Researchers at the University of Washington have developed a new COVID-19 test that has the speed of over-the-counter antigen tests and the accuracy of medical-grade PCR tests.
Image credits Nuttada Panpradist et al., (2022), Science Advances.
Dubbed the ‘Harmony’ test, this diagnostic tool looks for the genetic material of the SARS-CoV-2 virus in test samples. However, unlike PCR tests, which can take several hours to produce a result, the Harmony kit can provide a diagnosis in under 20 minutes with high accuracy.
The test was designed to be low-cost and straightforward to use, according to the authors, in a bid to help everyone, from doctors to the public, to better detect and track coronavirus infections.
New tools
“We designed the test to be low-cost and simple enough that it could be used anywhere,” said Barry Lutz, a UW associate professor of bioengineering, an investigator with the Brotman Baty Institute for Precision Medicine, and senior author of the paper. “We hope that the low cost will make high-performance testing more accessible locally and around the world.”
The Harmony test uses a “PCR-like” approach to detecting the virus — samples are obtained using a nasal swab and processed with ready-to-use reagents using a series of simple steps. The kit is meant to be used with a low-cost detector that can be operated using a smartphone, which provides the results. Each detector can handle up to four samples at a time.
The team explains that one of their main reasons for designing this test kit was the need for affordable and easy-to-use COVID-19 tests that provide reliable accuracy. Many at-home antigen kits available today test for pieces of the virus, not traces of its genetic material, and are only about 80-85% accurate and may be less accurate with the Omicron strain. PCR (polymerase chain reaction) tests are much better — providing around 95% accuracy — but are slow and cannot be carried out at home, as they require specialized devices and training to process. The Harmony kit is meant to combine the strengths of both of these types of tests.
Preliminary results show that Harmony is 97% accurate for nasal swabs. The test detects three different regions of the virus’ genome to help keep it effective against new strains: if a new variant of the virus develops many mutations in one region, the test can still detect the other two. The Harmony kit can detect the Omicron strain.
The step that makes PCR tests so time- and technology-intensive is a series of a few dozen heating and cooling cycles. Temperatures need to be very accurately controlled during these cycles to maintain the integrity of the sample. The Harmony test uses a similar method, known as RT-LAMP (reverse transcription loop-mediated isothermal amplification), with the key difference being that this doesn’t require the same temperature cycling.
“This test operates at a constant temperature, so it eliminates the time to heat and cool and gives results in about 30 minutes,” said Lutz.
Together with two of his colleagues, Lutz set up a new company for the UW — Anavasi Diagnostics — which will take the Harmony kit from an experimental device to a commercially-available product. The team believes that the kit will first be available for clinics and other medical institutions, then in settings where monitoring for infections is required, such as workplaces or schools. After these needs are met, they will adapt the test for home use.
“For a long time, the options have been either a PCR test that is expensive and typically takes a day or more to get a result, or a rapid antigen test that gives fast results and is low cost, but typically has lower accuracy than a lab PCR test,” said Lutz. “From the first day, we designed our test to be manufacturable at low cost and high volume, while delivering fast results with PCR-like performance.”
“We plan to make our test accessible and affordable throughout the world,” he adds.
The paper “Harmony COVID-19: A ready-to-use kit, low-cost detector, and smartphone app for point-of-care SARS-CoV-2 RNA detection” has been published in the journal Science Advances.
In the two years that SARS‑CoV‑2 has ravaged across the globe, it has caused immeasurable human loss. But we as a species have been able to create monumental solutions amidst great adversity. The latest achievement involves a standard face mask that can detect COVID-19 in your breath, essentially making the pathogen visible.
A COVID-19 sample becomes apparent on a mask filter under ultraviolet light. Image credits: Kyoto Prefectural University.
Japanese researchers at Kyoto Prefectural University have created a mask that glows in the dark if COVID-19 is detected in a person’s breath or spit. They did this by coating masks with a mixture containing ostrich antibodies that react when they contact the SARS‑CoV‑2 virus. The filters are then removed from the masks and sprayed with a chemical that makes COVID-19 (if present) viewable using a smartphone or a dark light. The experts hope that their discovery could provide a low-cost home test to detect the virus.
Yasuhiro Tsukamoto, veterinary professor and president of Kyoto Prefectural University, explains the benefits of such a technology: “It’s a much faster and direct form of initial testing than getting a PCR test.”
Tsukamoto notes that it could help those infected with the virus but who show no symptoms and are unlikely to get tested — and with a patent application and plans to commercialize inspection kits and sell them in Japan and overseas within the next year, the test appears to have a bright future. However, this all hinges on large-scale testing of the mask filters and government approval for mass production.
Remarkably, this all came with a little help from ostriches.
The ostrich immune system is one of the most potent on Earth
To make each mask, the scientists injected inactive SARS‑CoV‑2 into female ostriches, in effect vaccinating them. Scientists then extracted antibodies from the eggs the ostriches produced, as the yolk transfers immunity to the offspring – the same way a vaccinated mother conveys disease resistance to her infant through the placenta.
An ostrich egg yolk is perfect for this job as it is nearly 24 times bigger than a chicken’s, allowing a more significant number of antibodies to form. Additionally, immune cells are also produced far more quickly in these birds—taking a mere six weeks, as opposed to chickens, where it takes twelve.
Because ostriches have an extremely efficient immune system, thought to be the strongest of any animal on the planet, they can rapidly produce antibodies to fight an enormous range of bacteria and viruses, with a 2012 study in theBrazilian Journal of Microbiology showing they could stop Staphylococcus aureus and E. coli in their tracks – experts also predict that this bird will be instrumental in fending off epidemics in the future.
Tsukamoto himself has published numerous studies using ostrich immune cells harvested from eggs to help treat a host of health conditions, from swine flu to hair loss.
Your smartphone can image COVID-19 with this simple test
The researchers started by creating a mask filter coated with a solution of the antibodies extracted from ostriches’ eggs that react with the COVID-19 spike protein. After they had a working material, a small consort of 32 volunteers wore the masks for eight hours before the team removed the filters and sprayed them with a chemical that caused COVID-19 to glow in the dark. Scientists repeated this for ten days. Masks worn by participants infected with the virus glowed around the nose and mouth when scientists shone a dark light on them.
In a promising turn, the researchers found they could also use a smartphone LED light to detect the virus, which would considerably widen the scope of testing across the globe due to its ease of use. Essentially, it means that the material could be used to the fullest in a day-to-day setting without any additional equipment.
“We also succeeded in visualizing the virus antigen on the ostrich antibody-carrying filter when using the LED ultraviolet black light and the LED light of the smartphone as the light source. This makes it easy to use on the mask even at home.”
To further illustrate the practicability of the test, Tsukamoto told the Kyodo news agency he discovered he was infected with the virus after he wore one of the diagnostic masks. The diagnosis was also confirmed using a laboratory test, after which authorities quarantined him at a hotel.
Next, the team aims to expand the trial to 150 participants and develop the masks to glow automatically without special lighting. Dr. Tsukamoto concludes: “We can mass-produce antibodies from ostriches at a low cost. In the future, I want to make this into an easy testing kit that anyone can use.”
If one in 10 cold infections are from coronaviruses, then antibodies produced from these illnesses could surely give a bit more protection against COVID-19, right? A new study has just provided the answer to this question by showing that immunity induced by colds can indeed help fight off the far more dangerous novel coronavirus.
Image credits: Engin Akyurt.
A study from Imperial College London that studied people exposed to SARS-CoV-2 or COVID-19 found that only half of the participants were infected, while the others tested negative. Before this, researchers took blood samples from all volunteers within days of exposure to determine the levels of an immune cell known as a T cell – cells programmed by previous infections to attack specific invaders.
Results show that participants who didn’t test positive had significantly higher levels of these cells; in other words, those who evaded infection had higher levels of T cells that attack the Covid virus internally to provide immunity — T cells that may have come from previous coronavirus infections (not SARS-CoV-2). These findings, published in the journal Nature Communications, may pave the way for a new type of vaccine to prevent infection from emerging variants, including Omicron.
Dr. Rhia Kundu, the first author of the paper from Imperial’s National Heart & Lung Institute, says: “Being exposed to the SARS-CoV-2 virus doesn’t always result in infection, and we’ve been keen to understand why. We found that high levels of pre-existing T cells, created by the body when infected with other human coronaviruses like the common cold, can protect against COVID-19 infection.” Despite this promising data, she warns: “While this is an important discovery, it is only one form of protection, and I would stress that no one should rely on this alone. Instead, the best way to protect yourself against COVID-19 is to be fully vaccinated, including getting your booster dose.”
The common cold’s role in protecting you against Covid
The study followed 52 unvaccinated people living with someone who had a laboratory-confirmed case of COVID-19. Participants were tested seven days after being exposed to see if they had caught the disease from their housemates and to analyze their levels of pre-existing T cells. Tests indicated that the 26 people who tested negative for COVID-19 had significantly higher common cold T cells levels than the remainder of the people who tested positive. Remarkably, these cells targeted internal proteins within the SARS-CoV-2 virus, rather than the spike protein on its surface, providing ‘cross-reactive’ immunity between a cold and COVID-19.
