Epidemiological overlaps in COVID-19 and malaria within healthcare and community settings of Southern Ghana (preprint)

Background: COVID-19 disruptions in Africa in 2020-2022 contributed to reductions in malaria control activities including antimalarial surveillance programs. This study investigated the malaria burden and distribution on the background of active transmission of SARS-CoV-2 in Southern Ghana. Specifically, it aimed to identify epidemiological factors that can maximise programmatic control for both diseases, utilising community health education and medical screening (CHEMS). Methods: Between October-December 2022, prospective cross-sectional surveys, with CHEMS were conducted in Greater Accra and Central regions, where 994 participants enrolled either at a hospital or community setting provided demographic and clinical data including history of clinical malaria infection and antimalarial treatment in the past two weeks. Of this study population, 953 provided nasal/throat swabs for COVID-19 RT-PCR testing, with a subset of 136 participants also providing finger-prick blood for malaria RDT testing. Results: The study population comprised of 73.6% adults, with 54.6% COVID-19 vaccination rate. Overall, 18.1% of participants had a history of clinical malaria, which was associated (adjusted odds ratio > 1.50, P-value [≤] 0.022) with COVID-19 symptoms and positivity, study area and hospital setting, suggestive of overlaps in the epidemiological risk for malaria. On a background of widespread SARS-CoV-2 infections (12-37%), malaria parasitaemia was detected in 6%, with 2% being co-infections. Among the malaria positives, 9.5% had a history of antimalarial treatment, which suggested that their infections were recrudescent parasitaemia. Conclusion: The overlaps in the epidemiological risk for malaria and COVID-19 indicate that innovative surveillance programs, with community engagement are needed to maximise control interventions including treatment of asymptomatic malaria infections.

Opinions of Iranian dietitians on virtual nutritional consulting on the Instagram platform: a descriptive, cross-sectional study (preprint)

Background: The use of social media for obtaining health care advice has become more popular. There has been an expansion of the virtual environment by dietitians, the present study aimed to evaluate the opinions of Iranian dietitians on virtual nutritional counseling on the Instagram platform. Methods: The present descriptive, cross-sectional study recruited Iranian dietitians working in the field of nutrition counseling using Instagram. Participants were found through an extensive search with relevant keywords on Instagram. After identifying dietitians, an online questionnaire was made including questions on their activity in virtual counseling on Instagram and the challenges of virtual counseling. The link to the online questionnaire was sent to the participants. Descriptive statistics were used to analyze and interpret the data. Results: In this descriptive online survey, out of 163 eligible dietitians, 131 participated in the study. The average age of the participants was 30.8±6.7 years, of which 87.8% were women. Based on the results, 47.3% of the dietitians started virtual nutrition counseling during the COVID-19 pandemic and 35.2% stated that the number of their virtual clients increased during this pandemic. Also, 58.8% of dietitians believed that concepts are better transferred in face-to-face nutrition counseling compared to virtual counseling. Besides, 43.5% of counselors reported that the results in face-to-face counseling had higher efficacy. According to the participants, the most practical method for nutrition counseling on virtual platforms was using text and voice messaging, and the most common topic of virtual nutrition counseling was related to weight loss. Conclusion: Virtual nutritional counseling has expanded during the COVID-19 pandemic. Compared to face-to-face counseling, virtual counseling has limitations in the concept of transferring and yielding results.

Integrating science to address food and health within Global Agenda 2030.

When recovering from the pandemic, it is important for Planet Earth to address the Global Agenda 2030, including food and water crises, and to bounce forward sustainably. The World Economic Forum's Global Risk Report and Global Agenda 2030 provide a framework for action and an integrated global science agenda response, involving food and health, is essential. The UN 2021 Summit on Food Systems provides an opportunity for the global science community to come together to address the Summit's Action Tracks, including building resilience to vulnerabilities, shocks and stresses. There would be major global benefits to have an international scientific network working with the UN to address the mandates of the UN Food Summit and Global Agenda 2030.

