prevent airborne transmission of SARS-CoV-2

Island nation set to impose lockdown next week after virus escaped from quarantine centre

Two-thirds of passengers on first flight to Covid-free Kiribati diagnosed with virus

AbstractObjectivesTo estimate the burden and severity of suspected reinfection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).MethodsA retrospective cohort of members of Kaiser Permanente Southern California with PCR-positive SARS-CoV-2 infection between 1st March 2020 and 31st October 2020 was followed through electronic health records for subsequent positive SARS-CoV-2 tests (suspected reinfection) ≥90 days after initial infection, through 31st January 2021. Incidence of suspected reinfection was estimated using the Kaplan–Meier method. Cox proportional hazards models estimated the association of suspected reinfection with demographic and clinical characteristics, hospitalization, and date of initial infection.ResultsThe cohort of 75 149 was predominantly Hispanic (49 648/75 149, 66.1%) and included slightly more females than males (39 736, 52.9%), with few immunocompromised patients (953, 1.3%); 315 suspected reinfections were identified, with a cumulative incidence at 270 days of 0.8% (95% confidence interval (CI) 0.7–1.0%). Hospitalization was more common at suspected reinfection (36/315, 11.4%) than initial infection (4094/75 149, 5.4%). Suspected reinfection rates were higher in females (1.0%, CI 0.8–1.2% versus 0.7%, CI 0.5–0.9%, p 0.002) and immunocompromised patients (2.1%, CI 1.0–4.2% versus 0.8%, CI 0.7–1.0%, p 0.004), and lower in children than adults (0.2%, CI 0.1–0.4% versus 0.9%, CI 0.7–1.0%, p 0.023). Patients hospitalized at initial infection were more likely to have suspected reinfection (1.2%, CI 0.6–1.7% versus 0.8%, CI 0.7–1.0%, p 0.030), as were those with initial infections later in 2020 (150-day incidence 0.4%, CI 0.2–0.5% September–October versus 0.2%, CI 0.1–0.3% March–May and 0.3%, CI 0.2–0.3% June–August, p 0.008). In an adjusted Cox proportional hazards model, being female (hazard ratio (HR) 1.44, CI 1.14–1.81), adult (age 18–39, HR 2.71, CI 1.38–5.31, age 40–59 HR 2.22, CI 1.12–4.41, age ≥60 HR 2.52, CI 1.23–5.17 versus <18 years), immunocompromised (HR 2.48, CI 1.31–4.68), hospitalized (HR 1.60, CI 1.07–2.38), and initially infected later in 2020 (HR 2.26, CI 1.38–3.71 September–October versus March–May) were significant independent predictors of suspected reinfection.ConclusionsReinfection with SARS-CoV-2 is uncommon, with suspected reinfections more likely in women, adults, immunocompromised subjects, and those previously hospitalized for coronavirus 2019 (COVID-19). This suggests a need for continued precautions and vaccination in patients with COVID-19 to prevent reinfection.

Rate and severity of suspected SARS-Cov-2 reinfection in a cohort of PCR-positive COVID-19 patients

10.1016/j.cmi.2021.07.030

Widespread human SARS-CoV-2 infections pose a constant risk for virus transmission to animals. Here, we serologically investigated 1000 cattle samples collected in late 2021 in Germany. Eleven sera tested antibody-positive, indicating that cattle may be occasionally infected by contact to SARS-CoV-2-positive keepers, but there is no indication of further spreading.

Serological screening suggests single SARS-CoV-2 spillover events to cattle

10.1101/2022.01.17.476608

Does the advent of machine learning mean the classic methodology of hypothesise, predict and test has had its day?

Are we witnessing the dawn of post-theory science?

One of the most vulnerable groups throughout the Covid-19 pandemic has been the pediatric population. Reasons for this are numerous, including the fact that until recently, Covid-19 vaccinations were not available for children.

