Covid19-Sources

Background: Estimates of immunity and severity for the SARS-CoV-2 omicron subvariant BA.5 are important to assess the public health impact associated with its

This study estimates the effectiveness of previous infection with SARS-CoV-2 in preventing reinfection with Omicron BA.4/BA.5 subvariants using a test-negative, case–control study design. Cases (SARS-CoV-2-positive test results) and controls (SARS-CoV-2-negative test results) were matched according to sex, 10-year age group, nationality, comorbid condition count, calendar week of testing, method of testing, and reason for testing. Effectiveness was estimated using the S-gene “target failure” (SGTF) infections between May 7, 2022-July 4, 2022. SGTF status provides a proxy for BA.4/BA.5 infections, considering the negligible incidence of other SGTF variants during the study. Effectiveness was also estimated using all diagnosed infections between June 8, 2022-July 4, 2022, when BA.4/BA.5 dominated incidence. Effectiveness of a previous pre-Omicron infection against symptomatic BA.4/BA.5 reinfection was 15.1% (95% CI: -47.1-50.9%), and against any BA.4/BA.5 reinfection irrespective of symptoms was 28.3% (95% CI: 11.4-41.9%). Effectiveness of a previous Omicron infection against symptomatic BA.4/BA.5 reinfection was 76.1% (95% CI: 54.9-87.3%), and against any BA.4/BA.5 reinfection was 79.7% (95% CI: 74.3-83.9%). Results using all diagnosed infections when BA.4/BA.5 dominated incidence confirmed the same findings. Sensitivity analyses adjusting for vaccination status confirmed study results. Protection of a previous infection against BA.4/BA.5 reinfection was modest when the previous infection involved a pre-Omicron variant, but strong when the previous infection involved the Omicron BA.1 or BA.2 subvariants. Protection of a previous infection against BA.4/BA.5 was lower than that against BA.1/BA.2, consistent with BA.4/BA.5’s greater capacity for immune-system evasion than that of BA.1/BA.2. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement The authors are grateful for institutional salary support from the Biomedical Research Program and the Biostatistics, Epidemiology, and Biomathematics Research Core, both at Weill Cornell Medicine-Qatar, as well as for institutional salary support provided by the Ministry of Public Health, Hamad Medical Corporation, and Sidra Medicine. The authors are also grateful for the Qatar Genome Programme and Qatar University Biomedical Research Center for institutional support for the reagents needed for the viral genome sequencing. The funders of the study had no role in study design, data collection, data analysis, data interpretation, or writing of the article. Statements made herein are solely the responsibility of the authors. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: The study was approved by the Hamad Medical Corporation and Weill Cornell Medicine-Qatar Institutional Review Boards with waiver of informed consent. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes The dataset of this study is a property of the Qatar Ministry of Public Health that was provided to the researchers through a restricted-access agreement that prevents sharing the dataset with a third party or publicly. Future access to this dataset can be considered through a direct application for data access to Her Excellency the Minister of Public Health (https://www.moph.gov.qa/english/Pages/default.aspx). Aggregate data are available within the manuscript and its Supplementary information.

Correspondence from The New England Journal of Medicine — Risk of BA.5 Infection among Persons Exposed to Previous SARS-CoV-2 Variants

COVID-19 vaccines get their first update since the pandemic began. Here's what you need to know about them

BNT162b2 is a vaccine developed to prevent coronavirus disease 2019 (COVID-19). BNT162b2 is a lipid nanoparticle formulated nucleoside-modified messenger RNA (mRNA) encoding the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) spike protein ...

