25 April, 2022

The pathways and conditions of effectively combating the COVID-19 pandemic in Asia -

The rapid outbreak of COVID-19 pandemic urges to seek advanced solutions to combat the disease and minimize its impacts on humankind and society. We employ a causal mechanism approach and develop a crisp-set Qualitative Comparative Analysis (QCA) model to study successful pathways in curbing COVID-19 among 37 Asian countries. Structural variables of GDP per capita, governance, democracy, health access and quality alongside with two government response indexes from the real-time Oxford COVID-19 Government Response Tracker are included as causal conditions in our QCA model. We identified a total of seven successful pathways, covering countries in different development stages. Regardless of income levels, we found democracy is essential in effectively controlling the pandemic. High democratic scores are characterized in five over seven pathways. Extensive testing and comprehensive contact tracing strategies have proved to be effective in containing COVID-19, especially in developed and emerging countries. Surprisingly, we found limited impacts of stringent containment measures such as gathering restricted and social distancing. We traced back to the early days of COVID-19, and by performing hierarchical agglomerative cluster analysis, we learned that restrictive containment measures in the early days helped prevent the spread of the pandemic, especially in developing countries. In the context that democracy is in decline around the world, our empirical results suggest that democracy is still essential in controlling the disease. Also, countries in under-resourced settings can still effectively combat COVID-19 with appropriate and timely containment measures.

🖺 Full Text HTML: The pathways and conditions of effectively combating the COVID-19 pandemic in Asia

Immune and pathophysiologic profiling of antenatal COVID-19 in the GIFT cohort: A Singaporean case-control study. -

Background COVID-19 has been a major public health threat for the past two years, with disproportionate effects on the elderly, immunocompromised, and pregnant women. While much has been done in delineating immune dysfunctions and pathogenesis in the former two groups, less is known about the disease9s progression in expectant women and children born to them. To address this knowledge gap, we profiled the immune responses in maternal and child sera as well as breast milk in terms of antibody and cytokine expression and performed histopathological studies on placentae obtained from mothers convalescent from antenatal COVID-19. Methods and findings A total of 17 mother-child dyads (8 cases of antenatal COVID-19 and 9 healthy unrelated controls; 34 individuals in total) were recruited to the Gestational Immunity For Transfer (GIFT) study. Maternal and infant sera, and breast milk samples were collected over the first year of life. All samples were analyzed for IgG and IgA against whole SARS-CoV-2 spike protein, the spike receptor-binding domain (RBD), and previously reported immunodominant epitopes, with conventional ELISA approaches. Cytokine levels were quantified in maternal sera using multiplex microbead-based Luminex arrays. The placentae were examined microscopically. We found high levels of virus-specific IgG in convalescent mothers and similarly elevated titers in newborn children. Virus-specific IgG in infant circulation waned within 3-6 months of life. Virus-specific IgA levels were variable among convalescent individuals9 sera and breast milk. Convalescent mothers also showed a blood cytokine signature indicative of a persistent pro-inflammatory state. Four placentae presented signs of acute inflammation marked by neutrophil infiltration even though >50 days had elapsed between virus clearance and delivery. Administration of a single dose of BNT162b2 mRNA vaccine to mothers convalescent from antenatal COVID-19 increased virus-specific IgG and IgA titers in breast milk. Conclusions Antenatal SARS-CoV-2 infection led to high plasma titres of virus-specific antibodies in infants postnatally. However, this was not reflected in milk; milk-borne antibody levels varied widely. Additionally, placentae from COVID-19 positive mothers exhibited signs of acute inflammation with neutrophilic involvement, particularly in the subchorionic region. Virus neutralisation by plasma was not uniformly achieved, and the presence of antibodies targeting known immunodominant epitopes did not assure neutralisation. Antibody transfer ratios and the decay of transplacentally transferred virus-specific antibodies in neonatal circulation resembled that for other pathogens. Convalescent mothers showed signs of chronic inflammation marked by persistently elevated IL17RA levels in their blood. A single dose of the Pfizer BNT162b2 mRNA vaccine provided significant boosts to milk-borne virus-specific antibodies, highlighting the importance of receiving the vaccine even after natural infection with the added benefit of enhanced passive immunity. The study is registered at clinicaltrials.gov under the identifier NCT04802278.

