Tag Archives: COVID-19

COVID-19 seems to affect the brain — even in mild cases

From early on in the pandemic, there’s been strong evidence of COVID-19 can take a toll on the brain and the nervous system – with symptoms like the loss of smell and taste as hallmarks of early infection. Now, a new study further demonstrated the mental toll of the virus, which was linked with significant, lasting brain abnormalities even in mild cases.

Image credit: Pixabay.

Researchers found that COVID-19 seems to reduce the brain’s gray matter, mainly in areas linked with memory processing and smell. These changes were observed in both people who required hospitalization and in those who had a less severe infections. The damage seen in the brain was beyond the structural changes that normally happen with age and could not be explained by other factors.

The study looked at changes in the brains of 785 people aged 51-81, who previously contributed brain scans to the UK Biobank, a large-scale database of brain imaging data from over 45,000 UK residents. Out of the participants, 401 had a COVID-19 infection sometime between March 2020 and April 2021 – with 4% hospitalized for infections.  

The remaining 384 participants didn’t have COVID-19 but matched the infected participants in age, sex, and COVID-19 risk factors, such as whether they had diabetes. They served as the control group as they had no record of confirmed or suspected COVID-19. Everyone in the study was subject to two brain scans to allow comparisons.

“Using the UK Biobank resource, we were in a unique position to look at changes that took place in the brain following mild—as opposed to more moderate or severe—SARS-CoV-2 infection,” Genaëlle Douaud, lead author on the study, said in a statement. “We saw a greater loss of gray matter volume in infected participants.”

COVID-19 and the brain

The team used magnetic resonance imaging (MRI) to look at the brains. MRI uses a magnetic field and radio waves to generate images of tissues in the body. The MRI scans showed clear shrinkage in the brains of the people who caught the disease. Participants of the study caught COVID-19 about 4.5 months before their second scan.

The infected group had larger tissue loss in specific regions of the cerebral cortex – the outer surface of the brain. Shrinkage was most pronounced in the orbitofrontal cortex (which plays an important role in sensation) and in the parahippocampal gyrus (which is important for encoding new memories).

At the same time, those infected with COVID-19 had a larger reduction in overall brain size than the control group without the virus, the study showed. The authors also found tissue damage in areas of the brain linked with the primary olfactory cortex – a structure that gets sensory information from scent-detecting neurons in the nose.

On average, those who had the virus showed 0.2% to 2% greater tissue loss and damage over the course of about three years, compared with the control group. Estimates suggest that adults lose between 0.2% to 0.3% of gray matter in regions related to memory each year, so the extra loss would be out of the ordinary.

“It’s the only study in the world to be able to demonstrate before vs after changes in the brain associated with SARS-CoV-2 infection,” Naomi Allen, chief scientists at the Biobank, said in a statement. “Collecting a second set of scans has generated a unique resource to enable scientists to understand how the virus affects internal organs.”

The study stops short of explaining how impactful these changes are on the brain, and how long-lasting they are. However, problems associated with COVID-19 appear to be more pervasive than initially thought, and the specter of long COVID will likely continue for a long time to come.

The study was published in the journal Nature.

A new Omicron subvariant, 30% more contagious, is starting to sweep the world

I know — we’re all tired of the pandemic and we’re all hoping it’d be over by now. But unfortunately, the virus doesn’t really care about media fatigue or how tired we all are of this pandemic.

While substantial progress has been made on the vaccination front, new variants continue to emerge, and researchers warn that the pandemic is still not done yet. Now, a new Omicron variant (BA.2) is surging in several parts of the world, including the US, UK, and Hong Kong.

Graph made by William Ku, with data from the CDC.

Researchers warned us from the beginning that until we reach herd immunity at a global level, new variants will continue to emerge and we’d still be stuck in a pandemic — and this is exactly what we’re seeing now. After the more contagious Delta variant came in and swooped over the Alpha and Beta variants, Omicron made it all look like a joke.

The contagiousness math adds up very quickly.

Alpha was 50% more contagious than the original Wuhan strain. Delta is 40-60% more contagious than Alpha. Omicron is 105% more contagious than Delta. Now, the BA.2 Omicron variant appears to be 30% more contagious than the original Omicron, and we’re seeing the number of cases spike accordingly.

The emergence of the new subvariant coincides with a wave of lifting restrictions. Countries (especially those with a relatively high level of vaccination) were quick to relax restrictions and ease the political, social, and economic pressure they were causing — but this has come at a cost.

In the UK, the BA.2 variant has become dominant, and while at some point it seemed that the Omicron wave would simply burn out in the country, we’re seeing a new surge in cases and hospitalizations are starting to follow.

What we know about BA.2 Omicron so far

While it clearly appears to be more transmissible (and will likely become dominant across the world), we still don’t know how severe this subvariant is. Lab experiments from Japan suggest that it may have Delta-like characteristics and may cause more severe illness.

“More importantly, the viral RNA load in the lung periphery and histopathological disorders of BA.2 were more severe than those of BA.1 and even B.1.1. Together with a higher effective reproduction number and pronounced immune resistance of BA.2, it is evident that the spread of BA.2 can be a serious issue for global health in the near future,” a study not yet peer-reviewed concludes.

However, a separate study from South Africa found that a similar proportion of individuals with BA.1 and BA.2 infections required hospitalization, and data from Denmark suggests similar hospitalization rates for BA.1 and BA.2.

As is always the case with new variants and subvariants, it’s hard to tell exactly how things stand in the beginning. It’s also curious that while it seems to be taking over in several parts of Asia and Europe, BA.2 transmission in the US seems relatively low.

Importantly, while Omicron BA.2 shows some ability to evade vaccine immunity, it seems that boosters still provide excellent immunity. Overall, BA.2 shows the already well-known Omicron ability to evade some of the protection offered by two shots — but three shots offer over 90% protection against hospitalization.

Image credits: William Ku, with data from the CDC.

Long-term, it seems that booster-provided protection wanes in time, and the rate of booster shot delivery has also slowed down, presumably as people’s interest in the pandemic also wanes. But variants don’t care how much attention you’re paying.

Did we rip the bandaid too soon?

Another reason why BA.2 is spreading so quickly is that many countries have relaxed restrictions — or removed them altogether. Some researchers believe this was done too quickly.

In addition to extra transmissibility, the BA.2 subvariant also appears to be capable of escaping some of the treatments we have for COVID-19. While the original Omicron was capable of evading two of the four monoclonal antibody drugs used in infections in high-risk individuals, a study from New York University suggests that BA.2 can bypass a third drug, sotrovimab.

