COVID-19 vaccination in Palestine/Israel: citizenship, capitalism, and the logic of elimination. (Special Issue: Settler colonialism, structural racism, and the palestinian right to health.)

Despite Israel's responsibility under international law to combat the spread of contagious diseases and epidemics in its occupied territories, Israeli officials have refused to distribute COVID-19 vaccines to Palestinians in the West Bank and Gaza Strip. Through a critical discourse analysis of Israeli officials' statements regarding Israel's COVID-19 vaccination campaign, this paper explores how Israel evades this responsibility while presenting itself as committed to public health and human rights. We find that Israeli officials strategically present Palestinians as an autonomous nation when discussing COVID-19 vaccinations, despite Israel's ongoing attempts to prevent the creation of a Palestinian state. Relatedly, Israel justifies its refusal to vaccinate Palestinians on the grounds of the Palestinian Authority's economic independence, thereby obscuring Israel's control over the Palestinian economy. In this way, Israel relies on citizenship and economic inequality, as internationally sanctioned forms of exclusion, to deny Palestinians their right to health. Drawing on theorists such as Michel Foucault, Achille Mbembe, and Jasbir Puar, we argue that withholding vaccines from Palestinians reveals the ways that Israel furthers its settler-colonial aims under the guise of liberal humanitarianism and economic growth. Instead of directing these conclusions toward Israel as an exceptional case, we contend that these processes reveal how settler-colonial societies use liberal frameworks of citizenship and capitalism to carry out their racialized projects of elimination.

Cell-based high throughput screening to identify FDA/ EMA approved drugs that inhibit the endothelial pro-thrombotic switch during severe COVID19 infection

Background: A major complication of COVID19 is severe endothelial injury with micro-and macro-thrombotic disease in the lung and other organs. Several studies have identified high levels of inflammatory cytokines ( cytokine storm ), powerful activators of the endothelium, in plasma of severe COVID19 patients;indeed, COVID19 plasma was shown to activate endothelial cells (EC) in vitro. A consequence of EC activation is loss of anti-coagulant function, with release of pro-thrombotic Von Willebrand Factor (VWF). High levels of plasma VWF in severe COVID19 patients indicate systemic endothelial activation and increased risk of thrombosis. Aim(s): To identify drugs that decrease endothelial activation and VWF release, which may have a therapeutic impact in COVID19 patients. Method(s): We established an in vitro model of endothelial activation driven by 6 cytokines selected because of their high levels in COVID19 plasma. Cells were treated with the 6-cytokine cocktail for 24 hr;endothelial activation was confirmed by a panel of markers including ICAM1, measured by RT-qPCR and immunofluorescence (IF). Result(s): The treatment induced release of VWF and increased VWF-platelet string formation in a platelet flow-based assay. To identify drugs that blocked cytokine-induced VWF release, a high-throughput screening was carried out in human umbilical vein EC (HUVEC);VWF and ICAM1 expression were detected by IF;DAPI was used as nuclear stain. High content imaging screen of 3049 drugs from FDA/EMA-approved drug libraries identified drugs able to decrease VWF release following cytokine treatment. Top hits from several therapeutic classes including anti-inflammatory, anti-viral and hormones were taken forward for validation. Two hits were confirmed to inhibit cytokine-induced VWF release and VWF-platelet string formation. Selected findings were validated in lung microvascular EC. Conclusion(s): This study identified candidate drugs that reduce the enhanced VWF release caused by the cytokine storm typical of severe COVID19;these may be beneficial in the treatment of the pro-thrombotic risk in COVID19 patients.

Prognostic markers for the clinical course in the blood of patients with SARS-CoV-2 infection.

BACKGROUND: The presentation of peptides and the subsequent immune response depend on the MHC characteristics and influence the specificity of the immune response. Several studies have found an association between HLA variants and differential COVID-19 outcomes and have shown that HLA genotypes are associated with differential immune responses against SARS-CoV-2, particularly in severely ill patients. Information, whether HLA haplotypes are associated with the severity or length of the disease in moderately diseased individuals is absent. METHODS: Next-generation sequencing-based HLA typing was performed in 303 female and 231 male non-hospitalized North Rhine Westphalian patients infected with SARS-CoV2 during the first and second wave. For HLA-Class I, we obtained results from 528 patients, and for HLA-Class II from 531. In those patients, who became ill between March 2020 and January 2021, the 22 most common HLA-Class I (HLA-A, -B, -C) or HLA-Class II (HLA -DRB1/3/4, -DQA1, -DQB1) haplotypes were determined. The identified HLA haplotypes as well as the presence of a CCR5Δ32 mutation and number of O and A blood group alleles were associated to disease severity and duration of the disease. RESULTS: The influence of the HLA haplotypes on disease severity and duration was more pronounced than the influence of age, sex, or ABO blood group. These associations were sex dependent. The presence of mutated CCR5 resulted in a longer recovery period in males. CONCLUSION: The existence of certain HLA haplotypes is associated with more severe disease.

