Top 10: January 17

Copy-editor: Rob Camp


Galloway SE, Paul P, MacCannell DR, et al. Emergence of SARS-CoV-2 B.1.1.7 Lineage — United States, December 29, 2020–January 12, 2021. MMWR Morb Mortal Wkly Rep. ePub: 15 January 2021. Full-text:

B117, a more highly transmissible variant of SARS-CoV-2 has been detected in 10 US states. CDC recommends universal and increased compliance with mitigation strategies, including distancing and masking, and ramping up the vaccination campaign. The following figure shows how a more infectious virus could lead to many more deaths. Simplified, hypothetical scenario showing the number of new deaths every six days from three different virus strains, assuming each strain started from 10.000 infections. Source: Adam Kucharski, London School of Hygiene and Tropical Medicine.


Sridhar D, Gurdasani D. Herd immunity by infection is not an option. Science. 2021 Jan 15;371(6526):230-231. PubMed: Full-text:

A must-read by Devi Sridhar and Deepti Gurdasani. Do you remember ‘herd immunity in Brazil’? On 26 September 2020 we presented a medRxiv post by Buss et al. with a title suggesting that herd immunity might have been reached in Brazil’s Amazon region around Manaus. [Buss LF, Prete Jr CA, Abrahim CMM, et al. COVID-19 herd immunity in the Brazilian Amazon. medRxiv 2020, posted 21 September. Full-text:] In the meantime, the title of the paper was changed to Three-quarters attack rate of SARS-CoV-2 in the Brazilian Amazon during a largely unmitigated epidemic (13 December) and there is no herd immunity anymore in Manaus (The Guardian, 14 January).


Ranzani TO, Bastos LSL, Gelli JBM, et al. Characterisation of the first 250000 hospital admissions for COVID-19 in Brazil: a retrospective analysis of nationwide data. Lancet Respir Med 2021, published 15 January. Full-text:

In-hospital mortality among patients younger than 60 years was 31% (4204 of 13.468) in the Brazilian Northeast versus 15% (1694 of 11.196) in the South in this retrospective analysis by Fernando Bozza, Otavio Ranzani and colleagues. In their study, the authors included 232.036 patients admitted to hospital in Brazil between 16 February and 15 August 2020. In-hospital mortality was 38% (87.515 of 232.036 patients) overall, 59% (47.002 of 79.687) among patients admitted to the ICU, and 80% (36.046 of 45.205) among those who were mechanically ventilated.



Barnett BS, Carlo AD, Mezzadri A, Ruwanpura KN. The Invisible People Behind Our Masks. Ann Intern Med. 2021 Jan 12. PubMed: Full-text:

In our unprecedented efforts to rapidly secure large quantities of PPE, regulators have been inconsistent in addressing the unsettling truths about where some of it may originate. To contain the human cost of the pandemic, there is no doubt that we should maximize effective use of PPE, but Brian Barnett et al. argue that we must also ensure better work practices for those who enable us to wear it in the first place.



Lavine JS, Bjornstad ON, Antia R. Immunological characteristics govern the transition of COVID-19 to endemicity. Science. 2021 Jan 12:eabe6522. PubMed: Full-text:

In the future, SARS-CoV-2 may be no more virulent than the common cold. The question is when and what shall we do in the meantime. The authors conclusion: “Social distancing and an effective vaccine are critical for control during a virgin epidemic and the transition out of it, but once we enter the endemic phase, mass vaccination may no longer be necessary. The necessity for continual vaccination will depend on the age-dependence of the Infection Fatality Ratio (IFR). If primary infections of children are mild (CoV-1 and CoV-2), continued vaccination may not be needed as primary cases recede to mild childhood sniffles. If, on the other hand, primary infection is severe in children (as for MERS), then vaccination of children will need to be continued.”


Arce VM, Costoya JA. SARS-CoV-2 infection in K18-ACE2 transgenic mice replicates human pulmonary disease in COVID-19. Cell Mol Immunol (2021). Full-text:

Although several animal models of COVID-19 have been investigated, only a few (hamsters, ferrets, minks, cats, and non-human primates) have been found to be susceptible to the disease. Here, Victor Arce and José Costoya comment on a paper by Michael Diamond, Emma Winkler and colleagues that we presented on 29 August [Winkler ES, Bailey AL, Kafai NM, et al. SARS-CoV-2 infection of human ACE2-transgenic mice causes severe lung inflammation and impaired function. Nat Immunol. 2020 Nov;21(11):1327-1335. PubMed: Full-text:]. The authors conclude that the severity of disease observed following SARS-CoV-2 infection in K18-hACE2 mice might provide a useful model in which to investigate pulmonary disease and test antiviral countermeasures in this species.