🖺 Full Text HTML: Immune and pathophysiologic profiling of antenatal COVID-19 in the GIFT cohort: A Singaporean case-control study.

Transcriptome and DNA methylome analysis of peripheral blood samples reveals incomplete restoration and transposable element activation after 3-month recovery of COVID-19 -

Comprehensive analyses showed that SARS-CoV-2 infection caused COVID-19 and induced strong immune responses and sometimes severe illnesses. However, cellular features of recovered patients and long-term health consequences remain largely unexplored. In this study, we collected peripheral blood samples from recovered COVID-19 patients (average age of 35.7 years old) from Hubei province, China, 3 months after discharge; and carried out RNA-seq and whole-genome bisulfite sequencing (WGBS) to identify hallmarks of recovered COVID-19 patients. Our analyses showed significant changes both in expression and DNA methylation of genes and transposable elements (TEs) in recovered COVID-19 patients. We identified 639 misregulated genes and 18516 differentially methylated regions (DMRs) in total. Genes with aberrant expression and DMRs were found to be associated with immune responses and other related biological processes, implicating prolonged overreaction of the immune system in response to SARS-CoV-2 infection. Notably, a significant amount of TEs were aberrantly activated and TE activation was positively correlated with COVID-19 severity. Moreover, differentially methylated TEs may regulate adjacent gene expression as regulatory elements. Those identified transcriptomic and epigenomic signatures define and drive the features of recovered COVID-19 patients, helping determine the risks of long COVID-19, and providing guidance for clinical intervention.

🖺 Full Text HTML: Transcriptome and DNA methylome analysis of peripheral blood samples reveals incomplete restoration and transposable element activation after 3-month recovery of COVID-19

Parenting During COVID-19: A Sentiment and Topic Modeling Analysis of Reddit Data -

The coronavirus disease 2019 (COVID-19) pandemic has caused significant disruption in the lives of individuals across the globe. Especially during the early parts of the pandemic, parents took on increased caregiving responsibilities with little to no guidance from health organizations. Much of the research that has examined parenting during COVID-19 has stemmed from survey data. However, self-presentation biases may prevent survey researchers from obtaining authentic and accurate experiences from parents. Therefore, this study examined parents’ sentiment and emotional wellbeing during COVID-19 using Reddit data—specifically, posts from the Mommit and Daddit subreddits. Posts were scraped from December 2010 to December 2021. Sentiment analysis results suggest that Mommit posts express markedly more negative sentiment. However, since the onset of the pandemic in the United States, the average sentiment for both subreddits declined steadily at similar rates. Unsupervised topic modeling paired with qualitative analysis indicated that, in Mommit, sentiment changes may have been driven by increased expression of emotional distress around the role of motherhood, exhaustion with caregiving duties, and strained familial relationships. In Daddit, analyses suggested increased involvement in daily caregiving activities, concerns about bonding with children, and expressions of feelings relating to anxiety and depression. Notably, both subreddits show signs that parental stresses have continued to worsen since the onset of the pandemic. Future research should continue to monitor the emotional wellbeing of parents as the COVID-19 pandemic continues.

🖺 Full Text HTML: Parenting During COVID-19: A Sentiment and Topic Modeling Analysis of Reddit Data

Estimating the distribution of COVID-19-susceptible, -recovered, and -vaccinated individuals in Germany up to April 2022 -

