COVID-19 vaccinations aren’t stopping anytime soon.
Moderna said on Wednesday that Americans could start getting booster shots later this year to protect against coronavirus variants.
“It is likely that the countries that have already achieved high vaccine coverage are going to be ready to shift their focus to boosters in 2022 and possibly even starting at the end of this year,” Corinne M. Le Goff, Moderna’s chief commercial officer, said during a call with investors.
Le Goff said that countries like the US that quickly inoculate their populations could start getting booster shots soon, but because just about 5% of the global population has been vaccinated, most countries would continue giving residents the initial shots.
“I hope this summer to get the vaccine authorized for a boost so that we can help people getting boosted before the fall, so that we all have a normal fall and not a fall and winter like we just saw in the last six months,” Moderna CEO Stéphane Bancel said in an interview with Insider on Tuesday.
The US had administered more than 85 million doses of Moderna’s two-dose COVID-19 vaccine as of mid-April. Nearly half of American adults have received at least one shot of a vaccine from Moderna, Pfizer, or Johnson & Johnson, according to the Centers for Disease Control and Prevention.
Though the vaccines authorized for emergency use in many countries are highly effective, delays in rollouts and the spread of variants have led to an increase in COVID-19 cases globally. Many European countries have enforced shutdowns and curfews in the “third wave” of the pandemic, and COVID-19 cases reached record highs in India and Brazil this spring.
Epidemiologists have predicted that COVID-19 will become endemic, likely to continue spreading as a mild, flu-like illness after the pandemic subsides. Researchers may regularly produce booster shots to protect against new variants, similar to how they develop vaccines for the flu every season.
The logic and challenge behind the FDA and CDC’s decision to temporarily halt the one-shot vaccine.
The US rollout of Johnson & Johnson’s single-dose Covid-19 vaccine was halted Tuesday as regulators race to investigate rare blood-clotting complications linked to the shot. The move may force thousands of people scheduled to receive the shot this week to scramble for an alternative.
Both the Food and Drug Administration and the Centers for Disease Control and Prevention recommended a pause in distributing the vaccine after six reported cases of cerebral venous sinus thrombosis (CVST). These clots block blood flowing out of the brain and can quickly turn deadly.
The complications were found in women between the ages of 18 and 48, and they arose between six and 13 days after receiving the Johnson & Johnson vaccine. “Of the clots seen in the United States, one case was fatal, and one patient is in critical condition,” said Peter Marks, the head of the FDA’s Center for Biologics Evaluation and Research, during a Tuesday press conference.
However, the fact that so few cases led to a nationwide pause of the vaccine has raised questions about a possible overreaction.
Speaking at the White House on Tuesday, Anthony Fauci, head of the National Institute of Allergy and Infectious Diseases, argued that the CDC and FDA were acting “out of an abundance of caution” and emphasized that their Tuesday decision was a “pause,” implying that it is meant to be temporary.
“I don’t think that they were pulling the trigger too quickly,” Fauci said.
But the move has nonetheless created confusion for people slated to receive the Johnson & Johnson shot and raised fears that it could fuel hesitancy around Covid-19 vaccines.
Johnson & Johnson itself was already reeling from a manufacturing error at one of its suppliers that ruined 15 million doses. And in Colorado, three mass vaccination sites stopped administering the Johnson & Johnson vaccine last week after 11 people reported feelings of nausea and dizziness.
For regulators, the episode highlights the tricky challenge of balancing caution against an urgent need for a vaccine in a still-raging pandemic. And as they investigate the problem, they also have to try to maintain public confidence in the vaccination program. The pause helps show that regulators are taking potential problems seriously, but if they botch the messaging, that could make people less likely to get vaccinated.
What is cerebral venous sinus thrombosis and how is it connected to Johnson & Johnson’s Covid-19 vaccine?
Cerebral venous sinus thrombosis is a condition that blocks blood from leaving the brain. In the general population, it occurs in about five out of a million people. Symptoms of CVST include headache, blurred vision, seizures, and a loss of control of the body.
However, there are several factors that made regulators pay close attention to the recent cases following vaccinations with the Johnson & Johnson shot. Marks explained that patients with these clots also had thrombocytopenia, a condition where platelets in the blood drop to very low levels, leading to bleeding and bruising. The combination of blood clots and low platelets means that patients cannot receive conventional blood clot therapies like heparin, a blood thinner. That’s why health officials want to wait to resume vaccinations with the Johnson & Johnson vaccine until they can investigate the concern and come up with new guidelines if necessary.