The Impact of the COVID-19 Pandemic on Health Care Utilization Among Insured Individuals With Common Chronic Conditions

Objective: The COVID pandemic has had a significant impact on the US health care system. Our primary objective was to understand the impact of the COVID pandemic on non-COVID-related health care utilization among insured individuals with chronic conditions. Our secondary objective was to examine the differential impact by individual characteristics. Main Data Source: Medical and pharmacy claims data for individuals enrolled in a large insurer across the United States. Research Design: A retrospective and repeated cross-sectional study. Overall and condition-specific health care utilization and cost metrics in (1) March 1 to June 15 and (2) June 16 to September 30, 2020 were compared with the same months during 2016-2019. Subjects: Members of all ages with a diagnosis of diabetes, cardiovascular disease, or chronic kidney disease with commercial or Medicare Advantage insurance. Results: Most non-COVID-related health care utilization decreased drastically on March 1 to June 15, 2020 [odds ratio (OR) range across condition-specific tests: 0.55-0.69;incidence rate ratio (IRR) range for hospitalization/emergency department (ED) visit/outpatient visit: 0.65-0.77] but returned to closer to pre-COVID levels by June 16 to September 30, 2020 [OR range across condition-specific tests: 0.93-1.08;IRR range for hospitalization/ED visit/outpatient visit: 0.77-0.97]. Our study found an enormous increase in telehealth use on March 1 to June 15, 2020 (90-170 times prepandemic levels). A differential impact was observed by age, sex, region of residence, and insurance type. Implications: Further investigation is needed to assess the impact of these changes in health care utilization on long-term health outcomes.

The COVID-19, tuberculosis and HIV/AIDS: Ménage à Trois.

In December 2019, a novel pneumonic condition, Coronavirus disease 2019 (COVID- 19) caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), broke out in China and spread globally. The presentation of COVID-19 is more severe in persons with underlying medical conditions such as Tuberculosis (TB), Human Immunodeficiency Virus/Acquired Immunodeficiency Syndrome (HIV/AIDS) and other pneumonic conditions. All three diseases are of global concern and can significantly affect the lungs with characteristic cytokine storm, immunosuppression, and respiratory failure. Co-infections of SARS-CoV-2 with HIV and Mycobacterium tuberculosis (Mtb) have been reported, which may influence their pathogenesis and disease progression. Pulmonary TB and HIV/AIDS patients could be more susceptible to SARS-CoV-2 infection leading to lethal synergy and disease severity. Therefore, the biological and epidemiological interactions of COVID-19, HIV/AIDS, and TB need to be understood holistically. While data is needed to predict the impact of the COVID-19 pandemic on these existing diseases, it is necessary to review the implications of the evolving COVID-19 management on HIV/AIDS and TB control, including therapy and funding. Also, the impact of long COVID on patients, who may have this co-infection. Thus, this review highlights the implications of COVID-19, HIV/AIDS, and TB co-infection compares disease mechanisms, addresses growing concerns, and suggests a direction for improved diagnosis and general management.

Stop and Go: Barriers and Facilitators to Care Home Research.

Barriers to care home research have always existed, but have been thrown into sharp relief by the COVID-19 pandemic. Existing infrastructure failed to deliver the research, or outcomes, which care home residents deserved and we need to look, again, at how these barriers can be taken down. Barriers can be categorised as procedural (encountered before research starts), system (encountered during research) or resident-specific. To tackle these, research regulatory bodies need to adopt a standardised approach to how care home research is developed and designed, reviewed and regulated, and how such approaches can enable recruitment of as wide a range of residents and their representatives as possible, including those without the mental capacity to consent for research. Establishment of local, inter-disciplinary collaborations between universities, general practices, health and social care providers and care homes is another priority. This should be based on pre-existing models such as the 'Living lab' model developed in The Netherlands and now being implemented in the UK and Austria. These changes are critical to develop a sustainable research model. If well designed this will deliver better outcomes for residents and align with the individual and organisational priorities of those who care for them.