The Resurgence of Candida auris in California during the Novel Coronavirus (COVID-19) Pandemic, May 2020-May 2021

Background. In February 2019, California (CA) experienced its first C. auris outbreak in Orange County (OC). The CA Department of Public Health (CDPH) and OC with the Centers for Disease Control and Prevention (CDC), mounted a successful containment response;by November 2019, cases were limited to low-level spread in OC long-term acute care hospitals (LTACH). In May 2020, C. auris cases began to surge in OC, followed by extensive spread in six other southern CA local health jurisdictions (LHJ). CDPH with LHJ and CDC, initiated an aggressive, interjurisdictional containment response. Methods. We carried out response and preventive point prevalence surveys (PPS), onsite infection prevention and control (IPC) assessments, and in-service trainings at outbreak and interconnected hospitals and skilled nursing facilities in six LHJ. Other regional activities included: epidemiologic investigation, contact and discharge tracking and screening;increasing laboratory testing capacity;screening patients admitted to and from LTACH;statewide healthcare facility (HCF) education and outreach;sending regional outbreak HCF lists to all HCF;and biweekly state-LHJ coordination calls. The Antibiotic Resistance (AR) Lab Network supported testing. Results. From May 2020-May 2021, we conducted screening at 226 HCF, and identified 1192 cases at 93 HCF, mostly through screening (n=1109, 93%) and at LTACH (n=906, 76%);we identified 113 (10%) cases at ACH, including 35 (31%) in COVID-19-burdened units. Cases peaked in August 2020 (n=93) and February 2021 (n=191) and have since declined, with C. auris resurgence mirroring COVID-19 incidence. We conducted 98 onsite IPC assessments, and identified multiple, improper IPC practices which had been implemented in response to COVID-19, including double-gloving and -gowning, extended use of gowns and gloves outside patient rooms, and cohorting according to COVID-19 status only. Figure 1. C. auris and COVID-19 Cases in California through May 2021, and C. auris Cases by Local Health Jurisdiction (LHJ) May 2020-May 2021 Conclusion. The C. auris resurgence in CA was likely a result of COVID-19-related practices and conditions. An aggressive, coordinated, interjurisdictional C. auris containment response, including proactive prevention activities at HCF interconnected with outbreak HCF, can help mitigate spread of C. auris and potentially other novel AR pathogens.

High impact of COVID-19 in long-term care facilities, suggestion for monitoring in the EU/EEA, May 2020

Residents in long-term care facilities (LTCF) are a vulnerable population group. Coronavirus disease (COVID-19)-related deaths in LTCF residents represent 30-60% of all COVID-19 deaths in many European countries. This situation demands that countries implement local and national testing, infection prevention and control, and monitoring programmes for COVID-19 in LTCF in order to identify clusters early, decrease the spread within and between facilities and reduce the size and severity of outbreaks.

COVID-19 infection and Long-COVID. Effective guidance for return to work

Following the outbreak of a novel coronavirus disease, COVID-19 became a big challenge for public health. The world of work was severely affected during this crisis, while the pandemic highlighted the need to improve the interface between public health and occupational health, as well as to assess possible effects on occupational safety. Apart from acute health effects, a number of those infected are suffering from chronic symptoms for more than 12 weeks after the infection, a syndrome known as long-Covid. Building on existing information, non-binding guidelines to help employers and workers facilitate a smooth and effective return to work for workers suffering from long-lasting health effects of Covid-19 infection were developed by EU-OSHA. The guides cover all stages of the illness, including the acute phase, and address the time before and during return to work. Easy-to-follow advice is provided on how to keep in touch during sick leave, the back-to-work interview, measures such as temporary adjustments to working hours or duties, and where to get help. The proposed practices suggest that workers and managers should engage in a dialogue and hold a return-to-work meeting that, based on mutual understanding, will have as an outcome appropriate adjustments to work duties. Different categories of work demands, including cognitive, physical and emotional demands, are addressed. The proposed approach considers the return to work as part of the recovery process.

EU-OSHÁs perspective on occupational safety and health in the Covid-19 pandemic

In July 2020, EU-OSHA published the results of a comprehensive research project on the exposure of workers to biological agents at work and the related health problems. Although the research was initiated long before the pandemic, researchers had highlighted pandemic preparedness as an issue, as well as the general lack of monitoring of serious infectious diseases. The research also made evident a lack of awareness among workplace actors of the risks from exposure to biological agents at work, although a detailed legislative framework has been in place for many years, and consequently a lack of prevention measures at work, which became evident after the pandemic broke out. It highlighted the need for public health and occupational safety and health organisations to cooperate to mitigate the impact of the pandemic. The presentation will focus on the links between the research findings and the developments during the pandemic. It will furthermore present guidance produced by EU-OSHA and other relevant actions, with a view on the legislation that is in place. It will cover biological agents exposure as well as telework and ergonomic issues arising from it.

Association of HLA genotypes, AB0 blood type and chemokine receptor 5 mutant CD195 with the clinical course of COVID-19.