Another factor is that these cases occurred in younger women, who normally don’t face a high risk of these types of clots.
LOS BANOS, Philippines (Reuters) – Researchers wearing headlamps and protective suits race to untangle the claws and wings of bats caught up in a big net after dark in the Philippine province of Laguna.
The tiny animals are carefully placed in cloth bags to be taken away, measured and swabbed, with details logged and saliva and faecal matter collected for analysis before they are returned to the wild.
The researchers call themselves the “virus hunters”, tasked with catching thousands of bats to develop a simulation model they hope will help the world avoid a pandemic similar to COVID-19, which has killed nearly 2.8 million people.
(Open reut.rs/2OYdIHh in an external browser to see a picture story on the Philippine bat “virus hunters”.)
The Japanese-funded model will be developed over the next three years by the University of the Philippines Los Banos, which hopes the bats will help in predicting the dynamics of a coronavirus by analysing factors such as climate, temperature and ease of spread, to humans included.
“What we’re trying to look into are other strains of coronavirus that have the potential to jump to humans,” said ecologist Phillip Alviola, the leader of the group, who has studied bat viruses for more than a decade.
“If we know the virus itself and we know where it came from, we know how to isolate that virus geographically.”
Beyond work in the laboratory, the research requires lengthy field trips, involving traipsing for hours through thick rainforest and precarious night hikes on mountains covered in rocks, tree roots, mud and moss.
The group also targets bat roosts in buildings, setting up mist nets before dusk to catch bats and extract samples by the light of torches.
Each bat is held steady by the head as researchers insert tiny swabs into their mouths and record wingspans with plastic rulers, to try and see which of the more than 1,300 species and 20 families of bats are most susceptible to infections and why.
Researchers wear protective suits, masks and gloves when in contact with the bats, as a precaution against catching viruses.
“It’s really scary these days,” said Edison Cosico, who is assisting Alviola. “You never know if the bat is already a carrier.
“What we’re after is finding out if there are any more viruses from bats that can be transmitted to humans. We’ll never know if the next one is just like COVID.”
The bulk of those caught are horseshoe bats known to harbour coronaviruses, including the closest known relative of the novel coronavirus.
Horseshoe bats figure in two of the scenarios of World Health Organization experts investigating the origins of the SARS-CoV-2 virus that causes COVID-19.
Host species, such as bats, usually display no symptoms of the pathogens, although they can be devastating if transmitted to humans or other animals.
Deadly viruses to have originated from bats include Ebola and other coronaviruses, Severe Acute Respiratory Syndrome (SARS), and Middle East Respiratory Syndrome (MERS).
Humans’ exposure and closer interaction with wildlife meant the risk of disease transmission was now higher than ever, said bat ecologist Kirk Taray.
NPR’s Audie Cornish talks with Dr. Yvonne Maldonado, chair of the Committee on Infectious Disease for the American Academy of Pediatrics, about the COVID-19 vaccine trials in children.
AUDIE CORNISH, HOST:
This week Moderna began testing its COVID-19 vaccine in babies and young children 6 months to 11 years old, and Pfizer will soon follow. Now, it could still be many months, even a year or more, before a vaccine for young children is authorized. But meantime, we wanted to know; what exactly are researchers trying to learn through these trials? And we put that question to Dr. Yvonne Maldonado of Stanford. She’s chair of the American Academy of Pediatrics’ Committee on Infectious Diseases, and she’ll be involved in a couple of the Pfizer trials in children.
YVONNE MALDONADO: The little adage that we learn in pediatrics is that children are not little adults. And so you can’t just downsize something to their weight or age. So you need to start off assuming that they will be very different, although the biological mechanisms should be very similar.
CORNISH: If COVID cases are down by the summer, could it actually take longer to get the sufficient data that you need from trials with young children?
MALDONADO: Well, it depends on how much information we have about the vaccines themselves from adults. And so the reason I say that is you can do the studies in a variety of ways. One would be to wait for enough cases, but the other study would be to look at an immune correlate, which would be, do the children make the same antibody levels as adults? And is that good enough to assure that there could be protection?