Professor Ajit Lalvani, senior author of the study and Director of the NIHR Respiratory Infections Health Protection Research Unit at Imperial, explained:
“Our study provides the clearest evidence to date that T cells induced by common cold coronaviruses play a protective role against SARS-CoV-2 infection. These T cells provide protection by attacking proteins within the virus, rather than the spike protein on its surface.”
However, experts not involved in the study caution against presuming anyone who has previously had a cold caused by a coronavirus will not catch the novel coronavirus. They add that although the study provides valuable data regarding how the immune system fights this virus, it’s unlikely this type of illness has never infected any of the 150,000 people who’ve died of SARS-CoV-2 in the UK to date.
Other studies uncovering a similar link have also warned cross-reactive protection gained from colds only lasts a short period.
The road to longer-lasting vaccines
Current SARS-CoV-2 vaccines work by recognizing the spike protein on the virus’s outer shell: this, in turn, causes an immune reaction that stops it from attaching to cells and infecting them. However, this response wanes over time as the virus continues to mutate. Luckily, the jabs also trigger T cell immunity which lasts much longer, preventing the infection from worsening or hospitalization and death. But this immunity is also based on blocking the spike protein – therefore, it would be advantageous to have a vaccine that could attack other parts of the COVID virus.
Professor Lalvani surmises, “The spike protein is under intense immune pressure from vaccine-induced antibodies which drives the evolution of vaccine escape mutants. In contrast, the internal proteins targeted by the protective T cells we identified mutate much less. Consequently, they are highly conserved between the SARS-CoV-2 variants, including Omicron.” He ends, “New vaccines that include these conserved, internal proteins would therefore induce broadly protective T cell responses that should protect against current and future SARS-CoV-2 variants.”
As if getting sick with COVID-19 wasn’t bad enough, some people are unfortunate enough to experience debilitating symptoms weeks or even months after their so-called recovery. These effects that continue for a long time beyond the initial illness are known under the umbrella term of long COVID, and scientists have only just begun to truly understand what causes it. According to a new study from South Africa, long COVID is linked to persistent microclots that trap inflammatory molecules.
The WHO estimates that anywhere between 10% and 20% of COVID-19 patients will experience lingering symptoms for a month or longer following infection. These prolonged symptoms include persistent fever, brain fog, shortness of breath, muscle and joint pain, sleeping difficulties, and depression. It’s no coincidence that these are also some of the typical symptoms of patients recently infected with the coronavirus. But if the symptoms last for at least two months after the onset of the disease, then the patient officially suffers from long COVID, according to the latest WHO definition.
What’s particularly damning about long COVID is that the symptoms come in waves, ebbing and flowing. Just when you thought you were finally fully recovered, a new wave of relapse hits you in the head like a brick.
“A very common feature is the relapsing, remitting nature of the illness, where you feel as though you’ve recovered, then it hits you back,” said Nisreen Alwan, associate professor in public health at the University of Southampton, during a panel discussion hosted by the British Medical Journal.
“It’s a constant cycle of disappointment, not just to you but people around you, who really want you to recover,” she added, reflecting on her own battle with long Covid.
For the time being, there are no proven remedy or rehabilitation guidelines for those with long COVID, who have to brave the ordeal, with debilitating consequences in people’s daily functioning and their capacity to work productively. It’s then no wonder that the prestigious medical journal The Lancet has described long COVID as “a modern medical challenge of the first order.”
But by understanding what causes long COVID, scientists may finally have a target for new therapies meant to banish COVID for good after the virus is flushed from the body.
In a recent op-ed published this week in The Guardian, Resia Pretorius, the head of the science department at Stellenbosch University in South Africa, claims that her research has identified persistent microclots in long COVID patients. These microclots are resistant to fibrinolysis, the process by which healthy people break down blood clots. Clot formation is perfectly normal and healthy, for instance when you cut yourself, but when they persist this can be a bad sign.
These microclots house high levels of inflammatory molecules that may not only prevent the breakdown of the clots themselves but also cause long COVID by starving cells of the precious oxygen they need to sustain regular bodily functions.
“The presence of persistent microclots and hyperactivated platelets (also involved in clotting) perpetuates coagulation and vascular pathology, resulting in cells not getting enough oxygen in the tissues to sustain bodily functions (known as cellular hypoxia). Widespread hypoxia may be central to the numerous reported debilitating symptoms,” Pretorius wrote.
Since the inflammatory molecules are trapped inside the fibrinolytic-resistant microclots, they are not detected by traditional lab tests, leaving both doctor and patient confused. With no obvious pathology to account for their symptoms, some patients are told that their problems are psychological and they should try to meditate and exercise. But these new findings tell us that we should know better.
The South African scientist adds that antiplatelet and anticoagulation medication may be key in treating long COVID cases, although great caution needs to be exercised in order to avoid any dangers caused by bleeding. Additionally, Help (heparin-induced, extracorporal, lipoprotein/fibrinogen, precipitation) apheresis – in which microclots and inflammatory molecules are filtered out in a dialysis-style treatment – may also have positive outcomes for patients, Pretorius added.
“Even those without long Covid could benefit from such research, as symptoms noted in long Covid patients show many similarities to those seen in chronic and viral-related illnesses including myalgic encephalomyelitis/chronic fatigue syndrome (ME/CFS) – another disease that has been dismissed as “psychological” for decades. Just because we have not yet identified a biomarker for long Covid does not mean biomarkers do not exist. We just need to look harder,” she said.
Scientists have identified a previously unknown mutant strain in a fully vaccinated person who tested positive after returning from a short three-day trip to Cameroon.
Academics based at the IHU Mediterranee Infection in Marseille, France, discovered the new variant on December 10. So far, the variant doesn’t appear to be spreading rapidly and the World Health Organization has not yet labeled it a variant of concern. Nevertheless, researchers are still describing and keeping an eye on it.
The discovery of the B.1.640.2 mutation, dubbed IHU, was announced in the preprint server medRxiv, in a paper still awaiting peer review. Results show that IHU’s spike protein, the part of the virus responsible for invading host cells, carries the E484K mutation, which increases vaccine resistance. The genomic sequencing also revealed the N501Y mutation — first seen in the Alpha variant — that experts believe can make COVID-19 more transmissible.
In the paper, the clinicians highlight that it’s important to keep our guard and expect more surprises from the virus: “These observations show once again the unpredictability of the emergence of new SARS-CoV-2 variants and their introduction from abroad,” they write. For comparison Omicron (B.1.1.529) carries around 50 mutations and appears to be better at infecting people who already have a level of immunity. Thankfully, a growing body of research proves it is also less likely to trigger severe symptoms.
Like many countries in Europe, France is experiencing a surge in the number of cases due to the Omicron variant.
Experts insist that IHU, which predates Omicron but has yet to cause widespread harm, should not cause concern – predicting that it may fade into the background. In an interview with the Daily Mail, Dr. Thomas Peacock, a virologist at Imperial College London, said the mutation had “a decent chance to cause trouble but never really materialized. So it is definitely not one worth worrying about too much at the moment.”
The strain was first uploaded to a variant tracking database on November 4, more than two weeks before Omicron was sequenced. For comparison, French authorities are now reporting over 300,000 new cases a day thought to be mostly Omicron, with data suggesting that the researchers have identified only 12 cases of IHU over the same period.
On the whole, France has good surveillance for COVID-19 variants, meaning health professionals quickly pinpoint any new mutant strains. In contrast to Britain, which only checks three in ten cases for variants. The paper’s authors state that the emergence of the new variant emphasizes the importance of regular “genomic surveillance” on a countrywide scale.
The Omicron strain of the coronavirus is spreading quickly around the world. After the US surpassed one million new cases per day earlier this week, now the EU, as well, is passing that unfortunate milestone.
Image credits Path for Europe.
Following the New Year’s weekend, the US on Monday reported 1,082,549 new cases of coronavirus infections inside its borders, according to data from Johns Hopkins University. Although the number of cases reported on Mondays is typically higher than those on other days, due to delays in how tallying is processed over the weekend, this still marked a very worrying record. The figure was double that of the previous Monday.
Judging from previous data (leading up to the week ending on December 25th, 2021), the Omicron variant accounts for roughly 60% of these cases.
The European Union, as a whole, also reported passing this milestone yesterday, Wednesday 5th. Countries such as Britain and France have announced record numbers of daily new cases; Britain reached 200,000 on Tuesday, while France reported in excess of 270,000. Both of these figures are higher than any previously-seen number of new daily cases.
According to the Agence France-Presse (AFP), Cyprus now has the highest infection rate per capita, after reaching a record new 5,457 cases on Tuesday.
As in the US, the more infectious Omicron variant is behind a large portion of the new cases in the EU. Although this strain seems to produce less severe symptoms and generally results in fewer hospitalizations than previous variants, governments are still ill at ease over the growing number of cases. Hospitals and health services are still under immense pressure, and can easily become overwhelmed if a large number of patients seek help at the same time; the high number of infected individuals definitely raises the possibility that this can happen.
But the rampant spread of the virus also raises a chilling possibility: that of mutations taking place. The World Health Organization (WHO) warned of this possibility on Tuesday, in response to the numbers reported by the US and of the deteriorating situation in Europe.