After having affected the population for two years, the COVID-19 pandemic has reached a phase where a considerable number of people in Germany have been either infected with a SARS-CoV-2 variant, vaccinated, or both. Yet the full extent to which the population has been in contact with either virus or vaccine remains elusive, particularly on a regional level, because (a) infection counts suffer from under-reporting, and (b) the overlap between the vaccinated and recovered subpopulations is unknown. Since previous infection, vaccination, or especially a combination of both reduce the risk of severe disease, a high share of individuals with SARS-CoV-2 immunity lowers the probability of severe outbreaks that could potentially overburden the public health system once again, given that emerging variants do not escape this reduction in susceptibility. Here, we estimate the share of immunologically naive individuals by age group for each of the 16 German federal states by integrating an infectious disease model based on weekly incidences of SARS-CoV-2 infections in the national surveillance system and vaccine uptake, as well as assumptions regarding under- ascertainment. We estimate a median share of 7.0% of individuals in the German population have neither been in contact with vaccine nor any variant as of March 31, 2022 (quartile range [3.6%-9.8%]). For the adult population at higher risk of severe disease, this figure is reduced to 3.5% [1.3%-5.5%] for ages 18-59 and 4.3% [2.7%-5.8%] for ages 60 and above. However, estimates vary between German states mostly due to heterogeneous vaccine uptake. Excluding Omicron infections from the analysis, 16.1% [14.0%-17.8%] of the population in Germany, across all ages, are estimated to be immunologically naive, highlighting the large impact the Omicron wave had until the beginning of spring in 2022.

🖺 Full Text HTML: Estimating the distribution of COVID-19-susceptible, -recovered, and -vaccinated individuals in Germany up to April 2022

Financial stressors and subsequent health and wellbeing of individuals experiencing economic hardship during the COVID-19 pandemic: A qualitative interview study -

Aims There are concerns that the economic impacts of the COVID-19 pandemic, including employment inactivity and job loss, will have consequences for the population’s wellbeing. However, there is limited qualitative research into how financial hardship contributes to poor health outcomes in this context. This study aimed to explore factors affecting financial hardship and subsequent impacts for wellbeing during the pandemic. Methods Qualitative semi-structured interviews with 20 people experiencing financial hardship and six service providers employed in social welfare support services. Data were analysed using reflexive thematic analysis. Results Three main sources of financial stress were identified by participants: reductions in household incomes, increased living costs, and increased financial borrowing, which engendered emotional and physical burdens. Conclusion Our findings underline the importance of measures attending to the immediate needs of individuals, including accessible, co-located financial and psychological services, as well as broader measures that seek to reduce social and economic inequalities.

🖺 Full Text HTML: Financial stressors and subsequent health and wellbeing of individuals experiencing economic hardship during the COVID-19 pandemic: A qualitative interview study

The impact of labour market shocks on mental health: evidence from the COVID-19 first wave -

In this study, we estimate the effect of a negative labour market shock on individuals’ levels of stress, anxiety, and depression. We use a dataset collected during the first wave of the COVID-19 pandemic, on a representative sample of citizens from Italy, Spain, and the United Kingdom, interviewed on three occasions. We measure stress, anxiety and depression and labour shocks using validated scales. Our research design is a standard differences-in-differences model: we leverage the differential timing of shocks to identify the impact on mental health. In our estimations, a negative labour shock increases the measure of stress, anxiety, and depression by 16% of a standard deviation computed from the baseline.

🖺 Full Text HTML: The impact of labour market shocks on mental health: evidence from the COVID-19 first wave

Prosocial motivation for vaccination -

Vaccination has both private and public benefits. We ask whether social preferences—concerns for the well-being of other people—influence one’s decision regarding vaccination. We measure these social preferences for 549 online subjects: We give each subject $4 to play a public-good game and make contributions to public welfare. To the extent that one gets vaccinated out of concern for the health of others, contribution in this game is analogous to an individual’s decision to obtain vaccination. We collect COVID-19 vaccination history separately to avoid experimenter- demand effects. We find a strong result: Contribution in the public-good game is associated with greater demand to voluntarily receive a first dose, and thus also to vaccinate earlier. Compared to a subject who contributes nothing, one who contributes the maximum ($4) is 48% more likely to obtain a first dose voluntarily in the four-month period that we study (April through August 2021). People who are more pro-social are indeed more likely to take a voluntary COVID-19 vaccination.

