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.”

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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.

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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.

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Drug makers are increasingly turning to monoclonal antibodies to protect the millions of people who might not be able to use vaccines. But questions swirl about their cost and long-term viability.

AS THE COVID-19 vaccine rollout gathers pace, a population is at risk of being left behind: the millions of people around the globe who lack fully functional immune systems.

While the exact number of the immunocompromised worldwide is unknown, estimates suggest that about 10 million live in the U.S. alone, or around 3 percent of the national population. The number encompasses a diverse range of vulnerabilities, including rare genetic immune deficiencies, chronic illnesses that impair the immune system such as rheumatoid arthritis, and cancer and organ-transplant patients who must take immune-suppressing medications.

For them, vaccines might not be as effective, because they are less capable of making their own antibodies to neutralize the SARS-CoV-2 virus. Instead, pharmaceutical companies around the world are racing to develop alternative treatments that bypass the immune system altogether.

The most common option is called monoclonal antibody treatments. These artificially generated antibodies mimic the body’s natural immune response by binding to key sites on the virus’ spike protein, preventing it from entering cells and reproducing. Companies including AstraZeneca, Regeneron, and Eli Lilly are currently testing whether monoclonal antibodies can protect immunocompromised people from SARS-CoV-2.

“You often find that patients who have had bone marrow transplants end up getting terrible flu and other infections, which they can’t clear without additional help,” says Nicky Longley, an infectious diseases consultant at University College London Hospitals. “It was these heavily immune-suppressed populations who did very badly during the first wave of COVID-19.”

In addition, preventing immunocompromised people from getting infected will be a key part of keeping the disease in check in the long run, says Andrew Ustianowski, an infectious disease specialist at the U.K.’s National Institute for Health Research.

“If we want to control this virus and get back into normal life, then being able to protect everybody, so we don’t have ongoing transmission in subgroups of the population, is important,” he says.

But while many scientists are excited about the potential of monoclonal antibodies to address gaps in the world’s vaccination programs, questions remain. The coming months will tell us whether these treatments are sufficiently cost-effective to be used on a large scale, if they can really provide adequate protection for months at a time, and whether using monoclonal antibodies may inadvertently do more harm than good.

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What is the latest in COVID-19 vaccine advances?

8 COVID-19 vaccines gained authorization

Experts have explained time and again that in order to contain SARS-CoV-2 and prevent more coronavirus outbreaks in the future, vaccines are of utmost importance.

At the moment, there are eight COVID-19 vaccines with authorization in countries around the world.

So far, the Pfizer-BioNTech vaccine, which is an mRNA vaccine, has gained authorization for use in 50 countries. These include the United States, the United Kingdom, and the 27 countries that make up the European Union.

The vaccine developed by Moderna and the National Institute of Allergy and Infectious Diseases (NIAID), which is also an mRNA vaccine, is currently authorized in 36 countries. These include the U.S., the U.K., and E.U. countries.

Sputnik V, which is a viral vector vaccine developed by the Russian research institute Gamaleya, is authorized in eight countries: Algeria, Argentina, Belarus, Bolivia, Guinea, Russia, Serbia, and West Bank.

Close on its heels is the Oxford-AstraZeneca viral vector vaccine, which has gained use authorization in seven countries. These are Argentina, the Dominican Republic, El Salvador, India, Mexico, Morocco, and the U.K.

Other vaccines that have gained authorization in certain countries are:

• Covishield, a viral vector vaccine authorized in India
• Covaxin, an inactivated vaccine authorized in India
• The Sinopharm vaccine, also inactivated, which is authorized in six countries, including China, Egypt, and the United Arab Emirates
• The Sinovac vaccine, also inactivated, which is authorized in China, Indonesia, and Turkey

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Researchers are calling for clinical studies on vitamin B6, so we turned to the health experts.

By this point, several published research papers and clinical trials have shown that vitamins D and C, as well as minerals such as zinc and magnesium, may reduce the severity of symptoms in COVID-19 patients. Now, one researcher is calling on scientists to explore another helpful vitamin that may have been overlooked.

In an opinion article published in the journal Frontiers in Nutrition, Thanutchaporn Kumrungsee, an assistant professor at Hiroshima University in Japan, proposed that vitamin B6 could play a pivotal role in fighting the novel coronavirus. 

“There is growing evidence that vitamin B6 exerts a protective effect against chronic diseases such as cardiovascular diseases (CVD) and diabetes by suppressing inflammation, inflammasomes, oxidative stress, and carbonyl stress,” the article reads. “Additionally, vitamin B6 deficiency is associated with lower immune function and higher susceptibility to viral infection.”

However, some health experts remain suspicious—and for good reason. Ali Webster, PhD, RD, and director of research and nutrition communications at the International Food Information Council, says it’s still too soon to determine whether or not the vitamin could help lower your risk of experiencing adverse COVID-19 symptoms.

“There are plausible biological mechanisms for it doing so, and low levels of B6 in the body are associated with a weakened immune system,” she says. “But often, the promise of a positive impact is there but the outcome of well-designed studies is disappointing.”

Webster explains that the research on taking vitamin B6 in supplement form to reduce the risk for heart disease, stroke, certain types of cancer, and even cognitive decline is a bit inconclusive, as well.

“More research is needed in each of these areas in addition to the work to determine its effect on COVID-19 severity,” she adds.

Brittany Busse, MD, associate medical director at WorkCare, agrees that more research is needed. However, Busse notes that vitamin B6 is known to have an anti-inflammatory effect on the body, which could help you in both preventing and combating adverse COVID-19 symptoms.

“There are a lot of vitamins that can help decrease inflammation, potentially,” she says. “And B6 is one of them.”

