Patterns of Social Vulnerability - An Interactive Dashboard to Explore Risks to Public Health on the US County Level

Social vulnerability is the susceptibility of a community to be adversely impacted by natural hazards and public health emergencies, such as drought, earthquakes, flooding, virus outbreaks, and the like. Climate change is at the root of many recent natural hazards while the COVID-19 pandemic is still an active threat. Social vulnerability also refers to resilience, or the ability to recover from such adverse events. To gauge the many aspects of social vulnerability the US Center of Disease Control (CDC) has subdivided social vulnerabilities into distinct themes, such as socioeconomic status, household composition, and others. Knowing a community's social vulnerabilities can help policymakers and responders to recognize risks to community health, prepare for possible hazards, or recover from disasters. In this paper we study social vulnerabilities on the US county level and present research that suggests that there are certain combinations, or patterns, of social vulnerability indicators into which US counties can be grouped. We then present an interactive dashboard that allows analysts to explore these patterns in various ways. We demonstrate our methodology using COVID-19 death rate as the hazard and show that the patterns we identified have high predictive capabilities of the pandemic's local impact. © 2022 IEEE.

Food systems and violations of the human right to adequate food: reflectionson the COVID-19 pandemic in Brasil

Given the worsening situation of hunger and food and nutritional insecurity in Brazil due to the Covid-19 pandemic, this study aimed to: analyze the actions carried out by the State during the pandemic and understand how they contributed to the realization or violation of the Human Right to Adequate Food (DHAA);understand the relationship between these actions and the modus operandi of current food systems. This was an empirical study, based on the challenges and axes of the last National Plan for Food and Nutritional Security. Data collection was carried out in two major newspapers, followed by document analysis focused on the social dynamics expressed in its content. The results support that there was a process of violation of the DHAA during the pandemic in the four dimensions related to the obligation to guarantee it, mainly to the most vulnerable populations, due to both lack and insufficiency of actions. The results indicate that these violations are not just a short-term political result, but indeed are the product of the dynamics intrinsic to food systems, in symbiosis with the political and economic power relations that structure the Brazilian State, and their insertion in the dynamics of international capitalism.

Spread of Gamma (P.1) Sub-Lineages Carrying Spike Mutations Close to the Furin Cleavage Site and Deletions in the N-Terminal Domain Drives Ongoing Transmission of SARS-CoV-2 in Amazonas, Brazil

The Amazonas was one of the most heavily affected Brazilian states by the COVID-19 epidemic. Despite a large number of infected people, particularly during the second wave associated with the spread of the Variant of Concern (VOC) Gamma (lineage P.1), SARS-CoV-2 continues to circulate in the Amazonas. To understand how SARS-CoV-2 persisted in a human population with a high immunity barrier, we generated 1,188 SARS-CoV-2 whole-genome sequences from individuals diagnosed in the Amazonas state from 1st January to 6th July 2021, of which 38 were vaccine breakthrough infections. Our study reveals a sharp increase in the relative prevalence of Gamma plus (P.1+) variants, designated Pango Lineages P.1.3 to P.1.6, harboring two types of additional Spike changes: deletions in the N-terminal (NTD) domain (particularly Delta 144 or Delta 41-144) associated with resistance to anti-NTD neutralizing antibodies or mutations at the S1/S2 junction (N679K or P681H) that probably enhance the binding affinity to the furin cleavage site, as suggested by our molecular dynamics simulations. As lineages P.1.4 (S:N679K) and P.1.6 (S:P681H) expanded (Re > 1) from March to July 2021, the lineage P.1 declined (Re < 1) and the median Ct value of SARS-CoV-2 positive cases in Amazonas significantly decreases. Still, we did not find an increased incidence of P.1 variants among breakthrough cases of fully vaccinated patients (71%) in comparison to unvaccinated individuals (93%). This evidence supports that the ongoing endemic transmission of SARS-CoV-2 in the Amazonas is driven by the spread of new local Gamma/P.1 sublineages that are more transmissible, although not more efficient to evade vaccine-elicited immunity than the parental VOC. Finally, as SARS-CoV-2 continues to spread in human populations with a declining density of susceptible hosts, the risk of selecting more infectious variants or antibody evasion mutations is expected to increase. IMPORTANCE The continuous evolution of SARS-CoV-2 is an expected phenomenon that will continue to happen due to the high number of cases worldwide. The present study analyzed how a Variant of Concern (VOC) could still circulate in a population hardly affected by two COVID-19 waves and with vaccination in progress. Our results showed that the answer behind that was a new generation of Gamma-like viruses, which emerged locally carrying mutations that made it more transmissible and more capable of spreading, partially evading prior immunity triggered by natural infections or vaccines. With thousands of new cases daily, the current pandemics scenario suggests that SARS-CoV-2 will continue to evolve and efforts to reduce the number of infected subjects, including global equitable access to COVID-19 vaccines, are mandatory. Thus, until the end of pandemics, the SARS-CoV-2 genomic surveillance will be an essential tool to better understand the drivers of the viral evolutionary process.

