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Transl Behav Med ; 2021 May 08.
Article in English | MEDLINE | ID: covidwho-1220260


Face mask recommendations are conflicting across the world during the coronavirus disease 2019 (COVID-19) pandemic. While universal face mask wearing is a useful non-pharmaceutical preventive strategy, little is known about the perception of mask wearing during a pandemic. This study aimed to examine people's face mask use in China and Europe. An online survey was conducted among residents in China, Austria, Germany, and Switzerland from the 1st to 10th of April 2020. With a convenience sampling approach, 655 valid answers were received including 267 Chinese and 388 European residents (261 from Austria, 101 from Germany, 26 from Switzerland). Self-reported face mask wearing status and related perceptions were assessed. Compared with the Europeans, Chinese participants showed a stronger pro-masking tendency. Subjective norm was an important predictor of face mask wearing in public. Wearing of face masks in the Chinese sample was also associated with risk perception as well as obedience to advice from local health authority. Discrepancies in face mask wearing suggest that targeted measures to promote face mask wearing are needed in Europe. Globally coordinated guidelines on pandemics are also warranted to face the next waves of COVID-19 and other infectious respiratory diseases.

Curr Opin Urol ; 2021 May 06.
Article in English | MEDLINE | ID: covidwho-1219714


PURPOSE OF REVIEW: The purpose of this review is to evaluate the risk of intraoperative aerosol viral transmission and the impact of updated COVID-19 guidelines on minimally invasive surgery (MIS) in Austria. RECENT FINDINGS: The current literature does not support the risk of intraoperative viral transmission nor does it suggest a harm of minimally invasive procedures in the context of the COVID-19 pandemic. However, medical societies mostly adopted a precautionary approach with a focus on protective measures. Austrian surgeons considered MIS safe during the pandemic and Austria managed to keep the initial outbreak in control. Yet, MIS programs were still affected due to the postponements of elective procedures and switches to other methods by some surgeons. SUMMARY: The postponement and cancellation of MIS caused complexities in health-care delivery in Austria, whilst the evidence to substantiate this precautionary approach is missing. It must be noted, both the guidelines and our review are limited by the scarcity of evidence. In further consequence, regional factors should be considered while taking precautions. Specific studies on the severe acute respiratory syndrome coronavirus type 2 transmission risk during MIS are urgently needed.

Wien Klin Wochenschr ; 2021 May 06.
Article in English | MEDLINE | ID: covidwho-1219701


We performed a time series analysis in Vienna, Austria, investigating the temporal association between daily air pollution (nitrogen dioxide, NO2 and particulate matter smaller than 10 µm, PM10) concentration and risk of coronavirus disease 2019 (COVID-19) infection and death. Data covering about 2 months (March-April 2020) were retrieved from public databases. Infection risk was defined as the ratio between infected and infectious. In a separate sensitivity analysis different models were applied to estimate the number of infectious people per day. The impact of air pollution was assessed through a linear regression on the natural logarithm of infection risk. Risk of COVID-19 mortality was estimated by Poisson regression. Both pollutants were positively correlated with the risk of infection with the coefficient for NO2 being 0.032 and for PM10 0.014. That association was significant for the irritant gas (p = 0.012) but not for particles (p = 0.22). Pollutants did not affect COVID-19-related mortality. The study findings might have wider implications on an interaction between air pollution and infectious agents.

J Public Health (Oxf) ; 2021 May 05.
Article in English | MEDLINE | ID: covidwho-1216674


BACKGROUND: With the coronavirus disease 2019 (COVID-19) pandemic surging and new mutations evolving, trust in vaccines is essential. METHODS: We explored correlates of vaccine hesitancy, considering political believes and psychosocial concepts, conducting a non-probability quota-sampled online survey with 1007 Austrians. RESULTS: We identified several important correlates of vaccine hesitancy, ranging from demographics to complex factors such as voting behavior or trust in the government. Among those with hesitancy towards a COVID-19 vaccine, having voted for opposition parties (opp) or not voted (novote) were (95% Confidence Intervall (CI)opp, 1.44-2.95) to 2.25-times (95%CInovote, 1.53-3.30) that of having voted for governing parties. Only 46.2% trusted the Austrian government to provide safe vaccines, and 80.7% requested independent scientific evaluations regarding vaccine safety to increase willingness to vaccine. CONCLUSIONS: Contrary to expected, psychosocial dimensions were only weakly correlated with vaccine hesitancy. However, the strong correlation between distrust in the vaccine and distrust in authorities suggests a common cause of disengagement from public discourse.