“The more Omicron spreads, the more it transmits and the more it replicates, the more likely it is to throw out a new variant,” said WHO senior emergencies officer Catherine Smallwood in an interview for the AFP. “Now, Omicron is lethal, it can cause death […] maybe a little bit less than Delta, but who’s to say what the next variant might throw out? Even in well-capacitated, sophisticated health systems there are real struggles that are happening at the moment.”
On Tuesday, the British government announced that hospitals have switched to “war footing” due to staff shortages. Prime Minister Boris Johnson promised to take measures to address staff shortages in the most heavily affected areas, ranging from drafting medical volunteers to calling for army support.
Australia is also facing a record-high number of new cases, reaching almost 65,000 daily as of Wednesday.
The coronavirus can and did infect white-tailed deer, according to new research. The findings raise some concerns regarding our efforts to contain the virus, as deer could act as a ‘reservoir species’ igniting further outbreaks.
Image credits Robert Woeger.
Researchers at the Ohio State University report that white-tailed deer have tested positive for recent or active coronavirus infections in Northeast Ohio. The results are based on samples taken between January and March of 2021.
While there have been no reported cases of COVID-19 spreading from deer to humans, the authors warn that seeing the virus take hold among deer could pose a threat to public health later down the line. The main concern is that deer could become a reservoir species for the coronavirus, making efforts to control or eradicate the pathogen much more difficult. It also raises the risk of reinfection with the strains currently circulating among deer, or with new strains that mutated through the interaction between the coronavirus and the deer.
Foothold
“Based on evidence from other studies, we knew [deer] were being exposed in the wild and that in the lab we could infect them and the virus could transmit from deer to deer. Here, we’re saying that in the wild, they are infected,” explains Andrew Bowman, the study’s author and professor of veterinary preventive medicine at The Ohio State University.
“And if they can maintain it, we have a new potential source of SARS-CoV-2 coming into humans. That would mean that beyond tracking what’s in people, we’ll need to know what’s in the deer, too.”
The findings are based on nasal swabs taken from 360 wild white-tailed deer across nine different areas in Northeast Ohio. Genetic material indicative of a recent or active coronavirus infection was identified in over 35% (129) of the deer, in samples taken from six locations. Three different strains of the virus were identified in these tests.
The study builds on previous findings of coronavirus infection among white-tailed deer in Iowa, Illinois, Michigan, New York, and Pennsylvania.
The findings lead “toward the idea that we might actually have established a new maintenance host outside humans,” according to Bowman. The virus could mutate in deer, potentially creating an opportunity for new strains to reach humans. It’s also possible that the virus will circulate unmutated among deer while it continues to evolve in humans. If the general population loses immunity to these original strains, the deer could provide an avenue through which they could spill back into our communities.
It’s not yet clear how deer became infected with the coronavirus, nor what (if any) effect this has on their bodies. So far, the team is working on the assumption that the animals contracted the virus by drinking contaminated water, as the coronavirus is known to shed through human stool.
The paper “SARS-CoV-2 infection in free-ranging white-tailed deer” has been published in the journal Nature.
Virologists are rushing to learn more about a new variant of the virus that causes COVID-19, first identified in South Africa and now rapidly outcompeting other versions of the virus. The variant, denominated B.1.1.529, reportedly has more mutations than those of the Delta variant, which became the most dominant variant in the world, and may be more resilient against vaccinations.
Image credit: Flickr / Nick Anderson
By this point, there’s more speculation than actual facts. A researcher at UCL Genetics Institute said the variant may have evolved during a chronic infection of an immuno-compromised person in South Africa, likely someone with HIV. In fact, the previously discovered Beta variant, a coronavirus mutation identified in the country last year, may have also come from an HIV-infected person.
“Initially it looked like some cluster outbreaks, but from yesterday, the indication came from our scientists from the Network of Genomic Surveillance that they were observing a new variant,” South Africa’s Minister of Health Joe Phaahla said in a press conference, adding that it’s currently unclear where the variant has first emerged.
In a media briefing, Tulio De Oliveira, the director of the Center for Epidemic Response and Innovation, said the variant has “many more mutations than we have expected,” adding it’s spreading fast and that it will put pressure in South Africa’s health system in the coming weeks. He advised citizens to try to avoid “super spreading events.”
De Oliveira shared a chart at the briefing, showing how the variant quickly became dominant in the Gauteng province. The data, from samples from November 12 to November 22, shows how the B.1.1.529 (represented by the blue part) completely overtook the Delta (red) and Beta (green) variants, which took months to be dominant.
The World Health Organization (WHO) designated the new strain as a variant of concern, the fifth one to be given that classification. The organization has assigned it the Greek letter Omicron. Maria Van Kerkhove, the WHO’s technical lead on Covid-19, said in a Q&A that the variant’s many mutations could impact the virus’ behavior, but there’s still much we don’t know about it yet.
A lot of mutations don’t automatically mean a bad thing. It’s essential to know what these mutations are actually doing, and oftentimes, mutations don’t really do anything concerning. But what is concerning is that the virus is very different to the one that emerged in Wuhan, China in early 2020. This could mean that the currently used vaccines, designed based on the original strain, may not be as effective.
“This variant has a large number of mutations, some of which are concerning. Preliminary evidence suggests an increased risk of reinfection with this variant, as compared to other VOCs. The number of cases of this variant appears to be increasing in almost all provinces in South Africa. Current SARS-CoV-2 PCR diagnostics continue to detect this variant,” the WHO wrote in a statement.
The expansion of the new variant
So far, fewer than 100 sample sequences have been reported, according to the WHO, but already, cases were confirmed in South Africa, Hong Kong, Israel, Botswana, and Belgium. In South Africa, most of the cases are from Gauteng province, which is the most country’s most populous province. Only 24% of South Africa’s population is fully vaccinated.
In Hong Kong, infections were found in a person arriving from South Africa and a guest on the same quarantine hotel who tested positive days later. In Belgium, one case emerged in an unvaccinated woman who had traveled from Egypt via Turkey and developed flu symptoms. Israel also had one case from a person returning from Malawi.
The head of the European Commission, Ursula von der Leyen, asked for EU countries to put on the “emergency break” and stop flights from South Africa. “It’s now important that all of us in Europe act very swiftly, decisively, and united,” she said. The EU is experiencing new waves of the virus, with countries imposing new lockdowns and restrictions.
Several countries are already restricting the circulation of people coming from South Africa. Japan is now asking travelers arriving from much of southern Africa to quarantine for 10 days and take four tests during that time. Germany only allows Germans to fly into the country from South Africa, while the Czech Republic doesn’t allow the entry of people who spend more than 12 hours in Mozambique and Zambia. The US hasn’t specified any new rules yet.
Germany’s capital city is issuing a new set of restrictions in a bid to contain a resurgence in coronavirus cases.
Image via Pixabay.
Starting next Monday, unvaccinated citizens in Berlin will have to contend with a new set of restrictions. Due to a growing number of coronavirus cases in the city, they will be denied access to indoor dining areas, bars, gyms, and hairdressers.
Although the decision is bound to be unpopular among the public, officials explain that they are the best preventive measure at their disposal in order to avoid another full-blown epidemic. Fully-vaccinated individuals, and those who can show proof of recovery from COVID-19, will be able to enter leisure facilities and a list of other selected venues—a system known as “2G” in Germany.
Old foes
The decision to reinstate access restrictions for the unvaccinated is a response to “the rising number of coronavirus cases and the increasing pressure on intensive care units”, the Berlin senate said in a press release on Wednesday evening. Under Germany’s political organization system, Berlin is a ‘city-state’ — a state that consists of only one city.
These new restrictions were imposed by the local government, not the Federal government, and as such will only affect Berlin.
Under the new restrictions, theaters, museums, and outdoor events with more than 2,000 visitors will be off-limits to unvaccinated adults. Minors and those who have medical exemptions from receiving a vaccine will only need to show a negative test result.
Companies operating in Berlin have also been encouraged to transition as many employees as possible to work-from-home schemes, and limit office attendance to 50% of staff.
These measures are among the most — if not the most — restrictive yet in the whole of Germany. However, other areas and states might follow suit sooner rather than later; the country has been experiencing a rapid increase in new daily coronavirus infections over the last week. The states of Saxony, Bavaria, and Baden-Wuerttemberg are also in the process of increasing restrictions to deal with their own coronavirus flare-ups.
Germany’s adult vaccination rate sits at around 67%. Outgoing Chancellor Angela Merkel, who still retains her office until the new government is set up, warned that this percentage is “not high enough to prevent a rapid spreading of the virus”.
So far, she seems to have been right. Some hospitals in Germany have started postponing non-urgent surgeries to make resources and personnel available to deal with the increase in coronavirus cases.
The high-density microarray patch (HD-MAP). Credit: University of Queensland.
Researchers in Australia have developed a needle-free COVID-19 vaccine in the form of a patch that slowly delivers the serum through the skin. This type of vaccine delivery is not only painless, but studies on mice also showed that the generated immune response against the coronavirus was actually stronger than the jab.
