Ian Connellan
The numbers
Rising COVID-19 numbers in the US and Europe are alarming national leaders (in most cases) and leading to new lockdowns and predictions of winter case peaks.
In the US, cases are reported increasing in 41 states – the biggest surge since August – and insufficient testing may be contributing to under-reporting of new infections.
Across Europe, an average of more than 100,000 cases per day was reported in the past week. Yesterday France’s president Emmanuel Macron declared a state of emergency, including a 9pm–6am curfew starting on Saturday in nine cities.
The New York Times reported Macron as saying: “The virus is everywhere in France.”
On Monday, WHO director-general Tedros Adhanom Ghebreyesus told a media briefing: “Around the world, we’re now seeing an increase in the number of reported cases of COVID-19, especially in Europe and the Americas.
“Each of the last four days has been the highest number of cases reported so far. Many cities and countries are also reporting an increase in hospitalisations and intensive-care bed occupancy. At the same time, we must remember that this is an uneven pandemic.
“Countries have responded differently, and countries have been affected differently.
Almost 70% of all cases reported globally last week were from 10 countries, and almost half of all cases were from just three countries.”
Global
As at 16:14 CEST on Wednesday 14 October, cases confirmed worldwide by national authorities stood at 38,002,699 (287,031 of them reported in the preceding 24 hours). 1,083,234 deaths have been recorded (4108). (Source: WHO Coronavirus Disease Dashboard)
Johns Hopkins University’s Centre of Systems Science and Engineering (CSSE) reported (at 15:00 AEST on Thursday 15 October) 38,441,934 confirmed cases and 1,091,439 deaths.
Australia
The Department of Heath reported on 7 October that national confirmed cases stood at 27,341, a rise of 25 in 24 hours. 904 deaths have been recorded.
State by state: ACT 113 total cases (first case reported 12 March); NSW 4310 (25 January); NT 33 (20 March); Qld 1161 (29 January); SA 479 (2 February); Tas 230 (2 March); Vic 20,311 (25 January); WA 704 (21 February).
Research
Pause for safety – and definitions
Earlier this week US pharmaceutical giant Johnson & Johnson confirmed it was temporarily pausing its COVID-19 vaccine clinical trials due to an unexplained illness in a study participant. J&J did not elaborate on the illness, citing respect for the participant’s privacy.
In a statement, J&J stressed the priority it gives to “the safety and well being of the people we serve every day around the world”, and the difference between the terms “study pause” and a “regulatory hold”.
It says the former, “in which recruitment or dosing is paused by the study sponsor, is a standard component of a clinical trial protocol”. The latter “is a requirement by a regulatory health authority, such as the U.S. Food and Drug Administration (FDA).
The study pause follows a similar study pause in September by British-Swedish pharmaceutical company AstraZeneca. Their trials have since resumed.
Australian vaccine experts backed the company’s action and emphasised that such a pause isn’t unusual.
“It is not unusual to suspend a clinical trial if there is an adverse-reaction reported during testing,” wrote Murdoch University’s Jeremy Nicholson. “This is all part of checking that the vaccine (or drug) is safe.
“People can fall ill in clinical trials by chance and it may have nothing to do with the vaccine itself, this is especially likely in a large trial. Each case has to be investigated thoroughly to evaluate the cause and likelihood of it being trial related.”
“It does not mean the trial will not continue, and is required under ethical standards governing clinical trials,” wrote Australian Catholic University’s Roger Lord.
More safety = less carbon
The COVID pandemic has profoundly affected human activities – a state of affairs that ought to be reflected in energy use and carbon dioxide (CO2) emissions.
Now, an international team has presented daily estimates of country-level CO2 emissions for different sectors – for instance residential, transport and aviation – based on near-real-time activity data. The results have been published in Nature Communications.
The key result is an abrupt 8.8% decrease in global CO2 emissions in the first half of 2020 compared to the same period in 2019. This decrease is of a magnitude larger than during previous economic downturns or World War II. The timing of emissions decreases corresponds to lockdown measures in each country.
The research reveals that by 1 July, as lockdown restrictions relaxed and some economic activities restarted, especially in China and several European countries, the pandemic’s effects on global emissions diminished. But substantial differences persist between countries. In the US, for instance, where coronavirus cases are still increasing, emission declines have continued.
The study’s author’s write that the “absolute decreases in CO2 emissions are larger than any in history, including those that occurred during the recent 2008–2009 global financial crisis” and emphasise the message their results sends.
“At face value, an 8.8% relative reduction of emissions seems to be small when compared to the magnitude and extent of the disturbance of human activities that the COVID produced. This means that the long-term emissions decreases needed in this century to achieve [carbon reduction] targets must be based on structural and transformational changes in energy production systems, de-carbonisation of transportation and improved building energy use efficiency, that is an improvement of the carbon intensity of economies rather than decreases of human activities.”