Wien Med Wochenschr ; 2021 May 05.
Article in English | MEDLINE | ID: covidwho-1216226


A substantial number of neurological diseases lead to chronic impairment of activities of daily living (ADL) and physical or mental dependence. In Austria, homecare is provided mostly by female family members. Moreover, mainly female personnel, in the majority from southern and eastern European countries, contributes to care. Dependence and need for care vary between neurological diagnoses and accompanying diseases. Caregiver burden (CB) depends on patient- and caregiver-related and external factors, such as integrity of a family network, spatial resources, and socioeconomic factors. Depending on the neurological diagnosis, disease severity, and behavioral impairment and psychiatric symptoms, caregivers (CG) are at a significant risk of mental and somatic health problems because of limitations in personal needs, occupational and social obligations, financial burden, and restricted family life and leisure. Subjective and objective CB needs to be assessed in time and support should be provided on an individual basis. Recently, COVID-19 has caused additional multifactorial distress to dependent patients and informal and professional CG.

Journal of Community Positive Practices ; 21(1):59-70, 2021.
Article | WHO COVID | ID: covidwho-1215908


In the current context of the COVID-19 Pandemic and Globalization, the emphasis of Romanian migration in Western countries (particularly in this article in UK, Germany, and Austria) has become a phenomenon with multiple challenges and dilemmas on different levels and dimensions Thus, the special attention from the state authorities on these issues is not just a short-term task, requiring a complex collaboration between the political government, the medical system, and specialized researchers Both state institutions can establish medium and long-term interests regarding the effort to strengthen the Romanian state’s relations with citizens abroad, negotiate inter-community solutions, guide public policies to support the insertion on the labour market, etc , a complex set of analysis and solutions with a multidisciplinary scientific contribution In the conditions of intensifying the flows of Romanian immigrants, the risks of losing an important national productive and creative segment also increase Local human resources management is a strict subject of internal management and abroad human resources management, this being a subject of Community legislation, diplomatic communication and policies of inclusion, integration, and insertion in the labour market The long-term goal is to strengthen the sense of ethnic, cultural, linguistic, and religious identity and security of Romanians abroad, consolidating the Romanian cultural heritage © 2021 All Rights Reserved

Populism and New Patterns of Political Competition in Western Europe ; : 1-294, 2021.
Article | WHO COVID | ID: covidwho-1215583


This book analyses how party competition has adjusted to the success of populism in Western Europe, whether this is non-populists dealing with their populist competitors, or populists interacting with each other The volume focuses on Western Europe in the period 2007-2018 and considers both right-wing and left-wing populist parties It critically assesses the concept and rise of populism, and includes case studies on Austria, France, Germany, the Netherlands, Switzerland, Denmark, Finland, the United Kingdom, Greece, and Italy The authors apply an original typology of party strategic responses to political competitors, which allows them to map interactions between populist and non-populist parties in different countries They also assess the links between ideology and policy, the goals of different populist parties, and how achieving power affects these parties The volume provides important lessons for the study of political competition, particularly in the aftermath of a crisis and, as such, its framework can inform future research in the post-Covid-19 era This wide-ranging study will appeal to students and scholars of political science interested in populism and political competition;and will appeal to policy makers and politicians from across the political spectrum © 2021 selection and editorial matter, Daniele Albertazzi and Davide Vampa;individual chapters, the contributors All rights reserved

Water Policy ; 23(2):205-221, 2021.
Article | WHO COVID | ID: covidwho-1215217


The drinking water supply is a core element of national regulations for normal and emergency supply as well as coping with crisis events Particularly with regard to the interdependence of critical infrastructures means that water supply failures can have far-reaching consequences and endanger the safety of a society, e g , by impairing hospital operations In case of an emergency in the drinking water infrastructure, minimum supply standards, e g , for patients in hospitals, become important for emergency management during crisis situations However, wider recognition of this issue is still lacking, particularly in countries facing comparably minor water supply disruptions Several international agencies provide guideline values for minimum water supply standards for hospitals in case of a disaster Acknowledging these minimum standards were developed for humanitarian assistance or civil protection, it remains to be analyzed whether these standards apply to disaster management in countries with high water and healthcare supply standards Based on a literature review of scientific publications and humanitarian guidelines, as well as policies from selected countries, current processes, contents, and shortcomings of emergency water supply planning are assessed To close the identified gaps, this paper indicates potential improvements for emergency water supply planning in general as well as for supply of hospitals and identifies future fields of research