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Spotlighted but with gender bias: Underrepresentation and paradoxical representation of frontline women health workers in Chinese social media during COVID-19 -

Despite that women constitute the major force in the frontline health sector during COVID-19, representation and biased representation of women health workers still prevail. This study applied Latent Dirichlet Allocation (LDA) topic modeling on Weibo posts (N = 199,110) containing the keyword, “援鄂医疗队” (i.e., “aiding-Hubei medical team” where Hubei is the province that Wuhan is in). Posts were published during the first stage of COVID-19 (January 22, 2020 to June 30, 2020). Results revealed that frontline health workers were spotlighted on Weibo as serving the “nation,” saving the “patients,” and fulfilling family roles, indicating a home-country-isomorphism ideology. According to the 13 topics found in this online corpus, posts discussing health workers in a genderless collective lens tended to emphasize their professional roles; but when the woman identity of health workers became evident, posts tended to emphasize their family roles. Moreover, we observed the militarization of language that reinforced patriarchal masculinity. Corporates’ and male celebrities’ wave-riding and hashtag-jumping/hijacking – with posts celebrating their charitable activities toward COVID-19 medical teams – further deprived women health workers of their voices and visibility. Social bots, notably, participated in this message propagation process. Implications of findings are discussed.

🖺 Full Text HTML: Spotlighted but with gender bias: Underrepresentation and paradoxical representation of frontline women health workers in Chinese social media during COVID-19

Association between household composition and severe COVID-19 outcomes in older people by ethnicity: an observational cohort study using the OpenSAFELY platform -

Background Ethnic differences in the risk of severe COVID-19 may be linked to household composition. We quantified the association between household composition and risk of severe COVID-19 by ethnicity for older individuals. Methods With the approval of NHS England, we analysed ethnic differences in the association between household composition and severe COVID-19 in people aged 67 or over in England. We defined households by number of generations living together, and used multivariable Cox regression stratified by location and wave of the pandemic and accounted for age, sex, comorbidities, smoking, obesity, housing density and deprivation. We included 2 692 223 people over 67 years in wave 1 (01/02/2020-31/08/2020) and 2 731 427 in wave 2 (01/09/2020-31/01/2021). Findings Multigenerational living was associated with increased risk of severe COVID-19 for White and South Asian older people in both waves (e.g. wave 2, 67+ living with 3 other generations vs 67+ year olds only: White HR 1.61 95% CI 1.38-1.87, South Asian HR 1.76 95% CI 1.48-2.10), with a trend for increased risks of severe COVID-19 with increasing generations in wave 2. Interpretation Multigenerational living was associated with severe COVID-19 in older adults. Older South Asian people are over-represented within multigenerational households in England, especially in the most deprived settings. The number of generations in a household, number of occupants, ethnicity and deprivation status are important considerations in the continued roll-out of COVID-19 vaccination and targeting of interventions for future pandemics. Funding This research was funded in part, by the Wellcome Trust. For the purpose of open access, the author has applied a CC-BY public copyright licence to any Author Accepted Manuscript version arising from this submission.

🖺 Full Text HTML: Association between household composition and severe COVID-19 outcomes in older people by ethnicity: an observational cohort study using the OpenSAFELY platform

Snotwatch COVID-Toes: An ecological study of chilblains and COVID-19 diagnoses in Victoria, Australia -

Background The COVID-19 pandemic has caused widespread illness with varying clinical manifestations. One less- commonly-reported presentation of COVID-19 infection is chilblain-like lesions. Aims We conducted an ecological analysis of chilblain presentations in comparison with confirmed and suspected COVID-19 infections in a primary care setting to establish that a relationship exists between the two. Study Design Our study collated data from three Primary Health Networks across Victoria, Australia, from 2017-2021, to understand patterns of chilblain presentations prior to and throughout the pandemic. Using a zero-inflated negative binomial regression analysis, we estimated the relationship between local minimum temperature, COVID-19 infections and the frequency of chilblain presentations. Results We found a 5.72 risk ratio of chilblain incidence in relation to COVID-19 infections and a 3.23 risk ratio associated with suspected COVID-19 infections. COVID-19 infections were also more strongly associated with chilblain presentations in 0-16-year-olds throughout the pandemic in Victoria. Conclusion Our study statistically demonstrates that chilblains are significantly associated with COVID-19 infections in a primary care setting. This has major implications for clinicians aiming to diagnose COVID-19 infections or determine the cause of a presentation of chilblains. Additionally, we demonstrate the utility of large-scale primary care data and its potential application to monitoring the spread of COVID-19 infections across the state, supporting current epidemiological efforts for COVID-19 tracking.

