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Hu M, Lin H, Wang J, et al. The risk of COVID-19 transmission in train passengers: an epidemiological and modelling study. Clin Infect Dis 2020, published 29 July. Full-text: https://doi.org/10.1093/cid/ciaa1057
How risky is train traveling in the COVID-19 era? To answer this question, analyze passengers in Chinese high-speed trains. Jinfeng Wang and colleagues quantified the transmission risk using data from 2,334 index patients and 72,093 close contacts who had co-travel times of 0–8 hours from 19 December 2019 through 6 March 2020. Unsurprisingly, travelers adjacent to an index patient had the highest attack rate (3.5%) and the attack rate decreased with increasing distance, but increased with increasing co-travel time. The overall attack rate of passengers with close contact with index patients was 0.32%. The author’s conclusion: during COVID outbreaks, when travelling on public transportation in confined spaces such as trains, increase seat distance and reduce passenger density.
Aleta A, Martín-Corral D, Pastore y Piontti A, et al. Modelling the impact of testing, contact tracing and household quarantine on second waves of COVID-19. Nat Hum Behav 2020. Published 5 August. Full-text: https://doi.org/10.1038/s41562-020-0931-9
Some countries are currently facing second-wave scenarios. To understand the challenges ahead, Yamir Moreno, Esteban Moro, Alessandro Vespignani and colleagues integrated anonymized and privacy-enhanced data from mobile devices and census data and built a detailed agent-based model of SARS-CoV-2 transmission in the Boston metropolitan area. They found that a period of strict social distancing followed by a robust level of testing, contact-tracing and household quarantine could keep COVID-19 within the capacity of the healthcare system while enabling the reopening of economic activities.
Corbett KS, Edwards DK, Leist SR et al. SARS-CoV-2 mRNA vaccine design enabled by prototype pathogen preparedness. Nature 2020, published 5 August. Full-text: https://doi.org/10.1038/s41586-020-2622-0
Barney Graham, Andrea Carfi and colleagues show that mRNA-1273, a vaccine currently tested in Phase 3 trials, protects mice against SARS-CoV-2 infection in the lungs and noses without evidence of immunopathology. The vaccine induced both potent neutralizing antibody responses to wild-type (D614) and D614G mutant2 SARS-CoV-2 and CD8 T cell responses. The authors are prolific – a week ago, they evaluated the same vaccine in non-human primates and published their paper in the N Engl J Med (see Corbett et al., Top 10 July 29). Read also the last paragraph of this week’s paper where Corbett et al. describe a new paradigm for rapid vaccine development.
See also a Nat Biomed Eng editorial: Fast-and-fit vaccines. Published 10 August 2020. Full-text: https://doi.org/10.1038/s41551-020-00605-9
Baum A, Copin R, Ajithdoss D, et al. REGN-COV2 antibody cocktail prevents and treats SARS-CoV-2 infection in rhesus macaques and hamsters. bioRxiv 2020, pre-published 3 August. Full-text: https://doi.org/10.1101/2020.08.02.233320
In this pre-print paper, Christos Kyratsous and colleagues report the in vivo efficacy in both rhesus macaques and golden hamsters of a cocktail of two neutralizing antibodies targeting non-overlapping epitopes on the SARS-CoV-2 spike protein. The animals were first dosed with the cocktail and challenged three days later with 1×105 PFU of virus through intranasal and intratracheal routes. The cocktail, termed ‘REGN-COV-2’, greatly reduced viral load in the lower and the upper airways; it also decreased virus induced pathological sequalae when administered prophylactically or therapeutically. The paper has not yet been peer reviewed.
Harrison C. Focus shifts to antibody cocktails for COVID-19 cytokine storm. Nat Biotechnol 2020; 38:905–908. Full-text: https://doi.org/10.1038/s41587-020-0634-9
Combining agents targeting different cytokines may one day be used in supportive care for COVID-19 patients with acute respiratory distress syndrome. Charlotte Harrison takes you on a tour around Roche’s Actemra (tocilizumab, a mAb targeting IL-6R), Russian Biocad’s Ilsira (levilimab), Bermuda-based Kiniksa Pharmaceuticals’ mavrilimumab (a human IgG4 mAb targeting GM-CSF), R-Pharm’s olokizumab, a humanized anti-IL-6 mAb, Sylvant (siltuximab), an anti-IL-6 chimeric IgG1 mAb from EUSA Pharma and BeiGene, and many more.