The high-density microarray patch (HD-MAP) is the result of a collaboration between Brisbane-based biotechnology company Vaxxas and the University of Queensland. The patch doesn’t deliver an mRNA serum, like the popular Pfizer/BioNTech and Moderna. Instead, it was tested on a more affordable vaccine candidate developed by the University of Texas, called Hexapro.
The Hexapro vaccine uses a stabilized version of the spike protein from the surface of the coronavirus to train the human immune system to recognize and fight infection when the real virus is encountered. The manufacturing process is virtually the same as that for the flu vaccine. The serum is made in eggs and can be stored at a standard refrigerator temperature of 2 to 8 degrees Celsius, making the shot affordable and accessible to virtually all parts of the globe. Hexapro is currently undergoing clinical trials in Vietnam, Thailand, and Brazil.
Dr. David Muller of the University of Queensland’s Chemistry and Molecular Biosciences department wanted to take this vaccine to the next level. He and colleagues have developed HD-MAP, which they think could be a “game-changer for vaccine delivery in a pandemic setting.”
Tests on mice showed that the fingertip-sized patch produced strong immune responses that were effective at protecting the mice from infection with the virus that causes COVID-19. This includes the highly-contagious and more dangerous UK and South Africa variants.
Using patches instead of needle delivery possesses several significant advantages. Once the patch is applied on the patient’s shoulder or some other body part, more than 5,000 microscopic projections deliver the serum into the skin. The application of the patch does not cause pain or any kind of discomfort, unlike vaccine needles which many people abhor. It’s easy to use, which means there’s no need for highly trained medical staff and patients could perform the vaccination themselves.
When the patches are dry-coated, they remain stable for at least a month at 25 degrees Celsius and one week at 40 degrees Celsius. That’s mighty useful in settings where the cold storage infrastructure is lacking. Healthcare workers can take millions of these patches and then have enough time to distribute them across rural and remote areas that may be lacking electricity or mobile cold storage units.
Furthermore, the study’s findings suggest that the patch delivery produces a stronger immune response than the needle-based one.
Dr. David Muller holding the vaccine patch in its packaging. Credit: University of Queensland.
“Traditional intramuscular injection goes deep into the muscle where there aren’t a lot of immune cells. Using the patch, we are able to precisely target the layers of the skin which have a high density of immune cells. This results in a lot more efficient vaccine uptake and corresponding immune response. This vaccine works by targeting the body’s immune response (antibodies) to the spike protein on the surface of the virus. In simple terms, we are dry coating the spike protein onto thousands of tiny projections 250 µm in length. This coated vaccine patch is applied to the skin which deposits the vaccine into the dermal layers of the skin which are rich in immune cells. This precise delivery of the vaccine to the immune cells results in a very strong immune response to SARS-CoV-2,” Dr. Muller told ZME Science.
What remains now is to validate these findings in humans. The researchers are planning a phase I clinical trial for the patch in the second quarter of 2022.
“This will initially be designed around ‘booster’ dosing,” Dr. Muller said.
For years, researchers have dreamt of having one vaccine that could defend against all variants of coronaviruses. Now, according to a new study, we are one step closer to it.
Image credit: Flickr / Duncan C.
Researchers from Northwestern Medicine discovered that people with immunity to one type of coronavirus, either because of vaccination or because of natural infection, tend to have immunity against other similar coronaviruses. This is a bigger deal than it sounds. The new findings, the researchers argue, “provide a rationale for universal coronavirus vaccines.”
Coronaviruses have recently garnered attention due to their potential to cause pandemics — see current events. However, coronaviruses aren’t new — they’re a large family of viruses that cause upper-respiratory tract illnesses. Seven of them have been identified in humans so far, four of them being less problematic, while the other three are known to cause more severe illness, even death. These are the Severe Acute Respiratory Syndrome 1 Coronavirus (SARS-CoV-1), Middle Eastern Respiratory Syndrome Coronavirus (MERS), and now, Severe Acute Respiratory Syndrome 2 Coronavirus (SARS-CoV-2).
Most coronaviruses circulate among animals but sometimes, they can jump to humans, which is when they tend to become very dangerous. In less than 20 years, there have been outbreaks from the three above-mentioned viruses.
Various vaccines have shown efficacy at preventing Covid-19, helping to drive down the number of infections and deaths very significantly — this is what’s gonna help us get through this pandemic. But whether these also protect against other coronaviruses has so far remained unknown. Now, with the new study, we could be a step closer to having one vaccine for every coronavirus family and preventing future pandemics.
Understanding coronaviruses
In their study, the researchers found that plasma from patients vaccinated against SARS-CoV-2 produced antibodies that were cross-reactive, meaning potentially providing protection, against other coronaviruses – including SARS-CoV-1 and the common cold coronavirus (HCoV-OC43). This correspondence also appeared in other animals in the study.
Mice vaccinated with a SARS-CoV-1 vaccine generated immune responses that protected them against SARS-CoV-2. At the same time, mice immunized with Covid-19 vaccines and then exposed to HCoV-OC43 were also partially protected against it. This was because SARS-CoV-1 and SARS-CoV-2 are genetically similar, while the common cold coronavirus is more divergent.
There are three main species of coronaviruses that cause diseases in people: sarbecorivurses, including SARS-CoV2, merbecoviruses, responsible for MERS, and sarbecoviruses, including SARS-CoV-1. Each is so unique that it’s unlikely a single vaccine would fight the three groups. But what we could have is one vaccine effective for every species within each family.
“Until our study, what hasn’t been clear is if you get exposed to one coronavirus, could you have cross-protection across other coronaviruses? And we showed that is the case,” lead author Pabo Penaloza-MacMaster from Northwestern Medicine said in a statement. “Our study helps us re-evaluate the concept of a universal coronavirus vaccine.”
Of course, whether or not the same mice responses carry out in humans remains to be seen. Oftentimes, what works in mice doesn’t work in humans. Nevertheless, this is encouraging news, and having access to a universal coronavirus vaccine could be a fantastic tool to protect us from this group of viruses.
As many of us are nearing the one-year mark following our immunization, questions still remain regarding the long-term efficacy of our current vaccines. New research, however, is looking into it.
Image via Pixabay.
A team of researchers from the Beth Israel Deaconess Medical Center (BIDMC) has been analyzing the long-term immunization efficacy of the three vaccines approved by the U.S. Food & Drug Administration in December 2020. These are BNT162b2 (BioNTech, Pfizer), mRNA-1273 (Moderna), Ad26.COV2.S (Johnson & Johnson).
They evaluated the immune response produced by these vaccines at two to four weeks after complete immunization (i.e. after receiving the full number of shots) to that at eight months after vaccination.
Declining but not determined
“The mRNA vaccines were characterized by high peak antibody responses that declined sharply by month six and declined further by month eight,” said corresponding author Dan H. Barouch, MD, Ph.D., director of the Center for Virology and Vaccine Research at BIDMC, who helped develop the Ad26 platform in collaboration with Johnson & Johnson.
“The single-shot Ad26 vaccine induced lower initial antibody responses, but these responses were generally stable over time with minimal to no evidence of decline.”
Understanding the long-term efficacy of these vaccines is critical for our efforts to combat the COVID-19 pandemic. However, we didn’t have such information on hand up to now. Simply put, while the vaccines were tested to ensure safety and efficacy, the global context meant that their development process was greatly accelerated. We simply didn’t have the opportunity to obtain data pertaining to their long-term efficacy.
In a bid to help patch up this hole in our understanding, the team at BIDMC monitored the immunization levels of 61 participants over an eight-month period after they received their vaccines. The team measured the levels of antibodies, T cells, and other immune markers in the blood of these participants at two to four weeks after they received their shot (which is the point of peak immunity) and monitored them over an eight-month follow-up period.
Out of the 61 total participants involved, 31 received the BioNTech / Pfizer vaccine, 22 received the Moderna one, with the final 8 receiving the Johnson & Johnson single-shot vaccine.
All in all, the team explains that the Moderna vaccine produced more powerful and longer-lasting immunization effects than the BioNTech / Pfizer variant. That being said, all three variants produced effective immune responses against SARS-CoV-2 and had broad cross-reactivity to its strains.
However: the authors report that both mRNA-based vaccines (BioNTech / Pfizer and Moderna) produced sizable initial immune responses, but these got progressively weaker over time. At around the 6-month mark, immune markers in patients who received either of these two had already declined sharply compared to the 2-to-4 week mark. The same markers would decline even further at the eight-month mark.
The single-shot Johnson & Johnson vaccine, meanwhile, produced a weaker initial effect but was much more consistent over the study period.
Although these results might not sound very exciting or promising, they do not mean that the vaccines leave us vulnerable over time. For starters, there are still a lot of unknowns regarding exactly what immune responses in our bodies are needed to protect against SARS-CoV-2.
Furthermore, what the team tracked here are physical markers of immunity. But the antibodies themselves, for example, are the ‘soldiers’ that our body uses to protect itself against viruses. Their presence in the bloodstream is akin to our body being on alert. But even if they are not physically there, our bodies have already been primed regarding the structure of the virus, how to identify it, and which antibodies are needed to defeat it. Against this backdrop, an immune response against the pathogen can be mounted very quickly in case of infection.