Int. Symp. INFOTEH-JAHORINA, INFOTEH - Proc. ; 2021.
Article | WHO COVID | ID: covidwho-1214736


This paper develops a Generalized Linear Model using the Negative Binomial Regression with log link function to analyze the effects of mobility trends and seasons on COVID-19 cases The data of four European countries was used, namely Austria, Greece, Italy, and Czech Republic The dataset includes daily observations of registered COVID-19 cases, and the data of six types of mobility trends: retail and recreation, grocery and pharmacy, parks, transit stations, workplaces, and residential mobility for the period Feb 15 - Nov 15, 2020 The results suggest that the number of COVID-19 cases differs between seasons and different mobility trends © 2021 IEEE

Transportation Research Interdisciplinary Perspectives ; : 100376, 2021.
Article | WHO COVID | ID: covidwho-1213547


The study uses the case of two regions with small and medium sized cities (Agder in Norway and the greater Innsbruck area in Austria) and two European capitals, Vienna and Oslo, to showcase the impact of the COVID-19 pandemic on public transport ridership in northern and central Europe The comprehensive timeline of actions taken by governments and public transport providers in Austria and Norway, and their impact on public transport ridership in the first and second waves of the pandemic form the basis of a descriptive study Comparing the data, a strong negative impact on the public transport patronage in the first wave of the pandemic was found, despite a comparable low number of cases per 100,000 inhabitants Furthermore, a smaller impact of the second wave of the pandemic on the ridership was registered The study provides valuable first insights on how the pandemic affected different settlement types It also documents, in detail, the measures taken by two distinct European countries to curb the pandemic infection rates and how these actions impacted public transport patronage The results pointed in the direction of a need for further analysis of aspects such as “fresh fear” and “lingering fear” in relation to the effect of a pandemic on public transport Data availability limitations show the necessity of upgrading and aligning ridership and ticketing monitoring systems across Europe, to allow for better understanding of pandemic impacts on public transport in a more unified manner

Int J Psychol ; 2021 May 03.
Article in English | MEDLINE | ID: covidwho-1210662


COVID-19 and its containment measures have uniquely challenged adolescent well-being. Following self-determination theory (SDT), the present research seeks to identify characteristics that relate to well-being in terms of positive emotion and intrinsic learning motivation under distance schooling conditions and whether SDT's core postulates hold true in this exceptional situation. Feeling competent and autonomous concerning schoolwork, and socially related to others were hypothesised to relate to positive emotion and intrinsic learning motivation. The role of self-regulated learning (SRL) as a moderator was considered. Self-reports were collected from 19,967 secondary school students in Austria (Study 1) and Germany (Study 2). In both studies, structural equation modelling revealed that all basic needs were associated with positive emotion, and that competence and autonomy were associated with intrinsic learning motivation. Moderation effects of SRL were identified in Study 1 only: The association of autonomy and both outcomes and the association of competence and intrinsic learning motivation varied with the level of SRL. The results highlight the relevance of basic psychological need satisfaction and SRL in a situation in which adolescents are confronted with a sudden loss of daily routines.

Sci Rep ; 11(1): 9365, 2021 04 30.
Article in English | MEDLINE | ID: covidwho-1210117


Standard blood laboratory parameters may have diagnostic potential, if polymerase-chain-reaction (PCR) tests are not available on time. We evaluated standard blood laboratory parameters of 655 COVID-19 patients suspected to be infected with SARS-CoV-2, who underwent PCR testing in one of five hospitals in Vienna, Austria. We compared laboratory parameters, clinical characteristics, and outcomes between positive and negative PCR-tested patients and evaluated the ability of those parameters to distinguish between groups. Of the 590 patients (20-100 years, 276 females and 314 males), 208 were PCR-positive. Positive compared to negative PCR-tested patients had significantly lower levels of leukocytes, neutrophils, basophils, eosinophils, lymphocytes, neutrophil-to-lymphocyte ratio, monocytes, and thrombocytes; while significantly higher levels were detected with erythrocytes, hemoglobin, hematocrit, C-reactive-protein, ferritin, activated-partial-thromboplastin-time, alanine-aminotransferase, aspartate-aminotransferase, lipase, creatine-kinase, and lactate-dehydrogenase. From all blood parameters, eosinophils, ferritin, leukocytes, and erythrocytes showed the highest ability to distinguish between COVID-19 positive and negative patients (area-under-curve, AUC: 72.3-79.4%). The AUC of our model was 0.915 (95% confidence intervals, 0.876-0.955). Leukopenia, eosinopenia, elevated erythrocytes, and hemoglobin were among the strongest markers regarding accuracy, sensitivity, specificity, positive and negative predictive value, positive and negative likelihood ratio, and post-test probabilities. Our findings suggest that especially leukopenia, eosinopenia, and elevated hemoglobin are helpful to distinguish between COVID-19 positive and negative tested patients.

