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ngq, you sexy beast! Here is a sanity check for that clean meta. ;)
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                    [post_date] => 2020-07-21 11:21:55
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  • A new study in Science demonstrates the need for a coordinated approach for countries in Europe to lift lockdown measures in order to prevent subsequent outbreaks of cases. The research team from WorldPop highlight the significant impact of actions by countries that are populous, well-connected and with strong interventionsin place – which include France, Germany, Italy, Poland and the UK. The study produced over 1,200 exit strategy scenarios, using publicly available epidemiological data as well as anonymized mobile phone data to map population movement in 35 European countries. A notable finding of the study is that premature and uncoordinated easing of control measures by some countries could accelerate the resurgence of COVID-19 outbreaks across the entire continent by up to five weeks. The simulations furthermore show that synchronizing intermittent lockdowns across countries would lead to half as many necessary lockdown periods in order to achieve an end to community transmission in six months.
    • 



 


                    [post_title] => International Coordination is Essential to Avoid Resurgence
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                    [post_content] => 
WHO to create a COVID-19 Intellectual Property Pool


The WHO embraced a proposal by Costa Rica to develop a voluntary mechanism that would pool patents and regulatory testing data to develop drugs, vaccines and diagnostics for COVID-19. Modelled after the Medicines Patent Pool by UNITAID for HIV/AIDS medical products, the COVID IP Pool would serve as a repository that target governments, industry, universities and non-profit organizations in order to ensure equitable access to resulting medical products, something that the Access to COVID-19 Tools (ACT) Accelerator announced last month does not sufficiently address.


The WHO has until May 29 to finalize the framework for the voluntary pool. The US has expressed reservations, while it has been accused of “pandemic chauvinism” because it refused to attend the launch of the WHO ACT Accelerator and is alleged to have offered to buy a German vaccine developer, while the CEO of Sanofi said that the U.S. may get priority access to COVID-19 vaccine, even though the company is headquartered in France.


Covid-19 has exposed the limits of the pharmaceutical market model


As the global search for Coronavirus treatments and vaccines intensify, two articles this week highlight the limitations of the existing drug development models. Health Policy Watch featured an interview with the Director General of a trade association representing the leading pharmaceutical companies. Among the “old-new tensions between profit and public needs” that were discussed was the “concern” by the pharmaceutical industry that the newly adopted World Health Assembly resolution referenced WTO flexibilities that allow countries to override patents to ensure access to vaccines, therapeutics and diagnostics.


The STAT article, meanwhile, points to failures of the existing market model that do not sufficiently incentivize investment into new treatments and vaccines for neglected diseases and pandemic preparedness despite warnings. Building on an extensive body of research, the author advocates for a new economic model of drug development that does not rely on market mechanisms. That would include more open and transparent research and development practices that address the “rapid global expansion of intellectual property” as well as more expansive government initiatives to address collective challenges (particularly given the significant role of government-funded research).


The 15 drugs being tested to treat COVID-19 and how they work


Even under the most optimistic projections, developing new treatments and vaccines for COVID-19 will require far greater time and resources than would be required for repurposed existing therapeutic compounds. An article in Nature this week provides an overview of the 15 leading candidates of existing drugs that are being studied as treatments for COVID-19. These can be divided into two categories: those that target the viral replication cycle, and those that aim to control the symptoms of the disease. They include:


    