“Even though neutralizing antibody levels decline, stable T cell responses and non-neutralizing antibody functions at 8 months may explain how the vaccines continue to provide robust protection against severe COVID-19,” said lead author Ai-ris Y. Collier, MD, a maternal-fetal medicine specialist at BIDMC.
“Getting vaccinated (even during pregnancy) is still the best tool we have to end the COVID-19 pandemic.”
The paper “Differential Kinetics of Immune Responses Elicited by Covid-19 Vaccines” has been published in the New England Journal of Medicine.
It’s no secret that the pandemic has taken a huge toll on many people’s mental health, especially during the first wave of lockdowns when fear and anxiety were at their peak. And although crisis communication is paramount in order to dispel some uncertainties and keep people informed about potential dangers, the endless stream of newsfeeds related to COVID-19 and death rates have had the unintended consequence of making things only worse, from a mental health perspective.
There’s a lot to be said about how poorly the pandemic has been covered by mainstream media and how stupidly harmful conspiracies like QAnon and misleading ‘China virus’ narratives have been allowed to run rampant on social media. Let’s just say that history won’t be too kind when looking back at this tumultuous period. But at least we had some good memes to keep us sane.
A new study published today in the journal Psychology of Popular Media found that not all media formats have contributed to a worsening of mental health. Funny memes helped people feel calmer and better equipped to cope with the stress of the pandemic, according to researchers led by Jessica Gall Myrick, a professor at Pennsylvania State University.
“As the pandemic kept dragging on, I noticed old, but popular, memes being repurposed on social media to make commentary about life during COVID-19. Eventually it became more and more interesting to me how people were using social media, and memes in particular, as a way to think about the pandemic and cope with the stress of life during this time,” Myrick told ZME Science.
“We found that viewing just three memes can help people cope with the stress of living during a global pandemic.”
In a survey of nearly 750 people in December 2020, the researchers sought to determine how different types of memes and varying degrees of cuteness affected the mood and overall mental health of the participants.
Hundreds of popular memes that went viral on sites like “IMGflip” and “IMgur” were selected for this purpose and classified by factors such as whether the meme featured a human or animal, whether the human or creature was young or adult, and whether the caption was related to COVID-19 or not. Each participant had to rate the humor and cuteness of each meme. Those memes that were viewed as equally funny and cute were selected for the next leg of the study.
The researchers then went into the trenches and altered some of the memes from the shortlist, essentially making their own memes. For each meme, the researchers thus had a COVID-related and non-COVID-related caption in order to compare their effects. For instance, a meme might feature an angry-looking cat with a caption that said “New study confirms: Cats can’t spread COVID-19 but would if given option.” The non-COVID-related version of the meme showed the same cat image but with the caption, “New study confirms: Cats can’t sabotage your car but would if given option.”
“The biggest challenge was finding as many really funny or cute memes as we could to make sure we had a good pool of popular memes. My two co-authors and I are from three generations (I am a millennial, our second author Robin is a Gen X’er, and our third author Nick is in Gen Z), so what some of us thought was funny, there was always at least one other person who did not think it was so funny. It was a long process to find memes that were equally appealing to people across generations, but we were the perfect research team to tackle that challenge!” Myrick said.
“I had never really written memes myself before, just shared ones that other people made that I thought were funny or cute. For this study, we took real memes that we found online and just tweaked them slightly to help make sure that the differences between memes that different participants saw in our study were limited to the type of caption and type of image used. We did a separate study asking participants to look at more than a hundred memes prior to selecting the pool of memes for this study so we could ensure that the memes that were either about COVID-19 or not about COVID-19 would be judged as equally, realistic, funny, and cute. We also had someone who does write memes regularly review all of our memes before we tested to help ensure the slight edits we made for our study still kept the memes realistic,” she added.
In the last stage of the study, the participants were randomly assigned to view three kinds of memes based on their subject (animal or human), cuteness level (adult or baby), and caption (COVID or non-COVID-related). An equal number of participants were exposed to plain text without images to act as a control.
Based on the participants’ self-reported levels of stress and nervousness over the past month, the researchers found that the volunteers who viewed memes had high levels of positive emotions compared with those exposed to other types of media. Perhaps counter-intuitively, people who viewed memes with captions related to COVID-19 were more likely to report lower levels of stress surrounding the pandemic than people who viewed memes with no relation to COVID-19.
“We also found that the topic of the memes could affect how well they helped people cope with the stress of living through the pandemic. If people saw a set of memes with captions that were specifically about COVID-19, then they rated themselves as less stressed about COVID-19 than did people who saw memes that were not about COVID-19,” Myrick said.
What’s more, people exposed to COVID-related memes were also more likely to process the context of the content they viewed and felt more confident in their ability to cope with pandemic stress than those who viewed non-COVID-related captions. An exception was found to be cute memes — those that feature human or animal memes — which had no effect on how people thought about the pandemic regardless of whether or not they contained captions about COVID-19.
These findings suggest that using memes when communicating about stressful public events may help people feel less overwhelmed by negative news.
“Engaging memes can offer useful perspective, comfort, and validation for one’s own experience, all of which can be psychologically beneficial,” Myrick concluded.
“This study just exposed participants to three memes and asked them about their thoughts and feelings immediately afterward. It would be great to have the funding to do a longer-term study that better reflects our real digital lives where we see memes every day and test how this cumulative exposure to different types of memes can affect our stress levels and ability to cope with serious life events.”
Antibodies from the original strain of the virus that causes COVID-19, the one which started this pandemic, likely do not bind well to newer strains. The findings raise new concerns regarding emerging variants of the virus.
Image credits Katja Fuhlert.
Research from the University of Illinois Urbana-Champaign reports that antibodies against the original coronavirus strain aren’t that effective against some of the strains which developed later. The metastudy analyzed published studies to obtain patient data related to the sequence of antibodies they produced in response to the virus. These antibodies work by binding to, and thus neutralizing, the molecule that allows this virus to infect our cells — a particular spike protein on its surface.
While the antibodies recorded so far in patients who fought off the infection worked well against the original coronavirus strain, they’re not that effective in binding to emerging strains, the team explains. Understanding what kind of antibodies we naturally produce against a particular infection is a key step in the development of a vaccine, they add, so the results of this study could go a long way towards nipping a new pandemic in the bud.
Old dog, new tricks
“Antibody response is quite relevant to everything from understanding natural infection and how we recover from infection to vaccine design. The body has the capability to produce diverse antibody responses—it’s estimated we could make a trillion different antibodies. So when you see people are making quite similar antibodies to a particular virus, we call it convergent antibody response,” says Nicholas Wu, a professor of biochemistry at the University of Illinois, and lead author of the paper.
“That means we can design vaccines trying to elicit this kind of antibody response, and that is probably going to improve the responsiveness of more individuals to the vaccine.”
The team reports that the antibody response to the original virus was consistent among patients. Two main groups of antibodies were identified from published literature on this topic, and both bound well to the virus’ spike protein. Both were, also, quite effective in neutralizing the virus by targeting this protein. As such, our vaccines were also tailored to teach our bodies how to identify and attack the spike protein.
But the data gathered by the authors show that neither of these two groups of antibodies worked particularly well against newer variants of the virus. This has some pretty unpleasant implications for our current vaccines. As they are designed to coax our bodies into producing antibodies that attack the spike protein present on the original coronavirus, and these antibodies don’t bind very well to new strains, we have cause to question how effective current vaccines are at stopping new strains. At the same time, the results point to a particular weakness in our defense, one we could, potentially, fix through the use of vaccine boosters or a similar approach. In epidemiology, “what I don’t know can’t hurt me” is an approach that will get you killed.
“We really focused on characterizing the antibodies created in those infected with the original strain of the virus,” says graduate student Timothy Tan, the first author of the study. “Before we started the study, variants weren’t much of a problem. As they emerged, we wanted to see whether the common antibodies we identified were able to bind to newer variants.”
“Even though this antibody response is very common with the original strain, it doesn’t really interact with variants,” Wu said. “That, of course, raises the concern of the virus evolving to escape the body’s main antibody response. Some antibodies should still be effective—the body makes antibodies to many parts of the virus, not only the spike protein—but the particular groups of antibodies that we saw in this study will not be as effective.”
The team plans to extend their research to the antibody responses to the delta variant and other strains of the coronavirus. Their main objective is to see whether these strains also produce a convergent response in patients, and how the antibodies for these differ from the original strain
“We want to design vaccines and boosters, if needed, that can protect a majority of the population,” Tan said. “We expect that the antibody response to those variants would be quite different. When we have more data about the antibodies of patients who have been infected with variants, understanding the difference in the immune response is one of the directions that we would like to pursue.”
The paper “Sequence signatures of two public antibody clonotypes that bind SARS-CoV-2 receptor binding domain” has been published in the journal Nature Communications.
A combination of flawed studies, irresponsible politicians, and misinformation campaigns have made a lot of people opt for unproven and potentially dangerous treatment. This cynical misinformation has got to stop.
Doctors are fighting misinformation, alongside the pandemic
Ivermectin is a medication used to treat parasite infestations, mostly in animals, but also in humans in rare instances. The drug has some serious side effects, ranging from fever, vomiting, and skin rash to death, especially in an overdose (and possibly due to interaction with other medications). So far, nothing special.
