Weekly Coronavirus Update: Tuesday, August 4, 2020

Here is your weekly update on the latest Coronavirus research and news. This week’s update focuses on research about children, the effectiveness of social distancing, airborne transmission, potential treatments and vaccines, newborns, and what’s happening around the world.

1) A study regarding children and Coronavirus found that children five years and younger with mild to moderate COVID-19 symptoms had between 10 to 100 times as much viral RNA in their nasopharynx as older children and adults. Therefore, when young children cough, sneeze, or shout, they have the ability to drive the spread of the virus through the rest of the population. The authors concluded, “Behavioral habits of young children and close quarters in school and day care settings raise concern for SARS-CoV-2 amplification in this population as public health restrictions are eased.” The study was published this past week in the journal JAMA Pediatrics and can be read in full here: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2768952 and an article from the New York Times about the study can be found here: https://www.nytimes.com/2020/07/30/health/coronavirus-children.html

2) Somewhat related to the last point, I’m sure most people have seen the news headlines about the overnight camp in Georgia where 260 people tested positive for Coronavirus. A report published by a team of doctors and researchers in the CDC’s Morbidity and Mortality Weekly Report provided additional details and broke down the numbers further to look at the full picture infections. Of the 597 people present at the camp, 260 (44%) tested positive. In the 6–10 age group, 51% tested positive, 44% in the 11–17 age group, 33% of the 18–21 age group, and 29% of the 22–59 age group. These numbers demonstrate that all age groups are susceptible to infection. The report stated that campers took part in daily indoor and outdoor activities, one of which was “daily vigorous singing and cheering”, which would have spread viral RNA into the air from any infected individuals. Additionally, an average of 15 people slept in each cabin, which the report described as “relatively large cohorts”. According to the report, the camp implemented most of the CDC’s recommended strategies to prevent infection, including requiring masks for all staff members, but “measures not implemented were cloth masks for campers and opening windows and doors for increased ventilation in buildings.” You can read the full CDC report here: https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm?s_cid=mm6931e1_w#contribAff

3) While the debate about children returning school has been going on for months in the US, it’s also a topic of conversation here in the UK, which has had far fewer cases of the virus per capita than the US. A peer-reviewed paper published in The Lancet Child & Adolescent Health yesterday used modelling to indicate the need for much stronger testing and tracing systems in order to safely reopen schools in the UK. If the levels of testing and tracing do not increase, the models predict a second wave of the virus will peak in December 2020, with a “second wave of infections 2.0–2.3 times the size of the original COVID-19 wave” the UK experienced earlier this year. The authors concluded, “To prevent a second COVID-19 wave, relaxation of physical distancing, including reopening of schools, in the UK must be accompanied by large-scale, population-wide testing of symptomatic individuals and effective tracing of their contacts, followed by isolation of diagnosed individuals.” You can read the full study here: https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30250-9/fulltext

4) I’ve discussed research about masks in lowering the spread of the virus, but what do we know about the effectiveness of social distancing? A peer-reviewed study by researchers from the University of Texas looked at the real-world implications of social distancing based on data from 134 countries with varying policies. Overall, countries with a national social distancing policy experienced an estimated 65% reduction in the spread of the virus over the course of two weeks, preventing approximately 1.57 million cases. “National policy” is the key phrase here. In the US specifically, states that enacted social distancing policies had less movement by people (i.e. people stayed home) which correlated to a decrease in the spread of the virus in those states. The US response was not coordinated (i.e. nationwide), though, and the study showed that the US’s overall spread of the virus was no different from those nations that had no national social distancing policy. Therefore, a national social distancing policy would likely be beneficial to the US. With regard to the economic impact of social distancing, the authors concluded, “Despite the acute economic depression associated social distancing policies, long-term estimates indicate the prevention of mortality in the US could save $8 trillion dollars nationally, or $60,000 per US household.” You can read the full study here: https://journals.plos.org/plosone/article?id=10.1371/journal.pone.0236619
And a great wrap-up of it from “Your Local Epidemiologist” (a fantastic website for COVID information) here: https://yourlocalepidemiologist.com/social-distancing/
In addition to the above articles, this editorial from the journal Microbes and Infection calls for a national strategy to be implemented now in order to contain the virus by October: https://www.sciencedirect.com/science/article/pii/S1286457920301416?fbclid=IwAR2x4pYGutffhRuGD1diKRdOGljLVqgNV8bMhbIOcArP6ORgaKcTvybAI5A

5) A new study published in Nature confirmed the airborne nature of Coronavirus. The researchers collected air samples and surface samples from rooms of isolated COVID-19 patients at the University of Nebraska Medical Center. Their findings showed “significant environmental contamination in rooms where patients infected with SARS-CoV-2 are housed and cared for, regardless of the degree of symptoms or acuity of illness.” Viral RNA was found in the air, on surfaces, and on toilets (confirming previous research that showed the virus can be shed through a person’s stool). The findings highlight the importance of fresh airflow in enclosed spaces (e.g., opening windows; not using recirculated air in air conditioning units), the continued use of face masks, and the need to maintain physical distance from others. As a previous study also recommended, close the toilet lid before flushing in public restrooms. The full peer-reviewed study from Nature can be found here: https://www.nature.com/articles/s41598-020-69286-3