/blood , /diagnosis , Aged , Austria/epidemiology , /physiopathology , Female , Hematologic Tests , Humans , Male , Severity of Illness Index
Vaccines (Basel) ; 9(5):27, 2021.
Article | WHO COVID | ID: covidwho-1210176


(1) Background: The Austrian supply of COVID-19 vaccine is limited for now We aim to provide evidence-based guidance to the authorities in order to minimize COVID-19-related hospitalizations and deaths in Austria (2) Methods: We used a dynamic agent-based population model to compare different vaccination strategies targeted to the elderly (65 >= years), middle aged (45-64 years), younger (15-44 years), vulnerable (risk of severe disease due to comorbidities), and healthcare workers (HCW) First, outcomes were optimized for an initially available vaccine batch for 200,000 individuals Second, stepwise optimization was performed deriving a prioritization sequence for 2 45 million individuals, maximizing the reduction in total hospitalizations and deaths compared to no vaccination We considered sterilizing and non-sterilizing immunity, assuming a 70% effectiveness (3) Results: Maximum reduction of hospitalizations and deaths was achieved by starting vaccination with the elderly and vulnerable followed by middle-aged, HCW, and younger individuals Optimizations for vaccinating 2 45 million individuals yielded the same prioritization and avoided approximately one third of deaths and hospitalizations Starting vaccination with HCW leads to slightly smaller reductions but maximizes occupational safety (4) Conclusion: To minimize COVID-19-related hospitalizations and deaths, our study shows that elderly and vulnerable persons should be prioritized for vaccination until further vaccines are available

Journal of Clinical Medicine ; 10(9):28, 2021.
Article | WHO COVID | ID: covidwho-1210041


Despite being located close to the European epicenter of the COVID-19 pandemic in Italy, Austria has managed to control the first wave In Austria, the largest health insurance fund covers 7 million people and has 12,000 employees, including 3700 healthcare workers (HCW) For patient and staff safety, transmission control measures were implemented and mass testing of employees for SARS-CoV-2 antibodies was conducted An IgG SARS-CoV-2 rapid test on fingerstick blood was used as a screening test (ST), followed by serologic studies with 3 different immunoassays and confirmatory testing by a neutralization test (NT) Among 7858 employees, 144 had a positive ST and 88 were confirmed by a NT (1 12%, CI: 0 9-1 38%) The positive predictive value (PPV) of the ST was 69 3% (CI: 60 5-77 2) Interestingly, 40% of the NT positive serum samples were tested negative in all 3 immunoassays Of the total sample, 2242 HCW (28 5%) were identified Unexpectedly, there was no difference in the prevalence of NT positives in HCW compared to non-HCW (23/2242 vs 65/5301, p = 0 53) SARS-CoV-2 antibody prevalence was not increased among HCW Although HCW are at potentially increased risk for SARS-CoV-2 infection, transmission control measures in healthcare facilities appear sufficient to limit transmission of infection

International Journal of Environmental Research & Public Health [Electronic Resource] ; 18(7):05, 2021.
Article | WHO COVID | ID: covidwho-1209795