Butler-Laporte G, Lawandi A, Schiller I, et al. Comparison of Saliva and Nasopharyngeal Swab Nucleic Acid Amplification Testing for Detection of SARS-CoV-2: A Systematic Review and Meta-analysis. JAMA Intern Med. 2021 Jan 15. PubMed: Full-text:

Saliva instead of nasopharyngeal swab – the future of SARS-CoV-2 testing? In this review and meta-analysis, Guillaume Butler-Laporte suggest that saliva diagnostic accuracy is similar to that of nasopharyngeal swab, especially in the ambulatory setting.


Bastos ML, Perlman-Arrow S, Menzies D, Campbell JR. The Sensitivity and Costs of Testing for SARS-CoV-2 Infection With Saliva Versus Nasopharyngeal Swabs : A Systematic Review and Meta-analysis. Ann Intern Med. 2021 Jan 12. PubMed: Full-text:

Same topic. Saliva sampling seemed to be a similarly sensitive and less costly alternative that might soon replace nasopharyngeal swabs for collection of clinical samples for SARS-CoV-2 testing.



Marshall M. COVID’s toll on smell and taste: what scientists do and don’t know. Nature 2021, published 14 January. Full-text:

Almost a year later, some still haven’t recovered their senses of taste and smell, and for a proportion of people who have, odors are now warped: unpleasant scents have taken the place of normally delightful ones. Nature surveys the science behind this potentially long-lasting and debilitating phenomenon.


Starekova J, Bluemke DA, Bradham WS, et al. Evaluation for Myocarditis in Competitive Student Athletes Recovering From Coronavirus Disease 2019 With Cardiac Magnetic Resonance Imaging. JAMA Cardiol. 2021 Jan 14. PubMed: Full-text:

No need for cardiac magnetic resonance imaging (MRI) to evaluate student athletes recovering from COVID-19? In a study of 145 student athletes with COVID-19 who had mild to moderate symptoms or no symptoms during acute infection, cardiac MRI findings (at a median of 15 days after a positive test result for COVID-19) were consistent with myocarditis in only 2 patients (1,4%), based on updated Lake Louise criteria.



Gordon AC, Mouncey PR, Al-Beidh F, et al. Interleukin-6 Receptor Antagonists in Critically Ill Patients with Covid-19 – Preliminary report. medRxiv 2021, posted 9 January. Full-text:

When administered within 24 hours of commencing organ support in an intensive care unit, tocilizumab or sarilumab may reduce mortality. This is the result of a not-yet-published (pre-print) paper by Anthony Gordon et al. Death rate in the control group (n = 402) was 36%, tocilizumab (n = 353) 28%, sarilumab (n = 48) 22%.



If you read Spanish, read Llaneras K, Andrino B, Grasso D. Dos milliones de muertes en el mundo. El País 2021, published 16 January. Full-text:

El año 2021 llega en mitad de una pandemia que sigue elevando su factura: la cifra oficial de muertes acaba de superar los dos millones en todo el mundo. Además, el ritmo al que crecen las víctimas, lejos de reducirse, sigue acelerándose en España, Europa y prácticamente en todas partes.


Emcke C. La lección del virus: el vínculo social importa. El País 2021, published 15 January. Full-text:

La pandemia ha hecho añicos la idea de la soberanía individual cultivada por el neoliberalismo.


Ansede M. La cantidad de virus en la saliva ayuda a predecir el futuro de los pacientes con covid. El País 2021, published 15 January. Full-text:

Un equipo liderado por la inmunóloga Akiko Iwasaki, en la Universidad de Yale (EE UU), sostiene que la saliva ayuda a predecir la evolución de la enfermedad mucho mejor que las muestras tomadas con hisopo nasofaríngeo.



If you read French, read Hecketsweiler C. Entre les vaccins et les variants du Covid-19, c’est « une course contre la montre », selon le conseil scientifique. Le Monde 2021, published 16 January. Full-text : +

Pour l’instance, qui recommande d’accélérer la campagne, « les vaccins constituent un espoir pour résoudre en grande partie la pandémie, mais pas avant l’été-automne 2021 ».


Roucaute D. « Il y a une lumière au bout du tunnel mais le tunnel est très long » : les recommandations de l’OMS pour endiguer la pandémie de Covid-19. Le Monde 2021, published 16 January. Full-text :

Le comité d’urgence de l’agence onusienne s’est réuni plus tôt que prévu, jeudi, pour faire face à la flambée épidémique du début d’année.

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Bernd Sebastian Kamps