Clinical Public Health, Lancet, Médecins Sans Frontières, Bangladesh, India
development

Organisations. Lancet, Médecins Sans Frontières
Period. 14 – 20 May 2020

Social Distancing Works

An article in Health Affairs examines the role of social distancing measures in reducing the growth rate of the pandemic in the U.S. The authors conclude that jurisdictions with no physical distancing policies had 35 times more cases of COVID-19, and that the rate of new infections dropped the longer a physical distancing policy was in place.

COVID-19 can cause severe illness in children

A cross-sectional study in JAMA Pediatrics confirms earlier reports that COVID-19 can cause severe illness in children (CFR of 4.2), but considerably less than in adults. Similar to adult COVID-19 patients, severe cases in children are strongly associated with pre-existing comorbidities (including developmental delays, genetic anomalies, and immune suppression). A separate retrospective review in the Journal of Pediatrics, authors examined associations between underlying epidemiologic and clinical conditions with rates of hospitalization, finding positive correlations with neurological disorders (19%), cardiac conditions (9%), hematologic conditions (9%) and oncologic conditions (5%).

COVID-19 may  increase frequency of Children’s Kawasaki Syndrome

Emergent reports from around the world suggest an association between a Kawaski-like syndrome and COVID infection in children. An observational cohort study in the Lancet hypothesizes that COVID-19 may be responsible for the 30-fold increase in the incidence of hyper-inflammatory syndrome Kawasaki-like disease among older children in Italy.

RCTs pending on the benefits and safety of convalescent plasma for people with COVID-19

A Cochrane Rapid Review shows that only 32 patients in seven case-series studies have been studied systematically, and there is at this time limited evidence on the benefits and safety of convalescent plasma for people with COVID-19. The review noted that 47 studies are currently underway, and 22 of these are Randomized Control Trials. Cochrane will update this clinical review on a monthly basis as trial results emerge. It notes that its review and conclusions are likely be different from its current assessment of “limited evidence.”

80% of secondary transmissions may have been caused by a small fraction of infectious individuals

A pre-print publication on Wellcome Open Research examines outbreak size outside China, and highlights the high variability across countries in the overdispersion of COVID-19 transmission.  Findings suggest that 80% of secondary transmissions may have been caused by a small fraction of infectious individuals, and that the effective reproduction number could be drastically reduced by preventing relatively rare superspreading events.

Voluntary collective isolation and contact-tracing for vulnerable Indigenous Communities

The Lancet published a paper this week on a case study and potential protocols for indigenous populations in the Bolivian Amazon. The interdisciplinary study proposes a multiphase COVID-19 prevention and containment plan focused on voluntary collective isolation and contact-tracing that could be exported and adapted to local circumstances elsewhere to prevent widespread mortality in indigenous communities.

This development is part of the digest;