Researchers also caution that even mild cases can cause lasting brain damage (and potentially other problems as well). A study from Oxford found that the virus produces changes in the brain and may shrink grey matter.

Ultimately, the vast majority of people with booster shots should be able to evade the worst of the virus effects — but they can still be in for an unpleasant ride.

Emissions drop during pandemic contributed to record rainfall in China

In China, the COVID-19 social and economic shutdown coincided with record rainfall in eastern provinces in 2020 — and it’s no coincidence. This record rainfall quickly turned into flooding, leaving behind hundreds of deaths and millions evacuated. In a new study, researchers found that the extreme rainfall could have been caused by the drop in emissions registered in the country.

Image credit: Wikipedia Commons.

After rising swiftly for decades, global greenhouse gas emissions (GEI) dropped 6.4% in 2020, as the pandemic limited economic and social activities worldwide. The US contributed to most of the decline, while China saw a minor decrease (1.4%) because its economy recovered quickly after the outbreaks in early 2020, according to a 2021 study.

The emissions drop was linked with persistent extreme precipitation in the early and middle summer of 2020 in eastern China, a densely populated and urbanized region. The accumulated rainfall was so big that it broke its 60-year-record since 1961. Rain in the Yangtze River Delta, for example, exceeded the 41-year average by 79%.

Studies have looked at what could have caused this significant change in rainfall, with some suggesting it had something to do with the extreme weather conditions in the Indian Ocean. But a group of researchers wasn’t entirely convinced with this, suggesting that the abrupt drop in emissions was a key factor of the steep rain.

“Aerosols can affect clouds, precipitation, hydrological cycle and atmospheric circulation through microphysical as well as dynamical processes,” the researchers wrote. “In the last four decades, summer precipitation over eastern-central China has decreased significantly, which has been reported to be closely related to the increase in aerosols.”

Rain and greenhouse gas emissions

For the study, the researchers used the Energy Exascale Earth System Model, an ongoing, state-of-the-science Earth system modeling, simulation, and prediction project. It simulates most of the anthropogenic aerosol species, including sulfate, black carbon, and primary organic matter along with sea salt aerosols and natural dust.

Aerosols, usually linked with the burning of fossil fuels, can reduce the frequency of large-scale storms, leading to fewer rains. This new study suggests that the absence of these particles and lower greenhouse gas emissions caused the opposite effect, a big increase in rain. But the events that link the pandemic with the flood are more complex, the researchers said.

Lead author Yang Yang from Nanjing University told BBC that the aerosol reduction caused heating over land, while the decline in emissions caused cooling over the ocean. This intensified the temperature difference between land and sea while increasing sea level pressure and intensifying the winds bringing moist air to eastern China, which saw the intense rain.

Looking ahead, the researchers said the sudden change of the climate system driven by the Covid-19 crisis in 2020 would be very different from the changes triggered by the continuous but gradual emissions reduction to tackle global warming. This doesn’t mean we shouldn’t worry. If the world can’t reduce emissions faster, this could trigger more extreme weather events.

The study was published in the journal Nature.

The fascinating science behind the first human HIV mRNA vaccine trial – what exactly does it entail?

In a moment described as a “potential first step forward” in protecting people against one of the world’s most devastating pandemics, Moderna, International AIDS Vaccine Initiative (IAVI), and the Bill and Melinda Gates Foundation have joined forces to begin a landmark trial — the first human trials of an HIV vaccine based on messenger ribonucleic acid (mRNA) technology. The collaboration between these organizations, a mixture of non-profits and a company, will bring plenty of experience and technology to the table, which is absolutely necessary when taking on this type of mammoth challenge.

The goal is more than worth it: helping the estimated 37.7 million people currently living with HIV (including 1.7 million children) and protecting those who will be exposed to the virus in the future. Sadly, around 16% of the infected population (6.1 million people) are unaware they are carriers.

Despite progress, HIV remains lethal. Disturbingly, in 2020, 680,000 people died of AIDS-related illnesses, despite inroads made in therapies to dampen the disease’s effects on the immune system. One of these, antiretroviral therapy (ART), has proven to be highly effective in preventing HIV transmission, clinical progression, and death. Still, even with the success of this lifelong therapy, the number of HIV-infected individuals continues to grow.

There is no cure for this disease. Therefore, the development of vaccines to either treat HIV or prevent the acquisition of the disease would be crucial in turning the tables on the virus.

However, it’s not so easy to make an HIV vaccine because the virus mutates very quickly, creating multiple variants within the body, which produce too many targets for one therapy to treat. Plus, this highly conserved retrovirus becomes part of the human genome a mere 72 hours after transmission, meaning that high levels of neutralizing antibodies must be present at the time of transmission to prevent infection.

Because the virus is so tricky, researchers generally consider that a therapeutic vaccine (administered after infection) is unfeasible. Instead, researchers are concentrating on a preventative or ‘prophylactic’ mRNA vaccine similar to those used by Pfizer/BioNTech and Moderna to fight COVID-19.

What is the science behind the vaccine?

The groundwork research was made possible by the discovery of broadly neutralizing HIV-1 antibodies (bnAbs) in 1990. They are the most potent human antibodies ever identified and are extremely rare, only developing in some patients with chronic HIV after years of infection.

Significantly, bnAbs can neutralize the particular viral strain infecting that patient and other variants of HIV–hence, the term ‘broad’ in broadly neutralizing antibodies. They achieve this by using unusual extensions not seen in other immune cells to penetrate the HIV envelope glycoprotein (Env). The Env is the virus’s outer shell, formed from the cell membrane of the host cell it has invaded, making it extremely difficult to destroy; still, bnAbs can target vulnerable sites on this shell to neutralize and eliminate infected cells.

Unfortunately, the antibodies do little to help chronic patients because there’s already too much virus in their systems; however, researchers theorize if an HIV-free person could produce bnABS, it might help protect them from infection.

Last year, the same organizations tested a vaccine based on this idea in extensive animal tests and a small human trial that didn’t employ mRNA technology. It showed that specific immunogens—substances that can provoke an immune response—triggered the desired antibodies in dozens of people participating in the research. “This study demonstrates proof of principle for a new vaccine concept for HIV,” said Professor William Schief, Department of Immunology and Microbiology at Scripps Research, who worked on the previous trial.

BnABS are the desired endgame with the potential HIV mRNA vaccine and the fundamental basis of its action. “The induction of bnAbs is widely considered to be a goal of HIV vaccination, and this is the first step in that process,” Moderna and the IAVI (International AIDS Vaccine Initiative) said in a statement.

So how exactly does the mRNA vaccine work?