Is SARS-CoV-2 here to stay?
Worldwide, only a few repeat SARS-CoV-2 infections have been verified since the pandemic began. But in a Perspective article in Science, Jeffrey Shaman and Marta Galanti suggest that it’s likely the virus will become endemic – that it will be able to re-infect humans who’ve had it before.
Shaman and Galanti write that in many respiratory viruses (such the flu and the common cold) a number of processes – including particularly insufficient adaptive immune response, waning immunity and immune escape – can allow subsequent reinfection. While many questions remain about the nature of these immune responses and trajectories in the case of SARS-CoV-2, insight from other respiratory viruses points to the possibility of reinfection with it.
Shaman and Galanti note that cyclic persistence of COVID in human populations may be affected by ongoing opportunities for interaction with other respiratory pathogens – it’s possible infection with a different virus could provide some short-lived protection to SARS-CoV-2. But there will need to be greater monitoring of the clinical and population-scale interactions of it with other respiratory viruses, particularly influenza, before we’ll know.
At the population scale, a possible overlap between influenza and COVID outbreaks poses a serious threat to public health systems. But the authord note that non-pharmaceutical interventions adopted to mitigate COVID transmission – such personal protective equipment, social distancing and increased hygiene – may reduce the magnitude of seasonal influenza outbreaks.
Based on modelling of post-pandemic scenarios for SARS-CoV-2 to date, a duration of immunity similar to that of the other betacoronaviruses (about 40 weeks) could lead to yearly COVID outbreaks, whereas a longer immunity profile, coupled with a small degree of protective cross-immunity from other betacoronaviruses, could lead to apparent elimination of the virus followed by resurgence after a few years.
“Other scenarios are, of course, possible, because there are many processes at play and much that remains unresolved,” write Shaman and Galanti.
Research bites
A new study published in JAMA Pediatrics reports that mothers with SARS-CoV-2 infection rarely transmit the virus to their newborns when basic infection-control practices are followed. The findings – the most detailed data available on the risk of SARS-CoV-2 transmission between mothers and their newborns – suggest that more extensive measures like separating COVID-19-positive mothers from their babies and avoiding direct breastfeeding may not be warranted. “Our findings should reassure expectant mothers with COVID-19 that basic infection-control measures during and after childbirth – such as wearing a mask and engaging in breast and hand hygiene when holding or breastfeeding a baby – protected newborns from infection in this series,” says study senior author Cynthia Gyamfi-Bannerman, of NewYork-Presbyterian / Columbia University Irving Medical Center.
A new study of beliefs and attitudes toward COVID-19 in five different countries – the UK, US, Ireland, Mexico and Spain – has identified how much traction some prominent conspiracy theories can gain. Published in the journal Royal Society Open Science, the research reveals “key predictors” for susceptibility to fake pandemic news, and critically finds that a small increase in the perceived reliability of conspiracies equates to a larger drop in the intention to get vaccinated. The Cambridge University-led study asked participants to rate the reliability of several statements, including six popular myths about COVID-19. While a large majority of people in all five nations judged the misinformation to be unreliable, researchers found that certain conspiracy theories have taken root in significant portions of the population. The conspiracy deemed most valid across the board was the claim that COVID-19 was engineered in a Wuhan laboratory. “Certain misinformation claims are consistently seen as reliable by substantial sections of the public. We find a clear link between believing coronavirus conspiracies and hesitancy around any future vaccine,” says study co-author Sander van der Linden, of Cambridge.
Sudden permanent hearing loss seems to be linked to COVID-19 infection in some people, warn doctors, reporting the first UK case in the journal BMJ Case Reports. While the side-effect is uncommon, awareness of it is important because a prompt course of steroid treatment can reverse this disabling condition. “Despite the considerable literature on COVID-19 and the various symptoms associated with the virus, there is a lack of discussion on the relationship between COVID-19 and hearing,” say the report authors. “Given the widespread presence of the virus in the population and the significant morbidity of hearing loss, it is important to investigate this further.”
A new study led by researchers at Virginia Commonwealth University, US, suggests that for every two deaths attributed to COVID-19 in the US, a third American dies as a result of the pandemic. The results are published in the Journal of the American Medical Association. The study shows that deaths between 1 March and 1 August increased 20% compared to previous years, but deaths attributed to COVID-19 accounted for only 67% of those deaths. “Contrary to sceptics who claim that COVID-19 deaths are fake or that the numbers are much smaller than we hear on the news, our research and many other studies on the same subject show quite the opposite,” said lead author Steven Woolf. The study also contains suggestive evidence that state policies on reopening early in April and May may have fueled the surges experienced in June and July.