SeroNet Pooling Project of immunocompromised populations

Introduction: COVID-19 vaccination substantially reduces morbidity and mortality associated with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection and severe illness. However, despite effective COVID-19 vaccines many questions remain about the efficacy of vaccines and the durability and robustness of immune responses, especially in immunocompromised persons. The NCI-funded Serological Sciences Network (SeroNet) is a coordinated effort including 11 sites to advance research on the immune response to SARS-CoV-2 infection and COVID-19 vaccination among diverse and vulnerable populations. The goals of the Pooling Project are: (1) to conduct real-world data (RWD) analyses using electronic medical records (EMR) data from four health care systems (Kaiser Permanente Northern California, Northwell Health, Veterans Affairs-Case Western, and Cedars-Sinai) to determine vaccine effectiveness in (a) cancer patients;(b) autoimmune diseases and (c) solid organ transplant recipients (SOTR);(2) to conduct meta-analyses of prospective cohort studies from eight SeroNet institutions (Cedars-Sinai, Johns Hopkins, Northwell Health, Emory University, University of Minnesota, Mount Sinai, Yale University) to determine post-vaccine immune responses in (a) lung cancer patients;(b) hematologic cancers/hematopoietic stem cell transplant (HSCT) recipients;(c) SOTR;(d) lupus. Method(s): For our RWD analyses, data is extracted from EMR using standardized algorithms using ICD-10 codes to identify immunocompromised persons (hematologic and solid organ malignancy;SOTR;autoimmune disease, including inflammatory bowel disease, rheumatoid arthritis, and SLE). We use common case definitions to extract data on demographic, laboratory values, clinical co morbidity, COVID-19 vaccination, SARS-CoV-2 infection and severe COVID-19, and diseasespecific variables. In addition, we pool individual-level data from prospective cohorts enrolling patients with cancer and other immunosuppressed conditions from across network. Surveys and biospecimens from serology and immune profiling are collected at pre-specified timepoints across longitudinal cohorts. Result(s): Currently, we have EMR data extracted from 4 health systems including >715,000 cancer patients, >9,500 SOTR and >180,000 with autoimmune conditions. Prospective cohorts across the network have longitudinal data on >450 patients with lung cancer, >1,200 patients with hematologic malignancies, >400 SOTR and >400 patients with lupus. We will report results examining vaccine effectiveness for prevention of SARS-CoV-2 infection, severe COVID-19 and post-acute sequelae of COVID-19 (PAS-C or long COVID) in cancer patients compared to other immunocompromised conditions. Conclusion(s): Our goal is to inform public health guidelines on COVID-19 vaccine and boosters to reduce SARS-CoV-2 infection and severe illness in immunocompromised populations.

Comparison of HbA1c measurement in remotely prepared capillary versus standard venous blood samples

Background The COVID-19 pandemic has disrupted routine HbA1c testing. This has led to difficulties in monitoring glycaemic control and identifying people with suboptimal glycaemia. Delayed diagnosis of diabetes and suboptimal glycaemic control over extended periods can increase the risk of developing long-term complications of diabetes. The self-collection of capillary blood remotely (at home) for routine HbA1c testing can facilitate monitoring of glycaemic control whilst supporting virtual consultations. The aimof this study was to assess the clinical performance and user acceptance of capillary blood samples prepared remotely using the MiniCollect capillary blood collection device as an alternative to standard venous blood collection for HbA1c analysis. Methods Adult men and women with any type of diabetes were recruited. Following informed written consent, eligible participants provided a venous blood sample at their routine clinic appointment and subsequently prepared a capillary blood sample remotely. Participants also completed a bespoke usability questionnaire. Results Of 84 participants recruited, 62 capillary samples returned to the laboratory, with 41 having a paired venous sample for HbA1c analysis. HbA1c results using both collection methods demonstrated good agreement;Passing-Bablok Regression analysis, y=0 + 1x;R=0.986, Bland-Altman Difference Plot providing a mean difference of 0.3 mmol/mol. Conclusions Over half of participants found the MiniCollect device easy to use. The majority were in favour of the remote capillary blood collection service and would use it if routinely available. The remote self-collection of capillary blood for HbA1c is a convenient alternative for people with diabetes living and working in rural or urban settings ensuring optimal continuance of care.

The 2020/2021 Tokyo Olympics: Does Japan get the gold medal or the wooden spoon?

The Tokyo 2020/2021 Olympics will go down in history as the 'Pandemic Games'. Postponed by a year due to Covid-19, they were eventually held despite broad public protest and amidst the Delta variant wave. Japan brought home a record haul of medals, yet Prime Minister Suga Yoshihide resigned in ignominy shortly after the Games ended. So, was Tokyo 2020/2021 a 'success' or a 'failure', and for whom? We examine the policy and politics of the Games, considering the attribution of 'success' and 'failure' to the Olympics across a range of issues, actors, and narratives. Reviewing their economic, public health, soft power, and political impact, we find that the Tokyo 2020/2021 Olympics remain deeply ambiguous. Prime Minister Abe Shinzō's vision of a proud, 'reborn' Japan showcasing itself to the world obviously did not come to pass;neither did the promise of a 'Recovery Olympics' aiding in the reconstruction of the post-3/11 Tohoku region. Conversely, the predictions of a COVID-19 catastrophe, of even an 'Olympic variant', also failed to transpire. Rather, the Olympics became a pared-down event forced through by vested interests, notably the IOC and Dentsu. The political fallout was contained by one-party dominance in Japan's democracy, where even a forced mega-event during a pandemic was insufficient to threaten the Liberal Democratic Party's stranglehold on power. © 2023 The Author(s). Published by Informa UK Limited, trading as Taylor & Francis Group.

Teaching an undergraduate elective on the Great Recession (and the COVID-19 recession too)

The authors describe an undergraduate economics elective focused on the Great Recession and the recession resulting from the COVID-19 pandemic. They have taught the course with great success at both liberal arts colleges and research universities and at all levels of the curriculum ranging from a first-year seminar to an upper-level elective. They present a roadmap for instructors interested in offering the class. Although intermediate macroeconomics is assumed as a prerequisite, the authors discuss how they have adapted the class for students with different backgrounds. The course is divided into seven units: the housing bubble and asset pricing, housing policy and history, propagation and panic, monetary policy, fiscal policy, aftermath and international perspectives, and the macroeconomics of COVID-19. Sample assignments and readings are both provided. © 2022 Taylor & Francis Group, LLC.