So we are going to be doing a combination. And I think the company will make a decision ultimately with the FDA on whether the immune correlates – that is, whether the children mount a good immune response at equivalent to adults – is good enough to approve the vaccines. And so that’s where the discussions will be held.
CORNISH: By definition, a trial has risks. Can you talk about what some of the risks are here?
MALDONADO: Yeah. So the risks, of course – these are the – we’re also going to be doing a second phase of studies, which will be dose finding, and these will be in the younger age groups – so going down to the 2- to 5-year-olds and then to the 6-month-old to 2-year-olds. And the idea there will be to start at a very low dose of vaccine and see if the children tolerate it. And by that, I mean, do they get high fevers? Do they get significant pain or swelling at the site of injection? Could they have other allergic symptoms that we’re not aware of that might be different from what adults found?
And if they do experience more of those, then you might want not to go to the next higher dose, but you go to the higher dose that is well-tolerated. So, for example, a failure would be if you not only have higher side effects but you also don’t get the same kind of antibody response as you would in adults.
CORNISH: I recall hearing at one point that – in terms of children who had actually died from COVID, that kids of color were disproportionately affected. So what does that mean as you’re approaching a vaccine trial for young people?
MALDONADO: Well, you know, this happened during the HIV epidemic many years ago, and I worked through that. And I really – I have mixed feelings because I really don’t want to brand our racial and ethnic minority populations as being at risk for certain things. It’s not about race and ethnicity. It’s social determinants of health and health equity. So I want to make sure we look at this through an equity lens and make people understand that their children may be at risk because of the conditions in which they might be living, not because of their race or their color. So that is really important to me personally. And I think to pediatricians in general, equity is critical.
CORNISH: Is this a hopeful moment to you?
MALDONADO: Well, I think the hopeful moment came last December, when the first vaccine was licensed. I thought that was almost a miracle to see a vaccine come out less than a year after we had even known this virus existed. So, yes, the vaccines to me are extremely hopeful. I – by training, I’m a vaccinologist. And I do believe that – we know that vaccines have prevented 75% of deaths in children around the world in the last 20 years. These are simple ways to do this, but they need to be done carefully with equity in mind and safety in mind, first of all. And so, yes, I am very hopeful.
CORNISH: That’s Yvonne Maldonado, professor of pediatric infectious diseases at Stanford University, obviously a doctor as well.
Thank you for your time.
MALDONADO: Thank you so much for having me.
In the near future, travel may require digital documentation showing that passengers have been vaccinated or tested for the coronavirus. Answers to your questions.
Among governments and those in the travel industry, a new term has entered the vocabulary: vaccine passport.
One of President Biden’s executive orders aimed at curbing the pandemic asks government agencies to “assess the feasibility” of linking coronavirus vaccine certificates with other vaccination documents, and producing digital versions of them.
Denmark’s government said on Wednesday that in the next three to four months, it will roll out a digital passport that will allow citizens to show they have been vaccinated.
It isn’t just governments that are suggesting vaccine passports. In a few weeks, Etihad Airways and Emirates will start using a digital travel pass, developed by the International Air Transport Association, to help passengers manage their travel plans and provide airlines and governments documentation that they have been vaccinated or tested for Covid-19.
The challenge right now is creating a document or app that is accepted around the world, that protects privacy and is accessible to people regardless of their wealth or access to smartphones.
Here’s what we know about the current status of digital vaccine passports.
What is a vaccine pass or passport?
A vaccination pass or passport is documentation proving that you have been vaccinated against Covid-19. Some versions will also allow people to show that they have tested negative for the virus, and therefore can more easily travel. The versions being worked on now by airlines, industry groups, nonprofits and technology companies will be something you can pull up on your mobile phone as an app or part of your digital wallet.
“It’s about trying to digitize a process that happens now and make it into something that allows for more harmony and ease, making it easier for people to travel between countries without having to pull out different papers for different countries and different documents at different checkpoints,” said Nick Careen, senior vice president for airport, passenger, cargo and security at I.A.T.A. Mr. Careen has been leading I.A.T.A.’s travel pass initiative.
I.A.T.A. is one of several organizations that have been working on digital solutions to streamline the travel credentialing process for years; during the pandemic, these groups have focused on including vaccination status. The idea is that if you have all the pertinent information on your phone, a significant amount of time will be saved.
