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August 19 | Daily COVID-19 LST Report

Climate

· A survey of 335 nephrology clinic staff in India sought to assess perceived negative stigma from being a healthcare worker during the COVID-19 pandemic. The results showed that 54.6% of staff perceived significant stigma due their job, 36.1% of staff reported significant stress, and a strong correlation was shown between perceived stigma and stress.



Epidemiology

· A cross-sectional study in Spain investigated the presence of SARS-CoV-2 RNA fecal shedding at six wastewater treatment plants by testing 42 inflowing samples, 18 secondary treated outflowing samples, and 12 tertiary treated outflowing samples. They found SARS-CoV-2, positive by RT-PCR, in 87% of inflowing, 11% of secondary treated, and 0% of tertiary treated samples suggesting that wastewater analysis may provide alternative and effective environmental surveillance for SARS-CoV-2 fecal shedding and could help to direct public health response in certain communities.

· A mathematical model devised by group from Stockholm University reveals a herd immunity level to COVID-19 of about 43% when taking into account population heterogeneity by adjusting for age and social activity in a structured community.

Understanding the Pathology

· Investigators in Wuhan found that SARS-CoV-2, compared to six other coronavirus protein sequences, has distinct viral coding protein sequences that promote host responsive gene expression patterns such as increasing neutrophil activity and expression of key transcriptional factors. This matches data that show that show increases in blood neutrophil levels in severe COVID-19 patients and provides a mechanistic framework for the pathogenesis of SARS-CoV-2 infection.

Transmission & Prevention

An infectious disease physician at NYU Langone Vaccine Center discussed an inactivated protein immunogen proposed by Xia et al, 2020 as a COVID-19 vaccine candidate that was well-tolerated in phase 1 (n=96 adults) and phase 2 (n=224 adults) and induced SARS-CoV-2 neutralizing antibodies 14 days after the last booster vaccination, with most common side effects being self-limiting fever and injection site pain. The author suggests β-propiolactone–inactivated SARS-CoV-2 plus adjuvant as a potential vaccine candidate given its tolerability, safety, and ability to generate an immune response.


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