🖺 Full Text HTML: Snotwatch COVID-Toes: An ecological study of chilblains and COVID-19 diagnoses in Victoria, Australia

Prosocial motivation for vaccination -

Vaccination has both private and public benefits. We ask whether social preferences—concerns for the well-being of other people—influence one9s decision regarding vaccination. We measure these social preferences for 549 online subjects: We give each subject $4 to play a public-good game and make contributions to public welfare. To the extent that one gets vaccinated out of concern for the health of others, contribution in this game is analogous to an individual9s decision to obtain vaccination. We collect COVID-19 vaccination history separately to avoid experimenter- demand effects. We find a strong result: Contribution in the public-good game is associated with greater demand to voluntarily receive a first dose, and thus also to vaccinate earlier. Compared to a subject who contributes nothing, one who contributes the maximum ($4) is 48% more likely to obtain a first dose voluntarily in the four-month period that we study (April through August 2021). People who are more pro-social are indeed more likely to take a voluntary COVID-19 vaccination.

🖺 Full Text HTML: Prosocial motivation for vaccination

Regional replacement of SARS-CoV-2 variant BA.1 with BA.2 as observed through wastewater surveillance -

An understanding of circulating SARS-CoV-2 variants can inform pandemic response, vaccine development, disease epidemiology, and use of monoclonal antibody treatments. We developed custom assays targeting characteristic mutations in SARS-CoV-2 variants Omicron BA.1 and BA.2 and confirmed their sensitivity and specificity in silico and in vitro. We then applied these assays to daily wastewater solids samples from eight publicly owned treatment works in the greater Bay Area of California, USA, over four months to obtain a spatially and temporally intensive data set. We documented regional replacement of BA.1 with BA.2 in agreement with, and ahead of, clinical sequencing data. This study highlights the utility of wastewater surveillance for real time tracking of SARS-CoV-2 variant circulation.

🖺 Full Text HTML: Regional replacement of SARS-CoV-2 variant BA.1 with BA.2 as observed through wastewater surveillance

Epidemiological investigation of the COVID-19 outbreak in Vellore district in South India using Geographic Information Surveillance (GIS) -

Objectives: Geographical Information Surveillance (GIS) is an advanced digital technology tool that maps location-based data and helps in epidemiological modeling. We applied GIS to analyze patterns of spread and hotspots of COVID-19 cases in Vellore district in South India. Methods: Laboratory-confirmed COVID-19 cases from the Vellore district and neighboring taluks from March 2020 to June 2021 were geo-coded and spatial maps were generated. Time trends exploring urban-rural burden with an age-sex distribution of cases and other variables were correlated with outcomes. Results: A total of 45,401 cases of COVID-19 were detected with 20730 cases during the first wave and 24671 cases during the second wave. The overall incidence rates of COVID-19 were 462.8 and 588.6 per 100,000 populations during the first and second waves respectively. The pattern of spread revealed epicenters in densely populated urban areas with radial spread sparing rural areas in the first wave. The case fatality rate was 1.89% and 1.6% during the first and second waves that increased with advancing age. Conclusions: Modern surveillance systems like GIS can accurately predict the trends and pattern of spread during future pandemics. A real-time mapping can help design risk mitigation strategies thereby preventing the spread to rural areas.

🖺 Full Text HTML: Epidemiological investigation of the COVID-19 outbreak in Vellore district in South India using Geographic Information Surveillance (GIS)

SARS-CoV-2 testing of aircraft wastewater shows that mandatory tests and vaccination pass before boarding did not prevent massive importation of Omicron variant in Europe -

Background : Most new SARS-CoV-2 epidemics in France occurred following importation from abroad of emerging viral variants. Currently, the control of such risk of new variant importation is based on the negativity of a screening test (PCR or antigenic) and on an up-to-date vaccine status, such as International Air Transport Association travel pass. Methods: Wastewater of 2 planes arriving in Marseille (France) from Addis-Ababa (Ethiopia) on December 2021 were

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