In addition to I.A.T.A., IBM has been developing its own Digital Health Pass that would enable individuals to present proof of vaccination or a negative test to gain access to a public location, such as a sports stadium, airplane, university or workplace. The pass, built on IBM’s blockchain technology, can utilize multiple data types, including temperature checks, virus exposure notifications, test results and vaccine status. The World Economic Forum and the Commons Project Foundation, a Swiss nonprofit group, have been testing a digital health passport called CommonPass, which would allow travelers to access testing or vaccination information. The pass would generate a QR code that could be shown to authorities.
Why would I need a vaccine pass or passport?
As more people are inoculated, there will likely be aspects of public life in which only people who have been vaccinated are allowed to participate. Take the upcoming Super Bowl LV in Tampa, Fla., where a significant portion of attendees will be vaccinated health care workers. (Mr. Careen of I.A.T.A. said that sporting organizations, concert venues and tourism agencies have all reached out for identification tech support.)
In order to travel internationally, government and health authorities will need to know if you have been vaccinated or have tested negative for the virus. Many countries are already requiring proof of a negative test for entry. Such passes could be essential to restarting the tourism industry, said Zurab Pololikashvili, secretary general of the United Nations World Tourism Organization.
Post-immunization cases, sometimes called “breakthroughs,” are very rare and very expected.
It’s hard to know when exactly the first cases appeared. But certainly by January’s end, a slow trickle of post-vaccination infections had begun in the United States. They arose in the West, making headlines in Oregon; they sprouted in the Midwest and the South. Some of the latest reports have come out of Florida, Texas, and Hawaii. These breakthrough cases—discovered in people more than two weeks after they received their final COVID-19 shot—will continue to grow in number, everywhere. And that’s absolutely no cause for concern.
Breakthrough infections, which occur when fully vaccinated people are infected by the pathogen that their shots were designed to protect against, are an entirely expected part of any vaccination process. They’re the data points that keep vaccines from reaching 100 percent efficacy in trials; they’re simple proof that no inoculation is a perfect preventative. And so far, the ones found after COVID-19 vaccination seem to be unextraordinary.
Since mid-December, when the rollout of the newly authorized vaccines began, nearly 40 million Americans have received the jabs they need for full immunization. A vanishingly small percentage of those people have gone on to test positive for the coronavirus. The post-shot sicknesses documented so far seem to be mostly mild, reaffirming the idea that inoculations are powerful weapons against serious disease, hospitalization, and death. This smattering of cases is a hazy portent of our future: Coronavirus infections will continue to occur, even as the masses join the ranks of the inoculated. The goal of vaccination isn’t eradication, but a détente in which humans and viruses coexist, with the risk of disease at a tolerable low.
When breakthrough cases do arise, it’s not always clear why. The trio of vaccines now circulating in the United States were all designed around the original coronavirus variant, and seem to be a bit less effective against some newer versions of the virus. These troublesome variants have yet to render any of our current vaccines obsolete. But “the more variants there are, the more concern you have for breakthrough cases,” Saad Omer, a vaccine expert at Yale, told me. The circumstances of exposure to any version of the coronavirus will also make a difference. If vaccinated people are spending time with groups of unvaccinated people in places where the virus is running rampant, that still raises their chance of getting sick. Large doses of the viruscan overwhelm the sturdiest of immune defenses, if given the chance.
The human side of the equation matters, too. Immunity is not a monolith, and the degree of defense roused by an infection or a vaccine will differ from person to person, even between identical twins. Some people might have underlying conditions that hamstring their immune system’s response to vaccination; others might simply, by chance, churn out fewer or less potent antibodies and T cells that can nip a coronavirus infection in the bud.
The effects of vaccination are best considered along a spectrum, says Ali Ellebedy, an immunologist at Washington University in St. Louis. An ideal response to vaccination might create an arsenal of immune molecules and cells that can instantaneously squelch the virus, leaving no time for symptoms to appear. But sometimes that front line of fighters is relatively sparse. Should the virus make it through, “it becomes a race [against] time,” Ellebedy told me. The pathogen rushes to copy itself, and the immune system recruits more defenders. The longer the tussle drags on, the more likely the disease is to manifest.
The range of vaccine responses “isn’t a variation of two- to threefold; it’s thousands,” Ellebedy told me. “Being vaccinated doesn’t mean you are immune. It means you have a better chance of protection.”