The Rate Of Covid-19 Related Multisystem Inflammatory Syndrome In Children Is Skyrocketing

10.1140/epjs/s11734-021-00151-8

The diffusion of opinions in Social Networks is a relevant process for adopting positions and attracting potential voters in political campaigns. Opinion polarization, bias, targeted diffusion, and the radicalization of postures are key elements for understanding voting dynamics. In particular, social bots are a new element that can have a pronounced effect on the formation of opinions during elections by, for instance, creating fake accounts in social networks to manipulate elections. Here we propose a voter model incorporating bots and radical or intolerant individuals in the decision-making process. The dynamics of the system occur in a multiplex network of interacting agents composed of two layers, one for the dynamics of opinions where agents choose between two possible alternatives, and the other for the tolerance dynamics, in which agents adopt one of two tolerance levels. The tolerance accounts for the likelihood to change opinion in an interaction, with tolerant (intolerant) agents switching opinion with probability 1.01.0 (γ≤1\gamma \le 1). We find that intolerance leads to a consensus of tolerant agents during an initial stage that scales as τ+∼γ−1lnN\tau^+ \sim \gamma^{-1} \ln N, who then reach an opinion consensus during the second stage in a time that scales as τ∼N\tau \sim N, where NN is the number of agents. Therefore, very intolerant agents (γ≪1\gamma \ll 1) could considerably slow down dynamics towards the final consensus state. We also find that the inclusion of a fraction σ−B\sigma_{\mathbb{B}}^- of bots breaks the symmetry between both opinions, driving the system to a consensus of intolerant agents with the bots' opinion. Thus, bots eventually impose their opinion to the entire population, in a time that scales as τ−B∼γ−1\tau_B^- \sim \gamma^{-1} for γ≪σ−B\gamma \ll \sigma_{\mathbb{B}}^- and τ−B∼1/σ−B\tau_B^- \sim 1/\sigma_{\mathbb{B}}^- for σ−B≪γ\sigma_{\mathbb{B}}^- \ll \gamma.

Bi-layer voter model: Modeling intolerant/tolerant positions and bots in opinion dynamics

Key points:In December, SydPath sent out false negative COVID-19 results to around 900 peopleA staff member said some equipment in the SydPath laboratories was unworkable and not being repairedThey said staff were expected to work 14 to 16-hour shifts

Pathology insider describes unworkable conditions in SydPath PCR testing labs

10.31234/osf.io/gca56

Perceived stress has previously been implicated in the belief of conspiracies, with some authors suggesting that stress can precipitate increased belief in conspiracy theories. This preregistered survey study aimed to replicate findings by Swami et al. (2016) showing a positive correlation between belief in conspiracy theories and perceived stress. 372 Australian and New Zealand residents participated. Beliefs in conspiracy theories were measured using 11 items drawn mainly from existing scales (α = .87). Perceived stress was measured using the 10-item Perceived Stress Scale (PSS; α = .91). The average level of endorsement of conspiracy theories was relatively low (M = 1.89 on a Likert scale from 1 to 5; SD = 0.72). Supporting our hypothesis, we found a significant and positive correlation between perceived stress and belief in conspiracy theories, r(370) = .20, p = .001, 95% CI [.096, .292]. Future work could investigate the causal mechanism producing this association.

Evidence for a positive relationship between perceived stress and belief in conspiracy theories

They went into hospitals with heart attacks, kidney failure or in a psychiatric crisis. This story also ran on USA Today. It can be republished for free. They left with covid-19 — if they left at all.

Patients Went Into the Hospital for Care. After Testing Positive There for Covid, Some Never Came Out.

President Biden’s emergency covid-19 mandates have faced an avalanche of legal challenges. Two of those mandates — the Occupational Safety and Health Administration’s rule that businesses with 100 or more employees must require workers to be fully vaccinated or regularly tested and the Centers for Medicare and Medicaid Services’ regulation requiring vaccinations for staff at health-care facilities — will soon face scrutiny from the Supreme Court.

Opinion: The Supreme Court must uphold Biden’s vaccine mandates — and fast

Throughout 2021, two leading lights of the Royal Statistical Society Covid-19 Task Force drew on data for a weekly Observer column, and found themselves in the middle of Covid culture wars

Can you capture the complex reality of the pandemic with numbers? Well, we tried…

I mean, who wants to say “living with COVID” amirite? The connotation is that it’s just a necessary thing we have to do. But really, at some point, it kind

Living next door to Alice

A new book outlines the mistakes and missteps that made UK pandemic worse

Britain got it wrong on Covid: long lockdown did more harm than good, says scientist

As of early December, more than 2.3 million children aged 5 to 11 years had developed COVID-19 and 209 had died. Although a vaccine that’s 90.7% effective in preventing the illness was authorized for younger kids in late October, these figures apparently aren’t convincing enough to persuade many parents to vaccinate their children.