  • Chloroquine/hydroxychloroquine (primarily used to treat malaria)
    • 

  • Lpinavir and ritonavir (HIV/AIDS)
    • 

  • Nafamostat and camostat (pancreatitis)
    • 

  • Famotidine (heartburn)
    • 

  • Umifenovir (influenza virus A and B)
    • 

  • Nitazoxanide (anti-infective)
    • 

  • Ivermectin (anti-parasitic)
    • 

  • Corticosteroids (cytokine storm, acute respiratory distress syndrome)
    • 

  • Tocilizumab and sarilumab (cytokine storm, ARDS)
    • 

  • Bevacizumab (oncology)
    • 

  • Fluvoxamine (antidepressant)
    • 



Contact tracing apps: balancing privacy and public health


Traditional public health contact tracing systems require significant time and resources, as one projection by Johns Hopkins University estimates a workforce of 100,000-300,000 would be needed to contain COVID-19 in the U.S. alone at a cost of $12 billion. As a result, health systems are increasingly turning to mobile contact tracing apps that are pitched as a way to reduce these costs by automating the process of logging people’s contacts should they became infected in the future.  Despite their promise, there are outstanding challenges, including marginalizing vulnerable populations that may not have smartphones.


There are also privacy concerns that has led civil liberties advocates to raise warnings about potential abuses, including by authoritarian countries during and after the pandemic. The CSIS also urges policy makers that digital tools such as contact tracing apps are not “silver bullet” substitutes for investment in fundamental pandemic response capabilities. That message was echoed by health authorities in Iceland, where Rakning-19 yielded very little benefit compared to traditional public health systems, despite its high uptake of 40% of the population.


Machine learning applications


In Nature Machine Intelligence, authors report on machine learning tools applying pattern classification to identify three biomarkers associated with COVID-19 mortalities.


Another paper in Nature examine real-time tracking of self-reported symptoms to predict potential cases of COVID-19. The smartphone app allowed the authors to develop a model that was 80% accurate and showed that loss of smell and taste were additional symptoms indicative of COVID-19. While this study used simple statistical regression analysis, another paper in pre-print used machine learning algorithms on a smaller Brazilian dataset that achieved better performance of 92% specificity and 95% sensitivity.


                    [post_title] => WHO to create a COVID-19 Intellectual Property Pool
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The doubling rate of confirmed COVID-19 cases dropped to once every 21 days from a high of once every 7 days on April 1. As some countries experience stabilizing or declining national death tolls, it has prompted attempts to loosen lockdown measures. This includes France, Italy and Spain, three of the world’s hardest hit countries (accounting for 20% of cases and a third of all COVID-related deaths worldwide). Germany is begun to relax lockdown measures, as face masks have become mandatory in public. The National Health Service of the United Kingdom set out a six-week plan to ‘return to normal’ following projections that the U.K. has ‘likely survived the first wave’ of the pandemic and will get close to testing targets. Despite a record daily increase in confirmed cases,South Africa restarted some mining operations, as India has also begun to ease lockdown measures following a drop in reported


As some Asian-Pacific countries such as Singapore experience major outbreaks in the second wave of transmission, hospitals across Europe have raised concerns. The WHO noted that many states also do not have adequate testing capacity needed to support a safe reopening strategy that can detect, trace and isolate new COVID transmission. China has meanwhile provided a guide on how countries can prevent a second wave, including compulsory masks in public, fines for failure to exercise public hygiene practices, as well as public markings for social distancing lanes.


The LSHTM is gathering data on hundreds of intervention measures from around the world to determine factors contributing to disease outbreak as well as relative effectiveness of control strategies. For example, to date, Hong Kong’s swift surveillance, quarantine and social-distancing measures – such as the use of face masks and school closures – helped to cut Coronavirus transmission with only 4 deaths in a (urban) population of 7.5 million. The LSHTM platform is being developed to support the WHO’s technical support to member states, and includes more than 1,100 volunteers, multiple universities, public health organizations and non-profits, including ACAPS which analyses humanitarian crises.


                    [post_title] => ‘The second wave is in our hands’: WHO
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Ten countries have now confirmed more than 1,000 COVID-related deaths, with 14 countries reporting more than 10,000 cases. With less than 17% of all confirmed cases globally, Italy and Spain continue to account for more than 35% of all reported deaths (21,645 and 19,130, respectively). Both countries are experiencing a slow-down in the rates of transmission, however, and while Spain is beginning to relax control measures, Italy has extended lockdown measures until May.


