Asymptomatic COVID-19 Patients Can Contaminate Their Surroundings: an Environment Sampling Study.

The contamination of patients' surroundings by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) remains understudied. We sampled the surroundings and the air of six negative-pressure non-intensive care unit (non-ICU) rooms in a designated isolation ward in Chengdu, China, that were occupied by 13 laboratory-confirmed coronavirus disease 2019 (COVID-19) patients who had returned from overseas travel, including 2 asymptomatic patients. A total of 44 of 112 (39.3%) surface samples were positive for SARS-CoV-2 as detected by real-time PCR, suggesting extensive contamination, although all of the air samples were negative. In particular, in a single room occupied by an asymptomatic patient, four sites were SARS-CoV-2 positive, highlighting that asymptomatic COVID-19 patients do contaminate their surroundings and impose risks for others with close contact. Placement of COVID-19 patients in rooms with negative pressure may bring a false feeling of safety, and the importance of rigorous environment cleaning should be emphasized.IMPORTANCE Although it has been well recognized that the virus SARS-CoV-2, the causative agent of COVID-19, can be acquired by exposure to fomites, surprisingly, the contamination of patients' surroundings by SARS-CoV-2 is largely unknown, as there have been few studies. We performed an environmental sampling study for 13 laboratory-confirmed COVID-19 patients and found extensive contamination of patients' surroundings. In particular, we found that asymptomatic COVID-19 patients contaminated their surroundings and therefore imposed risks for other people. Environment cleaning should be emphasized in negative-pressure rooms. The findings may be useful to guide infection control practice to protect health care workers.

[The Response of Tribal Cultural Care to the Physical and Emotional Needs of Older Adults During the COVID-19 Pandemic].

As Taiwan's society ages, Tribal Cultural Health Stations serve as in situ long-term care centers that are committed to building a long-term care service model for indigenous peoples based on cultural care. The cultural sensitivity, cultural ability, and tribal ability of long-term care planners and professional helpers remains insufficient, making it difficult to achieve the policy goals of "designing for the tribes and for the locals" and "creating a cultural care mechanism". However, based on a foundation of local blood and geo-relationship and through the care expertise and interpersonal network established through long-term tribal cultivation and service, a cultural care mechanism that meets local awareness, local needs, and human trust has been formed by expanding linkages among the resources of all local stakeholders. During the COVID-19 epidemic, this has helped facilitate the recovery of the emotional and physical health of older tribal adults. For example, caregivers have been able to help ease the anxieties among older adults in indigenous communities regarding vaccination, fear of infection, isolation, and interpersonal suspicions. In addition, the positive role of the tribal cultural care mechanism as a social safety valve during the pandemic has been demonstrated.

Randomized, placebo-controlled, single-blind phase 1 studies of the safety, tolerability, and pharmacokinetics of BRII-196 and BRII-198, SARS-CoV-2 spike-targeting monoclonal antibodies with an extended half-life in healthy adults

Background: BRII-196 and BRII-198 are two anti-SARS-CoV-2 monoclonal neutralizing antibodies as a cocktail therapy for treating COVID-19 with a modified Fc region that extends half-life. Methods: Safety, tolerability, pharmacokinetics, and immunogenicity of BRII-196 and BRII-198 were investigated in first-in-human, placebo-controlled, single ascending dose phase 1 studies in healthy adults. 44 participants received a single intravenous infusion of single BRII-196 or BRII-198 up to 3,000 mg, or BRII-196 and BRII-198 combination up to 1500/1500 mg, or placebo and were followed up for 180 days. Primary endpoints were incidence of adverse events (AEs) and changes from pre-dose baseline in clinical assessments. Secondary endpoints included pharmacokinetics profiles of BRII-196/BRII-198 and detection of anti-drug antibodies (ADAs). Plasma neutralization activities against SARS-CoV-2 Delta live virus in comparison to post-vaccination plasma were evaluated as exploratory endpoints. Results: All infusions were well-tolerated without systemic or local infusion reactions, dose-limiting AEs, serious AEs, or deaths. Most treatment-emergent AEs were isolated asymptomatic laboratory abnormalities of grade 1-2 in severity. BRII-196 and BRII-198 displayed pharmacokinetics characteristic of Fc-engineered human IgG1 with mean terminal half-lives of 44.6–48.6 days and 72.2–83.0 days, respectively, with no evidence of interaction or significant anti-drug antibody development. Neutralizing activities against the live virus of the SARS-CoV-2 Delta variant were maintained in plasma samples taken on day 180 post-infusion. Conclusion: BRII-196 and BRII-198 are safe, well-tolerated, and suitable therapeutic or prophylactic options for SARS-CoV-2 infection. Clinical Trial Registration:ClinicalTrials.gov under identifiers NCT04479631, NCT04479644, and NCT04691180.

Social activity promotes resilience against loneliness in depressed individuals: A study over 14-days of physical isolation during the COVID-19 pandemic in Australia (preprint)

Loneliness is a subjectively perceived state of social isolation that is associated with negative emotional, cognitive, and physical health outcomes. Physical distancing and shelter-in-place public health responses designed to curb COVID-19 transmission has led to concerns over elevated risk of loneliness. Given that physical isolation does not necessitate social isolation in the age of digital communication, this study investigated the relationship between the frequency of social interaction and loneliness over a two-week period in people engaging in physical distancing, and examined whether this relationship was moderated by physical isolation level, age, or depression. A self-selected sample of N = 469 individuals across Australia who were engaged in physically distanced living completed daily surveys for 14-days during April to June of 2020. Multilevel modelling showed that more frequent social interaction with close, but not intermediate or distant contacts, was uniquely associated with lower loneliness. In addition, being younger, more depressed, more anxious, or having a mental health condition diagnosis (past or present) were also independently associated with higher loneliness. Critically, depression was the only significant moderator of the relationship between social interaction and loneliness over time, where more frequent social interaction with close contacts buffered against loneliness over time in high depression individuals only. The findings suggest that encouraging social activity with close contacts may promote resilience against loneliness in individuals with elevated depression symptoms.

Telephone-based Behavioral Activation with Mental Imagery for depression: a pilot randomized clinical trial in isolated older adults during the Covid-19 pandemic (preprint)

ObjectivesTo shield vulnerable persons, particularly the eldery, during the Covid-19 pandemic governments around the world have adviced to use social distancing and self-isolation. Social isolation might put older adults at an increased risk for mental health problems such as depression. There is a need for brief, easy-accessible psychological treatments for depressive symptoms that can be delivered remotely. The aim of this study was to investigate the feasibility, acceptability and preliminary efficacy of telephone-delivered Behavioral Activation with Mental Imagery for the treatment of depressive symptoms in individuals 65 years and older living in isolation during the covid-19-pandemic.MethodsIn this open-label pilot randomized clinical trial, N = 41 individuals aged 65 years or older with clinically significant symptoms of depression were randomly assigned to either a Behavioral Activation with Mental Imagery treatment condition, or an Attention-Assessment control condition delivered over the telephone over a four week period.ResultsDepressive symptoms decreased more in the treatment condition compared to the control condition. At post treatment 2 out of 16 participants in the treatment condition met diagnostic criteria for depression compared to 9 out of 13 in the control condition. Most participants in the treatment condition were satisfied with the treatment and few adverse effects were observed.ConclusionsThis pilot study suggests that behavioral activation with mental imagery delivered over the telephone is feasible, acceptable and potentially efficacious for the treatment of depressive symptoms in older individuals living in isolation. Replication in larger samples is needed.