Weekly Coronavirus Update: Tuesday, January 19, 2021

Happy Tuesday, everyone. Here is the latest in Coronavirus-related research and news. This week’s summary covers a new vaccine, pediatric hospitalizations, asymptomatic transmissions, immunity after Covid, new variants of the virus, lung damage, Covid in women with asthma, and of course your world update.

1) In vaccine news, peer-reviewed results from the Phase 1 and 2 trials for the Johnson & Johnson vaccine were published in the New England Journal of Medicine last week. Of those who received the vaccine, some experienced fatigue, headache, myalgia, or injection-site pain, but no severe adverse reactions occurred. The reported results were based on 805 participants split into three groups: one group that received a lower dose of the vaccine, one that received a higher dose, and one that received a placebo. In both groups receiving the actual vaccine, 90% had neutralizing antibodies to fight the virus 29 days after their first dose of the vaccine. By day 57, 100% of the participants had these antibodies and the levels had increased. Antibodies had further increased and stabilized in all participants 71 days after their first dose. A second dose was given approximately three months after the first, and J&J is also testing a single-dose version of their vaccine. Results from those trials will be reported in the near future. Based on the results of this trial, Johnson & Johnson decided to proceed with Phase 3 trials in which the vaccine will be tested on a much larger group of people (usually around 30,000). You can read the full study here: https://www.nejm.org/doi/full/10.1056/NEJMoa2034201?fbclid=IwAR3itWZpYfY9CRL6r-tyDNeGPOIYRugB_SopAMmW4HX2vVsgxeh8Lzw1d3A

2) A research letter published in the journal JAMA Pediatrics presented evidence that although children tend to be less susceptible to infection and severe cases of Covid-19, hospitalizations for people aged 19 years and younger have significantly increased. Looking at data from 22 US states, the researchers determined that in May 2020 only 2 out of every 100,000 children were hospitalized due to Covid-19. By November this number increased to 17.2 hospitalizations per 100,000 children. While the numbers may not sound high, the percentage increase in hospitalizations of children was more than double the rise in adult populations during the same time period. The researchers labelled this a “concerning trend” and cautioned that pediatric populations may require healthcare resources that are not readily available in all parts of the country. You can read the full report here: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2775008

3) Let’s revisit asymptomatic infections and transmission of the virus. A new peer-reviewed study published in the journal JAMA Network Open sought to understand what proportion of Covid-19 transmissions were associated with transmission from an asymptomatic person. Using an analytical model, the researchers concluded that more than half of all transmissions are caused by asymptomatic individuals, meaning that only identifying and isolating those with symptoms of Covid-19 will not be effective in controlling the spread of the virus. The researchers concluded, “These findings suggest that measures such as wearing masks, hand hygiene, social distancing, and strategic testing of people who are not ill will be foundational to slowing the spread of COVID-19 until safe and effective vaccines are available and widely used.” You can read the full study here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2774707?fbclid=IwAR0aylj1GZqUTwreHOc46VVnugCECKIci-WTVx0czkF_6XQfyNJeScUBVns

4) A study of over 20,000 healthcare workers in the UK revealed that people who were infected with Covid-19 had an 83% lower risk of becoming reinfected with the virus for at least 5 months after their first infection. In the study 6,614 participants tested positive for antibodies, and of those reinfections were detected in 44 of the participants. While the high level of protection from reinfection observed in this study was a positive finding, a press release from Public Health England, who conducted the study, cautioned that “early evidence from the next stage of the study suggests that some of these individuals [with antibodies] carry high levels of virus and could continue to transmit the virus to others.” Therefore, it is important for those who have already had the virus to continue wearing a mask, practice social distancing, and wash their hands regularly as they may still be able to spread the virus. The study has not yet undergone peer-review (important disclaimer), but you can read the pre-print here: https://www.medrxiv.org/content/10.1101/2021.01.13.21249642v1
Additionally, a press release about the study can be read here: https://www.gov.uk/government/news/past-covid-19-infection-provides-some-immunity-but-people-may-still-carry-and-transmit-virus

5) It’s becoming a bit difficult to keep up with all of the new variants of the virus, but in the past week new variants were discovered in both Columbus, Ohio and the country of Brazil, and just yesterday a new one was discovered in Germany. Researchers at The Ohio State University discovered one new variant in Ohio that has some identical aspects to the recently discovered new variant in the UK, as well as an evolution in a US strain with gene mutations that have not previously been identified anywhere else. The researchers reported that the mutations will likely make the virus more infectious, as is the case with the new UK and South African variants. The researchers published a not-yet-peer-reviewed paper about the new variants, which can be read here: https://www.biorxiv.org/content/10.1101/2021.01.12.426407v1
With regard to Brazil, two new variants have been identified there, and eight cases of the first new variant have already been detected in the UK. The second variant has been detected in the Brazilian city of Manaus as well as in Japan. Thus far I have not seen much information at all published about the Brazilian variants. News reports state that there are concerns these new variants will also be more transmissible. You can read a Sky News article about the Brazilian variants here: https://news.sky.com/story/covid-19-second-variant-from-brazil-likely-already-in-the-uk-sage-scientist-says-12189428
Finally, yesterday it was announced that 35 people tested positive for an unknown variant of the virus in Garmisch-Partenkirchen, a ski town in Germany. As this variant has just been discovered, we really don’t know anything about it yet. Samples of the new variant were sent to a hospital in Berlin for further study. You can read a news article about it here: https://www.politico.eu/article/new-coronavirus-variant-identified-in-german-hospital/

