China's Vision for a Future World Order and Its Implications for Global Governance

This analytical essay addresses authoritarian communitarianism as the normative and ideological underpinnings of the current Chinese foreign policy. In recent years, China has exhibited its ambition in bidding for its preferred world order, through both its rhetoric and behavior. Being well aware of this new development, people are debating about what is exactly China's world vision and its approach to a future world order. Driven by the puzzle in contemporary global affairs, this chapter focuses on the philosophical and ideological roots of China's world vision, rather than investigating its foreign policies directly. It is argued that China's world view today and its ensuing policy approach are substantially informed by the authoritarian version of communitarianism, deriving largely from the traditional Chinese thoughts of Confucianism. Inspired by authoritarian communitarianism as the main international ideology, China is envisaging a world order, based on values of international stability and communal harmony, emphasizing the role of nation states and vertical hierarchical order. This argument is further assessed with China's role and policy in the crisis of the on-going Covid-19 pandemic. Through this specific case, strength and limitation of China's world vision are better illuminated, with reference to global governance. It is concluded that the ideological struggle between China and mostly the West tends to generate substantial policy implications in contemporary global affairs. © 2023, The Author(s), under exclusive license to Springer Nature Switzerland AG.

PREVALENCE OF 16 RESPIRATORY VIRUSES DURING THE COVID-19 PANDEMIC IN SOUTHWEST REGION OF KOREA

SARS-CoV-2 virus emerged in January 2020 in Korea, and the COVID-19 pandemic changed quarantine policy, personal hygiene awareness, social contact policy, and so on. Therefore, prevalence of diseases has also changed. We investigated the prevalence of 16 respiratory viruses during the COVID-19 pandemic period. We analyzed 20,513 sputum specimens of patients with acute respiratory symptoms from over 350 hospitals in southwest region of Korea for 2 years (July 2020-June 2022) to determine positive rates of detection using the Allplex Respiratory Panel 1/2/3 (Seegene, Republic of Korea) which is a multiplex real-time PCR assay by month. The positive rate of most respiratory viruses was less than 5% at the early period (July 2020-June 2021) of COVID-19 pandemic, except for adenovirus, human rhinovirus and human bocavirus (hBoV). The positive rate of most respiratory viruses tends to decrease during the period of rapid increase in the number of COVID-19 infections except for coronavirus OC43 and hBoV. The positive rates of respiratory syncytial virus A, respiratory syncytial virus B, and parainfluenza virus 3 increased during the cold season just before the rapid increase in the number of COVID-19 infections. Influenza virus positivity was very low (<2%) during the COVID-19 pandemic. The low positive rate of most respiratory viruses in the early period of the COVID-19 pandemic may be related to strict quarantine policy at that time. The patterns of outbreaks of other respiratory viruses vary from virus to virus during the COVID-19 pandemic. Rapid increase in the number of COVID-19 infections during the COVID-19 pandemic has affected the prevalence of other respiratory viruses. [ FROM AUTHOR] Copyright of International Journal of Infectious Diseases is the property of Elsevier B.V. and its content may not be copied or emailed to multiple sites or posted to a listserv without the copyright holder's express written permission. However, users may print, download, or email articles for individual use. This may be abridged. No warranty is given about the accuracy of the copy. Users should refer to the original published version of the material for the full . (Copyright applies to all s.)

A Case Report of a Pregnant Woman with COVID-19 and Tuberculosis

We presented a case of a 32-week pregnant woman with coronavirus disease 2019 and tuberculosis delivering a healthy baby. She was treated with antituberculosis and other symptomatic treatments, and the nucleic acid test;the sputum tuberculosis bacterial smear turned negative;and the symptoms were significantly relieved. © Wolters Kluwer Health, Inc. All rights reserved.