The COVID 19 pandemic represents a major stress factor for non-infected pregnant women Although maternal stress during pregnancy increases the risk of preterm birth and intrauterine growth restriction, an increasing number of studies yielded no negative effects of COVID 19 lockdowns on pregnancy outcome The present study focused on pregnancy outcome during the first COVID 19 lockdown phase in Austria In particular, it was hypothesized that the national lockdown had no negative effects on birth weight, low birth weight rate and preterm birth rate In a retrospective medical record-based single center study, the outcome of 669 singleton live births in Vienna Austria during the lockdown phase between March and July 2020 was compared with the pregnancy outcome of 277 live births at the same hospital during the pre-lockdown months of January and February 2020 and, in addition, with the outcome of 28,807 live births between 2005 and 2019 The rate of very low gestational age was significantly lower during the lockdown phase than during the pre-lockdown phase The rate of low gestational age, however, was slightly higher during the lockdown phase Mean birth weight was significantly higher during the lockdown phase;the rates of low birth weight, very low birth weight and extremely low birth weight were significantly lower during the lockdown phase In contrast, maternal gestational weight gain was significantly higher during the lockdown phase The stressful lockdown phase in Austria seems to have no negative affect on gestational length and newborn weight among non-infected mothers

International Journal of Environmental Research & Public Health [Electronic Resource] ; 18(7):01, 2021.
Article | WHO COVID | ID: covidwho-1209534


Since the beginning of the COVID-19 pandemic a decline in mental health has been reported This online study investigated mental health and well-being in Austria during a strict lockdown In total, N = 1505 participants were recruited between 23 December 2020 and 4 January 2021 and levels of depression (PHQ-9), anxiety (GAD-7), sleep quality (ISI), well-being (WHO-5), quality of life (WHO-QOL) and stress (PSS-10) were measured 26% scored above the cut-off for moderate depressive symptoms (PHQ-9 >= 10;= 32%;= 21%), 23% above the cut-off for moderate anxiety (GAF-7 >= 10;= 29%;= 17%) and 18% above the cut-off for moderate insomnia (ISI >= 15;= 21%;= 16%) Mean-scores for quality of life (psychological WHO-QOL) were 68 89, for well-being (WHO-5) 14 34, and for stress (PSS-10) 16 42 The youngest age group (18-24) was most burdened and showed significantly more mental health symptoms compared with the oldest age group (65+) in depressive symptoms (50% vs 12%), anxiety symptoms (35% vs 10%), and insomnia (25% vs 11%, all p-values < 0 05) Mental health decreased compared to both the first lockdown earlier in 2020 and pre-pandemic data Further analyses indicate these findings were especially apparent for the under 24-year-olds, women, single/separated people, low incomes and those who do not partake in any physical activity (all p-values < 0 05) We highlight the need for ongoing mental health support, particularly to the most burdened groups

International Journal of Environmental Research & Public Health [Electronic Resource] ; 18(8):15, 2021.
Article | WHO COVID | ID: covidwho-1209492


Personal protective equipment and adherence to disinfection protocols are essential to prevent nosocomial severe acute respiratory syndrome coronavirus (SARS-CoV-2) transmission Here, we evaluated infection control measures in a prospective longitudinal single-center study at the Vienna General Hospital, the biggest tertiary care center in Austria, with a structurally planned low SARS-CoV-2 exposure SARS-CoV-2-specific antibodies were assessed by Abbott ARCHITECT chemiluminescent assay (CLIA) in 599 health care workers (HCWs) at the start of the SARS-CoV-2 epidemic in early April and two months later Neutralization assay confirmed CLIA-positive samples A structured questionnaire was completed at both visits assessing demographic parameters, family situation, travel history, occupational coronavirus disease 2019 (COVID-19) exposure, and personal protective equipment handling At the first visit, 6 of 599 participants (1%) tested positive for SARS-CoV-2-specific antibodies The seroprevalence increased to 1 5% (8/553) at the second visit and did not differ depending on the working environment Unprotected SARS-CoV-2 exposure (p = 0 003), positively tested family members (p = 0 04), and travel history (p = 0 09) were more frequently reported by positively tested HCWs Odds for COVID-19 related symptoms were highest for congestion or runny nose (p = 0 002) and altered taste or smell (p < 0 001) In conclusion, prevention strategies proved feasible in reducing the risk of transmission of SARS-CoV-2 from patients and among HCWs in a low incidence hospital, not exceeding the one described in the general population

European Journal of Psychotraumatology ; 12(1), 2021.
Article | WHO COVID | ID: covidwho-1208415