Sweden (12,540) is the latest country to exceed 10,000 cases, as the number of deaths doubled in less than a week, which has been blamed on its controversial voluntary public health measures. France (147,863) and Turkey (69,392) continue to experience significant daily increases in confirmed cases and deaths, while the U.K. is expected to see a drop in new cases and hospitalization, despite surpassing 10,000 deaths and approaching 100,000 cases. The U.K. Prime Minister Boris Johnson was moved out of Intensive Care over the weekend, noting “I owe (NHS staff) my life.”


Transmission rates in Russia have also raised concerns, as daily reported cases continue to surge 20% for a second consecutive day, approaching 28,000 cases and 232 deaths. As the number of COVID-related deaths in Belgium surpass China, Germany is reporting an increase of COVID-related outbreaks in nursing homes and hospitals, where the elderly account for only 17% of cases but 86% of all deaths.


Many European countries are also reporting high CFR near or above 10%, including Italy, Spain, France, the U.K., Netherlands, Belgium, and Sweden. This has been partly attributed to selective testing strategies, as a paper this week in BMJ suggests early and widespread testing may be contributing to Germany’s relatively low CFR (2%). The European CDC has recommended that countries scale up testing and surveillance systems to guide and monitor the escalation and de-escalation of mitigation strategies.


                    [post_title] => Regional Snapshot: Europe
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During this unprecedented global pandemic, U.S. President Trump announced his intention to suspend funding to the WHO over accusations of mismanagement. The move has been roundly criticized by many governments and the EU, global health experts as well as the UN Secretary General. The U.S., meanwhile, has raised questions about its own handling of the pandemic, as it remains the epicentre with almost a third of all worldwide cases (644,806) and over 20% of all COVID-related deaths. The five worst affected countries (U.S., Spain, Italy, Germany, France) account for over 60% of all cases and almost 80% of deaths globally.


                    [post_title] => Trump announces intention to suspend WHO funding
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April 9 marks the 100th day since the WHO was notified of the first case of “pneumonia of unknown cause” in Wuhan, China.


As of April 12 at 10am EST, the total worldwide deaths from COVID-19 has surpassed 110,000, as confirmed cases approach 1.8 million. The actual number of dead and infected worldwide are believed to be much higher, but testing shortages, different counting practices and concealment by some governments limit detection and reporting.


The U.S. is the current global epicentre with over 530,000 confirmed cases and over 20,000 deaths, while the five worst affected countries (U.S., Spain, Italy, Germany, France) account for over 60% of all cases and almost 80% of deaths globally.


Community transmission is spreading, and the rapid increase of cases across low- and middle-income countries has become a critical global issue, as over 20 developing countries are reporting more than 1,000 cases. The number of African cases increased approximately by 40% over the past week, with all 55 countries reporting cases and 8 African countries seeing exponential rise. South Africa’s border controls and lockdown over the past two weeks have significantly reduced the number of new cases.


The economic fallout from the global pandemic could push 500 million people into poverty (8% of global population), according to a UN University report. This would be the first time that poverty has increased globally in over thirty years. The World Bank and IMF have scaled up and accelerated efforts to provide emergency funding to countries, while the UN Office for the Coordination for Humanitarian Affairs (OCHA) issued a US$2 billion appeal for a Coordinated Global Humanitarian Response Plan, which as of April 8, is only 20% funded.


As governments confront the dual challenge of containing the viral pandemic and economic crisis, public health experts warn countries that premature re-opening could lead to a second wave of outbreaks, echoed as well by modelling projections in a recent Lancet paper. Oxfam has urged world leaders to contribute to the $2.5 trillion economic rescue plan set out by the UN to “keep poor countries and poor communities afloat.” Mounting job losses and disruptions to global supply chains are also expected to result in chronic food shortages, as countries are urged to keep trade open and to protect farmers.