Intelligent Surface-Enhanced Raman Scattering Sensor System for Virus Identification

COVID-19 has devastated the entire world for the past couple of years. Timely and efficient detection and identification of a virus are crucial in preventing the wider virus spread. By using intelligent sensors based on Surface-Enhanced Raman Scattering (SERS), it is possible to detect and identify virus automatically. In this study, we successfully applied the XGBoost Algorithm (Supervised Machine Learning) to classify the type of the virus using the SERS sensor data. The supervised approach has a limitation when a new type of virus arises, whose shape is different from the previously known samples. To tackle this problem, we investigated the unsupervised learning approaches that can cluster the virus data into different groups without labeled data. The unsupervised approach presented in this paper is called k-Shape Clustering. This technique compares the cross-correlation between different samples and then clusters them into similar or different groups. If a subvariant of a virus emerges, it would be clustered into the existing virus groups;if a new type of virus is found, it would be clustered into a new group. Both of the approaches have shown very promising results based on extensive evaluations. © 2022 IEEE.

Environmental collaboration and blockchain technology adoption in green medical supply chain management during the COVID-19 pandemic

In recent years, the resource shortage and environmental degradation have made enterprises and governments increasingly aware of the importance of sustainable development. Meanwhile, the COVID-19 pandemic has also increased the shortage of medical materials. Based on this, we investigate the tradeoff of the critical medical devices refurbishing strategies when blockchain is used in three different structures: manufacturer refurbishing, retailer refurbishing, and third-party refurbishing in the two-period refurbishing strategies. We find that the manufacturer always benefits from the adoption of blockchain technology strategy in the manufacturer refurbishing scenario. However, for the retailer in the second period, the retailer references the adoption of blockchain only if the willingness to pay is extremely high. Additionally, when the medical supply chain channel member chooses retailer refurbishing or third-party strategy, the manufacturer always likes to use blockchain technology. That's because it will help the information value spillover from the retailer to the manufacturer, which leads the manufacturer to get more profits and a lower profit for the retailer. However, in the retailer refurbishing or third-part strategy, the whole channel profits are higher than not adopting blockchain technology. Therefore, business managers can be based on our research to achieve profits Pareto-improving.

Classification of Respiratory Syncytial Virus and Sendai Virus Using Portable Near-infrared Spectroscopy and Chemometrics

There is evidence that it may be possible to detect viruses and viral infection optically using techniques such as Raman and infra-red (IR) spectroscopy and hence open the possibility of rapid identification of infected patients. However, high-resolution Raman and IR spectroscopy instruments are laboratory-based and require skilled operators. The use of low-cost portable or field-deployable instruments employing similar optical approaches would be highly advantageous. In this work, we use chemometrics applied to low-resolution near-infrared (NIR) reflectance/absorbance spectra to investigate the potential for simple low-cost virus detection suitable for widespread societal deployment. We present the combination of near-infrared spectroscopy and chemometrics to distinguish two respiratory viruses, respiratory syncytial virus (RSV), the principal cause of severe lower respiratory tract infections in infants worldwide, and Sendai virus (SeV), a prototypic paramyxovirus. Using a low-cost and portable spectrometer, three sets of RSV and SeV spectra, dispersed in phosphate-buffered saline (PBS) medium or Dulbecco’s modified eagle medium (DMEM), were collected in long-term and short-term experiments. The spectra were pre-processed, and analysed by partial least squares discriminant analysis (PLS-DA) for virus type and concentration classification. Moreover, the virus type/concentration separability was visualized in a low-dimensional space through data projection. The highest virus type classification accuracy obtained in PBS and DMEM is 85.8% and 99.7%, respectively. The results demonstrate the feasibility of using portable NIR spectroscopy as a valuable tool for rapid, on-site and low-cost virus pre-screening for RSV and SeV with the further possibility of extending this to other respiratory viruses such as SARS-CoV-2. IEEE

Screening potential Q-Marker from Huoxiang Zhengqi Shui based on UPLC-Q-TOF-MS fingerprints and molecular docking

