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.
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:
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.
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.
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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Researchers from UC San Francisco and the Chan Zuckerberg Biohub (CZ Biohub) have developed a new approach for COVID-19 testing that detects a distinct pattern of immune gene expression in infected individuals. This type of test could be used as a check against possible errors generated by the standard tests that directly detect the SARS-CoV-2 virus, the scientists said.
In addition, the gene expression patterns seen in COVID-19 patients in the study indicate that, unlike other respiratory viruses, SARS-CoV-2 may suppress immune reactions in the early stages of infection, setting the stage for the virus to spread before patients develop symptoms.
The immune response to respiratory infections is largely responsible for symptoms like fever, nasal congestion and cough, which might typically encourage someone to isolate from others and seek testing. Because people with COVID-19 are most infectious early in their disease course, this suppressed immune response in COVID-19’s first stages makes it more likely that individuals will infect others before they realize they are sick.
The leaders of the new study, published online in Nature Communications on Nov. 17, 2020, say that although the new testing approach analyzes completely different molecules – from the person infected, rather than from the virus that infects the person – it can be implemented using the same PCR technology on the same nasal swab samples. It could be used as a standalone test, or even combined into the same testing panels used in standard PCR tests to detect the virus. Combining the technologies could lessen the chances of false negative or false positive results, the researchers said.
“Without even having to detect the virus itself, these tests to measure changes in the expression of immune-related genes can determine whether or not someone has COVID-19,” said co-senior study author Chaz Langelier, MD, PhD, assistant professor in the Division of Infectious Diseases in the UCSF Department of Medicine, who led the research with Amy Kistler, PhD, of CZ Biohub.
The UCSF scientists created three proof-of-concept versions of the new test – one based on readouts of gene activity from three key genes, one based on readouts from 10 genes, and one based on 27 genes. The tests independently detected COVID-19 infection in clinically confirmed cases, increasing in sensitivity with the number of genes included.
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By testing approximately 1,000 blood donation samples each month in in the Brazilian cities of São Paulo and Manaus, an international team of researchers have shown that, while both cities have experienced large epidemics with high mortality, as much as three-quarters of the population in Manaus was infected between March and October, and a third of the population in São Paulo.
Researchers from the University of São Paulo (USP, São Paulo, Brazil), the Fundação Hospitalar de Hematologia e Hemoterapia do Amazonas (Hemoam, Manaus, Brazil), Fundação Pró-Sangue/Hemocentro de São Paulo, Imperial College London, and the University of Oxford United Kingdom, worked together to collect and analyze data on the prevalence of SARS-CoV-2 antibodies, a marker of prior infection, among blood donors in the Brazilian cities of Manaus and São Paulo.
Their research is published in the journal Science.
The authors state that these results are a data-based warning of what may be the extent of SARS-CoV-2 transmission in the absence of effective mitigation.
Brazil has experienced an unprecedented epidemic caused by SARS-CoV-2, with >6.5 million cases reported to date and >175 thousand deaths. The Amazon region, in the north of the country, has been hardest hit. In Manaus, mortality increased rapidly in April, with overwhelmed health services requiring communal graves to bury the dead.
Professor Nuno Faria, Associate Professor at the University of Oxford and Reader at Imperial College, principal investigator of CADDE project, said: “The large burden of illness and death caused by COVID-19 in Manaus emphasizes the importance of face coverings, social distancing and hand washing to stop the spread of infection throughout Brazil—measures that will be reinforced by vaccination to immunize individuals at risk and, ultimately, to protect whole populations.”
Dr. Lewis Buss, medical doctor and researcher at the University of São Paulo, said: “The blood banks in Manaus and São Paulo are part of the Recipient Epidemiology and Donors Study (REDS), which provided the infrastructure to rapidly establish a testing program. Because we used residual blood donation samples it was possible to generate a long time series, covering the entire period of SARS-CoV-2 transmission in Brazil.”