In recent months, however, demand for this anti-parasitic medication has skyrocketed. From an average of 4,600 weekly prescriptions in the US, demand has surged to over 88,000 in just one week in August. Poison control centers have recorded a surge in calls related to ivermectin.
“You are not a horse,” the Food and Drug Administration declared last month (yes, really).“You are not a cow. Seriously, y’all. Stop it.”
By now, doctors have already gotten used to fighting misinformation in the pandemic, but the ivermectin crazy has somehow managed to surpass even the drinking bleach problem.
Officials at many hospitals are desperately asking people to stop taking this unproven treatment and instead, focus on the only prevention mechanism that has been shown to work against COVID-19: vaccines. Yet despite several working, effective, and proven vaccines freely available on the market, an alarming number of people (especially in the US, but in other countries as well) are opting for ivermectin instead.
“We are alarmed by reports that outpatient prescribing for and dispensing of ivermectin have increased 24-fold since before the pandemic and increased exponentially over the past few months,” the Americal Medical Association said in a statement, joined by the American Pharmacists Association and American Society of Health-System Pharmacists. “As such, we are calling for an immediate end to the prescribing, dispensing, and use of ivermectin for the prevention and treatment of COVID-19 outside of a clinical trial.”
It’s not just the fact that people are opting for an unproven (and potentially toxic treatment); if they would do so in addition to proven treatment, the problem would be lower in scale. But the problem is that they are opting to do so instead of taking a vaccine.
“When people get fixated on inappropriate recommendations, then they unfortunately don’t get vaccinated,” said Hawaii Lt. Gov. Josh Green (D), an emergency room doctor who blames conservative media for fanning unfounded hopes about ivermectin. “They don’t do the things that will actually help.”
So where is all this enthusiasm for deworming medicine coming from?
Talking heads
Ivermectin has been promoted incessantly recklessly by some politicians, conservative talk show hosts, and even some physicians as a potential cure for COVID-19 — often, in opposition with vaccines.
For many, vaccines are part of a major international conspiracy. Sometimes it’s Big Pharma, other times it’s the government, or the Illuminati, or Bill Gates — it depends on which corner of the internet you ask — and they want you to take the evil vaccine, and not the magic cure that is ivermectin. Or something like that. Which doesn’t even make any sense as a conspiracy theory — pharma companies make far more money from treatments you take regularly than for a dose of vaccine. For instance, J&J estimated its vaccine price at $5 per dose, comparable to a single ivermectin pill. Even considering the more expensive vaccines, the theory just doesn’t add up.
These myths were further amplified in some corners of the media. For instance, one Wall Street Journal opinion piece was titled “Why Is the FDA Attacking a Safe, Effective Drug?” — but what the Wall Street Journal didn’t mention was that the author previously worked for the company that developed and marketed ivermectin, and was currently a fellow at a right-leaning, pro-free market think tank. Hardly what you’d call reliable journalism.
It gets even worse — if anything, the WSJ piece is an example of how not to do journalism. The article in case used one study from Egypt as one of its main arguments. But the study was withdrawn due to charges of data manipulation. Not only did the WSJ not retract the article, but the only correction they added is a paragraph of text at the end of the article. As a result, the article is still widely circulating as “evidence” that ivermectin works against COVID-19.
The connection between conservative media and ivermectin is unlikely to be a coincidence. Fox News hosts like Tucker Carlson, Sean Hannity, and Laura Ingraham have all repeatedly mentioned ivermectin as a treatment for COVID-19, using it to attack public health officials. Something similar has happened with hydroxychloroquine in 2020, which has since been proven ineffective.
This type of propaganda seems to be working. Republicans are much more likely to be anti-vaccines and pro-ivermectin, polls show. This would also explain why Republican states have the highest COVID-19 incidence and death rates.
Another staunch supporter of ivermectin against COVID-19 is Rand Paul, a United States Senator from Kentucky. Paul has taken numerous anti-scientific positions in the pandemic, from denying the usefulness of masks to minimizing the benefits of vaccines. His latest idea is less of science denial and more a flat-out lie. Paul claims that scientists won’t study ivermectin because they hate Donald Trump.
“The hatred for Trump deranged these people so much, that they’re unwilling to objectively study it,” Paul told a group in northern Kentucky late last week. “So someone like me that’s in the middle on it, I can’t tell you because they will not study ivermectin.”
But that couldn’t be further from the truth. Over a dozen studies on ivermectin are ongoing, including a large trial supported by NIH, which recently found that the results “cannot confirm the widely advertised benefits.” According to the World Health Organisation’s database of clinical studies for COVID-19, there are currently 16 trials investigating ivermectin, so Paul’s comments are demonstrably false.
We’ve also had quite a few studies that are already published, but they don’t really support ivermectin either.
What the science says about ivermectin
To be clear, it’s not completely impossible for ivermectin to offer minor benefits in treating the coronavirus. That’s why there are still ongoing studies, because if there’s even a slight chance, researchers want to know. But the existing data does not currently support taking ivermectin, and the prospects are slim at best.
Ivermectin was first identified as a potential treatment for COVID-19 based on experiments in isolated cells. Here’s one thing you should always remember with these studies: a lot of substances kill a lot of pathogens in a lab. That doesn’t mean they also translate to human treatments (and in the vast majority of cases, they don’t). Furthermore, the initial lab studies were done on very high concentrations of the drug, much more than what the human body can safely withstand (and much more than what is prescribed for killing parasites). But, out of desperation at first, the drug was prescribed widely in poorer countries — especially when vaccines were not available.
As months went by, several studies were published, but most involve a small sample size and questionable methodologies (in which ivermectin was prescribed at various dosages, and in conjunction with other drugs). Results were generally inconsistent and were often based on weak study designs.
The most viable evidence we have for ivermectin against COVID-19 comes from reviews of multiple studies; one such review was published in June 2021. The review eliminated low-quality studies and carefully examined ten higher quality (randomized-controlled) clinical trials. Its conclusions are clear:
“Compared with the standard of care or placebo, Ivermectin did not reduce all-cause mortality, length of hospital stay, or viral clearance in randomized controlled trials in patients with mostly mild COVID-19. IVM did not have an effect on adverse effects or severe adverse effects and is not a viable option to treat patients with COVID-19.”
You could argue that the ten studies here still only amounted to 1,100 patients (compared to studies on millions for vaccines), but this is still doesn’t justify the enthusiasm with which some are promoting this drug in the pandemic. As we’ve covered previously, there are other promising treatments being researched, and they don’t seem to be as popular — which is a good thing, because they’re not yet fully proven.
Another study from Argentina in 2020 claimed benefits for ivermectin. But again, a larger study from Brazil found “no effect whatsoever on our primary outcomes” for ivermectin. “So in our specific trial … we do not see the treatment benefits that a lot of advocates believe there should have been,” one of the study authors said at a symposium.
For now, at least, there’s simply no convincing reason to take ivermectin against COVID-19 — let alone to take it as a preventive measure.
— Dr Lizzie Skinner 🩺🏳️🌈💉 (@drlizzieskinner) July 16, 2021
As if all this wasn’t evidence enough that you shouldn’t take ivermectin, some of the most high-profile studies supporting its use were withdrawn amidst claims of data manipulation and ethical concerns. The above-mentioned study from Egypt had glaring data discrepancies and suspicions of plagiarism and was eventually withdrawn — though not after being widely shared as “evidence”. Another prominent paper supporting the use of ivermectin was withdrawn, but only after leading to the widespread usage of the drug in Latin America. The study had not been peer reviewed and was withdrawn from the preprint servers.
So in the end, what we have so far supporting ivermectin are flimsy observational studies and rogue clinicians’ opinions, whereas large-scale, reliable studies found no benefit to the drug. Even Merck, which manufactures the drug, says there is currently “no scientific basis for a potential therapeutic effect against COVID-19”. No matter where you look, there’s not much evidence supporting it.
A cynical play
We’re all understandably worried, sick, and tired of this ongoing pandemic. We all want a way to stay safe and get back to normal. The good thing is we have it in the form of vaccines. The bad news is that a large part of the public seems to not want it, and instead wants an unproven, potentially dangerous drug.
At first, it seems surprising to see just how popular ivermectin has become, but when you look at all the misinformation circulating social media and some right-leaning outlets, it all kind of fits. Promoted on right-leaning Facebook groups and through well-funded advertisments, ivermectin has become a part of the culture war.
The more you look at it, the more the push for ivermectin looks like a cynical attempt to either make money or push an agenda. If ivermectin does work, then the science will show it — but so far at least, it doesn’t really seem to work. So then why do so many, especially in conservative circles, promote it? Unlike what the likes of Rand Paul are claiming, politics isn’t stifling research on ivermectin, plenty of research is being carried out. But even as the research disproves their claims, they cling on to their beliefs and fuel more vitriol and distrust against the authorities and actual health experts — the last thing you want in a pandemic.
Opting for an unproven (and dangerous) treatment and acting against the vast majority of researchers, the CDC, FDA, WHO, and pretty much every health organization in the world, isn’t smart; it isn’t “sticking it to the man”, or “fighting the expert”; it’s not fighting against a conspiracy. It’s dumb. It’s putting people at risk, and it’s making it harder to put the pandemic behind us.