Objective To screen the potential quality markers (Q-Marker) of anti-coronavirus of Huoxiang Zhengqi Shui (, HZS) based on the ultra-performance liquid chromatography-quadrupole-time of flight-mass spectrometry (UPLC-Q-TOF-MS) fingerprints and molecular docking. Methods UPLC-Q-TOF-MS fingerprints and chemometric methods were employed to establish fingerprints and find out the difference between the peaks for the 27 batches of HZS samples. The SARS-CoV-2 main protease (Mpro) inhibition potential of the differential compounds among the 27 batches of HZS were further predicted by molecular docking with remdesivir as positive control. Results The UPLC-Q-TOF-MS fingerprints of 27 batches of HZS samples were set up with 27 common peaks. Combined with hierarchical clustering analysis (HCA) and principal component analysis (PCA), 14 common peaks were determined as differential compounds, and nine of them were identified as hesperidin, oxypeucedanin, neobyakangelicol, sinensetin, glycyrrhizic acid, 3,5,6,7,8,3',4'-heptamethoxyflavone, tangeretin, imperatorin and phellopterin. Molecular docking results showed that a total of six differential compounds were proven to have a certain inhibitory effect on SARS-CoV-2 Mpro, which can be used as potential Q-Marker of HZS, including hesperidin, oxypeucedanin, neobyakangelicol, glycyrrhizic acid, imperatorin and phellopterin. Conclusion The potential Q-Marker of HZS was determined by UPLC-Q-TOF-MS fingerprints, chemometric analysis and molecular docking. This method may provide a certain reference for the identification of various drug components, analysis of the differences of the same type drug components and pharmaceutical activity evaluation. Copyright © 2022 Editorial Office of Chinese Traditional and Herbal Drugs. All rights reserved.

A longitudinal study of COVID-19 disclosure stigma and COVID-19 testing hesitancy in the United States.

OBJECTIVES: This study examines the relationship between COVID-19 disclosure stigma and COVID-19 testing hesitancy and assesses their changes between November 2020 and 2021. STUDY DESIGN: This was a longitudinal cohort. METHODS: A total of 355 participants completed four study waves between November 2020 and November 2021. Factor analyses and Cronbach's alpha assessed the factor structure and internal consistency of the COVID-19 Disclosure Stigma scale. Paired t-tests and McNemar's Chi-squared test assessed change between the study waves. Multivariable logistic regression models examined the relationship between COVID-19 disclosure stigma and testing hesitancy at four study waves. RESULTS: COVID-19 disclosure stigma declined significantly between the last study waves (P = 0.030). The greatest disclosure concern was reporting a positive test to close contacts (range: 19%-21%) followed by disclosure to friends (range: 10%-15%) and family (range: 4%-10%). Over the course of the four study waves, COVID-19 testing hesitancy when symptomatic ranged from 23% to 30%. Older age, female gender, and having received a COVID-19 vaccine were associated with decreased odds of testing hesitancy. Greater COVID-19 disclosure stigma and more conservative political ideology showed a consistent relationship with increased odds of COVID-19 testing hesitancy. CONCLUSIONS: Study findings suggest that many people anticipate feeling stigmatized when disclosing positive test results, especially to close contacts. A substantial percentage of study participants reported hesitancy to be tested when symptomatic. This study identifies a need for interventions that normalize COVID-19 testing (e.g. engaging leaders with conservative followings), provide strategies for disclosing positive results, and allow anonymous notification of potential COVID-19 exposure.

Sequential immunization with SARS-CoV-2 vaccines

Sequential immunization is one of the special means to solve the shortage of vaccines, respond to SARS-CoV-2 variants and improve the efficacy of vaccines in the current pandemic period. This article mainly reviewed five sequential immunization strategies using the vaccines authorized by World Health Organization: priming with inactivated vaccine and boosting with recombinant protein vaccine, vector vaccine or mRNA vaccine;priming with vector vaccine and boosting with mRNA vaccine;prime-boost immunization with mRNA vaccines produced by different manufactures. Results of the related studies showed that heterologous sequential immunization strategies were safe and effective, and higher immunogenicity and efficacy could be achieved by sequential immunization. In addition, sequential immunization could provide certain protective effects against SARS-CoV-2 variants.

