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An Updated Covid Guide For four different types of households.


17 May 2021

The new C.D.C. guidance has excited many Americans and scared many others. Some people feel both emotions, understandably enough: They’re excited to start returning to more normal daily life and still scared by a pandemic that is killing about 600 Americans a day. This morning, I want to think through the real-world implications of the new guidelines for individual families. Those guidelines mostly allow people to behave more freely. But they will also lead some to take new precautions. I am going to break down households into four categories, depending on vaccination status:


Breakthrough Infections Rare Among Vaccinated Americans


19 Apr 2021

In the United States, the Centers for Disease Control and Prevention provided its first public data about breakthrough Covid-19 cases to CNN last week and it shows that vaccines have been highly effective at reducing infections, hospitalizations and death. As of last week, around 78.5 million Americans had been fully vaccinated and the CDC's data states that 5,800 cases of Covid-19 occurred among fully vaccinated people, 396 of whom required hospitalization with 74 deaths recorded.


U.S. Calls for Pause on Johnson & Johnson Vaccine After Clotting Cases


13 Apr 2021

The Food and Drug Administration and the Centers for Disease Control will stop using the vaccine at federal sites and urge states to do so as well while they examine the safety issues.


Likely Legal, ‘Vaccine Passports’ Emerge as the Next Coronavirus Divide


07 Apr 2021

Businesses and universities want fast, easy ways to see if students and customers are vaccinated, but conservative politicians have turned “vaccine passports” into a cultural flash point.


AZD1222 US Phase III trial met primary efficacy endpoint in preventing COVID-19 at interim analysis


23 Mar 2021

79% vaccine efficacy at preventing symptomatic COVID-19 100% efficacy against severe or critical disease and hospitalization Comparable efficacy result across ethnicity and age, with 80% efficacy in participants aged 65 years and over Favorable reactogenicity and overall safety profile




Articles


Delayed Localized Hypersensitivity Reactions to the Moderna COVID-19 Vaccine


12 May 2021

The Moderna COVID-19 vaccine may cause a delayed localized hypersensitivity reaction with a median latency to onset of 7 days after vaccine administration. This pruritic and variably tender reaction has a median duration of 5 days, but may persist for up to 21 days, and may occur again and sooner after the second vaccine dose; no serious adverse events were observed in association with this cutaneous reaction to the Moderna COVID-19 vaccine.




The epidemiological impact of the NHS COVID-19 App


12 May 2021

The COVID-19 pandemic has seen digital contact tracing emerge around the world to help prevent spread of the disease. A mobile phone app records proximity events between app users, and when a user tests positive for COVID-19, their recent contacts can be notified instantly. Theoretical evidence has supported this new public health intervention1-6, but its epidemiological impact has remained uncertain7. Here we investigated the impact of the NHS COVID-19 app for England and Wales, from its launch on 24 September 2020 through to the end of December 2020. It was used regularly by approximately 16.5 million users (28% of the total population), and sent approximately 1.7 million exposure notifications: 4.4 per index case consenting to contact tracing. We estimated that the fraction of app-notified individuals subsequently showing symptoms and testing positive (the secondary attack rate, SAR) was 6.0%, comparable to the SAR for manually traced close contacts. We estimated the number of cases averted by the app using two complementary approaches. Modelling based on the notifications and SAR gave 284,000 (108,000-450,000), and statistical comparison of matched neighbouring local authorities gave 594,000 (317,000-914,000). Roughly one case was averted for each case consenting to notification of their contacts. We estimated that for every percentage point increase in app users, the number of cases can be reduced by 0.8% (modelling) or 2.3% (statistical analysis). These findings provide evidence for continued development and deployment of such apps in populations that are awaiting full protection from vaccines.




Preliminary Findings of mRNA Covid-19 Vaccine Safety in Pregnant Persons


22 Apr 2021

BACKGROUND Many pregnant persons in the United States are receiving messenger RNA (mRNA) coronavirus disease 2019 (Covid-19) vaccines, but data are limited on their safety in pregnancy. CONCLUSIONS Preliminary findings did not show obvious safety signals among pregnant persons who received mRNA Covid-19 vaccines. However, more longitudinal follow-up, including follow-up of large numbers of women vaccinated earlier in pregnancy, is necessary to inform maternal, pregnancy, and infant outcomes.




Association of Race/Ethnicity With Likeliness of COVID-19 Vaccine Uptake Among Health Workers and the General Population in the San Francisco Bay Area


30 Mar 2021

Surveys have demonstrated racial differences in the public’s willingness to receive a COVID-19 vaccine1,2 but have not directly compared vaccine intentions among health workers and the general public.3 We investigated COVID-19 vaccine intentions among racially and ethnically diverse samples of health workers and the general population.




SARS-CoV-2 infection of the oral cavity and saliva


25 Mar 2021

Despite signs of infection—including taste loss, dry mouth and mucosal lesions such as ulcerations, enanthema and macules—the involvement of the oral cavity in coronavirus disease 2019 (COVID-19) is poorly understood. To address this, we generated and analyzed two single-cell RNA sequencing datasets of the human minor salivary glands and gingiva (9 samples, 13,824 cells), identifying 50 cell clusters. Using integrated cell normalization and annotation, we classified 34 unique cell subpopulations between glands and gingiva. Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) viral entry factors such as ACE2 and TMPRSS members were broadly enriched in epithelial cells of the glands and oral mucosae. Using orthogonal RNA and protein expression assessments, we confirmed SARS-CoV-2 infection in the glands and mucosae. Saliva from SARS-CoV-2-infected individuals harbored epithelial cells exhibiting ACE2 and TMPRSS expression and sustained SARS-CoV-2 infection. Acellular and cellular salivary fractions from asymptomatic individuals were found to transmit SARS-CoV-2 ex vivo. Matched nasopharyngeal and saliva samples displayed distinct viral shedding dynamics, and salivary viral burden correlated with COVID-19 symptoms, including taste loss. Upon recovery, this asymptomatic cohort exhibited sustained salivary IgG antibodies against SARS-CoV-2. Collectively, these data show that the oral cavity is an important site for SARS-CoV-2 infection and implicate saliva as a potential route of SARS-CoV-2 transmission.




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