Professor Ester Sabino, immunologist at the University of São Paulo, said: “Infection rates are currently high in Latin America and we find particularly high infection rates in Manaus, the largest urban metropolis in the Amazon region. Manaus is a warning for other cities, for example Sao Paulo could more than double the number of deaths if it reached a similar level of infection.”
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A new study that analyzed blood donations from December 2019 to early January helped show that the coronavirus infected people in the U.S. earlier than previously thought.
The coronavirus was present in the U.S. weeks earlier than scientists and public health officials previously thought, and before cases in China were publicly identified, according to a new government study published Monday.
The virus and the illness that it causes, COVID-19, were first identified in Wuhan, China, in December 2019, but it wasn’t until about Jan. 20 that the first confirmed COVID-19 case, from a traveler returning from China, was found in the U.S.
However, new findings published in the journal Clinical Infectious Diseases suggest that the coronavirus, known officially as SARS-CoV-2, had infected people in the U.S. even earlier.
“SARS-CoV-2 infections may have been present in the U.S. in December 2019, earlier than previously recognized,” the authors said.
This discovery adds to evidence that the virus was quietly spreading around the world before health officials and the public were aware, disrupting previous thinking of how the illness first emerged and how it has since evolved. It also shows the virus’s presence in U.S. communities likely didn’t start with the first case identified case in January.
Researchers came to this conclusion after the U.S. Centers for Disease Control and Prevention analyzed blood donations collected by the American Red Cross from residents in nine states. They found evidence of coronavirus antibodies in 106 out of 7,389 blood donations. The CDC analyzed the blood collected between Dec. 13 and Jan. 17.
The presence of antibodies in a person’s blood means they were exposed to a virus, in this case the coronavirus, and that their body’s immune system triggered a defensive response.
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Researchers have studied the mechanisms by which the novel coronavirus can reach the brains of patients with COVID-19. The results show that SARS-CoV-2 enters the brain via nerve cells in the olfactory mucosa.
Using post-mortem tissue samples, a team of researchers from Charité — Universitätsmedizin Berlin have studied the mechanisms by which the novel coronavirus can reach the brains of patients with COVID-19, and how the immune system responds to the virus once it does. The results, which show that SARS-CoV-2 enters the brain via nerve cells in the olfactory mucosa, have been published in Nature Neuroscience*. For the first time, researchers have been able to produce electron microscope images of intact coronavirus particles inside the olfactory mucosa.
It is now recognized that COVID-19 is not a purely respiratory disease. In addition to affecting the lungs, SARS-CoV-2 can impact the cardiovascular system, the gastrointestinal tract and the central nervous system. More than one in three people with COVID-19 report neurological symptoms such as loss of, or change in, their sense of smell or taste, headaches, fatigue, dizziness, and nausea. In some patients, the disease can even result in stroke or other serious conditions. Until now, researchers had suspected that these manifestations must be caused by the virus entering and infecting specific cells in the brain. But how does SARS-CoV-2 get there? Under the joint leadership of Dr. Helena Radbruch of Charité’s Department of Neuropathology and the Department’s Director, Prof. Dr. Frank Heppner, a multidisciplinary team of researchers has now traced how the virus enters the central nervous system and subsequently invades the brain.
As part of this research, experts from the fields of neuropathology, pathology, forensic medicine, virology and clinical care studied tissue samples from 33 patients (average age 72) who had died at either Charité or the University Medical Center Göttingen after contracting COVID-19. Using the latest technology, the researchers analyzed samples taken from the deceased patients’ olfactory mucosa and from four different brain regions. Both the tissue samples and distinct cells were tested for SARS-CoV-2 genetic material and a ‘spike protein’ which is found on the surface of the virus. The team provided evidence of the virus in different neuroanatomical structures which connect the eyes, mouth and nose with the brain stem. The olfactory mucosa revealed the highest viral load. Using special tissue stains, the researchers were able to produce the first-ever electron microscopy images of intact coronavirus particles within the olfactory mucosa. These were found both inside nerve cells and in the processes extending from nearby supporting (epithelial) cells. All samples used in this type of image-based analysis must be of the highest possible quality. To guarantee this was the case, the researchers ensured that all clinical and pathological processes were closely aligned and supported by a sophisticated infrastructure.