Process of forming tourists’ pro-social tourism behavior intentions that affect willingness to pay for safety tourism during the COVID-19 pandemic: a comparative analysis of South Korea and China

During the COVID-19 pandemic, South Korea implemented relatively flexible quarantine measures such as recommending social distancing. In contrast, China strictly controlled the pandemic, enforcing a ban on going out. This study examined the process of forming people’s pro-social tourism behavioral intention in both countries considering the differing disciplinary techniques in response to COVID-19. We employed a framework combining the Norm Activation Model and the Theory of Planned Behavior. This study contributes to creating a safe tourism environment, proposals for revitalizing tourism activities, and measures to ensure that tourism services are in line with public health. © 2022 Asia Pacific Tourism Association.

Self-Sovereign Identity and User Control for Privacy-Preserving Contact Tracing

Contact tracing apps use mobile devices to keep track of and promptly identify those who come in contact with an individual who tests positive for COVID-19. However, privacy is a major obstacle to the wide-spread use of such apps since users are concerned about sharing their contact and diagnosis data. This research overcomes multiple challenges facing contact tracing apps: (1) As researchers have pointed out, there is a need to balance contact tracing effectiveness with the amount of user identity and diagnosis information shared. (2) No matter what information the user chooses to share, the app should safeguard the privacy of user information. (3) On the other hand, some essential test result information must be shared for the contact tracing app to work. While contact tracing apps have done a good job maintaining contact information on the user's device, most such apps publish positive COVID-19 test results to a central server which have some risks for compromise. We address these challenges by (1) giving the user the right to choose how much information to share about their diagnosis and their identity, (2) building our novel contact tracing app on top of Self-Sovereign Identity (SSI) to assure privacy preserving user authentication with verifiable credentials, and (3) decentralizing the storage of COVID-19 test results. We, in collaboration with Verizon, have implemented our Privacy-preserving Contact Tracing (PpCT) app, leveraging SSI advances based on the blockchain for their 5G network. © 2021 ACM.

COVID19-OBKG: An Ontology-Based Knowledge Graph and Web Service for COVID-19

Given the huge amount of data from diverse sources and involving various conceptual fields in heterogeneous formats, researchers have encountered challenges in their effort to process, search for, and access knowledge about coronavirus disease 2019 (COVID-19). In this paper, we built COVID19-OBKG, an ontology-based knowledge graph and web service for COVID-19, to enable the access and retrieval of knowledge. First, we built the schema of COVID19-OBKG based on biomedical ontologies to guide the construction of the instance layer of COVID19-OBKG from top to bottom. Secondly, we collected data sources related to COVID-19, including structured databases and web pages. We acquired entities and relationships from data sources through named entity recognition and relation extraction algorithms and merged them with knowledge in biomedical ontologies. Thirdly, we modeled our data in the form of an attribute graph and stored it in Dgraph. Finally, we built a web service to support the retrieval and visualization of COVID19-OBKG, which verified the effectiveness of our approach to constructing a knowledge graph, and the usability of COVID19-OBKG. © 2021 IEEE.

Rapid Classification of Respiratory Syncytial Virus and Sendai Virus by a Low-cost and Portable Near-infrared Spectrometer

In this work, we present the combination of near-infrared spectroscopy and chemometrics to distinguish respiratory syncytial virus (RSV) and Sendai virus (SeV), the first study of its kind. Using a low-cost and portable spectrometer, a total of 440 virus spectra were collected over four separate sessions. The spectra were pre-processed by normalisation and baseline removal, and variable elimination was conducted based on the standard deviation. Partial least squares discrimination analysis was used to model the relationship between the spectra and the virus categories, resulting in the accuracy of 0.825 and 0.855 for validation and prediction, respectively. Since the portable spectrometer has simple operation and can provide analytical results in real time, it can be used as a viable tool for rapid, on-site and low-cost virus screening for RSV, SeV and possibly other similar viruses such as SARS-CoV-2.

