Experimental SARS-CoV-2 human challenge in young adults

Rationale: To establish a novel SARS-CoV-2 human challenge model enabling controlled investigation of pathogenesis, correlates of protection and efficacy testing of interventions. Method(s): Thirty-six healthy 18-29-year-old subjects, without evidence of previous infection or vaccination, received 10 TCID50 of a wild-type virus (SARS-CoV-2/human/GBR/484861/2020) intranasally. Following inoculation, subjects resided in a high-containment quarantine, with 24-hour medical monitoring. The study's main objectives were to identify a virus dose that induced well-tolerated infection in >50% of subjects and assess virus and symptoms over time. AEs and longitudinal disease profiles are presented. Result(s): Eighteen of thirty-four evaluable (~53%) subjects became infected and developed serum antibodies. Viral load rose steeply and peaked ~5 days post-inoculation (PI). Virus was first detected in the throat but rose to significantly higher levels in the nose, peaking at ~8.87 log10 copies/ml (median, 95% CI [8.41,9.53]). Viable virus was recoverable from the nose up to ~10 days PI, on average. Mild-to-moderate symptoms were reported by 16 (89%) infected subjects, beginning 2-4 days PI. Anosmia or dysosmia developed in 15 (83%) subjects. Results from lateral flow tests were associated with viable virus and modelling showed that twice-weekly rapid antigen tests could diagnose infection before 70-80% of viable virus had been generated. There were no overt lung function changes, CT abnormalities, or SAEs. Conclusion(s): This novel SARS-CoV-2 challenge of 18-29-year-olds was considered safe. Viral kinetics over the course of primary infection was established, with implications for public health recommendations and strategies to impact transmission.

Scenarios of social isolation during the first wave of the COVID-19 pandemic in Rio de Janeiro, Brazil

This work analyses the construction of social isolation as a public problem during the first wave of COVID-19, drawing on experiences in Rio de Janeiro which, in addition to being one of the country's major cities, had among the highest mortality rates in Brazil in 2020. We consider both the legal measures enacted by government agencies to contain the contagion and media coverage on the effects of these measures at the local level. The results show that, in the absence of compulsory confinement measures, urban public spaces were deployed both by government agencies and the media in a process by which social isolation was framed as a public problem. Legal measures affected daily patterns of movement, mobility, and sociability, and intervened in the dynamics of central urban functions and in access to and use of public spaces. Media reports gave voice to levels of public agreement or disagreement with regulations and emphasised the significance of legal measures to contain the spread of the virus. Public spaces are at the core of debates about compliance with legal measures to enforce social isolation because they are privileged places where social issues become visible and problematic material expressions of relationships between citizens and the law.

Controlling Coronavirus Infection: 'Plan B' Based on Non-vaccine / Drug Interventions

COVID-19 pandemic affected over 227 countries with more than 147 million infections that claimed 31.22 lacs lives. The first case of the pandemic was reported from China in Dec, 2019 showing pneumonia like symptoms that turned out to be the novel strain of coronavirus (2019-n-CoV). The WHO declared 2019-nCoV infection as the Public Health Emergency of International Concern and the disease named coronavirus disease (COVID-19). The infection curve of the pandemic has been flattened in many countries around the world, but the effective new antiviral drugs or vaccine has not yet developed. So far, we are saved by non-pharmaceutical interventions like handwashing, social distancing, quarantine, masks and health-care workers by personal protective equipments. Now the question arises that what we do if no effective drug or vaccine emerges? In the absence of effective drug/vaccines, pandemic has to be fought at community level not at hospi-tals. For such emergent situations, we need a 'Plan B' based non-vaccine/drug interventions.Copyright © 2021 Bentham Science Publishers.

History and Global Status of the New Coronavirus Covid-2019 and Aspects of Previous Infections of SARS-CoV and MERS-CoV: A Systematic Review

Introduction: Coronaviruses (CoV) is a diverse group of viruses that has been described in the literature since 1960, SARS, MERS, and the most recent SARS-CoV-2. This new virus is causing a worldwide pandemic outbreak in the first half of 2020, thousands of deaths, and a signifi-cant economic crisis. Objective(s): Due to this new context, the present study aimed to conduct a systematic study review of the new Coronavirus's global status (COVID-2019) and its aspects compared to the previous SARS-CoV infections MERS-CoV. Method(s): The study was conducted from January to September 2020, 89 clinical cases were sub-mitted to further analysis, and 77 studies were selected for systematic review under the PRISMA guidelines. Conclusion(s): In some countries, the SARS-CoV-2 pandemic appears to be out of control. In case of suspicion, tests are essential to identify the early stages of infection. If necessary, patients need to go into quarantine, and other public health measures should be taken following the World Health Organization guidelines. Advanced support is needed to identify and isolate infected patients, espe-cially vaccines and medicines that help control the virus and the epidemiological situation in each country. These measures are expected to reduce the rate of new cases of SARS-CoV-2.Copyright © 2021 Bentham Science Publishers.

COVID-19 and the Pathologies of Australia's Regulatory State

The COVID-19 pandemic has elicited a wide range of national responses with an even wider range of outcomes in terms of infections and mortalities. Australia is a rare success story, keeping deaths comparatively low, and infections too, until the Omicron wave. What explains Australia's success? Typical explanations emphasise leaders' choices. We agree, but argue that leaders' choices, and whether these are implemented effectively, is shaped by the legacy of state transformation. Decades of neo-liberal reforms have hollowed out state capacity and confused lines of control and accountability, leaving Australia unprepared for the pandemic. Leaders thus abandoned plans and turned to ad hoc, simple to implement emergency measures – border closures and lockdowns. These averted large-scale outbreaks and deaths, but with diminishing returns as the Delta variant took hold. Conversely, Australia's regulatory state has struggled to deliver more sophisticated policy responses, even when leaders were apparently committed, including an effective quarantine system, crucial for border controls, and vaccination programme, essential for exiting the quagmire of lockdowns and closed borders, leading to a partial return to top-down governing. The Australian experience shows that to avoid a public health catastrophe or more damaging lockdowns in the next pandemic, states must re-learn to govern.