Virtual Care for the Longitudinal Management of Chronic Conditions: A Systematic Review

As both the largest integrated health system and largest provider of telehealth in the country, the Veterans Health Administration (VHA) has a particular interest in understanding how best to implement and utilize virtual care. VHA has long embraced virtual care as part of its mission to "serve all who have served" regardless of their socioeconomic and geographic circumstances. Having begun conducting "virtual care" in the 1960s when doctors first communicated with patient's via TV screens,1 VHA has since provided over 2.6 million episodes of care to more than 900,000 Veterans in 20192 and has distributed over 50,000 data- and video-enabled iPads for Veterans throughout the country.3 Virtual care within VHA includes services such as MyHealtheVet secure messaging, the Home Telehealth program that combines case management principles with remote monitoring to improve access and coordinate care, and the VA Video Connect (VVC) video platform for synchronous visits within both specialty and primary care.4 Increasing Veteran access to care via virtual care has been an integral part of VHA's strategy for improving chronic disease management for a population that is on average older and sicker than their civilian counterparts.5,6 Given the importance that virtual care has for Veteran care even beyond the COVID-19 pandemic, understanding the strengths and limitations associated with synchronous virtual care will be critical in shaping how VHA utilizes virtual care going forward.

Sleep health among people with severe mental ill health during the COVID-19 pandemic: Results from a linked UK population cohort study

Objectives Sleep problems are a transdiagnostic feature of nearly all psychiatric conditions, and a strong risk factor for initial and recurrent episodes. However, people with severe mental ill health (SMI) are often excluded from general population surveys, and as such the extent and associates of poor sleep in this population are less well understood. This study explores sleep health in an SMI sample during the COVID-19 pandemic, using multiple regression to identify risk factors, including daily routine, wellbeing and demographics. Methods An existing cohort of people with an SMI diagnosis were sampled. Participants were invited to complete a self-report survey about their health and the impacts of COVID-19 and associated public health measures. Sleep duration, efficiency, and quality were measured using items from the Pittsburgh Sleep Quality Index (PSQI). Results Two hundred forty-nine adults (aged 21–84 years) completed the survey. Mean sleep duration and efficiency were similar to general population estimates, at 7 h 19 min and 78%, respectively. However, 43% reported “bad” sleep quality that was associated with being younger in age as well as disturbed routine and declined wellbeing. Indeed, 37% reported a disturbed routine during the pandemic. Conclusions High estimates of perceived poor sleep quality in the SMI population align with previous findings. Supporting people with SMI to maintain routine regularity may work to protect sleep quality and wellbeing. Future research should more closely examine sleep health in people with SMI, using accessible and scalable measures of objective and subjective sleep, examining longitudinal trends.

Setting up a Post Covid-19 Syndrome Service for Children and Young People across London - a Collaboration across Three Trusts

Aims Describe an interdisciplinary hub and spoke healthcare model for children and young people (CYP) with Post COVID-19 Syndrome Methods From November 2020, with NHS London and NHS England support, clinicians and AHP chief with backgrounds in infectious disease, adolescent medicine and psychiatry from across trusts in London collaborated to set up a hub and spoke model for delivering care to CYP with post COVID-19 syndrome. This was an iterative process with involvement of patient cohort. CYP are referred into a central weekly virtual multi-disciplinary 'hub' meeting for discussion with specialists across infectious disease;respiratory;rheumatology;neurology;chronic conditions (including ME/CFS );mental health;and allied health practitioners (AHP) with experience of rehabilitation including occupational therapists, and physiotherapists, dieticians, safeguarding practitioners. The groups has a diversity lead.The group has regular evidence-based CPD. Referrers (local paediatricians or GPs for 17-18 year olds) present patient to the MDT for discussion of diagnosis, investigation and management. Website-housed referral pathways including recommended baseline assessments are provided for referrers. A developing group of local integrated care service paediatric and AHP champions support local management, pathways and education around post COVID-19 syndrome. Patients follow one of two pathways: 1. Local management, using already available services which the MDT support 2. Face-to-face interdisciplinary consultation and rehabilitation for severe or complex cases. Local support MDT discussion, and advice to local team with letters to patients outlining impression and advice;school adjustments letters;leaflets for health professionals and CYP/ family across a range of known Post COVID symptoms and difficulties. AHP delivered virtual groups and webinars include pacing;emotional wellbeing;symptom management;eating, and sleep. As the first established post- COVID-19 service for CYP in England, we have led and supported the development of 14 other MDTs nationally. Results Between 1st April 2021 and 1st February 2022 89 patients were referred to the virtual MDT. All have received information leaflets to aid recovery. 25 CYP/families have attended the virtual groups so far. 57 CYP have received an interdisciplinary consultation and received bespoke MDT input. (see table 1) Conclusion In response to the clinical need of CYP with post COVID symptoms, the collaborative development of a Pan London service across 2 clinical sites, and 3 NHS trusts is an example of how specialist clinical care can be delivered virtually using a hub and spoke model for a proportion of patients with a complex disorder. The service development element is applicable to other future emerging diseases as well as a possible model for conditions that require multiple specialist inputs and can have confused pathways or delays in diagnosis (such as functional disorders or multi-organ pathology).