The experimental HIV vaccine delivers coded mRNA instructions for two HIV proteins into the host’s cells: the immunogens are Env and Gag, which make up roughly 50% of the total virus particle. As a result, this triggers an immune response allowing the body to create the necessary defenses—antibodies and numerous white blood cells such as B cells and T cells—which then protect against the actual infection.

Later, the participants will also receive a booster immunogen containing Gag and Env mRNA from two other HIV strains to broaden the immune response, hopefully inducing bnABS.

Karie Youngdahl, a spokesperson for IAVI, clarified that the main aim of the vaccines is to stimulate “B cells that have the potential to produce bnAbs.” These then target the virus’s envelope—its outermost layer that protects its genetic material—to keep it from entering cells and infecting them.  

Pulling back, the team is adamant that the trial is still in the very early stages, with the volunteers possibly needing an unknown number of boosters.

“Further immunogens will be needed to guide the immune system on this path, but this prime-boost combination could be the first key element of an eventual HIV immunization regimen,” said Professor David Diemert, clinical director at George Washington University and a lead investigator in the trials.

What will happen in the Moderna HIV vaccine trial?

The Phase 1 trial consists of 56 healthy adults who are HIV negative to evaluate the safety and efficacy of vaccine candidates mRNA-1644 and mRNA-1644v2-Core. Moderna will explore how to deliver their proprietary EOD-GT8 60mer immunogen with mRNA technology and investigate how to use it to direct B cells to make proteins that elicit bnABS with the expert aid of non-profit organizations. But readers should note that only one in every 300,000 B cells in the human body produces them to give an idea of the fragility of the probability involved here.

Sensibly, the trial isn’t ‘blind,’ which means everyone who receives the vaccine will know what they’re getting at this early stage. That’s because the scientists aren’t trying to work out how well the vaccine works in this first phase lasting approximately ten months – they want to make sure it’s safe and capable of mounting the desired immune response.

And even though there is much hype around this trial, experts caution that “Moderna are testing a complicated concept which starts the immune response against HIV,” says Robin Shattock, an immunologist at Imperial College London, to the Independent. “It gets you to first base, but it’s not a home run. Essentially, we recognize that you need a series of vaccines to induce a response that gives you the breadth needed to neutralize HIV. The mRNA technology may be key to solving the HIV vaccine issue, but it’s going to be a multi-year process.”

And after this long period, if the vaccine is found to be safe and shows signs of producing an immune response, it will progress to more extensive real-world studies and a possible solution to a virus that is still decimating whole communities.

Still, this hybrid collaboration offers future hope regarding the prioritization of humans over financial gain in clinical trials – the proof is that most HIV patients are citizens of the third world.

As IAVI president Mark Feinberg wrote in June at the 40th anniversary of the HIV epidemic: “The only real hope we have of ending the HIV/AIDS pandemic is through the deployment of an effective HIV vaccine, one that is achieved through the work of partners, advocates, and community members joining hands to do together what no one individual or group can do on its own.”

Whatever the outcome, money is no longer a prerogative here, and with luck, we may see more trials based on this premise very soon.

New, fast and high-accuracy test developed for COVID-19 infections

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.

Scientists identify the specific gene that protects against severe COVID-19

Researchers from Karolinska University have discovered a gene that reduces the severity of Covid infections by 20%. In their paper the scientists state that this explains why the disease’s symptoms are so variable, hitting some harder than others.

Why do some people fall severely ill from COVID-19 while others don’t? In addition to risk factors like age or obesity and plenty of other environmental factors, it also comes down to our varying genetic makeup. Therefore, researchers across the globe have begun the mammoth task of mapping the genes involved in making people more susceptible to catching SARS-CoV-2 (COVID-19) and developing a severe infection.

These large-scale efforts have thrown up more than a dozen genomic regions along the human chromosome containing large clusters of genes associated with severe COVID-19. However, the specific causal genes in these regions are yet to be identified, hampering our ability to understand COVID-19’s often selective pathology.

Now, scientists build on these findings to pinpoint a gene that confers protection from critical illness.

Neanderthal DNA protects against severe COVID-19

The previous studies from 2020 concentrated on the genetic data of people of European ancestry recorded by multi-disciplinary teams all over the world for the 1000 Genomes Project. This monumental collaboration uncovered a specific segment of DNA known as the OAS1/2/3 cluster, which lowers the risk of developing an acute COVID-19 infection by 20%. Inherited from Neanderthals in roughly half of all people outside of Africa, this segment is responsible for encoding genes in the immune system.

The genetic array came about as a result of the migration of an archaic human species out of the African continent about 70,000 years ago who mated and mingled DNA with Neanderthals reproduced in their offspring’s haplotypes, a set of inheritable DNA variations close together along a chromosome. 

However, most human haplotypes outside Africa now include DNA from Neanderthals and Denisovans (an ancient human originating in Asia). Consequently, this ancient region of DNA is heaving with numerous genetic variants, making it challenging to distinguish the exact protective gene that could serve as a target for medical treatment against severe COVID-19 infection.

A possible solution is that people of African descent do not contain these archaic genes in their haplotypes, making them shorter and easier to decipher.

To test this theory, the researchers checked the 1000 Genomes project database for individuals carrying only parts of this DNA segment – focusing on individuals with African ancestry who lack heritage from the Neanderthals. Remarkably, the researchers found that individuals of predominantly African ancestry had the same protective gene cluster as those of European origin.

Genetic studies should be a multi-cultural affair

Once they established this, the researchers collated 2,787 COVID-19 cases with the genetic data of 130,997 individuals of African ancestry to reveal the gene variant rs10774671 G thought to convey protection against COVID-19 hospitalization. Their results correspond to a previous, more extensive study of individuals of European heritage, with analysis suggesting it is likely the only causal variant behind the protective effect.

Surprisingly, this previously ‘useless’ ancient variant was found to be widespread, present in one out of every three people of white European ancestry and eight out of ten individuals of African descent.

In evolutionary terms, the researchers write that the variant exists today in both these gene pools “as a result of their inheritance from the ancestral population common to both modern humans and Neanderthals.” Accordingly, their data adds more weight to the standard held theory that a common ancestor originated in Africa millions of years ago before sharing their DNA across the globe.

And while there’s much more to uncover regarding the newly discovered variant, the researchers can firmly suggest at this stage that the protective gene variant (rs10774671 G) works by determining the length of a protein encoded by the gene OAS1. As the longer version of the protein is more effective at breaking down the virus than the unaltered form, a life-threatening infection is less likely to occur.