10.1001/jama.2021.21625

Why Parents Still Hesitate to Vaccinate Their Children Against COVID-19

The brother of former Labour leader Jeremy Corbyn has denounced politicians who have voted for Covid restrictions.

Piers Corbyn arrested after urging public to ‘burn MPs’ offices’

Deaths could hit 6,000 a day and delaying restrictions until New Year will cut effectiveness, say Sage experts

UK scientists: bring in curbs now or face up to 2m daily Covid infections as Omicron spreads

City project that used lateral flow tests to monitor population took pressure off NHS at critical time

Mass rapid tests in Liverpool cut hospital stays by a third

Predicting future COVID waves and hospital surges is always fraught with challenges, but there are early indications from Texas, Minnesota, Britain and South Africa that the U.S. health system will experience yet another great challenge

Op-Ed: How can we prevent a second winter of despair with Omicron?

AbstractBackground Vaccine mandates and vaccine passports (VMVP) for SARS-CoV-2 are thought to be a path out of the pandemic by increasing vaccination through coercion and excluding unvaccinated people from different settings because they are viewed as being at significant risk of transmitting SARS-CoV-2. While variants and waning efficacy are relevant, SARS-CoV-2 vaccines reduce the risk of infection, transmission, and severe illness/hospitalization in adults. Thus, higher vaccination levels are beneficial by reducing healthcare system pressures and societal fear. However, the benefits of excluding unvaccinated people are unknown.Methods A method to evaluate the benefits of excluding unvaccinated people to reduce transmissions is described, called the number needed to exclude (NNE). The NNE is analogous to the number needed to treat (NNT=1/ARR), except the absolute risk reduction (ARR) is the baseline transmission risk in the population for a setting (e.g., healthcare). The rationale for the NNE is that exclusion removes all unvaccinated people from a setting, such that the ARR is the baseline transmission risk for that type of setting, which depends on the secondary attack rate (SAR) typically observed in that type of setting and the baseline infection risk in the population. The NNE is the number of unvaccinated people who need to be excluded from a setting to prevent one transmission event from unvaccinated people in that type of setting. The NNE accounts for the transmissibility of the currently dominant Delta (B.1.617.2) variant to estimate the minimum NNE in six types of settings: households, social gatherings, casual close contacts, work/study places, healthcare, and travel/transportation. The NNE can account for future potentially dominant variants (e.g., Omicron, B.1.1.529). To assist societies and policymakers in their decision-making about VMVP, the NNEs were calculated using the current (mid-to-end November 2021) baseline infection risk in many countries.Findings The NNEs suggest that at least 1,000 unvaccinated people likely need to be excluded to prevent one SARS-CoV-2 transmission event in most types of settings for many jurisdictions, notably Australia, California, Canada, China, France, Israel, and others. The NNEs of almost every jurisdiction examined are well within the range of the NNTs of acetylsalicylic acid (ASA) in primary prevention of cardiovascular disease (CVD) (≥ 250 to 333). This is important since ASA is not recommended for primary prevention of CVD because the harms outweigh the benefits. Similarly, the harms of exclusion may outweigh the benefits. These findings depend on the accuracy of the model assumptions and the baseline infection risk estimates.Conclusions Vaccines are beneficial, but the high NNEs suggest that excluding unvaccinated people has negligible benefits for reducing transmissions in many jurisdictions across the globe. This is because unvaccinated people are likely not at significant risk – in absolute terms – of transmitting SARS-CoV-2 to others in most types of settings since current baseline transmission risks are negligible. Consideration of the harms of exclusion is urgently needed, including staffing shortages from losing unvaccinated healthcare workers, unemployment/unemployability, financial hardship for unvaccinated people, and the creation of a class of citizens who are not allowed to fully participate in many areas of society.

10.1101/2021.12.08.21267162

Evaluating the number of unvaccinated people needed to exclude to prevent SARS-CoV-2 transmissions

When the history of this pandemic is written, contrarian doctors divorced from patient care won’t be seen as its principal victims because YouTube removed their video, because someone called them “fringe,” or because someone put up posters reminding them of words they said.