BACKGROUND: COVID-19, the pandemic disease caused by infection with SARS-CoV-2, may take highly variable clinical courses, ranging from symptom-free and pauci-symptomatic to fatal disease. The goal of the current study was to assess the association of COVID-19 clinical courses controlled by patients' adaptive immune responses without progression to severe disease with patients' Human Leukocyte Antigen (HLA) genetics, AB0 blood group antigens, and the presence or absence of near-loss-of-function delta 32 deletion mutant of the C-C chemokine receptor type 5 (CCR5). PATIENT AND METHODS: An exploratory observational study including 157 adult COVID-19 convalescent patients was performed with a median follow-up of 250 days. The impact of different HLA genotypes, AB0 blood group antigens, and the CCR5 mutant CD195 were investigated for their role in the clinical course of COVID-19. In addition, this study addressed levels of severity and morbidity of COVID-19. The association of the immunogenetic background parameters were further related to patients' humoral antiviral immune response patterns by longitudinal observation. RESULTS: Univariate HLA analyses identified putatively protective HLA alleles (HLA class II DRB1*01:01 and HLA class I B*35:01, with a trend for DRB1*03:01). They were associated with reduced durations of disease instead decreased (rather than increased) total anti-S IgG levels. They had a higher virus neutralizing capacity compared to non-carriers. Conversely, analyses also identified HLA alleles (HLA class II DQB1*03:02 und HLA class I B*15:01) not associated with such benefit in the patient cohort of this study. Hierarchical testing by Cox regression analyses confirmed the significance of the protective effect of the HLA alleles identified (when assessed in composite) in terms of disease duration, whereas AB0 blood group antigen heterozygosity was found to be significantly associated with disease severity (rather than duration) in our cohort. A suggestive association of a heterozygous CCR5 delta 32 mutation status with prolonged disease duration was implied by univariate analyses but could not be confirmed by hierarchical multivariate testing. CONCLUSION: The current study shows that the presence of HLA class II DRB1*01:01 and HLA class I B*35:01 is of even stronger association with reduced disease duration in mild and moderate COVID-19 than age or any other potential risk factor assessed. Prospective studies in larger patient populations also including novel SARS-CoV-2 variants will be required to assess the impact of HLA genetics on the capacity of mounting protective vaccination responses in the future.

Informed consent and informed intervention: SARS-CoV-2 vaccinations not just call for disclosure of newly emerging safety data but also for hypothesis generation and testing.

BACKGROUND: COVID-19 infection is a major threat to patients and health care providers around the world. One solution is the vaccination against SARS-CoV-2. METHODS: We performed a comprehensive query of the latest publications on the prevention of viral infections including the recent vaccination program and its side effects. RESULTS: The situation is evolving rapidly and there is no reasonable alternative to population-scale vaccination programs as currently enrolled. CONCLUSION: Therefore, regulatory authorities should consider supplementing their conventional mandate of post-approval pharmacovigilance, which is based on the collection, assessment, and regulatory response to emerging safety findings.

Measures of infection prevention and incidence of SARS-CoV-2 infections in cancer patients undergoing radiotherapy in Germany, Austria and Switzerland.

PURPOSE: COVID-19 infection has manifested as a major threat to both patients and healthcare providers around the world. Radiation oncology institutions (ROI) deliver a major component of cancer treatment, with protocols that might span over several weeks, with the result of increasing susceptibility to COVID-19 infection and presenting with a more severe clinical course when compared with the general population. The aim of this manuscript is to investigate the impact of ROI protocols and performance on daily practice in the high-risk cancer patients during this pandemic. METHODS: We addressed the incidence of positive COVID-19 cases in both patients and health care workers (HCW), in addition to the protective measures adopted in ROIs in Germany, Austria and Switzerland using a specific questionnaire. RESULTS: The results of the questionnaire showed that a noteworthy number of ROIs were able to complete treatment in SARS-CoV­2 positive cancer patients, with only a short interruption. The ROIs reported a significant decrease in patient volume that was not impacted by the circumambient disease incidence, the type of ROI or the occurrence of positive cases. Of the ROIs 16.5% also reported infected HCWs. About half of the ROIs (50.5%) adopted a screening program for patients whereas only 23.3% also screened their HCWs. The range of protective measures included the creation of working groups, instituting home office work and protection with face masks. Regarding the therapeutic options offered, curative procedures were performed with either unchanged or moderately decreased schedules, whereas palliative or benign radiotherapy procedures were more often shortened. Most ROIs postponed or cancelled radiation treatment for benign indications (88.1%). The occurrence of SARS-CoV­2 infections did not affect the treatment options for curative procedures. Non-university-based ROIs seemed to be more willing to change their treatment options for curative and palliative cases than university-based ROIs. CONCLUSION: Most ROIs reported a deep impact of SARS-CoV­2 infections on their work routine. Modification and prioritization of treatment regimens and the application of protective measures preserved a well-functioning radiation oncology service and patient care.