Using genetic risk factors to design new COVID-19 drugs

Despite their promising results, the team cautions that the 1000 Genomes Project does not provide a complete picture of this genomic region for different ancestries. Nevertheless, it’s clear that the Neanderthal haplotype is virtually absent among individuals of primarily African ancestry, adding, “How important it is to include individuals of different ancestries” in large-scale genetic studies.

Senior researcher Brent Richards from McGill University says that it is in this way “we are beginning to understand the genetic risk factors in detail is key to developing new drugs against COVID-19.”

If these results are anything to go by, we could be on the cusp of novel treatments that can harness the immune system to fight this disease.

Nocebo effect could cause most COVID-19 vaccine symptoms

You’ve probably heard of the placebo effect — when patients think they’re getting an actual drug but they’re just getting a sugar pill or a hollow shell — and they recover just like they had been taking the actual drug. But the placebo effect also has a negative side, called the nocebo effect, when patients exhibit negative side effects after taking treatments with no pharmacological effects. This could be the case with some COVID-19 vaccines.

Image credit: Flick / New York National Guard.

In a meta-analysis of placebo-controlled COVID-19 vaccine trials, researchers compared the rate of adverse effects reported by those who got the vaccines to the one by patients who got the placebo shot (as in, an empty shot that isn’t actually a vaccine). Overall, two-thirds of participants reported adverse effects such as headaches and fatigue — including the ones in the placebo group.

In other words, a lot of the people reporting side effects didn’t get the vaccine at all. Instead, it was the nocebo effect giving them side effects, researchers argue.

“Nonspecific symptoms like headache and fatigue are listed among the most common adverse reactions following COVID-19 vaccination in many information leaflets,” senior author Ted Kaptchuk said in a statement. “This sort of information may cause people to misattribute common daily background sensations as arising from the vaccine.”

The researchers analyzed data from 12 clinical trials of Covid-19 vaccines. Trials included adverse effect reports from over 22,000 placebo recipients and 22,000 vaccine recipients. After the first shot, over 35% of those who got the placebo had adverse effects such as headaches and 16% reported a local event, such as swelling.

In comparison, 46% of vaccine recipients had at least one adverse effect, with two-thirds reporting at least one local event. While they had the actual vaccine treatment, researchers argue that at least some of their side effects can be attributed to the nocebo effect — considering some of the same effects happened in the placebo group. 

The researchers then looked at the side effects after the second shot. The rate of headaches and systemic symptoms was twice as high in those who got the vaccine compared to the placebo group, at 61% and 32% respectively. The gap was larger for local events, reaching 73% in vaccine recipients and 12% in the placebo group.

“Collecting systematic evidence regarding these nocebo responses in vaccine trials is important for COVID-19 vaccination worldwide, especially because concern about side effects is reported to be a reason for vaccine hesitancy,” lead author Julia W. Haas, PhD, an investigator at the Beth Israel Deaconess Medical Center, said in a statement.

The side effects of COVID-19

With over five million deaths worldwide because of the ongoing pandemic, vaccination programs have been very successful in reducing the number of new infections and the number of hospitalizations. However, about 20% of the population still refuse vaccination. In 2019, before the COVID-19 pandemic, the WHO described vaccination hesitancy as a global threat — and this year, we saw just how big of a threat this can be. 

Common symptoms such as headache and fatigue, which the study has associated with the nocebo effect, are listed among the most common adverse effects of COVID-19 in many information leaflets. This information can increase nocebo mechanisms and make patients falsely attribute symptoms to vaccination.

Full disclosure and education about nocebo effects could be helpful to address this, the researchers argued. Adding simple and accurate information about nocebo to the informed consent procedure can reduce medication-related adverse effects. Highlighting the possibility of not experiencing adverse effects can also be beneficial, they conclude. 

The study was published in the journal JAMA. 

WHO chief warns that the pandemic is ‘far from over’

The pandemic is “nowhere near over,” cautions the Director general of the World Health Organization (WHO), Tedros Ghebreyesus.

Image via United States Mission Geneva / Flickr.

Ghebreyesus’ statement, issued Monday at the World Health Summit in Berlin, comes against a backdrop of countries reporting record numbers of new infections, especially in the 24 hours leading to the statement. This dramatic increase in cases is largely fueled by the more infectious Omicron strain and is already pushing governments to take more action against the virus.

Still here, going nowhere

“The pandemic will end when the world chooses to end it. It is in our hands, we have all the tools we need: effective public health tools and effective medical tools,” he added.

Several countries around the world are looking at staggering rates of daily new coronavirus cases. In the United States, the number of new cases has once again reached 1 million per day on January 18, after slightly dipping below that over the last week.

Europe is not faring very well either. Germany has blazed past 100,000 new cases per day, and reports from France show that it has passed 460,000. In the rest of the world, Brazil has shattered its previous record of new cases, reaching over 135,000 new cases.

The Omicron strain is considered to drive a large percentage of these cases. Due to its infectiousness, the WHO estimates that it will infect half of all Europeans by March. That is an understandably chilling prospect for lawmakers, who fear that high infection rates will translate into a much higher number of people seeking medical help; hospitals are already struggling to handle COVID-19 patients, and a sizable increase in demand could swamp healthcare services on a wide scale.

Governments around the world are already ramping up efforts against the virus by instituting new containment measures and speeding the rollout of vaccine boosters.

“Omicron may be less severe, on average, but the narrative that it is a mild disease is misleading,” Ghebreyesus added on Tuesday.

Omicron is currently responsible for over 70% of new cases, at least in Europe — but likely elsewhere as well.

These developments come just a few days after the two-year anniversary of the first known death caused by COVID-19, on January 11, 2020. Since then, the virus has claimed over 5.5 million lives according to official records, but likely more.

In light of these developments, the World Tourism Organization cautioned businesses and lawmakers in Europe not to expect foreign arrivals to return to their normal volume until 2024 at the earliest. Tourism and travel inside the EU remain affected as well, due to both disruptions in air travel and local containment measures.

Other areas of the world have also tightened restrictions for international and local travel in a bid to control the spread of the virus. One exception seems to be China, which marginally relaxed some internal travel restrictions in preparation for the Lunar New Year holiday later this month.

Masks made of ostrich cells make COVID-19 glow in the dark

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 the Brazilian 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.”

Scientists may have solved the mystery of long COVID

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.

New COVID variant identified in France — but experts say we shouldn’t fear it

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.

Protection from the AstraZeneca vaccine drops significantly three months after the second dose

If you were looking for yet another reason on why to get a COVID-19 booster, here’s one. The protection given from the Oxford-AstraZeneca vaccine starts declining after three months of getting the second dose, according to a new study. The researchers analyzed data from 42 million vaccinated people in Brazil and two million in Scotland, finding that a quick booster is important. 