For these reasons and more, Viviana Simon, a virologist at the Icahn School of Medicine at Mount Sinai, in New York, dislikes the term breakthrough case, which evokes a barrier walling humans off from disease. “It’s very misleading,” she told me. “It’s like the virus ‘punches’ through our defenses.”
Vaccination is actually more like a single variable in a dynamic playing field—a layer of protection, like an umbrella, that might guard better in some situations than others. It could keep a lucky traveler relatively dry in a light drizzle, but in a windy maelstrom that’s whipping heavy droplets every which way, another person might be overwhelmed. And under many circumstances, vaccines are still best paired with safeguards such as masks and distancing—just as rain boots and jackets would help buffer someone in a storm.
Almost 60% of frontline health and social care workers (HSCWs) experienced a mental health disorder during the first COVID-19 lockdown, with many suffering “very high rates of distress”, suggests a new study led by researchers at UCL and the University of Haifa, Israel.
Given the significantly high levels of mental health disorders across all HSCWs, the researchers (part of the UCL-led COVID Trauma Response Working Group*), are now calling for long-term planning to meet the needs of staff from across health and social care, including specialist trauma services to be set up for healthcare workers, similar to the specialist commissioned NHS psychological trauma services for military veterans.
The ‘Frontline-COVID study’, published in the European Journal of Psychotraumatology, surveyed 1,194 HSCWs, who worked in UK hospitals, nursing or care homes and other community settings, to identify and compare the rates of mental health disorder across different job roles and places of work.
The study, carried out just after the first wave of COVID in the UK between 27 May and 23 July, 2020, found that 58% of HSCWs met the threshold for any mental health disorder; 22% met criteria for post-traumatic stress disorder (PTSD); 47% had clinically significant anxiety and 47% had depression. Symptom levels were high across all job roles and settings.
Importantly, the study found that it was not just doctors and nurses who were experiencing clinically significant distress, but all staff from across health and care.
Furthermore, the research also identified some specific mental health risk factors, principally: concern about infecting others with COVID; being unable to talk with their managers about how they were coping; feeling stigmatised (about their role); and not having had reliable access to personal protective equipment (PPE). Key predictors for PTSD included staff being redeployed to other teams and having had COVID themselves.
The research was conducted by the COVID Trauma Response Working Group, formed by UCL psychiatrists and psychologists, who are calling for immediate additional mental health support for HSCWs. This is the first UK study to assess mental health disorders across all health and social care settings during COVID-19.
Lead author, Dr Talya Greene (UCL Psychiatry and University of Haifa), said: “Our study shows that more than half of health and social care staff surveyed met criteria for a mental disorder following the first wave of COVID-19 in the UK. Importantly, we found that rates of distress were high, not only among doctors and nurses, but across a wide range of health and social care roles, such as allied health professionals, ambulance workers, hospital porters, pharmacists, and care home staff.
“Let’s be clear: we may be on the verge of a mental health crisis across the health and social care sector. So we need to make sure that specialist help is offered and accessible across all the different roles and settings.
“It is important that this support (for those that need it) is planned for the long-term. Our findings highlight the urgency for immediate long-term funding for specialist mental health services for health and social care workers.”
Co-author, Dr Jo Billings (UCL Psychiatry), said: “A really important finding from our study is that it showed that, in addition to doctors and nurses, all staff across the health and social care sector need to be offered help. This study also highlights the need for reliable access to PPE for all staff working in health and social care roles, and further investigation of barriers to communication between managers and staff. Our findings also highlight that staff redeployed into new frontline roles are at particular risk of being traumatised and are likely to require additional support during redeployment.”
Scientists say they still have more to learn about the symptoms of Covid-19 infections, long Covid, and the new variants.
It’s been more than a year since Covid-19 landed in the United States. And the once-perplexing array of symptoms like coughing, fever, shortness of breath, and loss of taste and smell are now very familiar to doctors around the country.
The range of possibilities when someone shows up to a doctor’s office with new respiratory symptoms “is very, very narrow these days,” said Anish Mehta, medical director for clinical quality and virtual health at Eden Health, and an assistant clinical professor of medicine at the Icahn School of Medicine at Mount Sinai. “It’s probably Covid if you have fever and you’re coughing, or if you have a fever and feel muscles aches.”