Probing SARS-CoV-2-positive plasma to identify potential factors correlating with mild COVID-19 in Ghana, West Africa.

BACKGROUND: West Africa has recorded a relatively higher proportion of asymptomatic coronavirus disease 2019 (COVID-19) cases than the rest of the world, and West Africa-specific host factors could play a role in this discrepancy. Here, we assessed the association between COVID-19 severity among Ghanaians with their immune profiles and ABO blood groups. METHODS: Plasma samples were obtained from Ghanaians PCR-confirmed severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-positive individuals. The participants were categorized into symptomatic and asymptomatic cases. Cytokine profiling and antibody quantification were performed using Luminex™ multiplex assay whereas antigen-driven agglutination assay was used to assess the ABO blood groups. Immune profile levels between symptomatic and asymptomatic groups were compared using the two-tailed Mann-Whitney U test. Multiple comparisons of cytokine levels among and between days were tested using Kruskal-Wallis with Dunn's post hoc test. Correlations within ABO blood grouping (O's and non-O's) and between cytokines were determined using Spearman correlations. Logistic regression analysis was performed to assess the association of various cytokines with asymptomatic phenotype. RESULTS: There was a trend linking blood group O to reduced disease severity, but this association was not statistically significant. Generally, symptomatic patients displayed significantly (p < 0.05) higher cytokine levels compared to asymptomatic cases with exception of Eotaxin, which was positively associated with asymptomatic cases. There were also significant (p < 0.05) associations between other immune markers (IL-6, IL-8 and IL-1Ra) and disease severity. Cytokines' clustering patterns differ between symptomatic and asymptomatic cases. We observed a steady decrease in the concentration of most cytokines over time, while anti-SARS-CoV-2 antibody levels were stable for at least a month, regardless of the COVID-19 status. CONCLUSIONS: The findings suggest that genetic background and pre-existing immune response patterns may in part shape the nature of the symptomatic response against COVID-19 in a West African population. This study offers clear directions to be explored further in larger studies.

Stop and Go: Barriers and Facilitators to Care Home Research

Barriers to care home research have always existed, but have been thrown into sharp relief by the COVID-19 pandemic. Existing infrastructure failed to deliver the research, or outcomes, which care home residents deserved and we need to look, again, at how these barriers can be taken down. Barriers can be categorised as procedural (encountered before research starts), system (encountered during research) or resident-specific. To tackle these, research regulatory bodies need to adopt a standardised approach to how care home research is developed and designed, reviewed and regulated, and how such approaches can enable recruitment of as wide a range of residents and their representatives as possible, including those without the mental capacity to consent for research. Establishment of local, inter-disciplinary collaborations between universities, general practices, health and social care providers and care homes is another priority. This should be based on pre-existing models such as the ‘Living lab’ model developed in The Netherlands and now being implemented in the UK and Austria. These changes are critical to develop a sustainable research model. If well designed this will deliver better outcomes for residents and align with the individual and organisational priorities of those who care for them.