Image credit: Flickr / Province of British Columbia.

Three months after the second AstraZeneca dose, the risk of hospitalization and death is double that of two weeks after the second dose, the researchers found. The risk increases threefold four months after the second dose and fivefold after five months. The study showed similar numbers in Brazil and Scotland. 

Both countries had a similar 12-week interval between the two doses, and both prioritized health workers and people at risk of severe disease. However, the two countries had a different dominant variant, which suggests that the decline in effectiveness was likely due to vaccine waning and not due to variations in one variant or the other. 

“By drawing on findings from data sets in two countries with differing dominant COVID-19 variants, the researchers have been able to disentangle vaccine waning from the effects of changes in variants – strengthening the evidence for the ongoing booster programme,” Andrew Morris, Director of Health Data Research UK, said in a statement. Still, the figures should be treated with caution, the researchers argued, as it’s difficult to compare unvaccinated to vaccinated people with similar characteristics, especially among older age groups with more people vaccinated.

The growing need for boosters

Professor Aziz Sheikh, Director of the University of Edinburgh’s Usher Institute and study lead, said that thanks to the findings, governments will now be able to design booster programs to ensure maximum protection remains. “If eligible for a booster and you have not had yet had one, I would highly recommend that you book one soon,” he added. 

The call for booster COVID-19 shots has been intensified amid the expansion of the new Omicron variant, first identified in South Africa in late November. Researchers and doctors are now trying to grasp the risk that the new variant represents, with initial data suggesting that it is spreading faster than the previous Delta variant.

In fact, Omicron seems to be displacing Delta, as it’s much more contagious. The variant is already present in 89 countries, according to the World Health Organization (WHO), with cases doubling every 1.5 to 3 days where there’s community spread.

Both Pfizer/BioNTech and Moderna already said that two doses of their COVID-19 vaccines don’t provide enough protection against Omicron, but three doses do. So if you need another reason to get a booster as quickly as possible, there it is.

The study behind the AstraZeneca vaccine was published in The Lancet.

Cases of eating disorders have doubled in the US during the pandemic

The number of hospitalizations for health disorders has doubled across the US during the pandemic (between January 2018 and December 2020), according to new research. The largest part of this increase was represented by cases of anorexia or bulimia.

Image via Pixabay.

Despite this, other common behavioral health conditions such as depression, alcohol use, or opioid use disorder, haven’t registered any meaningful changes during this time.

Eating issues

“This pandemic era is going to have some long-term impacts on the course of disease and the course of weight over the lifespan,” says Kelly Alison, Ph.D., Director of the Center for Weight and Eating Disorders at the University of Pennsylvania, co-author of the paper. “What that does for eating disorders? We just don’t know.”

Although the team can’t yet tell what the cause of this increase is, they believe that we’re looking at the combined effect of several factors ranging from the toll the pandemic has taken on our mental health, an outsized focus on weight gain in parallel with constantly viewing ourselves on video calls, and even symptoms of COVID-19 itself. There is also very little data on how this trend will affect public health in the long run.

The study included data from over 3.2 million individuals across the U.S., with a mean age of 37.7 years old. According to the findings, the number of inpatient care cases for eating disorders remained pretty stable over time, at approximately 0.3 cases per 100,000 people per month, until May 2020. At that date, the number of cases doubled, to 0.6 per 100,000. This increase was registered across anorexia nervosa, bulimia nervosa, and other and unspecified eating disorders.

The average length of inpatient stays for such cases has also increased. This was on average 9 days and 8 days between June to December of 2018 and 2019, respectively, going up to 12 days between June and December of 2020. A similar increase was not seen for the 3 behavioral health conditions used as controls over the same timeframe.

As far as outpatient care cases for eating disorders have increased from around 25 per 100,000 people per month to 29 per 100,000. The age range of inpatient patients ranged from 12 to 20 pre-pandemic, rising to 18 to 28 after its onset.

The average length of inpatient stays for such cases has also increased. This was on average 9 days and 8 days between June to December of 2018 and 2019, respectively, going up to 12 days between June and December of 2020. A similar increase was not seen for the 3 behavioral health conditions used as controls over the same timeframe.

Stress caused by the pandemic and the changes it caused in our lives could be one of the drivers of this increase, the team reports. Additionally, the shift towards video calls for conferences at work gives us ample opportunity to look at ourselves, which can create a further drive towards the development of eating disorders.

“During the pandemic, having a lack of routine and structure primed us in terms of our behaviors around food,” says Ariana Chao, Ph.D., from Penn’s School of Nursing.

Social media reflects this increase in self-scrutiny and concerns regarding weight, the authors report. As far as eating disorders are concerned, discussions about weight can be “very triggering”, Allison explains, so social media can create a lot of stress in patients at risk. Different people handle this stress differently, the team adds, with some binge eating, while others didn’t eat enough.

For now, it’s not clear whether the rising trend in eating disorder cases will continue after the pandemic. The present study is based on data up to December 2020, so it’s missing the latest part of the picture. The team is now hard at work analyzing data recorded well into 2021 to see how these trends are evolving.

“We really need more research,” says Chao. “Adversity can be a long-term predictor of developing eating disorders. Even the transition back to ‘normal’ can exacerbate eating disorders. Everything is changing so rapidly. Then again, people are also resilient. It’s hard to say what the long-term implications will be.”

The paper “Trends in US Patients Receiving Care for Eating Disorders and Other Common Behavioral Health Conditions Before and During the COVID-19 Pandemic” has been published in the journal JAMA Network Open Psychiatry.

UK faces new surge of COVID-19 infections due to Omicron variant

The Omicron Covid-19 variant, which appears to be more contagious than other previous strains of the virus, is expanding fast across the United Kingdom, and the government is preparing a new set of restrictions. The country has already registered the first death of a person with the variant, which is expected become dominant in London in the next few days.

UK Prime Minister Boris Johnson. Image credit: Flickr / Number 10.

As of Monday, there were 4,714 confirmed cases of Omicron in the UK, according to Health Secretary Sajid Javid speaking to Parliament, with the total daily infections with all strains estimated at 200,000. Javid said the new variant is spreading “at a phenomenal rate, doubling every two days in infections.” That’s something never seen before in the pandemic, he added.

The UK has already increased its Covid-19 alert level to four, which means a high or rising level of transmission — a level that hadn’t been seen in place since May. New guidelines were also implemented this week, asking people to work from home whenever possible and wear a mask when going to the shops and on public transportation — something that was previously not the case in Britain.