                    [post_title] => Global Snapshot
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                    [post_content] => 
Short-term forecasts of COVID-19 deaths in multiple countries


Imperial College London, 8 April 2020


https://sangeetabhatia03.github.io/covid19-short-term-forecasts/index.html


This weekly report by Imperial College London presents forecasts of transmission and mortality estimates over the coming week for 42 countries with active transmission, accounting for the impact of control measures. The caveat with these forecasts is that accuracy varies with the quality of surveillance and reporting, i.e. presenting likely underestimates for countries with poor reporting. That said, based on transmissibility estimates, the COVID-19 epidemic is expected to demonstrate:


    

  • Stabilizing patterns in 14 countries (including Italy, Iran, Iraq, South Korea);
    • 

  • Slow-growth transmission (1<Rt<2) in Spain and Netherlands; and
    • 

  • Rapidly growing transmission (Rt>2) across 26 countries (including Algeria, Brazil, Canada, China, Egypt, France, Germany, India, Japan, Peru, Turkey, U.K. and U.S.).
    • 



Based on central forecasting trends, reported deaths in the coming week are expected to be:


    

  • Relatively small (<100) and large (100-1000) in 29 countries;
    • 

  • Large (1,000-5,000) in 8 countries (including Algeria, Brazil, Germany, Iran, and Turkey); and
    • 

  • Very large (5,000+) in 5 countries (France, Italy, Spain, U.K. and U.S).
    • 



New COVID-19 forecasts for Europe: Italy & Spain have passed the peak of their epidemics; UK, early in its epidemic, faces a fast-mounting death toll


Institute for Health Metrics and Evaluation, 7 April 2020


http://www.healthdata.org/news-release/new-covid-19-forecasts-europe-italy-spain-have-passed-peak-their-epidemics-uk-early-its


New COVID-19 forecast from IHME found that among European nations, the peak daily death rate from the pandemic will occur during the third week of April, with the pandemic spreading from Southern Europe. According to current trajectories, 151,680 COVID-19 deaths could occur during the “first wave” of the pandemic in Europe, while the U.S. is expected to face 81,766 deaths. Declines in deaths are now occurring in Italy and Spain as most regions in the two countries have passed their peaks in the number of deaths, while other nations are approaching their peaks and still others facing peak mortality later in April. The death toll in many countries is compounded by demand for hospital resources well in excess of what is available. Predicted peaks in daily COVID-19 deaths appear to be highly variable among EEA countries, likely reflecting the equally variable ways that the novel coronavirus initially spread and then continued to affect Europe.


Projecting hospital utilization during the COVID-19 outbreaks in the United States


Moghadas et al, National Academy of Sciences, 3 April 2020


https://www.pnas.org/content/117/16/9122


Findings


Without isolation and with R0 = 2.5, treatment of critically ill patients at the outbreak peak would require 3.8x more ICU beds than exist in the U.S. (or 2x if R0 = 2). With self-isolation by 20% of cases within 24 hours of symptom onset, the outbreak trajectory would delay and flatten, and the number of ICU beds needed at the peak would reduce by 48.4% (or 73.5% if R0 = 2).


Interpretation


Hand washing and self-isolation is shown to significantly contribute to reducing the rate of spread of COVID-19, and therefore reducing the number of ICU beds needed at any one time. This could facilitate emergency mobilization to expand mobilization of critical care capacity to handle the burgeoning outbreak.


                    [post_title] => Research on Forecasting Peak Transmission and Health System Utilization
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Estimating the number of infections and the impact of non- pharmaceutical interventions on COVID-19 in 11 European countries (Flaxman et al, Imperial College London)


Findings


This study attempts to infer the impact of different interventions across 11 European countries using a semi-mechanistic Bayesian hierarchical model. The authors estimate that through the end of March, interventions taken by countries likely averted 59,000 deaths while reducing reproduction numbers. During this period, the authors also estimate that 7-43 million people may have been infected across the 11 countries (or approx. 2-11% of total population). Spain and Italy are estimated to have the highest attack rate, with Germany and Norway on the lower end (possibly reflecting the relative stages of the epidemics.