Second-Year Review of the NSF-DoD REU Site: HYPER

The challenges associated with achieving hypersonic flight, developing advanced propulsion systems, and designing reusable launch platforms are strongly interdisciplinary. Exposing undergraduate students to interdisciplinary research is recognized as a means to equip society's future engineers and scientists with the broad skillset necessary to contribute to these areas. The jointly funded NSF-DoD REU site Advanced Technologies for Hypersonic Propulsive, Energetic and Reusable Platforms (HYPER) unites multidisciplinary interests to study advanced structures and systems with application to hypersonics, space, propulsion, and energy. Over the course of two 10-week summer sessions (2019 and 2021), participants have gained hands-on training in contemporary challenges such as: (1) utilizing advanced manufacturing techniques for high-value components, (2) integrating in situ monitoring of stress-strain evolution, (3) developing novel methods for improved internal cooling and heat transfer effectiveness, (4) mitigating flutter through advanced rotor dynamic control, etc. Eleven research projects have been crafted to engage students in PhD-level topics. Many of these challenges rely on approaches that cut across disciplines and research techniques (e.g., experiments and computer simulation). The present reporting serves as a synopsis of challenges, advances, and lessons learned conducting the research thus far. The site HYPER has six core objectives that relate to: (1) preparing students for graduate school and/or research-oriented careers, (2) fostering technical skills in student participants, (3) improving participants' communication skills, (4) marketing to and recruiting a diverse group of participants, and more. Assessment of the program outcomes according to these objectives are reported here with data gathered after two years. Program outcomes were conducted with an external evaluator affiliated within the University of Central Florida's Program Evaluation and Educational Research Group (PEER). Results demonstrate a very effective site with strongly positive outcomes for all participants. Insights are provided so this research effort may be confirmed by other independent sites. It should be noted that the 2020 session was postponed out of an abundance of caution based on the uncertain and evolving conditions facilitated by the COVID-19 pandemic. © American Society for Engineering Education, 2022.

Coronavirus disease 2019 subphenotypes and differential treatment response to convalescent plasma in critically ill adults: secondary analyses of a randomized clinical trial.

PURPOSE: Benefit from convalescent plasma therapy for coronavirus disease 2019 (COVID-19) has been inconsistent in randomized clinical trials (RCTs) involving critically ill patients. As COVID-19 patients are immunologically heterogeneous, we hypothesized that immunologically similar COVID-19 subphenotypes may differ in their treatment responses to convalescent plasma and explain inconsistent findings between RCTs . METHODS: We tested this hypothesis in a substudy involving 1239 patients, by measuring 26 biomarkers (cytokines, chemokines, endothelial biomarkers) within the randomized, embedded, multifactorial, adaptive platform trial for community-acquired pneumonia (REMAP-CAP) that assigned 2097 critically ill COVID-19 patients to either high-titer convalescent plasma or usual care. Primary outcome was organ support free days at 21 days (OSFD-21) . RESULTS: Unsupervised analyses identified three subphenotypes/endotypes. In contrast to the more homogeneous subphenotype-2 (N = 128 patients, 10.3%; with elevated type i and type ii effector immune responses) and subphenotype-3 (N = 241, 19.5%; with exaggerated inflammation), the subphenotype-1 had variable biomarker patterns (N = 870 patients, 70.2%). Subphenotypes-2, and -3 had worse outcomes, and subphenotype-1 had better outcomes with convalescent plasma therapy compared with usual care (median (IQR). OSFD-21 in convalescent plasma vs usual care was 0 (- 1, 21) vs 10 (- 1, to 21) in subphenotype-2; 1.5 (- 1, 21) vs 12 (- 1, to 21) in suphenotype-3, and 0 (- 1, 21) vs 0 (- 1, to 21) in subphenotype-1 (test for between-subphenotype differences in treatment effects p = 0.008). CONCLUSIONS: We reported three COVID-19 subphenotypes, among critically ill adults, with differential treatment effects to ABO-compatible convalescent plasma therapy. Differences in subphenotype prevalence between RCT populations probably explain inconsistent results with COVID-19 immunotherapies.