The Omicron sub-lineages BA.4 and BA.5 were first detected in England in April 2022. A case surge followed despite England having recently experienced waves with BA.1 and BA.2. This study used a whole population test-negative case-control study design to estimate the effectiveness of the vaccines currently in use as part of the UK COVID-19 vaccination programme against hospitalisation following infection with BA.4 and BA.5 as compared to BA.2 during a period of co-circulation. Incremental VE was estimated in those vaccinated with either a third or fourth dose as compared to individuals with waned immunity who had received their second dose at least 25 weeks prior. Vaccination status was included as an independent variable and effectiveness was defined as 1-odds of vaccination in cases/odds of vaccination in controls. During the study period, there were 32,845 eligible tests from hospitalised individuals. Of these, 25,862 were negative (controls), 3,432 were BA.2, 273 were BA.4, 947 were BA.5 and 2,331 were either BA.4 or BA.5 cases. There was no evidence of reduced VE against hospitalisation for BA.4 or BA.5 as compared to BA.2. The incremental VE was 56.8% (95% C.I.; 24.0-75.4%), 59.9% (95% C.I.; 45.6-70.5%) and 52.4% (95% C.I.; 43.2-60.1%) for BA.4, BA.5 and BA.2, respectively, at 2 to 14 weeks after a third or fourth dose. VE against hospitalisation with BA.4/5 or BA.2 was slightly higher for the mRNA-1273 booster than the BNT162b2 booster at all time-points investigated, but confidence intervals overlapped. These data provide reassuring evidence of the protection conferred by the current vaccines against severe disease with BA.4 and BA.5. ### Competing Interest Statement The authors have declared no competing interest. ### Funding Statement None ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: PHE Research Ethics and Governance Group Statement: Surveillance of COVID-19 testing and vaccination is undertaken under Regulation 3 of The Health Service (Control of Patient Information) Regulations 2002 to collect confidential patient information (http://www.legislation.gov.uk/uksi/2002/1438/regulation/3/made) under Sections 3(i) (a) to (c), 3(i)(d) (i) and (ii) and 3(3). The study protocol was subject to an internal review by the PHE Research Ethics and Governance Group and was found to be fully compliant with all regulatory requirements. As no regulatory issues were identified, and ethical review is not a requirement for this type of work, it was decided that a full ethical review would not be necessary. All necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present work are contained in the manuscript. Data cannot be made publicly available for ethical and legal reasons, i.e. public availability would compromise patient confidentiality as data tables list single counts of individuals rather than aggregated data

There was no evidence of reduced VE against hospitalisation for BA.4 or BA.5 as compared to BA.2. In those who had received their 3rd or 4th dose 2 to 14 weeks ago, the incremental VE as compared to those who were 25 or more weeks post their 2nd dose was 50-60%. pic.twitter.com/QCmPyMqPlr— Freja Kirsebom (@freja_kirsebom) September 2, 2022

Beschäftigte waren im ersten Halbjahr 2022 so lange krankgeschrieben wie noch nie - im Schnitt 9,1 Tage.

DECT depicted proximal arterial thrombosis in 5.4% of patients and perfusion abnormalities suggestive of widespread microangiopathy in 65.5% of patients. Lung microcirculation was abnormal in 4 patients with normal lung parenchyma.

All 41 patients had extensive lung damage, while 36 had massive abnormal clotting.

Bay-VOC - Bayerische Plattform zur Überwachung von SARS-CoV-2 Varianten

Nature Communications - The health impacts associated with SARS-CoV-2 infection are still not well understood. Here, the authors report findings from a survey of ~150,000 people in Denmark, and...