High-affinity, neutralizing antibodies to SARS-CoV-2 can be made without T follicular helper cells

[Figure: see text].

Multi-Center Phase II Study of Oral Azacitidine (CC-486) Plus CHOP As Initial Treatment for Peripheral T-Cell Lymphoma (PTCL)

INTRODUCTION: Nodal PTCL with T-follicular helper phenotype (PTCL-TFH), which includes angioimmunoblastic T-cell lymphoma (AITL), is characterized by recurrent mutations affecting epigenetic regulators such as TET2, DNMT3A, IDH2 and RHOA. The association of aberrant DNA methylation with lymphomagenesis provides rationale for clinical application of hypomethylating agents. Azacitidine, an epigenetic modifier which inhibits DNA methyltransferase, has shown clinical activity as a single agent and in combination in R/R PTCL. We report the findings of the first study of oral azacitidine (CC-486) plus CHOP as initial treatment for PTCL (ClinicalTrials.gov - NCT03542266). METHODS: This phase 2 study prioritized enrollment of PTCL-TFH. Subjects received CHOP on day 1 of each cycle for 6 cycles. Priming with oral azacitidine (CC-486) at 300 mg daily was administered for 7 days prior to cycle 1 of CHOP, and for 14 days before CHOP cycles 2-6. Supportive care included mandatory G-CSF. The primary endpoint is CR per 2014 IWG criteria. Secondary endpoints include ORR, safety and survival. Correlative biomarker studies are planned to assess genomic mutations by next-generation-sequencing (NGS), in addition to methylation and transcription profiles. Using a Simon two-stage design comparing an CR of ≥60% with treatment to an unacceptable CR of ≤35% (alpha=10%, power=80%), 9 or more CR out of 17 enrolled patients were required to declare the treatment worthy of further study. RESULTS: From 6/2018 to 3/2020, 21 subjects with previously untreated PTCL were enrolled at 4 centers, and the study met its accrual. At study entry, 17 patients (81%) had PTCL-TFH (16 AITL and 1 TFH), 3 with PTCL-NOS, 1 with ATLL, including 5 (24%) with CD30+ disease. The median age was 66 years (range 22-77), and the M:F ratio was 1.6:1. Nineteen (90%) had stage III/IV disease, 10 (48%) had elevated LDH, 7 (33%) had bone marrow involvement, and 9 (43%) had IPI 3-5. Treatment was generally well tolerated with expected side effects. Grade 3-4 hematologic toxicities included neutropenia (71.4%), thrombocytopenia (9.5%) and anemia (14.3%), with febrile neutropenia uncommon (14.3%). Grade 3-4 non-hematologic toxicities included fatigue (14.3%), hyponatremia (14.3%), diarrhea (4.8%), vomiting (4.8%), rash (4.8%), and elevated ALT (4.8%). One incidence each of influenza A, COVID-19 pneumonia, C.diff and strongyloides hyperinfection were observed and treated. There was no study treatment-related mortality to date. As of July 2020 at a median follow-up of 7 months (range 4-25 months), one subject withdrew consent after cycle 1 (patient preference), and 20 subjects had at least one response assessment, including 15 completed treatment, 2 progressed during treatment, and 3 nearing completion of therapy. At interim assessment after cycle 3 (n=20), the ORR was 85% with CR at 55% (90%CI of 34.7%-74.1%). To date, the preliminary end-of-treatment (EOT, n=17) CR was 76.5% (90%CI of 53.9%-91.5%) for all evaluable patients and was 86.7% for 15 PTCL-TFH, exceeding primary endpoint threshold. CR did not correlate with CD30 expression. The estimated 1-yr PFS for all patients was 56.8% (95%CI of 26.3%-87.3%), with 1-yrs PFS for PTCL-TFH at 61.1% (95%CI of 29.5%-92.7%), and the estimated 1-yr OS for all patients was 74.4% (95%CI of 48.8%-100.0%), with 1-yr OS for PTCL-TFH at 88.9% (95%CI of 68.4%-100.0%). Mutational status by NGS was determined in 15 patients to date. The frequencies of the TET2, RHOA, DNMT3A, and IDH2 mutations were 73%, 40%, 13% and 13%, respectively. TET2 mutations were significantly associated with CR (p=0.014), favorable PFS (p-0.012) and OS (p=0.042). In contrast, DNMT3A mutations were associated with adverse OS (p=0.028). CONCLUSIONS: This study provides the first demonstration that addition of hypomethylating agent oral azacitidine (CC486) to CHOP as initial therapy is feasible, safe, and induces high CR rate in PTCL-TFH subtype, with expected side effects. Although preliminary, the EOT CR to date exceeds the