Kaufman HW, Chen Z, Niles J, Fesko Y. Changes in the Number of US Patients with Newly Identified Cancer Before and During the Coronavirus Disease 2019 (COVID-19) Pandemic. JAMA Netw Open 2020;3(8):e2017267. Full-text: https://doi.org/10.1001/jamanetworkopen.2020.17267
During and after lockdowns, people go into hibernation mode, but cancer does not. Now Harwey Kaufman and colleagues report a cross-sectional study about patients across the United States who received clinical laboratory testing related to any of 6 cancer types (i.e., breast, colorectal, lung, pancreatic, gastric, and esophageal). Each patient was counted once, at the first instance of a cancer-related ICD-10 code. The authors compared 258,598 patients from the baseline period (January 6, 2019, to February 29, 2020) with 20,180 patients from the COVID-19 period (March 1 to April 18, 2020). During the pandemic, the weekly number of newly identified patients fell 46.4% (from 4310 to 2310) for the 6 cancers combined, with significant declines in all cancer types, ranging from 24.7% for pancreatic cancer (from 271 to 204; p = 0.01) to 51.8% for breast cancer (from 2208 to 1064; p < 0.001). The authors anticipate that a delay in diagnosis will likely lead to presentation at more advanced stages and poorer clinical outcomes.
Matsuo T, Kobayashi D, Taki F, et al. Prevalence of Health Care Worker Burnout During the Coronavirus Disease 2019 (COVID-19) Pandemic in Japan. JAMA Netw Open 2020; 3(8):e2017271. Full-text: https://doi.org/10.1001/jamanetworkopen.2020.17271
How prevalent is burnout among frontline health care workers (HCWs) during the COVID-19 pandemic? Takahiro Matsuo and colleagues conducted an online cross-sectional survey among HCWs at a tertiary hospital in Tokyo which had among the highest numbers of patients with COVID-19 in Japan. Among the final sample of 312 HCW’s, the burnout prevalence was 31.4% (98 of 312). Nurses: 59/126 (46.8%); radiological technologists: 8/22 (36.4%); pharmacists: 7/19 (36.8%). Find more details (i.e., burnout was more prevalent in participants with fewer years of experience) in the paper.
Leonhardt D. The Unique U.S. Failure to Control the Virus. The New York Times 2020, published 6 August. Article: https://www.nytimes.com/2020/08/06/us/united-states-failure-coronavirus.html | Graphics: Lauren Leatherby
One country stands alone, as the only affluent nation to have suffered a severe, sustained outbreak for more than four months: the United States.
Rubin EJ, Baden LR, Morrissey S. The Impact of Covid-19 on Patients with Other Diseases, with Arnold Epstein. N Engl J Med 2020; 383:e62. Access: https://www.nejm.org/doi/full/10.1056/NEJMe2027046
Audio interview (22:08) with Arnold Epstein who talks about the collateral impact of COVID-19 on the care of patients with other diseases and on the U.S. health care system itself.
Scudellari M. How the pandemic might play out in 2021 and beyond. Nature 2020, published 5 August. Full-text: https://www.nature.com/articles/d41586-020-02278-5
In this Nature news feature, Megan Scudellari reports what scientists predict for the next months and years.
Beyond plate borders
Gibb R, Redding DW, Chin KQ et al. Zoonotic host diversity increases in human-dominated ecosystems. Nature 2020, published 5 August. Full-text: https://doi.org/10.1038/s41586-020-2562-8
Are changes in the way and intensity we use land creating hazardous interfaces between people, livestock and wildlife reservoirs of zoonotic disease? Kate Jones and colleagues provide important evidence for this claim. They analyzed 6,801 ecological assemblages and 376 host species worldwide and found that wildlife hosts of human-shared pathogens and parasites comprised a greater proportion of local species richness (18–72% higher) and total abundance (21–144% higher) in places dominated by humans (secondary, agricultural and urban ecosystems) compared with nearby undisturbed habitats.
Read also the discussion by Richard S. Ostfeld and Felicia Keesing: Species that can make us ill thrive in human habitats. Does the conversion of natural habitats to human use favour animals that harbour agents causing human disease? Nature 2020, published 5 August. Full-text: https://www.nature.com/articles/d41586-020-02189-5