Summer is almost over, but you know what isn’t? The pandemic. Unfortunately, we still have a battle ahead of us, and if we let our guard down, we can still get hurt. This painful lesson was recently presented by a case study published by the CDC, in which an unvaccinated teacher infected half of her classroom.
The Marin County elementary school in California had been more careful than most. Masks were required indoors at all times, desks were spaced apart, and students were taught to maintain social distance. But all it took was one event.
It happened on May 19, and started with some fatigue and nasal congestion. The unvaccinated teacher wasn’t feeling very bad, but she was feeling a bit off. She shrugged it off for a day or two, dismissing it as allergies. She was normally masked, but she made an exception for storytime when she took her mask off to read to her class aloud. That’s all it took for the delta variant to sneak into the class.
The teacher got a test on her second day of symptoms and at the end of the affair, 12 of her 22 students later tested positive. The mask was only off for a few minutes.
“Evidence has repeatedly demonstrated that multi-layer prevention strategies – such as vaccination for all children and adults who are eligible; masks for all students, teachers, staff, and visitors; ventilation; cohorting; physical distancing; and screening testing – work to prevent the spread of Covid in schools,” said Dr Rochelle Walensky, the CDC director, at a press briefing on Friday.
Vaccinate teachers
We know that children aren’t as vulnerable to the disease as adults are, but for parents, the idea of acceptable risk to their children is, of course, hard to manage and accept — and opening up school has proven quite the challenge.
This month alone, in Brevard County, Florida, 1,623 children were infected, and over 8,000 were quarantined. In the Atlanta area, thousands of positive cases were confirmed — and several other areas have suffered similar outbreaks. A simulation carried out by a CDC-funded lab found that in elementary schools without either masks or regular testing, 3 in 4 children could become infected in the first three months.
In the US, just like in many other countries, schools have become ideological battlefields, with parents hoping to open up schools in accordance to the guidance offered by doctors opposed by parents opposing masks (and often, vaccinations as well). But if teachers aren’t vaccinated, it seems like it’s only a matter of time before the virus starts spreading in the classroom.
The outbreak “highlights the importance of vaccinating school staff members who are in close indoor contact with children ineligible for vaccination as schools reopen,” the report concludes.
The report seems to add even more evidence that vaccine mandates in schools may become required, especially as for now at least, many children are not eligible for coronavirus vaccines.
Vaccines save lives. You’ve heard this message countless times before, and for good reason — because it’s true. Now, a new study puts some hard numbers behind this claim, showing that the early COVID-19 vaccination program in the U.S. prevented 140,000 deaths and 3 million cases of COVID-19 by the second week of May. The real, up-to-date number of lives saved is likely much greater three months later, especially considering the surge of Delta.
At least $1.4 trillion was saved up to May thanks to the vaccines
For their assessment, Sumedha Gupta, an economist at Indiana University-Purdue University Indianapolis and Christopher Whaley, a policy researcher at RAND, a nonprofit research organization, combed through data on the number of vaccine doses administered in each state, as well as the number of COVID-19 deaths for each state. When this information was plugged into a mathematical model, they were able to estimate the difference between the number of deaths that would have occurred with no vaccine and the actual number of deaths.
“Existing estimates of the efficacy of state vaccination campaigns in reducing COVID-19 cases and deaths were projections based on simulations using data from COVID-19 vaccine trials. Since trials are conducted in controlled environments, simulated predictions may deviate from actual population outcomes. So starting in March, as reliable state vaccination data began to become publicly available, our team began to estimate reductions in COVID-19 morbidity and mortality at the population level due to the vaccination underway. Our study finds that by May 9, 2021, COVID-19 vaccinations had averted 139,393 COVID-19 deaths, with an estimated economic benefit of $625 billion to $1.4 trillion from the lives saved,” Gupta and Whaley told ZME Science.
The effects of vaccine rollout on the number of deaths varied for each state, depending on vaccine coverage and restrictions. For instance, New York state saw the largest reduction, seeing 11.7 fewer COVID-19 deaths per 10,000 adults, while Hawaii had the smallest reduction, with only 1.1 fewer COVID-19 deaths per 10,000 adult inhabitants.
This assessment is only valid up to early May. Even so, given the ever changing and unpredictable nature of this pandemic, it was very challenging for the researchers to conduct this study as each week they had to incorporate new data for each state.
“Initially, with each additional week our estimates would evolve as in several states vaccination rates were still low, campaigns were just beginning to ramp up, and any impact of the vaccines would be expected to show up only after a lag. By May states were mostly at near-universal eligibility (all ages 12 years and older) and had established vaccination procedures, allowing us to consistently estimate changes in COVID -19 cases and deaths associated with the vaccinations thus far,” the researchers said.
So far, the United States has experienced over 37 million confirmed cases and 623,000 COVID-19 deaths. That’s a staggering toll, but if it’s any indication, this study shows that the situation could have been much worse, especially now that Delta is causing a surge in cases.
“Two Americas”
COVID-19 cases have risen almost eightfold from the beginning of July and the country could see a return to 200,000 cases a day, a level not seen since the pandemic’s worst days in January and February, when vaccine coverage was almost nonexistent.
Currently, about 60% of the US population has had at least one dose and nearly 51% are fully vaccinated, according to the Centers for Disease Control and Prevention (CDC). This leaves around 90 million Americans who are still unvaccinated, making them “sitting ducks for this virus,” in the words of Dr. Francis Collins, director of the National Institutes of Health.
Despite a surplus of available vaccines, in recent weeks the rate of vaccination has slowed substantially against a backdrop of vaccine hesitancy. This has led to what Dr. Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, calls “two Americas” — one is the vaccinated population and the other is the unvaccinated population.
On July 16, 2021, Centers for Disease Control and Prevention Director Dr. Rochelle Walensky revealed that 99.5% of recent U.S. deaths from COVID-19 were of unvaccinated people. “Those deaths were preventable with a simple, safe shot,” she said. Walensky also said that 97% of current COVID-19 hospitalizations are of unvaccinated people.
“Vaccination rates have significantly reduced, even in states where a large share of the population remains unvaccinated. Our study finds a large benefit of high rates of COVID-19 vaccinations. Therefore there are real concerns about areas with still very low-vaccination rates and therefore at continued risk of future COVID-19 surges and evolving variants,” Gupta and Whaley said.
“This far vaccinations remain the most reliable means to check the pandemic. Therefore, for our team, and other scientists studying measures and policies that can help bring the pandemic under control, it remains of paramount importance to continue to inform all stakeholders of the enormous realized benefits at the population level from state vaccination drives. We hope the findings of our study will be beneficial to clinicians, scientists, policymakers and citizens in promoting the uptake of these live-saving drugs,” they concluded.
The findings appeared in the journal Health Affairs.
As the highly contagious Delta variant is sweeping through the United States and other countries across the globe, retailers are reporting new mask shortages, bringing back memories from the pandemic’s debut.
Five states broke records for the average number of daily new COVID cases over the weekend, according to CNBC, despite the fact that this time a significant portion of the population is vaccinated. That’s because Delta is far more contagious than the original strain. For instance, these Chinese researchers previously found that people infected with Delta had about 1,000 times the viral load in their respiratory tract compared to those infected with the original strain.
Louisiana had 126 cases per 100,000 residents as of Sunday, which is more than three times the national average, while Mississippi and Florida averaged 110 and 101 cases per 100,000 residents, respectively.
“We’re in the middle of the summer, people are gathering again with people, they’re in large groups, the vaccine has given a false sense of security in some ways to people, and they forget,” Dr. Perry Halkitis, dean of the Rutgers School of Public Health, told CNBC
As a result of these surges in cases, many cities, businesses, and even entire states have reintroduced mask mandates, which has driven up the sale of cloth and surgical masks. Mask sales in the last week of July were up 51% over the week prior, according to Adobe’s Digital Economy Index, which tracks more than 1 trillion visits to U.S. retail sites.
However, this is as good a time as any to have a conversation about mask quality. You see, at the beginning of the pandemic, public health experts were very wary about what guidelines to issue concerning face covering. That’s because they were concerned that people would start hoarding vital medical supplies, leading to dangerous shortages for medical workers.
Although manufacturers and retailers are now reporting trouble keeping up with this recent heightened demand, the supply chain for personal protection equipment is much more robust than in early 2020. Back then, people were advised to use whatever they could find, even if that meant making a cloth mask with their own hands at home. Some facial covering is better than nothing at all, the thinking went.
But we’re past that now. Experts advise that people buy quality masks with a very tight fit that offer much more reliable protection from infection, especially for those who are unvaccinated or part of vulnerable populations.
“A cloth mask surely can give you some protection. But it’s not the kind of protection that you’ll get when you use a much more effective mask. We have not talked about that nearly enough,” Michael Osterholm, leading epidemiologist and Director of the Center for Infectious Disease Research and Policy at the University of Minnesota, told NBC’s Meet the Press.
According to Axios, N95 and KN95 are the most effective face coverings, followed by surgical masks, and then by cloth masks with a double layer. N95s are not suitable for children for all-day wear, who should wear a mask that has at least two layers.