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Testing half the population weekly with inexpensive, rapid-turnaround COVID-19 tests would drive the virus toward elimination within weeks — even if those tests are significantly less sensitive than gold-standard clinical tests, according to a new study published today by University of Colorado Boulder and Harvard University researchers.
Such a strategy could lead to “personalized stay-at-home orders” without shutting down restaurants, bars, retail stores and schools, the authors said.
“Our big picture finding is that, when it comes to public health, it’s better to have a less sensitive test with results today than a more sensitive one with results tomorrow,” said lead author Daniel Larremore, an assistant professor of computer science at CU Boulder. “Rather than telling everyone to stay home so you can be sure that one person who is sick doesn’t spread it, we could give only the contagious people stay-at-home orders so everyone else can go about their lives.”
For the study, published in the journal Science Advances, Larremore teamed up with collaborators at CU’s BioFrontiers Institute and the Harvard T.H. Chan School of Public Health to explore whether test sensitivity, frequency, or turnaround time is most important to curb the spread of COVID-19.
The researchers scoured available literature on how viral load climbs and falls inside the body during infection, when people tend to experience symptoms, and when they become contagious.
They then used mathematical modeling to forecast the impact of screening with different kinds of tests on three hypothetical scenarios: in 10,000 individuals; in a university-type setting of 20,000 people; and in a city of 8.4 million.
When it came to curbing spread, they found that frequency and turnaround time are much more important than test sensitivity.
For instance, in one scenario in a large city, widespread twice-weekly testing with a rapid but less sensitive test reduced the degree of infectiousness, or R0 (“R naught”), of the virus by 80%. But twice-weekly testing with a more sensitive PCR (polymerase chain reaction) test, which takes up to 48 hours to return results, reduced infectiousness by only 58%. When the amount of testing was the same, the rapid test always reduced infectiousness better than the slower, more sensitive PCR test.
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Researchers have developed a new artificial intelligence platform that detects COVID-19 by analyzing X-ray images of the lungs.
Called DeepCOVID-XR, the machine-learning algorithm outperformed a team of specialized thoracic radiologists — spotting COVID-19 in X-rays about 10 times faster and 1-6% more accurately.
The researchers believe physicians could use the A.I. system to rapidly screen patients who are admitted into hospitals for reasons other than COVID-19. Faster, earlier detection of the highly contagious virus could potentially protect health care workers and other patients by triggering the positive patient to isolate sooner.
The study‘s authors also believe the algorithm could potentially flag patients for isolation and testing who are not otherwise under investigation for COVID-19.
The study will be published on Nov. 24 in the journal Radiology.
“We are not aiming to replace actual testing,” said Northwestern’s Aggelos Katsaggelos, an A.I. expert and senior author of the study. “X-rays are routine, safe and inexpensive. It would take seconds for our system to screen a patient and determine if that patient needs to be isolated.”
“It could take hours or days to receive results from a COVID-19 test,” said Dr. Ramsey Wehbe, a cardiologist and postdoctoral fellow in A.I. at the Northwestern Medicine Bluhm Cardiovascular Institute. “A.I. doesn’t confirm whether or not someone has the virus. But if we can flag a patient with this algorithm, we could speed up triage before the test results come back.”
Katsaggelos is the Joseph Cummings Professor of Electrical and Computer Engineering in Northwestern’s McCormick School of Engineering. He also has courtesy appointments in computer science and radiology. Wehbe is a postdoctoral fellow at Bluhm Cardiovascular Institute at Northwestern Memorial Hospital.
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