6) In potential treatment news, yesterday Eli Lilly & Co. began the third phase of testing on their COVID-19 antibody drug. The monoclonal antibody drug is being tested in US nursing homes on approximately 2,400 residents and staff. If the drug is found to be effective, it could be mass produced and used as a temporary prevention treatment in at-risk populations or as a therapeutic for Coronavirus patients. Other pharmaceutical companies are also trialling similar drugs, but Eli Lilly’s seems to be the furthest along at the moment. You can read more about it in the following news articles: https://www.reuters.com/article/us-health-coronavirus-treatments-antibod/next-big-covid-19-treatment-may-be-manufactured-antibodies-idUSKBN24Z1DY and https://abcnews.go.com/Health/eli-lilly-launches-late-stage-antibody-treatment-trial/story?id=72139356

7) An international team of researchers tested seven different vaccines in 32 monkeys, with 20 other monkeys receiving placebo injections. The findings revealed that all monkeys who received a vaccine developed neutralizing antibodies against COVID-19, and the 20 who received placebos all became sick when exposed to the virus. The leading vaccine in the trial was the one developed by Johnson & Johnson. Of the monkeys who received that vaccine, five showed complete protection from the virus in the upper and lower respiratory tracts and one experienced a low level of the virus in its nose. It is important to note that while vaccines were effective in monkeys, there is no guarantee they will be effective in humans. Still, this research can give us a bit of cautious hope. The full peer-reviewed study, published in the journal Nature, can be found here: https://www.nature.com/articles/s41586-020-2607-z_reference.pdf
Johnson & Johnson hopes to begin a Phase 3 trial of its vaccine in humans by September. You can read a New York Times article about this vaccine here: https://www.nytimes.com/2020/07/30/health/covid-19-vaccine-monkeys.html

8) A similar study was conducted on monkeys using the vaccine developed by Moderna and the peer-reviewed results were published in The New England Journal of Medicine. The Moderna vaccine was given to 16 monkeys, and 8 monkeys were not vaccinated and used as a control group. All monkeys received drips of Coronavirus in their noses following two rounds of the vaccine. Those monkeys who did not receive the vaccine contracted the virus. Of those receiving the vaccine, some showed levels of virus in their noses, but they were significantly less than the unvaccinated monkeys. Additionally, those who received the vaccine were able to quickly clear the detected infection. High levels of neutralizing antibodies were found in the vaccinated monkeys. The full study can be read here: https://www.nejm.org/doi/full/10.1056/NEJMoa2024671?query=RP
Additionally, the Moderna vaccine has now begun a Phase 3 trial of the vaccine, which will take place in over 30,000 humans. The New York Times also reported on this vaccine: https://www.nytimes.com/2020/07/28/health/coronavirus-moderna-vaccine-monkeys.html

9) Someone asked last week if I had read anything about newborns and COVID-19. While a study that I mentioned a few weeks ago found one baby born with Coronavirus in France, a new peer-reviewed study published in The Lancet Child & Adolescent Health collected data on newborns in three New York City hospitals over a two-month time period. The findings showed that of 1,481 deliveries, 8% of the mothers tested positive for Coronavirus. A total of 120 babies were born to these mothers, and all tested negative for Coronavirus within 24 hours of delivery. All mothers were allowed to breastfeed their babies. After 14 days, none of the babies had contracted Coronavirus and none exhibited symptoms of the virus. The authors concluded, “Our data suggest that perinatal transmission of COVID-19 is unlikely to occur if correct hygiene precautions are undertaken, and that allowing neonates to room in with their mothers and direct breastfeeding are safe procedures when paired with effective parental education of infant protective strategies.” The full study can be read here: https://www.thelancet.com/action/showPdf?pii=S2352-4642%2820%2930235-2

10) Finally, your US and world update. In the US, the number of new infections last week fell by 5%, but there were still over 435,000 new infections, or an average of over 62,000 new cases each day. That’s not exactly good news when you compare it to, say, the state of Victoria in Australia, which has implemented a strict lockdown and curfew after experiencing 500–600 daily new cases (for context, nearly half of all US states are at or above that number of daily new cases, yet none of them have taken similar measures as Australia to contain the virus). Additionally, testing in the US fell by 6% last week and the number of deaths grew by 36% with a total of 8,583 for the week. India and Brazil continue to experience extremely high numbers of daily new cases as well, with over 50,000 new cases yesterday in India and nearly 18,000 in Brazil. Meanwhile, in Europe some countries such as Spain, France, Germany, Belgium, and Luxembourg are beginning to see new spikes of infections in some areas. These increases come just a few weeks after many countries began easing restrictions and allowing people to return to some form of normalcy. The infection rate in the UK is also beginning to rise, and over the weekend the Prime Minister backpedalled on easing some restrictions such as the reopening of bowling alleys, casinos, indoor performance venues, and close-contact beauticians in an attempt to avoid another nationwide lockdown.
Sources for the information in this bullet point include:
US Coronavirus information: https://graphics.reuters.com/HEALTH-CORONAVIRUS/USA-TRENDS/dgkvlgkrkpb/index.html
World Coronavirus case number information: https://www.worldometers.info/coronavirus/country/us/
Australian measures: https://www.theguardian.com/commentisfree/2020/aug/04/its-not-going-to-be-easy-experts-on-what-australia-must-do-to-curb-covids-spread
Spikes in Europe: https://www.theguardian.com/world/2020/jul/31/how-the-covid-19-resurgence-is-dividing-opinion-across-europe
UK information: https://www.bbc.co.uk/news/uk-53609467

That’s all for this week. Please stay safe, everyone!