Importance SARS-CoV-2 enters the nasopharynx to replicate; nasal irrigation soon after diagnosis could reduce viral load and inhibit furin cleavage necessary for cell entry, thereby reducing morbidity and mortality. Objective To determine whether initiating nasal irrigation after COVID-19 diagnosis reduces hospitalizations and death in high-risk outpatients, and whether irrigant composition impacts severity. Design Unblinded randomized clinical trial of two nasal irrigation protocols in older outpatients PCR positive for SARS-CoV-2, with an observational arm using laboratory-confirmed cases in the CDC COVID-19 Case Surveillance dataset. Setting Single-lab community testing facility associated with the emergency department (ED) in Augusta, GA. Participants A consecutive sample of high-risk adults were enrolled within 24 hours of a positive COVID-19 test between September 24 and December 21 of 2020. Patients aged 55 and older were remotely consented. Among 826 screened, 321 of 694 eligible patients were unable to be reached, 294 refused participation, and 79 participants were enrolled. Interventions Participants were randomly assigned adding 2.5 mL povidone-iodine 10% or 2.5 mL sodium bicarbonate to 240 mL of isotonic nasal irrigation twice daily for 14 days. Main Outcomes and Measures The primary outcome was hospitalization or death from COVID-19 within 28 days of enrollment by daily self-report confirmed with phone calls and hospital records, compared to the CDC Surveillance Dataset covering the same time. Secondary outcomes compared symptom resolution by irrigant additive. Results Seventy-nine high-risk participants were enrolled (mean [SD] age, 64 [8] years; 36 [46%] women; 71% Non-Hispanic White), with mean BMI 30.3. Analyzed by intention-to-treat, by day 28, COVID-19 symptoms resulted in one ED visit and no hospitalizations in 42 irrigating with alkalinization, one hospitalization of 37 in the povidone-iodine group, (1.27%) and no deaths. Of nearly three million CDC cases, 9.47% were known to be hospitalized, with an additional 1.5% mortality in those without hospitalization data. The total risk of hospitalization or death (11%) was 8.57 times that of enrolled patients (SE=2.74; P=.006). 62 completed daily surveys (78%), averaging 1.8 irrigations/day. Eleven had irrigation complaints, and four discontinued. There were no significant differences by additive. Conclusion SARS-CoV-2+ participants initiating nasal irrigation were over 8 times less likely to be hospitalized than the national rate. Trial Registration [ClinicalTrial.gov][1] Identifier: [NCT04559035][2] Author Approval All authors have filled out ICMJE and approved submission. Conflict of Interest Statement Materials were provided by Neilmed Inc. and Rhinosystems Inc. The study was supported by funding from the Bernard and Anne Gray Donor Advised Fund Community Foundation for Greater Atlanta, Neilmed Inc., and Rhinosystems. No authors have conflict of interest. Question After testing positive for COVID-19, will rapidly initiating nasal irrigation reduce the risk of morbidity and mortality compared to a national dataset? Findings A consecutive sample of 79 high-risk adults (mean age 64, BMI 30.3) were randomized to initiate one of two nasal irrigation protocols within 24 hours of a positive COVID-19 test. Compared to a CDC COVID-19 National Dataset observational arm, 1.27% of participants initiating twice daily nasal irrigation were hospitalized or died, compared to 11%, a significant difference. Meaning In high-risk outpatients testing positive for SARS-CoV-2 who initiated nasal irrigation rapidly after diagnosis, risk of hospitalization or death was eight times lower than national rates reported by the CDC. ### Competing Interest Statement The authors have declared no competing interest. ### Clinical Trial NCT04559035 ### Funding Statement Materials were provided by Neilmed Inc. and Rhinosystems Inc. The investigator-initiated study was supported by funding from the Bernard and Anne Gray Donor Advised Fund Community Foundation for Greater Atlanta, Neilmed Inc., and Rhinosystems. No authors received payment or services from a third party for any aspect of the submitted work. ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: Institutional Review Board Office Augusta University 1120 15th St., CJ-2103 Augusta GA 30912-7621 Email: IRB{at}augusta.edu Phone: 706-721-3110 I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes Data is available from the University of Augusta Department of Emergency Medicine Research Office, and online from the CDC COVID-19 Case Surveillance Public Use Data [1]: http://ClinicalTrial.gov [2]: /lookup/external-ref?link_type=CLINTRIALGOV&access_num=NCT04559035&atom=%2Fmedrxiv%2Fearly%2F2021%2F12%2F08%2F2021.08.16.21262044.atom

Objectives In our previous research, we have reported mathematical model with molecular simulation analysis to predict the infectivity of seven SARS-CoV-2 variants. In this report, we aimed to predict the relative risk of the recent new variants of SARS-CoV-2 based on our previous research. Methods We subjected Omicron BA.4/5 or BA.2.75 variant of SARS-CoV-2 to the analysis for the evolutionary distance of the spike protein gene (S gene) to appreciate the changes of the spike protein. We performed the molecular docking simulation analyses of the spike protein with human angiotensin-converting enzyme 2 (ACE2) to understand the docking affinity in these variants. We then compared the evolutionary distance and the docking affinity of these variants with that of the seven variants which were analyzed in our previous research. Results The evolutionary distance of the S gene in BA.4/5 or BA.2.75 from the Wuhan variant were longer than the other variants. The highest docking affinity of the spike protein with ACE2 (ratio per Wuhan variant) was observed in BA.2.75. Conclusion It is important to note that BA.2.75 has both the highest docking affinity and the longest evolutionary distance of the S gene. These results suggest that the infection of BA.2.75 can be spread further than preexisting variants. ### Competing Interest Statement The authors have declared no competing interest. * S gene : spike protein gene ACE2 : angiotensin-converting enzyme 2 RBD : receptor-binding domain

