November 4 | Daily COVID-19 LST Report

Understanding the Pathology

· Should we be testing for more than SARS-CoV-2 antibodies? Microbiologists, pathologists, and public health experts associated with Mount Sinai Hospital analyzed 3277 blood specimens from recovered COVID-19 patients and found that neutralizing antibody level is the highest 31-35 days post symptom onset, even though general SARS-CoV-2 antibody levels had been high (well above the 160 titer range cutoff) long before this, suggesting the importance of also testing for neutralizing antibodies.

Transmission & Prevention

· How do close contact and aerosol transmission risks compare? Swiss environmental engineers applied a Quantitative Microbial Risk Assessment (QMRA) to evaluate SARS-CoV-2 infection risk via aerosol transmission and close indoor contact using dose-response mice models and infection risk data from meta-analyses and found lower infection transmission risk via aerosol exposure within one hour (10^-6 to 10^-4) compared to close contact (10^-1; 12.8% risk within 1m) in a typically ventilated room (10-400 square-meters) with one infected person. Close contact may pose higher infection risk than aerosol transmission, but suggest real-life circumstances (i.e. prolonged exposure, higher density) could heighten risk of aerosol transmission not accounted for in this analysis.

· Are transmission precautions in schools beneficial? Infectious Disease physicians from the US and UK reviewed data on transmission and detection of SARS-CoV-2 infection and found that children under 10 years old are less susceptible to contracting SARS-CoV-2, transmission of the virus is more robust in high schools compared to primary schools, and schools with transmission prevention measures in place have seen less viral spread compared to schools with no preventative measures, supporting the implementation of transmission prevention measures in schools (high schools in particular) to slow viral spread in the community.

R&D: Diagnosis & Treatments

· Polyester or foam nasal swabs: which is better? A comparative analysis investigated sensitivity of polyester and foam nasal swabs stored in viral transport media (VTM), saline, or dry tubes from 126 convalescent COVID-19 patients and found polyester and foam swabs had sensitivities of 87.3% versus 94.5% in VTM, 87.5% versus 93.8% in saline, and 75.0% versus 90.6% in dry tubes, respectively. Polyester swabs had higher cycle threshold values and decreased performance compared to foam swabs when viral loads were near detection threshold, but because estimated sensitivity above 87% was deemed sufficient for times of public health emergency, polyester swabs stored in VTM or saline may suffice in settings where swab shortages exist.

Mental Health & Resilience Needs

· How do science literacy and neurological mechanisms contribute to false beliefs? A Behavioral Neurologist from University of California, San Francisco describes that the neural mechanism behind false beliefs in COVID-19 conspiracy theories and science denial in healthy individuals is similar to those that have Lewy body dementia or Fronto-temporal dementia, concluding that “developing frontal circuitry to support the process of reasoning is part of education and science literacy and stands at the core of a healthy democracy.” Establishing this is the responsibility of the medical and scientific community through changes in the education system and working with political officials.

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