Background: Children and adolescents are affected in various ways by the lockdown measures due to the COVID-19 pandemic Therefore, it is crucial to better understand the effects of the COVID-19 pandemic on mental health in this age-group Objective: The objective was to investigate and compare the effects of the COVID-19 pandemic on mental health in three age groups (1–6 years, 7–10 years, 11–19 years) and to examine the associations with psychological factors Methods: An anonymous online survey was conducted from 9 April to 11 May 2020 during the acute phase of major lockdown measures In this cross-sectional study, children and adolescents aged between 1 and 19 years were recruited as a population-based sample They were eligible if they were residents in Austria, Germany, Liechtenstein or Switzerland, were parents/caregivers of a child aged between 1 and 10 years or adolescents ≥11 years, had sufficient German language skills and provided informed consent Results: Among 5823 participants, between 2 2% and 9 9% reported emotional and behavioural problems above the clinical cut-off and between 15 3% and 43 0% reported an increase in these problems during the pandemic Significant age-related effects were found regarding the type and frequency of problems (χ2(4)≥50 2, P ≤ 0 001) While preschoolers (1–6 years) had the largest increase in oppositional-defiant behaviours, adolescents reported the largest increase in emotional problems Adolescents experienced a significantly larger decrease in emotional and behavioural problems than both preschoolers and school-children Sociodemographic variables, exposure to and appraisal of COVID-19, psychotherapy before COVID-19 and parental mental health significantly predicted change in problem-scores (F ≥ 3 69, P ≤ 0 001) Conclusion: A substantial proportion of children and adolescents experience age-related mental health problems during the COVID-19 pandemic These problems should be monitored, and support should be offered to risk-groups to improve communication, emotion regulation and appraisal style © 2021 The Author(s) Published by Informa UK Limited, trading as Taylor & Francis Group

Bundesgesundheitsblatt Gesundheitsforschung Gesundheitsschutz ; 64(4): 472-480, 2021 Apr.
Article in German | MEDLINE | ID: covidwho-1196558


The challenges posed by the COVID-19 pandemic face different institutional structures and traditions of action in the European health systems. This article uses the example of the public health services in Sweden, France and Austria to address the question of the similarities and differences in the measures taken to combat the pandemic (status: November 2020).Among the countries presented in this article, Austria is the least affected by the pandemic and France is the most affected. In all analysed health systems there is a tension between national and regional responsibilities. France's healthcare system is particularly centralized, while Sweden's is strongly regional and municipal. Governments in the nation states are striving to obtain pandemic containment powers independent of parliamentary decisions. Sweden differs from Austria and France in that its pandemic containment strategy is based primarily on recommendations and appeals rather than directives and bans. The sequences of action during the pandemic and, apart from Sweden, the instruments used to contain the pandemic are similar. The course of the pandemic and the measures taken in Austria and France show clear parallels with those in Germany. The protection of particularly vulnerable groups has not been sufficiently successful in all countries and remains a challenge to be met.

Pandemics , Austria , Europe/epidemiology , Germany/epidemiology , Health Services , Humans , Pandemics/prevention & control , Public Health , Sweden
20.; 23/04/2021; TrialID: NCT04864561
Clinical trial register | ICTRP | ID: ictrp-NCT04864561





Biological: SARS-CoV-2 virus

Primary outcome:

Occurrence of solicited and unsolicited adverse events;Occurrence of adverse events as determined by medical assessment;Selection of optimal dose


Inclusion Criteria:

1. Seropositive to the challenge virus SARS-CoV-2 (Anti-Spike IgG or Anti-nucleocapsid
IgG) at screening with previous microbiological confirmation of SARS-CoV-2 infection >
3 months prior to enrolment (confirmed via medical notes/ or PHE).

2. Aged 18-30 years on proposed date of enrolment.

3. Assessed using the QCOVID risk tool to have an absolute risk of COVID-associated death
of less than 1 in 250,000 (0.0004%) and COVID-associated hospital admission risk of
less than 1 in 5000 (0.02%).

4. Body Mass Index (BMI) =18.5 kg/m2and =28 kg/m2.

5. In good health with no history of clinically significant medical conditions (as
described in Exclusion criteria) that would interfere with subject safety, as defined
by medical history, physical examination, routine laboratory tests, cardiovascular
magnetic resonance imaging or echocardiogram, ECG, pulmonary function tests and Chest
X-Ray as determined by the Investigator at a screening evaluation.