Loud Silenced Doctors

Summary 1. SPI-M-O groups now estimate a growth rate of around 0.4 per day for the Omicron variant of SARS-CoV-2, which is consistent with a doubling time of around 2 days. Areas with higher incidence of Omicron cases, for example London and Greater Manchester, are starting to see increases in hospital admissions, however, much of this will still be associated with Delta. The hospital impact of Omicron cases is yet to be seen. 2. SPI-M-O has considered an updated range of scenarios from 2 academic groups who have modelled the impact of Omicron transmission on trajectories of infections, hospitalisations, and deaths. These groups suggest it is almost certain that there will be a very substantial peak of infections (much larger than occurred during January 2021). There are highly likely to be between 1,000 and 2,000 hospital admissions per day in England by the end of the year. Many of these hospitalisations are already ‘in the system’ due to the lags between infection, symptom onset, and the subsequent need for health care. The recently announced expanded and expedited booster vaccination programme will not affect transmission and severe and mild disease in time to mitigate these hospitalisations for the rest of 2021. 3. Scenarios that assume no further restrictions beyond Plan B generally lead to trajectories in daily hospital admissions in England that have a minimum of 3,000 hospital admissions per day at their peaks, with some scenarios having significantly worse outcomes during the first few months of 2022. To prevent such a wave of hospitalisations, more stringent measures would need to be implemented before 2022. 4. Behaviour change (spontaneous, recommended, or mandated) could significantly affect the peak of infections and hospitalisations. Current modelling assumes no change in behaviours beyond those previously seen on imposition of equivalent measures in the past. Non-mandated behaviour change, however, has the potential to make a big difference in either direction – changes in mixing over the festive period, between generations and within different networks, could increase transmission, but rapidly doubling cases may lead to a spontaneous precautionary reduction in mixing patterns. As Omicron is doubling so quickly, it is highly likely that, if behaviour changed or measures were implemented only after noticeable increases in hospital admissions, it would be too late to materially decrease peak hospitalisations. 5. It is not only hospitalisations that will increase substantially, but the number of infections and cases will likely lead to significant levels of milder disease that may have implications for workforce and school absences. 6. As with previous large waves of infection, different settings, such as hospitals, care homes, and prisons, will experience Omicron outbreaks. Healthcare setting-associated (nosocomial) infections, in particular, have already been seen and are widely expected, with the subsequent impacts of high staff absence. 7. Extensive uncertainties in these scenarios remain. The current estimated growth rate of Omicron, the speed and coverage of the booster roll out, and level of protection through vaccine effectiveness estimates (particularly against severe disease) and cross-protection due to previous infection will all impact these trajectories. There currently remains no strong evidence that Omicron infections are either more or less severe than Delta infections.

SPI-M-O: Consensus statement on COVID-19, 15 December 2021

Coronavirus latest as the UK reports its highest daily caseload ever at 78,610; Study finds Omicron variant multiplies 70 times faster than Delta in human lungs, SAGE expert says it is possible that a million people could be isolating with COVID on Christmas Day.

COVID news live: Record number of boosters given out for second day - as Whitty predicts Omicron wave will 'peak quite fast'

In the last few days a number of genomes have been uploaded by South Africa, Australia and Canada that whilst having many of the defining mutations of B.1.1.529 (Omicron) do not have the full set and also have a number of their own unique mutations. This was first described in Issue #359

Proposal to split B.1.1.529 to incorporate a newly characterised sibling lineage

The first potent anti-Covid pill will be a big help

Why Paxlovid is a Just-in-Time Breakthrough

The continuing spread of SARS-CoV-2 remains a Public Health Emergency of International Concern. What physicians need to know about transmission, diagnosis, and treatment of Covid-19 is the subject of ongoing updates from infectious disease experts at the Journal.In this audio interview conducted on November 16, 2021, the editors are joined by Stanford’s Michelle Mello to discuss the fundamentals of public health law and its shifting application to the Covid-19 pandemic.

10.1056/NEJMe2118197

Audio Interview: The Legal Basis for Covid-19 Restrictions and Mandates

A study published in The BMJ looks at time since receiving the Pfizer-BioNTech COVID-19 vaccine and risk of SARS-CoV-2 infection.

expert reaction to study looking at COVID infection risk as time increases after second Pfizer vaccine dose in Israel

The approval by the Subject Expert Committee (SEC) will need to be accepted by the Drugs Controller General of India – which is expected within days – and has to be followed by a formal inclusion in the government’s coronavirus immunisation campaign.

Expert panel clears use of Covaxin for ages 2-18