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December 2 | Daily COVID-19 LST Report

Climate

· A review by pediatric specialists with The Ruth & Bruce Rappaport Faculty of Medicine in Haifa, Israel discusses the phenomenon known as “vaccine hesitancy” (continued deferment of vaccines despite proven effectiveness and extremely rare adverse effects), and the barrier it could create for eventual adoption of a COVID-19 vaccine, and suggest patient education on vaccine contraindications and lack of evidence supporting adverse reactions or autoimmune disease associations may reduce vaccine hesitancy. Additionally, they suggest thorough vaccine research and multimedia educational campaigning will be needed for the coming COVID-19 vaccines.


· An observational study conducted by academics at the Department of Health and Kinesiology at Texas A&M University analyzed COVID-19 cases between within 817 United States (US) counties and found a positive association between percentage of Black residents and COVID-19 cases that was moderated by explicit and implicit racial attitudes, which persisted in the presence of other control variables (country demographics, subjective well-being, median household income, food security, percent uninsured, and percent unemployed). These data indicate COVID-19 cases are increased with high percent of Black county residents and implicit racial attitudes, suggesting disproportionate burden among Black US residents and need for increased cultural awareness and sensitivity among healthcare professionals.

Epidemiology

· Physician scientists from Universidad Nacional de Cuyo in Mendoza, Argentina created a Susceptible-Exposed-Infected-Recovered (SEIR) model to explore COVID-19 management policies and found detection and isolation of just 50% of asymptomatic patients infected with SARS-CoV-2 could significantly reduce hospital bed usage and deaths, suggesting that massive screening initiatives including asymptomatic people will facilitate detection and isolation of all SARS-CoV-2 infected people, allowing for pandemic control in lieu of a complete regional shutdown.

· Computer scientists from Greece and Scotland analyzed the ability of Google Trends (COVID-19 related search terms) to predict the trajectory of the COVID-19 outbreak at the state and national level and found a statistically significant correlation between Google Trends data and COVID-19 cases and deaths by Pearson and Kendall correlation analysis, while prediction analysis by quantile regression predicted the early spread of COVID-19 in several regions. The authors suggest Google Trends can aid epidemic forecasting and allow health care systems to prepare for local outbreaks.

· Indonesian epidemiologists conducted a systematic review and meta-analysis of 14 studies regarding recurrent SARS-CoV-2 RNA positivity (total of 2568 patients) and found 14.8% of recovered COVID-19 patients tested positive by RT-PCR after recovery (95% CI: 11.44–18.19; i^2=78%). Average time from last negative to the recurrent positive test was 9.8 days (95% CI: 7.31–12.22; i^2=93%) and time from illness onset to re-detectable positive test was 35.4 days (95% CI 32.65–38.24; i^2=77%), suggesting that further research is needed to better understand whether individuals with recurrent positivity can transmit SARS-CoV-2 or if recurrent positivity is due to inactive viral shedding.

· A retrospective study conducted by maternal and child health specialists at Tongji Medical College in Wuhan, China assessed clinical characteristics of SARS-CoV-2 among 43,126 individuals in the Hubei Province, including a subset of 1,989 healthcare workers, and found healthcare workers with SARS-CoV-2 infection had a 0.99% fatality rate with 30.90% reporting fatigue and 19.15% reporting myalgia, while 2,026 demographically matched workers of other occupations with SARS-CoV-2 infection had a 2.02% fatality rate with 25.02% reporting fatigue and 13.43% reporting myalgia. This suggests that healthcare workers may have a lower risk of COVID-19 related fatality compared to other occupational groups, but they may also have a higher risk for symptomatic infection.

Transmission & Prevention

· Italian immunologists review the challenges of SARS-CoV-2 vaccine development in the elderly populations at high risk for COVID-19: elderly populations have relatively poor immune responses due to immunosenescence, comorbidities, and pharmacologic treatments; and increased pro-inflammatory cytokines (IL-6, 8, TNF-alpha) worsen both SARS-CoV-2 prognosis and vaccine efficacy. A systems biology approach considering clinical, socio-economic, immunological factors alongside advanced technologies, adjuvants, and vectors are necessary to develop an effective SARS-CoV-2 vaccine for the elderly.


Mental Health & Resilience Needs

· An international group of psychiatrists summarized guidelines provided by the International Academy of Suicide Research (IASR) on the reported increase in mental health concerns and suicide attempts after pandemics and they hypothesize that the COVID-19 pandemic might also be followed by similar issues due to several factors, with at-risk populations including the elderly, socially isolated individuals, healthcare professionals, and young children. Recommendations include: videoconferencing for suicide risk assessment rather than teleconferencing, careful attention toward elderly patients in isolation, and increased awareness of mental health concerns during and following the COVID-19 pandemic.

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