6. Volunteer is willing and able to give written informed consent for participation in
the study

7. Willing to allow the investigators to discuss the volunteer's medical history with
their General Practitioner or any relevant health authority

8. Allow the investigator to register volunteer details with a confidential database (The
Over-volunteering Prevention Service) to prevent concurrent entry into clinical

9. Agreement to refrain from blood donation during the course of the study

10. a. For women of child bearing potential (WOCBP), a willingness to practice continuous
effective contraception during the study and, a negative pregnancy test on the day(s)
of screening and challenge b. For men, a willingness to practice continuous effective
contraception (see below) from day of challenge to 6 months post treatment with

11. Able and willing (in the investigator's opinion) to comply with all study requirements

12. No clinically relevant findings in medical history or on physical examination

Exclusion Criteria:

1) History or evidence of any clinically significant or currently active cardiovascular,
(including thromboembolic events), respiratory (excluding SARS CoV-2 infection),
dermatological, gastrointestinal, endocrine, haematological, hepatic, immunological,
rheumatological, metabolic, urological, renal, neurological or psychiatric illness.

1. Volunteers with any history of physician diagnosed and/or objective test confirmed
asthma, chronic obstructive pulmonary disease, pulmonary hypertension, reactive airway
disease, or chronic lung condition of any aetiology or who have experienced:

i) Significant/severe wheeze in the past ii) Respiratory symptoms including wheeze
which has ever resulted in hospitalisation iii) Known bronchial hyper reactivity to

2. History of thromboembolic, cardiovascular or cerebrovascular disease

3. History or evidence of diabetes mellitus (Type I or Type II)

4. Any concurrent serious illness including history of malignancy that could interfere
with the aims of the study or a subject completing the study. Basal cell carcinoma
within 5 years of treatment or with evidence of recurrence is also an exclusion.

5. Migraine with associated neurological symptoms such as hemiplegia or vision loss.
Cluster headache/migraine or prophylactic treatment for migraine

6. History or evidence of autoimmune disease or known immunodeficiency of any cause
(including HIV).

7. Psychiatric illness including volunteers with a history of depression and/or anxiety
with associated severe psychiatric comorbidities, for example psychosis. Specifically,
i) Volunteers with history of anxiety-related symptoms of any severity within the last
2 years if the Generalized Anxiety Disorder-7 score is =5 ii) Volunteers with a
history of depression of any severity within the last 2 years if the Patient Health
Questionnaire-9 score is =4 iii) Significant claustrophobia

8. Bleeding disorder (e.g. factor deficiency, coagulopathy or platelet disorder), or
prior history of significant bleeding or bruising following injections or

9. Other major disease that, in the opinion of the Investigator, could interfere with a
subject completing the study and necessary investigations.

2) Clinically significant smoking history. Defined as: Current smoker (any smoking
including e-cigarettes in the last 3 months) or > 2 pack year smoking history at any time
(2 pack years is equivalent to 20 cigarettes daily for 2 years), or use of any nicotine
containing products within the last 3 months.

3) History or presence of alcohol addiction, or excessive use of alcohol (average weekly
intake in excess of 28 units alcohol; one unit being a half glass of beer, a small glass of
wine or a measure of spirits) 4) History of use of drugs of misuse, with evidence of a
negative drugs of misuse urine test required at screening and quarantine admission 5)
History of anaphylaxis or any allergy likely to be worsened by any component of the study
agent or proposed treatment regime.

6) Clinically active rhinitis (including hay fever) or history of moderate to severe
rhinitis, or history of seasonal allergic rhinitis likely to be active at time of inclusion
into the study and/or requiring regular nasal corticosteroids on at least weekly basis,
within 30 days of admission to quarantine.

7) Any significant abnormality altering the anatomy of the nose or nasopharynx, clinically
significant history of epistaxis (nose bleeds) or any nasal or sinus surgery within six
months of inoculation 8) Clinical, radiological, or laboratory evidence of current active
TB disease or latent TB infection 9) Previous VZV pneumonia 10) Positive HBsAg, HCV or HIV
antibodies 11) Has received a vaccination for SARS-CoV-2 either as part of a clinical study
or as part of licensed vaccine rollout.

12) Concurrent use of oral, inhaled or systemic steroid medication or use within the last 6
months (steroids used as a cream or ointment are permissible), or the use of other
immunosuppressive agents concurrently or within the last 6 months.

13) Administration of immunoglobulins and/or any blood products within the three months
preceding the planned study challenge date 14) Current use of any medication or other drug
taken through the nasal or inhaled route including cocaine or other recreational drugs 15)
Plans to receive any vaccination 30 days prior to enrolment and/or 30 days following
enrolment 16) Current pregnancy or pregnancy within the last 6 months, lactation or
intention to become pregnant during study period 17) Sha