“Sadly at least one patient has now been confirmed to have died with Omicron,” Prime Minister Boris Johnson told reporters when visiting a vaccination center. “So I think the idea that this is somehow a milder version of the virus – I think that’s something we need to set on one side – and just recognize the sheer pace at which it accelerates.”

Johnson set the target of offering every adult a third Covid-19 vaccine by the end of December, a month earlier than originally planned. The government had already reduced the period between the second and third doses from six months to three – focusing its Covid response in vaccination instead on reimposing further restrictions.

The Prime Minister also said there’s “a tidal wave of Omicron” on its way to the UK but showed confidence on the booster shot, which could bring protection levels back up. Two doses of the Covid-19 vaccine “are simply not enough to give the level of protection we all need,” he added, encouraging people to get their new shot. 

The speech seemed to have had an effect, as long queues were reported outside vaccination sites in the UK and the National Health Service (NHS) website to book the booster shot even crashed on Monday. The NHS returned this week to the highest level of emergency preparedness, which means the response to Omicron will be nationally coordinated.

It won’t stop in the UK

The new variant is still being studied by researchers around the world but reportedly has more mutations than those of the Delta variant and could be more resilient against vaccination. The World Health Organization (WHO) designated Omicron as a variant of concern, the fifth so far to obtain that classification, as countries tighten restrictions. Although it’s still early days, this is by far the most contagious strain of the virus we’ve seen.

Maria van Kerkhove, WHO’s technical manager of the pandemic, told El Pais newspaper that the world is “facing a tsunami of infections” because of the Delta and the Omicron variants. She asked governments not to delay action, suggesting the use of masks, remote working and preparing hospitals but dismissing new quarantines. 

In an initial study, Pfizer and BioNTech, manufacturers of one of the Covid-19 vaccines currently available, found a 25-fold reduction in the neutralization ability of vaccines against the Omicron variant. Nevertheless, the two companies argued an extra boosted shot would provide the sufficient protection to fight the strain of the virus.

Will COVID-19 kill the open-plan office?

Taking down walls makes office cheaper, but it also made them perfect spreaders for viruses and bacteria. A flood of changes promises to bring back those walls — or rather, take a bite out of the office itself.

Viral transmission

It was supposed to be the ‘better’ way, a design that would foster collaboration, creativity, and cooperation among teams. Companies loved it, and the open plan office became the default of many corporations. However, it wasn’t just ideas and thoughts that were easily shared, but also pathogens.

A decade ago, researchers in Arizona conducted a study to see just how fast a virus can spread inside an average office space. They placed a nonpathogenic virus on the door to an open plan office with 80 employees. In only 4 hours, over half of the commonly touched surfaces became contaminated. By the end of the day, virtually the entire office (as well as the bathrooms, doors, and breakroom) were contaminated.

“Behaviors in the workplace contribute to the spread of human viruses via direct contact between hands, contaminated surfaces and the mouth, eyes, and/or nose,” the researchers conclude.

As it turns out, while creativity and cooperation may be hard to quantify, viral spread was not, and open plan offices were more likely to make people sick. A recent study found that people working in this type of office were more likely to take sick days off.

When the COVID-19 pandemic came, the viral transmission hazards of offices confirmed, and open offices were linked to viral transmission. Droplets from a single sneeze can travel several meters, contaminating surfaces for days; even if carefully cleaned, the open office was bound to be less safe than more isolated types of offices.

Then, after people increasingly started working from home last year, returning to work in an open plan office simply seemed unacceptable to most. Many workplaces introduced layout changes including buffer zones and plastic screens intended to reduce the risk of viral transmission, up to the point where there was even a plexiglass shortage.

But this created the illusion of safety rather than actual safety, and people weren’t too keen to return to open spaces — and not just because of the pandemic.

A growing list of grievances

The open plan office, it turns out, had it coming from a long time ago.

Systematic surveys showed that the effects of open-plan offices were not always as positive as purported. Many workers complained about high levels of noise which was hampering productivity and causing stress and higher blood pressure in workers. Many would scurry on to quiet rooms, and it was not uncommon for open offices to actually decrease face-to-face conversations — in the noise and the crowd, direct communication ironically became rarer. In one 2018 study, face-to-face communication was found to decline by up to 70% due to the open office, while electronic communication increased as employees began to “socially withdraw”. Another 2018 study found that employees were aware of the viral transmission risks associated with open spaces, and the fear of infection triggered significant stress. Workers also reported feeling more distracted in open spaces.

Furthermore, the open space takes away what little privacy employees have. It’s hard to hide a cluttered desk in an open space, and it’s likely that everyone around will know what you’re eating — and when. If your job entails phone conversation, that’s also a problem: one study found that employees were less likely to share honest opinions on phone calls while in an open space, due to fears that their co-workers may hear them.

Indeed, the open plan office, the lovechild of so many corporations, was in trouble way before the pandemic.

For all the advantages it offered, like easier office logistics and breaking up silo working, open spaces seemed to cause a fair bit of trouble. The thing is, even though many disliked open spaces, they didn’t have much of a say in the matter. At least, until recently.

The Great Resignation and working from home

Working from home has a draw that many employees have discovered during the pandemic.

Among the many unexpected consequences of the pandemic is a phenomenon people are starting to call The Great Resignation. Basically, the world is experiencing an unexpected exodus of workers. A whopping 4 million Americans a month are quitting their jobs, and workers in other parts of the world are echoing similar trends, sending shockwaves across the entire market.

It’s hard to say why this is happening. A part of it can be traced to economic initiatives meant to tackle the effects of the pandemic, but that’s just the tip of the iceberg. A lot of people are feeling burned out, want a better life balance, or are just looking for better or more meaningful jobs. To add even more fuel to this fire, plenty of workers have become accustomed to the advantages of working from home and are prepared to quit their jobs if they’re not given the option of working from home.

“What will it take to encourage much more widespread reliance on working at home for at least part of each week?” asked Frank Schiff, the chief economist of the US Committee for Economic Development, in The Washington Post in 1979. Now, we know: a pandemic and a great wave of resignations.

Basically, the pandemic has shown that in a great number of cases, we can in fact work from home — despite what some employers would have you believe. A whopping 37 percent of U.S. jobs could potentially be done remotely, and this spells trouble for all offices, not just open ones.

Indeed, for many jobs, the technology of working from home is already easily accessible. It was the culture of the workplace that was keeping people inside the workplace. But now, that’s all been blown open.