Medical researchers have also learned more about how a Covid-19 infection can ripple through the circulatory, nervous, and immune systems with symptoms like rashes, blood clots, strokes, and even foot lesions dubbed “Covid toes.” They’re also more familiar with the more than 10 percent of Covid-19 survivors who are reporting long-term symptoms, including difficulty thinking and focusing, heart palpitations, hair loss, and mood swings.
Yet even now researchers are finding new symptoms. Tim Spector, a professor of molecular epidemiology at King’s College London, has been studying Covid-19 throughout the pandemic through a Covid-19 Symptom Study smartphone app. He recently started receiving reports of mouth ulcers and something he calls Covid tongue — a fuzzy yellow-white coating on the tongue.
“It came about because people sent me images of their tongue,” said Spector. “I posted them and then people started … realizing that’s what they had originally when they had Covid. It’s a strange phenomenon that no doctor thought was related.”
Though cases and hospitalizations are falling, and multiple Covid-19 vaccines are rolling out, the SARS-CoV-2 virus that causes Covid-19 is still spreading, and new variants are threatening to undo some of the progress made during the pandemic. The more the virus spreads, the more likely it is to acquire new mutations. Changes in symptoms could be a warning sign of these changes to the virus. So doctors have to remain on their toes.
“I think the lesson is unusual symptoms can come out of the blue with no clear explanation,” said Andrew Chan, a professor of immunology and infectious disease at the Harvard T.H. Chan School of Public Health, who collaborated with Spector on the symptom study app. “It has to be on every health care provider’s mind.”
The list of Covid-19 symptoms is still getting longer
The fact that Covid-19 has spread so widely, with 115 million cases worldwide to date, means the disease has had opportunities to affect people under a variety of circumstances including preexisiting health conditions, age, nutrition, living standards, and access to health care. How Covid-19 interacts with these variables is part of why there are so many different symptoms.
As the fight against COVID-19 continues, scientists have turned to an unlikely source for a potentially effective treatment: tiny antibodies naturally generated by llamas.
While the world has welcomed the news of multiple vaccines against COVID-19, the search for effective treatments for those who contract the virus is ongoing. Now scientists are looking to what might seem to be an unlikely source: the South American llama.
Researchers are using the ultrabright X-rays of the Advanced Photon Source (APS), a U.S. Department of Energy (DOE) Office of Science User Facility at DOE’s Argonne National Laboratory, to help turn naturally generated llama antibodies into potentially effective therapies against SARS-CoV-2, the virus that causes COVID-19. Antibodies are the immune system’s natural defense against infection, and when extracted from blood, they can be used to design treatments and vaccines.
“Llamas generate these nanobodies naturally in high yields, and they fit into the pockets on the surface of proteins that larger-size antibodies can’t access.” — Jason McLellan, The University of Texas at Austin.
“We have received more than 50 llama antibodies with several proteins of SARS-CoV-2,” said Andrzej Joachimiak, director of the Structural Biology Center (SBC) at the APS and co-director of the Center for Structural Genomics of Infectious Diseases. (Researchers at the APS do not work with the live virus, but with crystals grown from simulated proteins.) These antibodies are part of ongoing collaborations with several partners, including researchers at the National Institutes of Health (NIH) and the National Institute of Arthritis and Musculoskeletal and Skin Diseases (NIAMS), Joachimiak said, and will be analyzed using the APS to see if they combat the virus’s infectivity.
While it may seem surprising that scientists are turning to llamas, there’s a very good reason for it.
Llamas belong to a group of mammals called camelids, a group that also includes camels and alpacas. Thanks to a quirk of nature, camelids produce a unique type of antibody against disease. These antibodies, often referred to as nanobodies, are about half the size of the antibodies produced by humans. They’re also remarkably stable and easy for scientists to manipulate.
This genetic quirk, which causes camelids such as llamas to produce these smaller antibodies with single protein chains, was discovered by accident in the late 1980s by scientists in Belgium. Since then, scientists have worked with camelid nanobodies to create treatments against several diseases with great success. Their small size allows them to bind to areas of viral proteins that larger antibodies cannot fit into, blocking those proteins from connecting with cells.
“Llamas generate these nanobodies naturally in high yields, and they fit into the pockets on the surface of proteins that larger-size antibodies can’t access,” said Jason McLellan, an associate professor at The University of Texas at Austin.