Busse also adds that the severity of COVID-19 is based largely on how much inflammation your body creates in response to the virus. Thus, it’s key to keep inflammation levels low by eating a diet that’s rich in fruits, vegetables, and legumes; engaging in regular, moderate exercise; getting plenty of sleep; and managing stress.

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Three COVID-19 vaccines – from Pfizer/ BioNtech, Moderna and Oxford-AstraZeneca – look set to be the most common ones for Europeans.

While they all have the same goal, there are substantial differences between jabs from their composition and reported effectiveness, to their price and ease of conservation and distribution.

Original Source

With two Covid-19 vaccines approved for emergency use and politicians, health care workers and residents of long-term care facilities rolling up their sleeves, it’s a natural question: What about me and my loved ones?A lot of factors play into the answer, and it depends on each person’s health, what they do for a living and where they live.States will handle immunization campaigns differently, experts say. Some campaigns may be smoother than others, but if there is one piece of advice to keep in mind, it’s this: Keep taking measures to protect yourself and your family until you’re inoculated.That means continuing to wear masks, socially distance, avoid large gatherings and regularly wash your hands.

“People just need to be patient,” said Claire Hannan, executive director of the Association of Immunization Managers. “They need to be vigilant and protect themselves from the virus.”As for when Americans can get back to in-person socializing, “I would leave that to Dr. (Anthony) Fauci,” she said, referring to the nation’s top infectious disease expert and President-elect Joe Biden’s incoming chief medical adviser.You have more questions; here are more answers:

Who is getting vaccinated first?

As has been widely reported, health care workers and residents of long-term care facilities are first in line, followed by adults ages 75 and older and frontline essential workers such as first responders.

The next phase will be adults between 65 and 75, those between 16 and 64 with high-risk medical conditions and “other essential workers,” according to the US Centers for Disease Control and Prevention’s Advisory Committee on Immunization Practices.The CDC accepted the ACIP recommended allocation phases Tuesday. To be clear, the CDC guidelines are only that. States wield a good deal of authority in how the vaccines are handled, and Florida Gov. Ron DeSantis said Wednesday he will issue an executive order to ensure senior citizens (65 and older) are the first members of the general public to be vaccinated.

Who is an essential worker?

The ACIP defines frontline essential workers as anyone employed in “sectors essential to the functioning of society (who) are at substantially higher risk of exposure” to the coronavirus. Besides first responders, that includes those working in education and child care, food and agriculture, manufacturing, corrections, the US Postal Service, public transit and grocery stores. There are roughly 30 million people in this category.Jockeying for the vaccineOther essential workers, according to ACIP, are people working in transportation, logistics, food service, construction, housing, finance, information technology, communications, energy, sanitation, media, law, public health and the water/wastewater industries. The category encompasses about 57 million Americans.

When will the general public get the vaccine?

This is a moving target that will be dictated by numerous variables. Dr. Vivek Murthy, Biden’s nominee for surgeon general, said he believes it may take until late spring to finish vaccinating high-risk populations, if all goes according to plan. That means mid-summer may be a “realistic” timeline for the general public to begin vaccinations, he told NBC.

“If everything goes well, we may see a circumstance where, by late spring, people who are in lower risk categories can get this vaccine,” he said, “but that would really require everything to go exactly on schedule. I think it’s more realistic to assume that it may be closer to mid-summer, early fall when this vaccine makes its way to the general population.”A recent ACIP chart indicated the general public may start getting the vaccine in about 20 weeks — putting the target in May — which is “kind of in line with what I was thinking, too,” Hannan said.Because states will handle rollouts differently, Hannan says it’s a good idea for people to monitor state health department websites for specifics. Some states are setting up “public-facing dashboards,” she said, and the New Mexico Department of Health on Wednesday announced a website that will allow residents to register for notifications on when they qualify to receive the vaccine.

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The U.S. has administered 1.12 million vaccine doses, according to Bloomberg’s count

The first Covid-19 shots have been given to more than 2.7 million people in six countries, according to data collected by Bloomberg. It’s the start of the biggest vaccination campaign in history and one of the largest logistical challenges ever undertaken.

Vaccinations in the U.S. began Dec. 14 with health-care workers, and so far 1.12 million doses have been administered, according to a state-by-state tally by Bloomberg. Those numbers are accelerating as a second vaccine by Moderna Inc. is distributed.

The U.S. is allocating 5.1 million doses of Pfizer and BioNTech’s vaccine  and 6 million doses of Moderna’s shot for distribution through this week. Both vaccines require two doses taken several weeks apart. The second doses are being held in reserve until they’re ready to be administered.

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Ellume USA’s rapid at-home test was developed through the NIH RADx Initiative.

The U.S. Food and Drug Administration granted emergency use authorization (EUA) today for an innovative COVID-19 viral antigen test developed with support from the National Institutes of Health’s Rapid Acceleration of Diagnostics (RADx) Initiative. Ellume USA LLC, Valencia, California, designed the test for use at home without a prescription. This is the first EUA awarded for an at-home COVID test that can be purchased over the counter.  Ellume developed the test with a $30 million contract and technical support from the RADx Tech program, managed by the National Institute of Biomedical Imaging and Bioengineering (NIBIB), part of NIH.

The test is performed using a mid-turbinate nasal swab designed for comfortable self-sampling.  The sample is inserted into a single-use cartridge that returns results in 15 minutes. The at-home test analyzer connects to the user’s smartphone through Bluetooth and pairs with a downloadable app that provides step-by-step instructions and displays results.

Users can share real-time results from the test, selling for approximately $30, with healthcare professionals, employers, and schools for efficient COVID-19 tracking. Ellume plans to scale-up manufacturing to deliver millions of home tests per month in 2021.

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