The clock is ticking, but change is unlikely to be definitive

Semi-open spaces, or other types of designs tweaking the open space may be more palatable for workers in the near future.

From the very start, the idea behind open plan offices was flexibility and freedom; but now, many people want a different type of flexibility and freedom. In the short term, the pandemic virtually stopped the usage of such offices, but in the long run, it triggered changes that will likely lead to their downfall.

However, this doesn’t mean that the concept will become obsolete or go away — far from it. But the idea that the open plan office is the space of the future (as some companies were keen to believe) seems bound to fail. There is still a place for these offices in some companies, in some instances, but it’s not a panacea or a universally desirable solution; the open plan office is likely to become a niche rather than a go-to option.

Of course, offices as a whole will likely change and clever design changes may yet salvage open spaces or help convert them into something more palatable. Truth be told, we’re not sure what type of offices will be desirable, or how the idea of the office will morph in this extremely volatile period.

Ultimately, the cascade of changes triggered by the pandemic is far from over — it’s just beginning. We’re just starting to see their effects, who knows what will happen next?

Not only is mixing COVID-19 vaccines safe — it provides better protection than a single type

A study into COVID-19 vaccines found that people have higher levels of immunity when receiving the first dose of AstraZeneca or Pfizer followed by a Moderna or Novavax shot nine weeks after, compared to two shots of the same vaccine. While this is a relatively small study, it seems to suggest that the mix-and-match approach works when it comes to COVID-19 vaccines — at least in some combinations.

Image credit: Flickr / Province of British Columbia.

Researchers at the University of Oxford tested vaccine combinations on a group of over 1,000 volunteers over 50. The Moderna and Novavax vaccines increased immunity after the AstraZeneca vaccine, compared to a second AstraZeneca shot, while only Moderna increased antibodies after Pfizer, compared to a full vaccination with Pfizer. 

Mix and match

The COVID-19 pandemic has already caused more than five million deaths to date — and with new variants constantly emerging, there’s no way out of the pandemic other than vaccination.

Over three billion people were vaccinated with at least one dose, but that figure is only 2% to 8% in low-income countries. Around the world, 24 Covid-19 vaccines have been already approved, but manufacturing and distribution remain major challenges, especially in the less-developed parts of the world. For countries like this, where availability is a problem, mixing between different vaccines could be a game-changer, the researchers suggest.

Results varied based on the particular type of vaccine mix. The researchers found levels of antibodies 17 times higher in those individuals who got the first shot of AstraZeneca followed by a shot of Moderna, and four times higher when followed by Novavax. Meanwhile, for those who got the first jab of Pfizer, antibodies were 1.3 times higher when getting a second shot of Moderna and 20% lower with Novavax. 

The team at Oxford also explored the impact of vaccine combinations against novel COVID-19 variants, specifically the Delta and the Beta ones. In both cases, they registered a reduction in the levels of antibodies and a very little drop in T-cell responses. The Omicron variant, which was just recently discovered, wasn’t included in the study. 

Of the mixed schedules studied, perhaps the most relevant to low-income countries is the AstraZeneca/Novavax, the researchers argued, as neither require ultra-low temperature storage and also given the low cost of the AstraZeneca. The WHO is expected to soon authorize the Novavax to be delivered through the Covax initiative.   

Validating a strategy

While previous studies demonstrated the short-term safety of vaccine combinations, this is the first one to publish data from randomized controlled trials examining the immunity levels and safety of using different vaccines over a longer period of time. 

“Multiple vaccines are appropriate to complete primary immunisation following priming with BNT (Pfizer) or ChAd (AstraZeneca), facilitating rapid vaccine deployment globally and supporting recognition of such schedules for vaccine certification,” the researchers, members of the Oxford Vaccine’s Group Com-Cov, wrote in The Lancet. 

Several countries had already been using vaccine combinations for a while now, especially as they were faced with low vaccine supplies and slow vaccination campaigns. This was the case of Germany, for example, which offered booster shots of Pfizer and Moderna to vulnerable individuals, regardless of their previous vaccine. But not everyone supports this strategy.

Back in July, the World Health Organization advised people against mixing and matching COVID-19 vaccines, and it remains to be seen whether this recommendation will change in light of the new information. Mixing vaccines could offer new hope to lower-income countries that have not completed their primary vaccination campaigns and could now start using different vaccine brands. 

The study was published in the journal The Lancet.

Needle-free COVID-19 vaccine proves to be promising alternative to jabs

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.

Findings appeared in the journal Science Advances.

Young adults are grieving the developmental milestones they’ve missed under the pandemic

Young adults around the world are experiencing grief and loss due to the COVID-19 pandemic, new research reveals, despite few having directly experienced the death of someone close.

Image credits Randy Rooibaatjie.

A new study focusing on college students’ experiences with the pandemic points to a growing burden of grief and loss. The results highlight that young adults today are struggling with “losses in life, not of life”. These ‘shadow losses’ are not discussed and remain unknown and unaddressed by officials and healthcare providers. However, they could mark the current generations of young adults for a very long time to come.

Shadow losses are grief-inducing experiences that do not involve death. Losing touch with your family and friends, missing important social events or opportunities, are all examples of shadow losses.

A gentle sorrow

The authors hope that such results will help officials and healthcare providers better help young adults to adjust to their experiences during the pandemic, and the ones that will come after. These results were collected as part of class assignments asking students to reflect on the earliest and most significant losses they experienced due to the COVID-19 pandemic.

“We wanted the students to emphasize what they’re feeling and how they’re coping,” said Raven Weaver, assistant professor in Washington State University’s Department of Human Development, and first author of the study. “We as a society don’t often talk about this, but there is progress in normalizing conversations around death, loss, and grief.”

“The idea of self-disenfranchisement was very common,” “They would say things like ‘It was a loss, but not a death, so it shouldn’t be a big deal.’ There’s a sense that we shouldn’t grieve smaller losses. But we need to acknowledge that talking about smaller losses is a healthy response and can benefit our mental health.”

Several participants mentioned feeling grief following the death of someone close to them, but most responses fell into the scope of ‘shadow losses’. This is a term coined by thanatologist Cole Imperi that refers to the grief caused by the loss of important experiences or opportunities. The results, as Weaver explains, also show that students tended to minimize the importance of these shadow losses to their mental health, despite the impact these had on their overall wellbeing.

The responses were collected from the stories 86 students submitted as part of the courses Weaver and her co-authors teach at the Washington State University and the University of Wisconsin. These courses — one, for example, is the HD 360: Death and Dying course — traditionally have a similar project dealing with death-related grief, but the authors wanted to capture a clearer snapshot of other kinds of loss that people experienced during the pandemic.