You can find a list of reputed N95 mask resellers in the United States here.
As vaccination campaigns unfold across the world, almost 1 in 3 people worldwide have received at least one dose of a COVID-19 vaccine. But with so many people unable or unwilling to get a vaccine, the dreaded coronavirus won’t go away anytime soon.
As 99.5% of people killed by COVID-19 in the past 6 months were unvaccinated, researchers are still working on various treatments that could improve survival rates and reduce symptom intensity. Let’s have a look at some of the most promising ones.
There’s no magic pill — but treatments have progressed. Image credits: Danilo Alvesd.
As the pandemic unwinded, we’ve seen several potential treatments being trialed. From the hydroxychloroquine saga to steroids and even patient blood plasma, there’s been no shortage of COVID-19 trials. But it’s not always easy to tell what works, and trials haven’t been spared of controversy.
For instance, despite being touted by many as a useful drug, there’s still no strong evidence that ivermectin is an effective treatment against the coronavirus.
Potential treatments
Something that has been showing promise is dexamethasone, a glucocorticoid medication used to treat a range of conditions, from rheumatic problems, skin diseases, severe allergies, and asthma to brain swelling and eye pain following eye surgery.
Many doctors have been using corticosteroids as a treatment for COVID-19 even in the early stages of the pandemic — which makes a lot of sense. In patients whose immune systems are over-reacting (which is often what damages the lungs and other organs), corticosteroids like dexamethasone, which are also readily available and inexpensive, can be very useful as anti-inflammatory drugs.
Trials have backed this up and currently, the NIH recommends the use of dexamethasone in some people hospitalized with severe COVID-19, especially in those who require respiratory support.
It’s especially important to push effective treatments in areas where vaccinations are lagging.
Tocilizumab, a drug used for the treatment of rheumatoid arthritis, can also help some patients. A recent review found that “tocilizumab may have substantial effectiveness in reducing mortality among COVID-19 patients, especially among critical cases.” Another study noted that while the drug may not have a significant impact in non-critical cases, it can offer a “survival benefit” in critical cases.
Another approved treatment for COVID-19 is Remdesivir, developed by Gilead. Remdesivir was initially hailed with much promise, but more extensive surveys have shown that the biggest improvement is in the recovery time. Patients who received the drug had a median recovery time of 10 days as compared with 15 days. The drug also seems to offer a modest reduction of lower respiratory tract infections.
Rigel Pharmaceuticals’ drug fostamatinib (marketed in the US as TAVALISSE) could also show promise. The drug has recently been approved by regulators for a condition called chronic immune thrombocytopenia (a disorder that can lead to easy or excessive bruising and bleeding). More recently, the drug is also investigated for treating hospitalized coronavirus patients. In April 2021, a Phase II trial carried out with the NIH found that the drug halved the risk of serious adverse effects compared to standard treatment care. Rigel is currently gathering participants for a Phase III trial.
Another drug in the pipeline for COVID-19 is Lenzilumab, a monoclonal antibody that is currently undergoing assessments for controlled asthma and rheumatoid arthritis. A randomized, double-blind, placebo-controlled trial from the NIH is currently advancing, looking to assess the efficacy of Lenzilumab on 400 patients.
Something else which has been trialed is blood plasma from COVID-19 survivors. When people recover from the disease, their blood contains antibodies that can fight the coronavirus; if transferred to other people, this could also help others fight the disease more easily — or so the theory goes.
However, despite promising initial studies, recent reviews have found less convincing data. Some studies showed promising results, others didn’t, but the overall sample sizes are still relatively small, and the matter is far from settled.
Why it’s so hard to figure out what works
Ultimately, there is no unique, standardized treatment for COVID-19, and sometimes, different countries seem to have different ideas of what works. The main problem is that developing antiviral treatments is always hard — any antiviral drug needs to target a specific part of the virus’ lifecycle, and must be able to kill the virus while leaving the cell it occupies unharmed.
To make matters even worse, viruses tend to adapt quickly to treatments, and through mutations, can develop resistance to drugs.
However, treatments and patient care have progressed, and research is coming up fast. According to Harvard, the US government alone is investing over $3 billion to develop new antiviral medications both for COVID-19 and for future pandemic threats.
The best way to protect yourself is still through vaccination. Breakthrough infections (infections that break through the vaccine) are very rare, and when they do happen, they still pose a far smaller risk than in the unvaccinated.
A VISUALISATION BASED ON A STRUCTURAL ANALYSIS OF THE SARS- COV-2 VIRUS (IMAGE: ISO.FORM LLC/ CC-BY-4.0).
The Delta variant which is currently dominating COVID-19 cases in the United States and elsewhere in the world is much more contagious than earlier strains. What’s more, data from the CDC released last month suggests that vaccinated people can also transmit Delta, which wasn’t thought to be the case with other variants. Two new studies released this month confirm that the mRNA vaccines are less effective than during the original clinical trials before Delta. However, Moderna’s vaccine seems to offer significantly higher protection than the one designed by Pfizer/BioNTech.
Delta variant is putting a dent in vaccine efficacy, but Moderna seems to do better
All viruses evolve, undergoing mutations that can significantly change the way they spread and replicate. It’s a game of chance, and after hundreds of millions of dice rolls, new variants that are more dangerous than the original coronavirus strains were bound to surface.
Scientists have identified more than 20 mutations in the Delta variant, but two may be crucial in helping it transmit more effectively than earlier strains. The first is the L452R mutation, which increases the spike protein’s ability to bind to human cells, thereby increasing its infectiousness. This mutation may also aid the virus in evading the neutralizing antibodies produced by both vaccines and previous infection. The second is a novel T478K mutation on the virus’ spike protein that clings onto the ACE receptor in human cells, facilitating viral entry into the lungs.
After Delta was first identified in December 2020 in India, it quickly spread across the world and overpowered previous strains, becoming the dominant variant. By the end of July, Delta was causing more than 80% of new COVID-19 cases, according to the CDC.
The CDC further adds that Delta is more transmissible than the common cold and influenza, as well as smallpox and Ebola.
This means that people who are not vaccinated face a tremendous risk of infection and spreading the virus. The highest spread of cases and severe outcomes are happening in places with low vaccination rates, and the vast majority of hospitalizations of deaths have been among the unvaccinated.
However, this doesn’t mean that vaccinated people are completely immune — quite far from it. When an infection occurs in a vaccinated individual, doctors call it a “breakthrough case”. According to the CDC, even people with “breakthrough cases” carry tremendous amounts of virus in their nose and throat, and, according to preliminary reports, can spread the virus to others whether or not they have symptoms.
According to two new reports posted in pre-print on medRxiv, Moderna’s vaccine may result in fewer breakthrough cases than the product designed by Pfizer and BioNTech. An analysis of 50,000 patients from Minnesota, Florida, Wisconsin, Arizona, and Iowa registered in the Mayo Clinic Health System showed that the efficacy of Moderna’s vaccine dropped to 76% in July from 86% in January. However, Pfizer/BioNTech performed much worse, its efficacy dropping to 42% in July from 76% earlier this year.
In Florida, which is currently going through its worst COVID-19 surge to date, patients fully vaccinated with Moderna had a 60% lower risk of infection than those fully vaccinated with Pfizer/BioNTech, according to the Mayo study published by inference, a Massachusetts data analytics firm.
A second study that analyzed antibodies in fully vaccinated elderly patients in an elderly care home in Ontario seems to confirm Moderna’s superior protection.
“Residents administered mRNA-1273 (Moderna) mounted stronger total and neutralizing antibody responses than those administered BNT162b2 (Pfizer-BioNTech),” wrote the authors from the Lunenfeld-Tanenbaum Research Institute at Mount Sinai Hospital in Toronto, Canada.
Third dose boost may be warranted soon
Taken together, these recent findings suggest that a Moderna booster shot may be necessary for those who received a Pfizer vaccine earlier this year. A third dose booster may be particularly warranted for elderly individuals.
Another study of interest that appeared this weekend analyzed vaccine efficacy from another angle by looking at how the risk of infection was affected by the elapsed time since full vaccination in Israel, one of the first countries to have the majority of its citizens vaccinated. The study involved nearly 34,000 fully vaccinated adults with Pfizer/BioNTech’s product who were tested with a standard RT-PCR test between May 15 and July 26. The median time between their second dose of the vaccine and the RT-PCR test was 146 days and 1.8% of study participants had tested positive.
According to the results, the more time had elapsed since their second dose of vaccine, the higher the risk of infection, which adds further weight to the notion that a third booster shot may be required.
“In this large population study of patients tested for SARS-CoV-2 by RT-PCR following two doses of mRNA BNT162b2 vaccine, we observe a significant increase of the risk of infection in individuals who received their last vaccine dose since at least 146 days ago, particularly among patients older than 60,” the authors noted.
Although the two mRNA vaccines seem to be less effective against the Delta strain compared to the original strains, fully vaccinated individuals are getting infected to a much lesser extent than unvaccinated people. Moreover, although breakthrough infections may occur, the odds of them leading to hospitalization and death among fully vaccinated individuals are very low.