McLellan has years of experience working with camelid nanobodies. He and his graduate student Daniel Wrapp, along with Xavier Saelens’ group in Belgium, have isolated nanobodies that have proven effective against respiratory syncytial virus (RSV) and two coronaviruses: severe acute respiratory syndrome (SARS) and Middle East respiratory syndrome (MERS).
When the genetic sequence of SARS-CoV-2 was released in January of 2020, McLellan, Wrapp and Saelens worked quickly to test whether any of the antibodies that they had previously isolated against the original SARS-CoV (taken from a Belgian llama named Winter) could also bind and neutralize SARS-CoV-2. They discovered that one of these nanobodies, which they had characterized using the SBC beamlines at the APS, might be effective against SARS-CoV-2. McLellan said this nanobody — called VHH72 — is now under development as a treatment for COVID-19. He and Wrapp received a 2020 Golden Goose Award for this research.
While some of the behaviors that lead to SARS-CoV-2 infections are clear, new waves of COVID-19 cases do not always follow predicted patterns.
Now, however, a study from researchers at New York University’s Courant Institute of Mathematical Sciences describes a possible means of spotting infection surges before they happen through the analysis of online searches.
The researchers discovered a correlation between a surge in searches relating to activities outside the home — activities that could put people at risk of SARS-CoV-2 infection — and a rise in COVID-19 cases 10–14 days afterward. Infections fell when there was an increase in searches relating to stay-at-home activities.
Study author Anasse Bari, a clinical assistant professor at the Courant Institute, notes that experts have already successfully used data mining “in finance to generate data-driven investments, such as studying satellite images of cars in parking lots to predict businesses’ earnings.”
“Our research shows the same techniques could be applied to combatting a pandemic by spotting, ahead of time, where outbreaks are likely to occur,” says senior author Megan Coffee of the Division of Infectious Disease & Immunology at the New York University (NYU) Grossman School of Medicine.
Identifying with greater precision those behaviors that produce infection spikes can help epidemiologists and policymakers more effectively shape public policies regarding closures, lockdowns, and so on.
The system that the study paper describes avoids privacy issues by involving only large clusters of anonymized data.
The study appears in Social Network Analysis and Mining.
The researchers’ first step was to develop categories based on search phrases or keywords that they could then track.
The two key categories that they tracked were called the mobility index and the isolation index.
The team assigned certain searches to the mobility index track, including “theaters near me,” “flight tickets,” and other inquiries about activities that involve leaving the home and being in physical proximity with others.
As Bari puts it, “When someone searches the closing time of a local bar or looks up directions to a local gym, they give some insight into what future risks they may have.”
For the isolation index track, the researchers collected search queries — such as “at-home yoga” or “food delivery” — that indicated an intention to remain home and isolated.
The researchers based their categorization of keywords on the Democracy Fund + UCLA Nationscape survey — a study in which respondents listed the things that they would be doing if “restrictions were lifted on the advice of public health officials regarding activities.”
The survey found that the top three activities that people missed were “going to a stadium/concert,” “going to the movies,” and “attending a sports event.”
According to Bari, “This is a first step toward building a tool that can help predict COVID-19 case surges by capturing higher risk activities and intended mobility, which searches for gyms and in-person dining can illuminate.”
The researchers collected search data for March through June in 2020 from all 50 states in the United States. They used Google Trends to track trends in the data, allowing them to develop the mobility and isolation indexes.
The researchers also created a “Net Movement Index” to indicate the relationship between the two indexes. A higher Net Movement indicated a shift toward mobility search queries and away from isolation searches.
The authors write, “We theoretically expect that a sudden decline in net movement (i.e., more people staying home) would correspond to a reduction in COVID-19 spread, with a lag equivalent to the incubation period of COVID-19.”
In 42 of the 50 states, each rise in Net Movement accurately predicted an increase in COVID-19 infections 10–14 days later.
The authors of the study explored the relationship between the mobility index and infection rates following the removal of stay-at-home orders in five states: Arizona, California, Florida, New York, and Texas.
Following the implementation of each lockdown, the mobility index had significantly decreased, mirrored closely by a reduction in infections. However, the easing of stay-at-home orders in Arizona, California, Florida, and Texas preceded a sharp increase in the mobility-type searches, followed shortly by a spike in the number of reported infections in June 2020.