One of the major themes that emerged, they report, is that the students encountered huge challenges in communicating with loved ones in a “normal” way, and this had a profound effect on their well-being. Another large impact was caused by the loss of social interactions and of opportunities in education.

“It was difficult reading students’ experiences of not being able to say goodbye in person, of visiting a nursing home and talking through a window, or only talking via technology,” Weaver said. “But talking about these experiences helps people. That’s what we’re working toward.”

Grief, the paper explains, is a natural response caused both by tangible and intangible losses (the loss of a loved one vs. losses in social activity or security, for example). The authors cite previous research stating that for every death caused by the pandemic, an estimated nine people grieved. Their goal was to attempt to quantify the effects of intangible losses during this time, especially as “young adults reported higher levels of depression, anxiety, and post-traumatic stress disorder symptoms compared to pre-pandemic levels”.

All in all, the paper concludes that young adults experienced “substantive loss” during the pandemic, including missing out on important events that constitute developmental milestones, loss of contact with their friends and family, and the loss of opportunities regarding education and career development.

These factors should be taken into account by officials and healthcare providers, the paper adds, as they have a sizeable effect on the development and well-being of entire generations caught by the pandemic during a critical time in their lives.

The paper “Young adults’ experiences with loss and grief during COVID-19” has been published in the journal Death Studies.

India has administered 1 billion vaccine doses to its citizens, moving closer to 100% goal

Last week, India passed an important milestone: the country has administered 1 billion doses of COVID vaccine to its citizens, according to government data. With this, roughly 75% of its population has been immunized with at least one dose — around 708 million people. Around one-third (30%) of the country has been fully immunized with two shots of vaccine.

Image credits Christian Emmer.

Other countries have managed similar vaccination rates as percentages of their population — Canada, for example, sits at around the 77% mark, while Portugal hit 88% — but India’s achievement impresses through sheer numbers. One billion doses are no small feat.

The country has had a pretty rough experience with this pandemic. But it also made sizeable efforts to contend with the virus, and this achievement carries on that trend.

For example, India was among the first countries to issue lockdowns and use contact tracing to limit the spread of the coronavirus. Still, things have not been going swimmingly for the country, especially since the rise of the Delta variant, and for a long time, India was among the countries with the most cases.

High score

“This achievement belongs to India, every citizen of India,” wrote Indian Prime Minister Narendra Modi on Twitter (original tweet in Hindi). “I express my gratitude to all the vaccine manufacturing companies of the country, workers engaged in vaccine transportation, health sector professionals engaged in vaccine development.”

India’s very large population, currently inching toward the 1.4 billion mark, is one of the factors working against its efforts to combat the coronavirus pandemic. Other populous countries know how challenging it can be to source, deliver, and administer a large number of vaccine doses. Even countries with lower populations but robust infrastructures and strong economies — like the USA — have had their own hiccups in vaccination efforts.

Apart from this, India’s population is still largely rural, living outside metropolitan areas. Its economy, although large and diverse, is still mostly people-driven, and much less resilient to public health issues than those of more developed countries. Its infrastructure is also relatively undeveloped in many geographical areas.

This all makes the country’s vaccination milestone all that much more impressive.

Against this backdrop, New Delhi is setting even more ambitious goals for itself. Government officials are aiming to have all of India’s adult population vaccinated by the end of the year. I, personally, cheer them on, although I do have my reservations regarding how feasible such a target actually is. Experience in other areas of the world shows us that the last steps towards full vaccination are the hardest, and slowest to go through.

Still, reaching that goal means India will need to administer around 1.8 billion doses. A production target the government set in June called for 2 billion doses to be produced by December. Local manufacturers have reportedly ramped up production in recent months to reach that target.

India started its vaccination program in January of this year. So far, only those above 18 years of age can receive a shot. Several vaccines have been approved for use by the government, including the AstraZeneca shot and the Russian Sputnik-V. A new vaccine, a three-dose shot produced by local manufacturer Cadila Healthcare, has also been approved for use in those under 18.

There are over 70,000 state-run vaccination centers currently administering free shots in India. A further 2,000 private centers also offer vaccine shots, although these charge for the service.

Covid-19 reinfection is remains likely in unvaccinated people

Among the many unknowns of the COVID-19 pandemic are the duration of immunity and the odds of reinfection. There’s still very limited information on the virus’ long-term immune responses and reinfection but now, a new study, suggests that people who have been infected with the virus can expect to catch it again in one or two years. 

Image credit: Flickr / Ricardo Huñis.

Collecting data to establish the rate of reinfection of an infectious disease normally takes several years — and we haven’t really had the time with Covid-19, which has been circulating actively for just a year and a half. With this in mind, researchers at Yale University decided to look at immunological data from other coronaviruses, such as SARS-CoV-1. 

By understanding how other coronaviruses evolve and how they are connected to each other, the team could model the likelihood of reinfection for SARS-CoV-2. They identified traits across the other viruses and with this estimated the decline in antibody levels after infection, as well other factors needed to understand reinfection.

“The overall goal of the study was to provide an answer to a question that at this point in the pandemic would be impossible to answer empirically, which is how long after you’ve been infected by SARS-CoV-2 can you expect to possess immunity against the virus before you become vulnerable to reinfection?” Hayley Hassler, one of the study’s co-authors, said in a statement.

A very likely reinfection

The model projected the risk of reinfection only under endemic conditions, in which everybody has been infected or vaccinated. Overall, the study suggests that immunity from SARS-CoV-2 doesn’t really last a long time. The risk of reinfection is about 5% at four months after the initial infection (if exposed to the disease). After 17 months, the number goes up to 50%.

Natural immunity against coronaviruses in humans is usually short-lived. Even so, this is a much shorter immune period (about two times shorter) than other human coronaviruses. The fact that Covid-19 has more dangerous outcomes during and after infection is another reason for concern.

Some news coverage has compared SARS-CoV-2 to the flu and measles, suggesting that these viruses could provide similar types of immunity, but this is misleading, according to the researchers. The viruses aren’t that much related to each other and can’t be expected to have similar properties. A life-long immunity of Covid-19 should be ruled out, they added. We may be stuck with yearly vaccines for COVID-19, much like we have for the flu.

“As the COVID-19 pandemic continues, reinfection is likely to become increasingly common. Maintaining public health measures that curb transmission—including among individuals who were previously infected with SARS-CoV-2—coupled with persistent efforts to accelerate vaccination worldwide is critical to the prevention of COVID-19 morbidity and mortality,” the researchers wrote.

The study was published in the journal The Lancet Microbe.