COVID Booster: targeted treatments, genomic sequencing and elimination?

Money makes the Swiss more likely to get tested and less likely to get vaccinated

There’s evidence around the world that poorer people – who are more likely to have high-exposure jobs, among other risk factors – are at higher risk of catching COVID-19. A Swiss study has found that in Switzerland, poorer people were also less likely to get tested for COVID-19.

“In this whole-population study of the COVID-19 epidemic in Switzerland in 2020-21, we found that people living in wealthier areas were more likely to get tested for SARS-CoV-2 but less likely to test positive and be admitted to hospital or the ICU, and less likely to die, compared with those in poorer areas,” write the authors of a paper published in The Lancet.

They highlight that this is an example of the “inverse care rule”: good medical care is likely to serve the people who need it least, even in a wealthy nation like Switzerland.

98% of Victoria’s second wave came from one quarantine breach

As Victoria heads into a fifth lockdown, researchers at the University of Melbourne and the Peter Doherty Institute have published a paper on the second: analysing the genomics of Victoria’s disastrous second wave.

Most – 98% – of the SARS-CoV-2 genomes were linked, and could be traced back to a single index case in hotel quarantine.

“Our genomic ‘enhanced outbreak detection’ system revealed a rapid escalation of an outbreak originating from a single breach of hotel quarantine. The outbreak strain spread very rapidly within Victoria and was quickly seen in other Australian states and territories,” says Courtney Lane, first author of the paper, which is published in The Lancet.

“This led to a major overhaul of Victoria’s hotel quarantine system and immediate public health response, including a lockdown. Our data also showed that prior to the second wave, Victoria successfully eliminated all earlier circulating strains, providing confidence in the effectiveness of these decisive public health actions.

“Further sequencing over time showed that once the second wave was over in October, the circulating strain responsible had again disappeared.”

Elimination is still possible, argue Kiwi academics

An editorial in The BMJ has argued that it’s still possible to eliminate COVID-19 – although it might not be possible to eradicate it.

Elimination, write Sir David Skegg and Professor Philip Hill, of the University of Otago, NZ, is “maximum action to control SARS-CoV-2 and stop community transmission as quickly as possible”. This is the strategy NZ has pursued throughout the pandemic, and it has enjoyed low disruption and significant economic benefits from this – as have most other countries that have aimed for elimination, argue Skegg and HIll.

Eradication, on the other hand, “normally means permanent reduction to zero of the worldwide incidence of an infection”. This has only been done for smallpox, worldwide.

“Stamping out most COVID-19 should be more feasible with the advent of highly effective vaccines—if current problems of global scarcity and inequitable distribution can be resolved,” write Skegg and Hill.

Australians find a targeted treatment for COVID-19

Researchers at the Doherty Institute and Peter MacCallum Cancer Centre have found a method of treating COVID-19 that stops it from replicating in lab-grown, human cells.

The treatment relies on a CRISPR gene-editing tool that binds to target RNAs in cells. It’s been a subject of interest because it could potentially track and stop cancer cells.

The researchers were able to modify it to bind to COVID RNA, stopping it from replicating.

“The flexibility of CRISPR-Cas13 – which only needs the viral sequence – means we can look to rapidly design antivirals for COVID-19 and any new emerging viruses,” says Professor Sharon Lewin, corresponding author on a paper describing the research, published in Nature Communications.

Woman dies after getting two COVID variants at once

A Belgian case study has described a 90-year old woman who had been infected simultaneously with the Alpha and Beta variants of COVID-19.

Unfortunately, the woman died on 8 March 2021.

She lived alone and had not been vaccinated against COVID-19. A PCR test showed that she had both strains simultaneously.

“This is one of the first documented cases of co-infection with two SARS-CoV-2 variants of concern,” says molecular biologist Dr Anne Vankeerberghen from the OLV Hospital in Aalst, Belgium.

“Both these variants were circulating in Belgium at the time, so it is likely that the lady was co-infected with different viruses from two different people. Unfortunately, we don’t know how she became infected.”

The case study was presented at the European Congress of Clinical Microbiology & Infectious Diseases on Sunday.

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