Clean production of biofuel from waste cooking oil to reduce emissions, fuel cost, and respiratory disease hospitalizations

Renewable energies are cleaner forms of energy, and their use, has intensified in recent decades. Thus, this work presents a proposal for reducing the emissions, fuel cost, and respiratory disease hospitalizations using environmental cost accounting principles to produce biodiesel production from waste frying oil. In our methodology, we conducted surveys, and collected waste cooking oil samples from local households and restaurants in São Paulo city, Brazil. Then, we produced biodiesel using these samples. Data on air pollutants were collected and correlated with the number of hospitalizations for respiratory diseases and their costs. Our results indicate that 330,000 respiratory disease hospitalizations were recorded in São Paulo city between 2009 and 2018, and the total cost for the Brazilian government reached US $117 million. Improving the city air quality by switching from fossil fuels to biodiesel could reduce the annual number of hospitalizations to 9880 and cost US $3.518 million, because the amount of pollutants emitted from burning fossil fuels was positively correlated with the number of respiratory disease hospitalizations and their costs. Moreover, the emission rates of particulate matter with particles less than 10 and 2.5 µm in diameter exceeded the World Health Organization limits throughout the study period. Using the survey data, we estimated that the average monthly quantity of waste cooking oil was 9794.6 m3, which could generate 9191.2 m3 of biodiesel and produce 239,713 t CO2 of carbon credits. Environmental cost accounting revealed that it would be possible to achieve an annual profit of approximately US $300 million from the sale of excess biodiesel, carbon credits, and glycerine, and fuel acquisition savings which could improve the image of São Paulo city and quality of life of its residents. Thus, we present this as a way to reduce cost and hospitalizations, and increase the number of available hospital beds for other diseases, such as COVID-19. © 2021 by the authors. Licensee MDPI, Basel, Switzerland.

P09.35 COVID-19 in Patients with Lung Cancer – Experience from a Thoracic Oncology Center

Introduction: Cancer patients appear to be at higher risk of complications from sars-cov-2 infection. Specific data regarding lung cancer patients, on active treatment and/or recent diagnosis is limited. Recent data suggests that a bad prognosis is associated with older age (>65 years-old), comorbidities, ECOG2, steroids (>10mg prednisolone), anticoagulants, chemotherapy and chemotherapy-immunotherapy. With this study we aim to investigate the clinical presentation, baseline characteristics and outcomes of patients with lung cancer and Covid-19. Methods: A retrospective case study was carried out at Centro Hospitalar Universitário de São Joao (CHUSJ), a tertiary hospital in the Oporto region of Portugal. Data from all patients from our center was evaluated, and lung cancer patients with covid19 diagnosis during the first 2 months of the Covid-19 pandemic in Portugal (March-April) were included. Results: A total of 5 patients with active lung cancer had a diagnosis of Covid-19 at our center. Adenocarcinoma was the histological type in all patients (n=5, 100%). Most had metastatic stage IV lung cancer (n=3;60,0%). Two patients (40,0%) had relevant comorbidities including HBP, Diabetes and Heart Failure due to heart valvular disease. Of the patients on anti-neoplasic treatment, median time from the last chemotherapy administration to Covid-19 diagnosis was 4 days (min 4;max 39 days). Four patients (80,0%) were receiving corticosteroid therapy. The most common symptoms were cough (n=4, 80,0%) and dyspnea (n=3, 60,0%). Lab results revealed neutrophilia in all patients (n=5, 100%), lymphopenia in 4 patients (80,0%), anemia in 4 patients (80,0%), leukocytosis in 2 patients (40,0%). An example of chest CT scan features is represented in the image attached. All patients (n=5, 100,0%) were admitted to hospital and received oxygen therapy. Two (40,0%) received HFNC with good tolerability and one (20,0%) NIV. Two patients were admitted to Intensive Care Unit, with recovery. No patient received mechanical ventilation or extracorporeal membrane oxygenation. Empirical sars-cov-2 treatment with hydroxychloroquine was administered in most patients (n=4, 80,0%) and antibiotics in three (60,0%). Two of the patients had recent chemotherapy treatment (4 days before diagnosis), and later developed pancytopenia during the next days associated with clinical deterioration. Three patients (60,0%) died after a median time of 5 days since Covid-19 diagnosis (min 2;max 16 days). [Formula presented] Conclusion: This study is one of the first to report outcomes that can be associated with Covid-19 in Lung Cancer patients and highlights the necessity to create protocols to reduce their susceptibility and bad outcomes in future waves of Covid-19. Keywords: lung cancer, Covid19, infection