threshold of meeting study primary endpoint. Final efficacy data as well as response according to subtype and mutational profiling will be updated at ASH. This active combination will be further evaluated in the upcoming ALLIANCE/Intergroup randomized study A051902, comparing oral azacitidine-CHO(E)P with duvelisib-CHO(E)P against CHO(E)P in CD30 negative PTCL. [Formula presented] Disclosures: Ruan: Seattle Genetics: Research Funding;AstraZeneca: Consultancy, Research Funding;Celgene: Consultancy, Research Funding;Juno: Consultancy;BMS: Consultancy, Research Funding;Pharmacyclics: Research Funding;Kite Pharma: Consultancy. Moskowitz: Seattle Genetics: Research Funding;Incyte: Research Funding;Merck: Consultancy;Seattle Genetics: Consultancy;Bristol-Myers Squibb: Research Funding;Merck: Research Funding;Imbrium Therapeutics, L.P.: Consultancy;Miragen Therapeutics: Consultancy. Mehta-Shah: Bristol Myers-Squibb: Research Funding;Genetech: Research Funding;Innate Pharmaceuticals: Research Funding;Kyowa Kirin: Consultancy;Verastem: Research Funding;Karyopharm Therapeutics: Consultancy;Celgene: Research Funding;C4 Therapeutics: Consultancy. Sokol: EUSA Pharma: Consultancy, Honoraria, Speakers Bureau;Kymera Therapeutics: Membership on an entity's Board of Directors or advisory committees;Kyowa/Kirin Inc.: Membership on an entity's Board of Directors or advisory committees. Horwitz: Portola: Consultancy, Research Funding;Aileron: Consultancy, Research Funding;Celgene: Consultancy, Research Funding;Beigene: Consultancy;Daiichi Sankyo: Research Funding;C4 Therapeutics: Consultancy;ADCT Therapeutics: Consultancy, Research Funding;Millenium/Takeda: Consultancy, Research Funding;Innate Pharma: Consultancy;Corvus: Consultancy;Trillium: Consultancy, Research Funding;Kyowa Hakka Kirin: Consultancy, Research Funding;GlaxoSmithKline: Consultancy;Mundipharma: Consultancy;Infinity/Verastem: Research Funding;Forty Seven: Consultancy, Research Funding;Seattle Genetics: Consultancy, Research Funding;Miragen: Consultancy;Myeloid Therapeutics: Consultancy;Verastem: Consultancy, Research Funding;Vividion Therapeutics: Consultancy;Affirmed: Consultancy;ASTEX: Consultancy;Janssen: Consultancy;Kura Oncology: Consultancy. Rutherford: LAM Therapeutics: Research Funding;Juno: Consultancy;AstraZeneca: Consultancy;Seattle Genetics: Consultancy;Genentech/Roche: Research Funding;Regeneron: Research Funding;Celgene: Consultancy;Heron: Consultancy;Karyopharm: Consultancy, Research Funding;Dova: Consultancy;Kite: Consultancy. Coleman: Novartis Pharmaceuticals: Research Funding;Innocare: Research Funding;Merck Sharp & Dohme Corp.: Research Funding;BeiGene: Research Funding;Acerta: Research Funding;Ipsen Group: Research Funding;BMS (Celgene Corporation): Research Funding;AstraZeneca Pharmaceuticals, LP: Research Funding;Karyopharma Therapeutics, Inc.: Research Funding;ARCUS Biosciences: Research Funding;AstraZeneca Pharmaceuticals, LP (Acerta Pharma BV Trials): Research Funding;Incyte Corporation: Research Funding;Eli Lilly and Company: Research Funding;EMD Serono Research and Development Institute Inc.: Research Funding;Genetech (F. Hoffman-LaRoche Ltd): Research Funding;Hutchinson MediPharma, LTD: Research Funding;Klus Pharma, Inc.: Research Funding;MeiPharma, Inc.: Research Funding;Seattle Genetics: Research Funding;Boston BIoMedical, Inc.: Research Funding. Melnick: Jubilant: Consultancy;Epizyme: Consultancy;Constellation: Consultancy;Janssen: Research Funding;Daiichi Sankyo: Research Funding. Cerchietti: BMS: Research Funding. Leonard: ADC Therapeutics: Consultancy;MEI Pharma: Consultancy;Bayer: Consultancy;Gilead/Kite: Consultancy;Karyopharm: Consultancy;GenMab: Consultancy;Regeneron: Consultancy;Sutro: Consultancy;AstraZeneca: Consultancy;Roche/Genentech: Consultancy;BMS/Celgene: Consultancy;Epizyme: Consultancy;Miltenyi: Consultancy. Martin: Regeneron: Consultancy;I-MAB: Consultancy;Sandoz: Consultancy;Janssen: Consultancy;Karyopharm: Consultancy, Research Funding;Teneobio: Consultancy;Bayer: Consultan y;Beigene: Consultancy;Cellectar: Consultancy;Incyte: Consultancy;Kite: Consultancy;Morphosys: Consultancy;Celgene: Consultancy. OffLabel Disclosure: Oral azacitidine (CC-486) as hypomethylating agent for the treatment of peripheral T-cell lymphoma