Objective To assess the effectiveness of mandatory use of face covering masks (FCMs) in schools during the first term of the 2021–2022 academic year. Design A retrospective population-based study. Setting Schools in Catalonia (Spain). Population 599 314 children aged 3–11 years attending preschool (3–5 years, without FCM mandate) and primary education (6–11 years, with FCM mandate). Study period From 13 September to 22 December 2021 (before Omicron variant). Interventions A quasi-experimental comparison between children in the last grade of preschool (5 years old), as a control group, and children in year 1 of primary education (6 years old), as an interventional group. Main outcome measures Incidence of SARS-CoV-2, secondary attack rates (SARs) and effective reproductive number (R*). Results SARS-CoV-2 incidence was significantly lower in preschool than in primary education, and an increasing trend with age was observed. Six-year-old children showed higher incidence than 5 year olds (3.54% vs 3.1%; OR 1.15 (95% CI 1.08 to 1.22)) and slightly lower but not statistically significant SAR (4.36% vs 4.59%; incidence risk ratio 0.96 (95% CI 0.82 to 1.11)) and R* (0.9 vs 0.93; OR 0.96 (95% CI 0.87 to 1.09)). Results remained consistent using a regression discontinuity design and linear regression extrapolation approaches. Conclusions We found no significant differences in SARS-CoV-2 transmission due to FCM mandates in Catalonian schools. Instead, age was the most important factor in explaining the transmission risk for children attending school. Data are available upon reasonable request.

The COVID-19 pandemic has been unpredictable as more is learned about the varied side effects of the virus. One surprising finding is the heightened risk of stroke and heart attack—and not just for older adults.

3 good reasons to get your kids vaccinated against covid: ▶️ Risk of hospitalization reduced by 83% ▶️ Risk of MIS-C (multisystemic inflammatory syndrome) reduced by 90% ▶️ Immunity generated by vaccination (alone or after an infection) immunity generated by 1-2 infections

1/ 🧵 Welcher Impfstoff wäre als update sinnvoll und was wird im Herbst erhältlich sein. Ich beschränke mich hier auf die Frage ob monovalenter (reiner Omikron-Impfstoff) oder bivalenter (Impfstoff, der zu 50% Omikron und zu 50% den sog. wild-type/WT) enthält, sinnvoller ist.— Jan Hartmann (@pelagicbird) July 26, 2022

Whereas pathogen-specific T and B cells are a primary focus of interest during infectious disease, we have used COVID-19 to ask whether their emergence comes at a cost of broader B cell and T cell repertoire disruption. We applied a genomic DNA-based approach to concurrently study the immunoglobulin-heavy (IGH) and T cell receptor (TCR) β and δ chain loci of 95 individuals. Our approach detected anticipated repertoire focusing for the IGH repertoire, including expansions of clusters of related sequences temporally aligned with SARS-CoV-2–specific seroconversion, and enrichment of some shared SARS-CoV-2–associated sequences. No significant age-related or disease severity–related deficiencies were noted for the IGH repertoire. By contrast, whereas focusing occurred at the TCRβ and TCRδ loci, including some TCRβ sequence–sharing, disruptive repertoire narrowing was almost entirely limited to many patients aged older than 50 y. By temporarily reducing T cell diversity and by risking expansions of nonbeneficial T cells, these traits may constitute an age-related risk factor for COVID-19, including a vulnerability to new variants for which T cells may provide key protection.