Interpretation


While the two to three-week delay between transmission changes and observed impact on mortality make it difficult to evaluate the effectiveness of recent interventions, the authors urge that preliminary evidence suggests that current interventions remain in place and that trends in cases and deaths be closely monitored to provide reassurance that transmission is slowing.


                    [post_title] => Research: Estimating the number of infections and the impact of non- pharmaceutical interventions on COVID-19 in 11 European countries
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                    [post_modified] => 2020-08-13 22:42:39
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                    [post_date] => 2020-04-03 12:34:50
                    [post_date_gmt] => 2020-04-03 16:34:50
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As of April 3, Italy and Spain together make up almost half of all confirmed deaths globally (13,915 and 10,348, respectively), while each country has also surpassed 110,000 confirmed cases. Across Europe, ten countries are reporting more than 10,000 cases, while seven countries have reported over 1,000 deaths. Many European countries are also reporting alarmingly high Case Fatality Rates over 5%. Including Italy (12%), Netherlands and Spain (9.1%), UK (8.7%), France (7.1%), Belgium (6.6%), and Sweden (5.2%). This has been partly attributed to selective testing strategies in these countries, while widespread testing is likely contributing to relatively low CFR rate in countries like Germany (1.2%) and Austria (1.4%). The European CDC has nonetheless warned that current testing capacity and if countries do not enact mitigation strategies, Europe could see a scenario similar to China by the middle of April.


                    [post_title] => Stats Summary: Europe
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                    [post_date] => 2020-03-29 10:54:16
                    [post_date_gmt] => 2020-03-28 14:46:16
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The pandemic continues to grow exponentially. As of March 25, It took only 6 days for the global case number to double from 200,000 to over 400,000 (and 2 days from 300,000 to 400,000).


At least 650,567 cases and 30,299 deaths have been reported in 199 countries as of March 28 at 2:30pm EST. Europe and the U.S. account for almost two thirds of all cases globally.  There is growing alarm, however, as case reports are increasing in many low- and middle-income countries.


Select Case Fatality Rates (for countries with at least 50 deaths)


Worldwide: 4.7%

Italy: 10.6%

Spain: 7.9%

Iran: 7.1%

China: 4.1%

France: 6.1%

US: 1.6%

South Korea: 1.5%

Canada: 1.2%

Germany: 0.7%


                    [post_title] => Global rise is exponential
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                    [post_modified] => 2020-08-13 22:45:49
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The European CDC warned that with current testing capacity and if nations do not enact mitigation strategies, Europe could see by the middle of April a scenario similar to what China experienced in Hubei province at the beginning of the outbreak.


Spain and Germany are leading the increase in number of confirmed cases, accounting for 12% and 13.5% of newly confirmed cases globally on March 28, totalling 65,719 and 50,871 respectively. While Germany has maintained a relatively low CFR (0.75%), the death toll in Spain (5,138) now exceeding China. The decreasing trend in Italy earlier this week did not continue, as the total number of confirmed cases surpassed 86,498 with an alarming CFR of 10.56%.


                    [post_title] => Europe needs testing capacity and mitigation strategies
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            [post_date] => 2020-07-21 11:21:55
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            [post_content] => 
    

  • A new study in Science demonstrates the need for a coordinated approach for countries in Europe to lift lockdown measures in order to prevent subsequent outbreaks of cases. The research team from WorldPop highlight the significant impact of actions by countries that are populous, well-connected and with strong interventionsin place – which include France, Germany, Italy, Poland and the UK. The study produced over 1,200 exit strategy scenarios, using publicly available epidemiological data as well as anonymized mobile phone data to map population movement in 35 European countries. A notable finding of the study is that premature and uncoordinated easing of control measures by some countries could accelerate the resurgence of COVID-19 outbreaks across the entire continent by up to five weeks. The simulations furthermore show that synchronizing intermittent lockdowns across countries would lead to half as many necessary lockdown periods in order to achieve an end to community transmission in six months.
    • 



 


            [post_title] => International Coordination is Essential to Avoid Resurgence
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