Pharmaceutical interview training during COVID: feedback from a remote experience with expert patients

Context: During the first cycle of pharmacy studies, the community pharmacy internship aims to allow all students to apply, in real situation, knowledge acquired during coordinated teaching on most important pathologies and main therapeutic classes. The objective of this paper is to describe a module deployed during the first period of containment against COVID 19. Methods: We present the remote pharmaceutical interview grid developed with Partner patients, as well as the items classes used for the evaluation of the device. Results-Discussion: The technical feasibility proved to be acceptable;the pre-existing pedagogical format remained robust through the remote exercise;the module tested looks like a "hybrid" format, thanks to the interaction with a partner who is both a pedagogical partner and a left-pointing-double-angle real right-pointing-double-angle patient. Conclusion: This module is complementary to the pre-existing face-to-face format deployed in the classroom.

Temperature screening and detection of Covid-19 in school-aged children: A retrospective cohort study assessing the efficacy of temperature screening in schools

In July 2020, Corinth School District was the first in Mississippi to return to the classroom setting. Coronavirus disease 2019 (Covid-19) protocols were developed to maintain the safety of students. These included mandatory masking, seating charts, desk spacing, sanitizing protocols, lunch within classrooms, alteration of extracurriculars, cancellation of assemblies, and quarantine policies. Temperature screenings were also performed. Students registering as febrile would undergo Covid-19 testing. To evaluate the efficacy of temperature scanning as a surveillance method for Covid-19 in the school setting, deidentified data was obtained from the Corinth School District. Overall incidence and grade level incidence of Covid-19 were calculated in children attending school from July 27, 2020 to September 25, 2020. Data were examined for a correlation between documented fevers and Covid-19 positivity. Reports provided by the school district were investigated for positive test groupings signifying a school-related outbreak. Of 28 children with fevers at school, zero tested positive for Covid-19. Twenty-six children tested positive for Covid-19;none were febrile at school. The incidence of Covid-19 in our population during the study period was 1.03%. Incidence in elementary students was 0.34%, 0.93% in middle school, and 2.51% in high school students. There were no school outbreaks during the study period. Both relative risk and odds ratio were calculated as equal to zero (0.00). Temperature scanning is not a sensitive screening method for Covid-19 in school children.Copyright © 2023 Policy Studies Organization.

Herbal and Ayurvedic Plants as Remedial Approach for Viral Diseases with Focus on COVID-19: A Narrative Review

Background: Infectious diseases have posed a major threat to human survival for centu-ries and can devastate entire populations. Recently, the global outbreak of COVID-19 has increased exponentially, affecting more than 200 countries and millions of lives since the fall of 2019, largely due to the ineffectiveness of existing antiviral therapies. WHO announced it a public health emer-gency of international concern. A significant waiting period in antiviral therapy hindered by the rapid evolution of severe acute respiratory syndrome-coronavirus-2 aggravated the situation ensuing imposition of strict laws (e.g., communal dissociation, international travel restrictions, and mainte-nance of hygiene) that would help in inhibiting further outspread of COVID-19. Ayurveda system of medicine offers a holistic approach to the COVID-19 pandemic. Objective(s): This review aims to highlight the potential of medicinal herbs and Ayurvedic drugs as the remedial approach for viral diseases, such as COVID-19. Method(s): We reviewed the literature from journal publication websites and electronic databases, such as Bentham, Science Direct, Pub Med, Scopus, USFDA, etc. Result(s): The drugs used in the traditional system of medicine have the potential to prevent and cure the infected patient. Ayurvedic therapies are known for regulating immunity and rejuvenation properties that behold much promise in the management of COVID-19 disease. Government of India, Ministry of AYUSH recommends some precautionary fitness measures and an increase in immunity with special reference to respiratory health. Conclusion(s): While there is no medication for COVID-19 as of now, taking preventive measures and boosting body immunity is highly recommended. A number of medicinal plants that play an im-portant role in revitalizing the immune system are easily accessible in home remedies.Copyright © 2023 Bentham Science Publishers.

Quarantine acceptance and adherence: qualitative evidence synthesis and conceptual framework.

Aim: Emergent infectious diseases often lack medical treatment or preventive vaccines, thus requiring non-pharmaceutical interventions such as quarantine to reduce disease transmission. Quarantine, defined as the separation and restriction of movement of healthy people who have potentially been exposed to the disease, remains contentious especially when the risks and benefits are not fully discussed and not effectively communicated to the people by the organizations who impose this public health measure. Subject and methods: A qualitative evidence synthesis was conducted to examine the phenomenon of adherence to quarantine focused on the following questions: What strategies affect adherence to quarantine? What are the barriers and facilitators to quarantine acceptance? What benefits and harms of quarantine have been described or measured? Results: The evidence synthesis produced 18 findings assessed with high confidence. The findings were used to construct a conceptual framework for inter- and within-organization coordination and public communication that includes the following topics for consideration: desired orientation for implementation; population demographics; perceptions of messages; prior acceptance of quarantine; likelihood of impacts of quarantine; perceptions of health infrastructure; and perceptions of policy importance. Conclusion: The findings and conceptual framework can guide development of effective non-pharmaceutical interventions and as such have direct relevance to public health policy and decision-making for intervening in emergent infectious diseases outbreak such as the ongoing COVID-19 pandemic.