SARS-CoV-2 infection can result in the development of a constellation of persistent sequelae following acute disease called post-acute sequelae of COVID-19 (PASC) or Long COVID[1][1]–[3][2]. Individuals diagnosed with Long COVID frequently report unremitting fatigue, post-exertional malaise, and a variety of cognitive and autonomic dysfunctions[1][1]–[3][2]; however, the basic biological mechanisms responsible for these debilitating symptoms are unclear. Here, 215 individuals were included in an exploratory, cross-sectional study to perform multi-dimensional immune phenotyping in conjunction with machine learning methods to identify key immunological features distinguishing Long COVID. Marked differences were noted in specific circulating myeloid and lymphocyte populations relative to matched control groups, as well as evidence of elevated humoral responses directed against SARS-CoV-2 among participants with Long COVID. Further, unexpected increases were observed in antibody responses directed against non-SARS-CoV-2 viral pathogens, particularly Epstein-Barr virus. Analysis of circulating immune mediators and various hormones also revealed pronounced differences, with levels of cortisol being uniformly lower among participants with Long COVID relative to matched control groups. Integration of immune phenotyping data into unbiased machine learning models identified significant distinguishing features critical in accurate classification of Long COVID, with decreased levels of cortisol being the most significant individual predictor. These findings will help guide additional studies into the pathobiology of Long COVID and may aid in the future development of objective biomarkers for Long COVID. ### Competing Interest Statement In the past three years, H.K. received expenses and/or personal fees from UnitedHealth, Element Science, Aetna, Reality Labs, Tesseract/4Catalyst, F-Prime, the Siegfried and Jensen Law Firm, Arnold and Porter Law Firm, and Martin/Baughman Law Firm. He is a co-founder of Refactor Health and HugoHealth, and is associated with contracts, through Yale New Haven Hospital, from the Centers for Medicare & Medicaid Services and through Yale University from Johnson & Johnson. A. I. consults for 4BIO Capital, BlueWillow Biologics, Healthspan Technologies, Revelar Biotherapeutics, RIGImmune, and Xanadu Bio. A.M.R. is an inventor of a patent describing the REAP technology. A.M.R. is the founder of Seranova Bio and holds equity in Seranova Bio. ### Funding Statement This work was supported by grants from National Institute of Allergy and Infectious Diseases (R01AI157488 to A.I.), FDA Office of Womens Health Research Centers of Excellence in Regulatory Science and Innovation (CERSI) (to A.I.), Fast Grant from Emergent Ventures at the Mercatus Center (to A.I.), RTW Foundation (to D.P.), the Howard Hughes Medical Institute Collaborative COVID-19 Initiative (to R.M. and A.I.), and the Howard Hughes Medical Institute (to A.I. and R.M.). ### Author Declarations I confirm all relevant ethical guidelines have been followed, and any necessary IRB and/or ethics committee approvals have been obtained. Yes The details of the IRB/oversight body that provided approval or exemption for the research described are given below: This study was approved by the Mount Sinai Program for the Protection of Human Subjects (IRB #20-01758) and Yale Institutional Review Board (IRB #2000029451 for MY-LC; IRB #2000028924 for enrollment of pre-vaccinated Healthy Controls). Informed consent was obtained from all enrolled participants. I confirm that all necessary patient/participant consent has been obtained and the appropriate institutional forms have been archived, and that any patient/participant/sample identifiers included were not known to anyone (e.g., hospital staff, patients or participants themselves) outside the research group so cannot be used to identify individuals. Yes I understand that all clinical trials and any other prospective interventional studies must be registered with an ICMJE-approved registry, such as ClinicalTrials.gov. I confirm that any such study reported in the manuscript has been registered and the trial registration ID is provided (note: if posting a prospective study registered retrospectively, please provide a statement in the trial ID field explaining why the study was not registered in advance). Yes I have followed all appropriate research reporting guidelines and uploaded the relevant EQUATOR Network research reporting checklist(s) and other pertinent material as supplementary files, if applicable. Yes All data produced in the present study are available upon reasonable request to the authors. [1]: #ref-1 [2]: #ref-3

Very excited to share our latest research on immunological features of #LongCovid. Our 2+ year collaboration with @PutrinoLab with many other fantastic colleagues and patients - Mount Sinai Yale Long COVID (MY-LC) study by @sneakyvirus1 et al. 🧵(1/) https://t.co/8cGj51HyGn— Prof. Akiko Iwasaki (@VirusesImmunity) August 10, 2022

This cohort study examines the association between ambulatory COVID-19 and risk of venous thromboembolism.

The BA.5 bivalent booster is rolling out just after Labor Day in the US, as we learned this evening https://t.co/CiY2snwrws Here are some thoughts on the potential merits and disadvantages for this plan pic.twitter.com/bE1aITMFIA— Eric Topol (@EricTopol) August 24, 2022

Keeping up with COVID-19 vaccines can be a daunting task. To help people keep up, Yale Medicine mapped out a comparison of the five most prominent ones.

The Technical Advisory Group for Emergency Use Listing listed Nuvaxovid (NVX-CoV2373) vaccine against COVID-19 and Covovax (NVX-CoV2373) vaccine against COVID-19 for emergency use on 20 December 2021 and 17 December 2021 respectively. The Novavax vaccine will be manufactured in two different facilities. In Europe, the vaccine will be manufactured under the trade name Nuvaxovid and has been approved by the European Medicines Agency, and in India, the vaccine will be manufactured by Serum Institute of India under the trade name Covovax and has been approved by the Drugs Controller General of India. The WHO Strategic Advisory Group of Experts on Immunization (SAGE) has issued interim policy recommendations for the use of the Novavax (NVX-CoV2373) vaccine. This article provides a summary of those interim recommendations. For the purposes of this article, the vaccine will be referred to as Novavax (NVX-CoV2373).