THE ALPHA COLLABORATION FOR RANDOMISED MEGA-STUDIES TO IMPROVE MORTALITY AND DISABILITY

Background: COVID-19 trials took <1 year to identify therapies reducing death in >30,000 patients but the Australian Placental Transfusion Study took >12 years to show that delaying cord clamping reduced death or major disability (cerebral palsy, severe visual loss, deafness, or cognitive delay) in 1,531 preterm infants. What can this teach us? Further, as composite outcomes of death or major disability can be inconclusive if each is unequally affected (as in the NeOProM Collaboration1) 2 important aims are (i) global co-operation (https://www.alphacollaboration.com/) to identify core Participant-Intervention-Comparator-Outcome questions for trials assessing mortality, a key outcome, and (ii) to answer those questions in much larger, faster trials. Such trials will also yield much more precise estimates of disability in survivors than was previously typical - a major benefit. Method: To inform these aims we compared enrolment in 2 COVID-19 trials and in 10 trials by IMPACT collaborators with samples >1,500 in high- or low-or-middle-income countries (HIC/LMIC). Results: The COVID-19 trials took 3-9 months, enrolling 13 - 219 per-site-per-year. Perinatal trials took 16-86 months, enrolling 5 - 1,700 per site per year. Trials in pregnant women or LMIC (n = 53,092) enrolled 5 times more than trials in newborns or restricted to HIC (n = 9,014). (Table) Conclusions: Greater international collaboration could resolve questions of shared relevance and priority more rapidly. Megatrials addressing mortality may benefit from highly streamlined processes for enrolment and minimal data collection, e.g., RECOVERY's one-page outcome form.

“I WILL NOT HAVE ANOTHER BABY - THE PANDEMIC AND ISOLATION HAS BEEN TOO HARD” - THE IMPACT OF COVID-19 ON NEW PARENTS IN SYDNEY, AUSTRALIA

Background: The COVID-19 pandemic has caused unprecedented alterations to daily life. This sub-study of participants from the BABY1000 pilot birth cohort study explored the experiences of parents with children born in Australia prior to February 2020, compared to those whose children were born during the pandemic. Methods: Participants were invited to complete an online survey exploring the impact of COVID-19 and associated public health orders on their pregnancy and postpartum experiences, and included closed and open questions and the Depression Anxiety Stress Scale (DASS-21). Participants were also invited to participate in focus group discussions. The beliefs, values, and practices of participants were examined using discourse analysis. Results: From September to November 2021, 87 parents completed the survey (mean age 33.5 years [SD 3.7], 60% born in Australia). From this, 22 participated in one of five focus group discussions. Six themes were identified concerning the experience of parenting during the COVID-19 pandemic (% of comments relating to the theme): (1) Lack of support (39%), (2) Impact on family relationships and shared experiences (31%), (3) Stress and mental health impacts (26%), (4) Changes to healthcare access and delivery (26%), (5) Altered family lifestyles and routines (23%), and (6) Possible long-term impacts on families (10%). The mean DASS score was 43 (“moderate anxiety”) and there were no significant differences in mean score between mothers whose children were born before or during the pandemic. Conclusions: COVID-19 significantly impacted the experiences of women and their families engaged in a prospective study during pregnancy and postpartum.

FEASIBILITY AND ACCEPTABILITY OF BABY1000 - LESSONS FROM CONDUCTING A NOVEL EARLY BIRTH COHORT STUDY DURING THE COVID-19 PANDEMIC

Background: Few birth cohort studies begin prospective data collection in very early pregnancy. The BABY1000 pilot study aims to assess the feasibility and acceptability of biological sample collection, health indicator measurement and questionnaire administration through early pregnancy and the first 2000 days of life. Methods: The feasibility and acceptability of BABY1000 were evaluated using mixed methods. Participants were invited to complete an online survey with an additional offer to a virtual focus group discussion. Quantitative feedback was analysed descriptively. Qualitative responses were analysed using discourse analysis to examine the beliefs, values, and practices of participants. Results: From September to November 2021, 87 mothers completed the survey (mean age 33.5 years [SD 3.7], 60% born in Australia). From this, 22 parents participated in one of five focus groups. Main reported benefits of study participation were the ability to have children assessed physically, access additional scans, and ask researchers questions face-to-face. Protocol changes introduced due to COVID-19, including at-home data collection, affected participants' perceptions of the benefits of involvement and represented the highest number of comments received (27% of comments from survey and focus group feedback). Most participants reported feeling comfortable with sample collection (>95%), though less reported feeling comfortable or neutral about taking their own stool sample (80%). Conclusions: It is feasible to collect a range of biological samples, questionnaire, and health indicator data from early pregnancy up to two years of age with moderately high acceptability. Unsurpisingly, protocol changes due to the COVID-19 pandemic affected participants' perceptions of study involvement.