PIN20 Predicting the IMPACT of Vaccination Strategies in the COVID-19 Pandemic Using a Susceptible-Exposed-Infectious-Removed (SEIR) MODEL

Objectives: Coronavirus (COVID-19) has resulted in 84.53 million infections and 1.85 million deaths world-wide in 2020 and both numbers are still increasing. Using a Susceptible-Exposed-Infectious-Removed (SEIR) model, this study aimed to predict the impact of different vaccination strategies in the UK on mortality, productivity loss, and healthcare burden. Methods: A SEIR model was built in R using the UK estimated age-group specific proportions of asymptomatic infections, probability of severe symptoms and death rate from published literature. Assuming vaccine supply covers 20% or 50% of the UK population as two base scenarios, three population-wide vaccination strategies with different age group priorities were modelled. Total number of infections, COVID-19 related deaths, quality-adjusted life years (QALYs) lost, cost for critical and non-critical care, and productivity loss were estimated. Results: In the 20% population coverage scenario, 2 million more infections were prevented by vaccinating the 15-34 age group first, compared to vaccinating those over 65 first. A £6.6 billion reduction (13%) in direct healthcare costs was predicted by prioritising people over 65. Productivity and QALY losses were minimised by prioritising the 15-34 age group, while only vaccinating those over 65 resulted in the lowest number of deaths. Increasing population coverage from 20% to 50% resulted in drops in QALY loss and healthcare burden, but did not affect the age group strategy. A strategy that prioritises elderly vaccination would minimise QALY losses only if the death rate amongst 15-34s dropped by 17.4% (from 10.9% to 9%). Conclusions: With constraints in vaccine supplies, greater reductions in hospitalisation costs related to COVID-19 and deaths were associated with a vaccination strategy prioritising older age groups. Lower QALY and productivity losses were associated with a vaccination strategy prioritising younger cohorts. Future research adding age-group specific social distancing measures may provide further insights.