I would definitely recommend taking the new #BA5 booster in 2-3 weeks. Definitely get the updated shot instead of the old Wuhan 1.0 shot if you can. UK and European approval unclear for BA5 booster. US will definitely be the first for BA5 shot.— Eric Feigl-Ding (@DrEricDing) August 24, 2022

The development of vaccines against SARS-CoV-2 would be greatly facilitated by the identification of immunological correlates of protection in humans. However, to date, studies on protective immunity have only been performed in animal models and correlates of protection have not been established in humans. Here, we describe an outbreak of SARS-CoV-2 on a fishing vessel associated with a high attack rate. Predeparture serological and viral RT-PCR testing along with repeat testing after return to shore was available for 120 of the 122 persons on board over a median follow-up of 32.5 days (range 18.8 to 50.5 days). A total of 104 individuals had an RT-PCR positive viral test with Ct

Understanding of the most probable transmission routes and identifying the risk environments for disease spread should always be among the first critical steps in the response to future disease threats. This is one of the most vital public health lessons of the COVID-19 pandemic: with a well-informed understanding of the dominant mode(s) of transmission of an infectious disease, effective control strategies can quickly be specified, higher risk activities and environments can be defined, and public health leaders may then set the course for a response that aims to efficiently and rapidly mitigate widespread transmission. Laboratory, field, modeling, and case studies have demonstrated that airborne transmission via inhalation of virus-laden aerosols is important, if not dominant, for COVID-19.1,2,3,4,5,6,7,8 Aerosols are small respiratory particles that are suspended in the air and can be carried on air currents over long distances.9 They are released into the air during normal respiratory activities. Aerosols produced by infected individuals may contain pathogens and can be inhaled by others to cause new infection; when this occurs, it is known as airborne transmission. This can occur in both the near-field (within the vicinity of the infection source) and far-field (greater distance away from the infection source). To combat the risk of airborne transmission of COVID-19, control strategies that reduce the concentration of (and therefore, the likelihood of inhaling) potentially infectious respiratory aerosols must be implemented. Increased outdoor air ventilation to dilute aerosols and reduce their concentration and/or enhanced filtration efficiency to remove particles from recirculated air have been shown to be effective as part of an overall strategy to reduce risk. These strategies should be prioritized in occupied environments in which aerosols accumulate most rapidly: indoor spaces with low outdoor air ventilation and/or low levels of (or no) filtration.10,11,12,13 Despite significant progress across other elements of pandemic response – including vaccines and boosters, rapid tests, treatments, and expanded access to high efficiency masks – ventilation and filtration have remained insufficiently addressed, even more than two years into the pandemic. This has finally shifted following the March 2022 Biden-Harris Administration launch of the Clean Air in Buildings Challenge, a key component of the National COVID-19 Preparedness Plan. This initiative calls on all building owners and operators across the domains of school, work, and travel to adopt key strategies to improve indoor air quality in their buildings and reduce the spread of COVID-19.14 The Administration’s announcement quickly elevated the discussion around the importance of indoor air quality and advanced a new framework for recognizing and rewarding science-based efforts in buildings that promote health and safety and improve resilience to future pandemics. In light of the announcement of this new recognition system for buildings, experts from the Lancet COVID-19 Commission’s Task Force on Safe School, Safe Work, and Safe Travel have identified the following four key actions that represent the most effective, fundamental steps toward promoting healthier indoor environments and reducing the risk of airborne infectious disease transmission indoors.

Kann man sich gegen #COVID19 zu oft impfen lassen?Wissenschaftler aus Freiburg haben dazu in eine Studie veröffentlicht. "Wir sehen nach der vierten #Corona-Impfung kein Verschwinden der Immunantwort und auch kein erhöhtes Risiko für Nebenwirkungen",…#ImpfenSchuetzt pic.twitter.com/p90TCueEbm— Ralf Wittenbrink (@RWittenbrink) August 16, 2022

Pediatric Research - SARS CoV-2 detected in neonatal stool remote from maternal COVID-19 during pregnancy