Detection of SARS-CoV-2 intra-host recombination during superinfection with Alpha and Epsilon variants in New York City.

Recombination is an evolutionary process by which many pathogens generate diversity and acquire novel functions. Although a common occurrence during coronavirus replication, detection of recombination is only feasible when genetically distinct viruses contemporaneously infect the same host. Here, we identify an instance of SARS-CoV-2 superinfection, whereby an individual was infected with two distinct viral variants: Alpha (B.1.1.7) and Epsilon (B.1.429). This superinfection was first noted when an Alpha genome sequence failed to exhibit the classic S gene target failure behavior used to track this variant. Full genome sequencing from four independent extracts reveals that Alpha variant alleles comprise around 75% of the genomes, whereas the Epsilon variant alleles comprise around 20% of the sample. Further investigation reveals the presence of numerous recombinant haplotypes spanning the genome, specifically in the spike, nucleocapsid, and ORF 8 coding regions. These findings support the potential for recombination to reshape SARS-CoV-2 genetic diversity.

Where there's a will there's a way: Examining the possible impacts of the COVID-19 pandemic on incidents of mass violence in the USA

"Where there's a will there's a way" is a proverb that simply means if someone is determined to do something, he or she will find a way to accomplish it regardless of obstacles. Unfortunately, this is very true for those who wish to commit acts of violence wish to commit acts of violence. The purpose of this chapter is to examine the possible impacts of the COVID-19 pandemic on incidents of mass and multiple victim violence in the US. More specifically, what impact did efforts such as stay-at- home/shelter-in-place orders, telecommuting options for workers, school closures, cancellation of large public events, and the suspension of non-essential travel have upon the extent and characteristics of mass violence. (PsycInfo Database Record (c) 2022 APA, all rights reserved)

Screening of potential inhibitors of COVID-19 with repurposing approach via molecular docking.

SARS-CoV-2 (COVID-19) is the causative organism for a pandemic disease with a high rate of infectivity and mortality. In this study, we aimed to assess the affinity between several available small molecule and proteins, including Abl kinase inhibitors, Janus kinase inhibitor, dipeptidyl peptidase 4 inhibitors, RNA-dependent RNA polymerase inhibitors, and Papain-like protease inhibitors, using binding simulation, to test whether they may be effective in inhibiting COVID-19 infection through several mechanisms. The efficiency of inhibitors was evaluated based on docking scores using AutoDock Vina software. Strong ligand-protein interactions were predicted among some of these drugs, that included: Imatinib, Remdesivir, and Telaprevir, and this may render these compounds promising candidates. Some candidate drugs might be efficient in disease control as potential inhibitors or lead compounds against the SARS-CoV-2. It is also worth highlighting the powerful immunomodulatory role of other drugs, such as Abivertinib that inhibits pro-inflammatory cytokine production associated with cytokine release syndrome (CRS) and the progression of COVID-19 infection. The potential role of other Abl kinase inhibitors, including Imatinib in reducing SARS-CoV and MERS-CoV viral titers, immune regulatory function and the development of acute respiratory distress syndrome (ARDS), indicate that this drug may be useful for COVID-19, as the SARS-CoV-2 genome is similar to SARS-CoV.

The evolving SARS-CoV-2 epidemic in Africa: Insights from rapidly expanding genomic surveillance. (preprint)

Investment in Africa over the past year with regards to SARS-CoV-2 genotyping has led to a massive increase in the number of sequences, exceeding 100,000 genomes generated to track the pandemic on the continent. Our results show an increase in the number of African countries able to sequence within their own borders, coupled with a decrease in sequencing turnaround time. Findings from this genomic surveillance underscores the heterogeneous nature of the pandemic but we observe repeated dissemination of SARS-CoV-2 variants within the continent. Sustained investment for genomic surveillance in Africa is needed as the virus continues to evolve, particularly in the low vaccination landscape. These investments are very crucial for preparedness and response for future pathogen outbreaks.