6) In other “new variant” news, the Centers for Disease Control and Prevention in the US used modelling to predict that the highly contagious UK variant of the virus (estimated to be 50–70% more transmissible than previous variants) is likely to become the dominant strain of the virus in the US by sometime in March. The report warned that “a higher rate of transmission will lead to more cases, increasing the number of persons overall who need clinical care, exacerbating the burden on an already strained health care system, and resulting in more deaths.” The report was published in the CDC’s Morbidity and Mortality Weekly Report (MMWR) and can be read in full here: https://www.cdc.gov/mmwr/volumes/70/wr/mm7003e2.htm?s_cid=mm7003e2_w

7) A new peer-reviewed study published in the journal Nature found that in patients with pneumonia caused by Covid-19, activity from specific immune cells was linked to long-term inflammation of the lungs. The researchers from Northwestern University examined the fluid from 88 patients’ lungs, which showed a high number of T cells were present and nearly 70% of alveolar macrophages (immune cells in the lungs’ tiny air sacs) contained Covid-19. Their findings suggest that when Covid-19 reaches the lungs, it has the ability to infect macrophages. The macrophages respond by producing T cells, which then stimulate the macrophages to make more inflammatory molecules, leading to persistent inflammation of the lungs, which can then threaten a patient’s life. The authors noted that a small number of patients with Covid pneumonia develop respiratory failure, “but it is these patients who account for almost all of the morbidity, mortality, and socioeconomic cost associated with the COVID-19 pandemic.” You can read the full study here: https://www.nature.com/articles/s41586-020-03148-w

8) The idea that adult women with asthma may be at higher risk of severe Covid-19 was proposed in a letter published in in The Lancet Respiratory Medicine by researchers from Australia and Spain. The researchers cited four studies that showed between 56–71% of all hospitalized Covid patients with asthma were women. They posited that women with asthma may suffer more severe cases of Covid-19 for several reasons: women with asthma have significantly higher severity of the disease, hospitalizations, healthcare costs, and mortality than men with asthma; hormonal differences across the lifespan tend to increase women’s susceptibility to severe asthma; and structural differences in women’s lungs contribute to their risk of hospitalization with Covid-19. While more research is necessary on the link between women with asthma and severe Covid-19, the authors concluded, “As the body of literature grows, medical professionals should consider the evidence for targeted treatments for specific populations, including inhaled corticosteroids and monoclonal antibodies in women with asthma and SARS-CoV-2 infection.” You can read the fully text of the research letter here: https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(21)00007-2/fulltext

9) Now, your world update. First, in the US the number of daily cases is beginning to drop, but with an average of 207,495 new daily infections over the past week, the numbers are still nowhere near where they need to be in order to keep the virus under control. The number of total deaths in the US will likely surpass 400,000 today, and over the past two weeks daily deaths have increased 21% with an average of 3,225 deaths per day over the past week. Hospitalizations have increased 2% over the past two weeks. As of yesterday, 123,848 people were hospitalized in the US. Per capita, Arizona still leads the nation in the number of new daily infections, followed by California, South Carolina, New York, and Oklahoma. Cases are still rising in 31 states, Washington DC, the US Virgin Islands, and Puerto Rico.
— For my Indiana readers, the daily number of new cases has fallen 24% over the past two weeks, daily deaths have fallen 48%, and hospitalizations have dropped 14%. Over the past week an average of 3,629 new cases were reported each day. Warrick County, where the majority of my Indiana family members live, leads the state in terms of daily infections per capita. Vanderburgh County now ranks fifth in the state for new infections.
— The UK is now two weeks into its third national lockdown, and numbers are finally starting to come down a bit. The number of new daily cases has decreased 18% over the past two weeks and yesterday the number was the lowest it’s been since December 27 with 37,535 new cases. Deaths, however, have increased by 83% over the past two weeks. Last Wednesday the UK had 1,564 deaths in one day, the highest ever since the pandemic began. Hospitalizations are also higher than they’ve ever been during the pandemic with 37,475 people in hospital. The UK government announced recently that they hoped all adults would receive at least one dose of a Covid vaccine by September, though they were not willing to promise that everyone would receive their second dose within 12 weeks of the first dose, as was their previous plan.
— Elsewhere, the virus is surging in Japan, where hospitals “are on the brink of collapse” according to a news article in the Guardian. The nation recorded 4,890 new cases yesterday and over half of the country’s population currently live in areas where a state of emergency has been declared. Meanwhile, China is experiencing its biggest outbreak since last March, with over 100 new cases of the virus being recorded every day for the past seven days. In the outskirts of Shijiazhuang city, a 4,000-person quarantine center has been built. It could be used to quarantine entire villages in the event of an outbreak. According to the Guardian, the buildings in the quarantine center “are equipped with bathrooms, wifi and air conditioning and will house close contacts of confirmed virus patients.”
Sources:
US numbers: https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html
Indiana numbers: https://www.nytimes.com/interactive/2020/us/indiana-coronavirus-cases.html
UK numbers: https://www.nytimes.com/interactive/2020/world/europe/united-kingdom-coronavirus-cases.html
UK vaccine information: https://apnews.com/article/business-coronavirus-pandemic-coronavirus-vaccine-89797ad678c18042d18386985a38859e
Japan information: https://www.theguardian.com/world/2021/jan/19/hospitals-japan-close-collapse-serious-covid-cases-soar
China information: https://www.theguardian.com/world/live/2021/jan/19/coronavirus-live-news-independent-pandemic-panel-critical-of-china-and-who-california-urges-pause-to-moderna-vaccine?page=with:block-600688f88f089d1901664802#block-600688f88f089d1901664802

That’s all for this week. Please stay safe, everyone!

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