Epidemiology
· Vaccinating the oldest against COVID-19 saves both the most lives and most years of life. Demographers from University of California, Berkeley and Bucknell University conducted a mathematical analysis of life tables from United States, Germany, and South Korea and found vaccinating the elderly first maximizes both lives saved and years of future life saved. They argue that this finding contradicts the misconception that vaccinating the elderly conflicts with the principle of maximizing the years of future life saved and strongly recommend prioritizing COVID-19 vaccines for the elderly.
· Community-tested cases of SARS-CoV-2 lineage B.1.1.7 may have higher mortality. A team of mathematicians and scientists from the London School of Hygiene’s Centre of Mathematical Modelling of Infectious diseases conducted a stratified analysis on the new SARS-CoV-2 lineage B.1.1.7 that emerged in the UK using a dataset of over 2.2 million positive community cases and 17,452 COVID-19 related deaths. Using COX proportional hazard models to control for geographical and temporal differences, researchers identified the estimated hazard of death for the B.1.1.7 to be 1.55 (CI 1.39-1.72) or a 39-72% higher mortality compared to other SARS-CoV-2 strains. Though they acknowledge a number of potential confounding factors, authors suggest the B.1.1.7 variant causes more severe disease compared to other variants.
Management
· Neonates of COVID-19 positive mothers in a 16 hospital study all tested negative and had good clinical outcomes. A retrospective case series from the department of pediatrics at the University of California described the early outcomes and inpatient management of neonates born to women with perinatal SARS-CoV-2 infection. Every infant born to the 70 COVID-19 positive mothers across 16 hospitals were well appearing and tested negative for SARS-CoV-2. The authors note that although clinical outcomes were good overall, clinical management was largely inconsistent with current U.S. Covid-19 guidelines for nursery care, suggesting concerns about the feasibility and acceptability of those recommendations.
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