Category: Corona Virus

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Trivalent coronavirus vaccine created by Duke scientists shows promising early results - WTVD-TV

In a recent study published in JAMA Network Open, researchers examined the willingness to accept the coronavirus disease 2019 (COVID-19) vaccine and reasons for hesitancy in Hong Kong.

Study:COVID-19 Vaccination Willingness and Reasons for Vaccine Refusal. Image Credit:Anishka Rozhkova/Shutterstock.com

Hong Kong has been exemplary in its response to the COVID-19 pandemic until the highest daily mortality was recorded in the city. COVID-19 deaths per capita in Hong Kong are also far higher than in other high-income Asia-Pacific economies.

Hong Kongs poor vaccination coverage in older populations might account for the observed COVID-19 mortality.

Specifically, over 82% of older adults 80 were non-vaccinated or had only received one vaccine dose, compared to 6.7% in England, 9% in Singapore, and 2.9% in New Zealand. A possible explanation for vaccine refusal could be the sustained periods of zero-COVID, i.e., no local cases, in Hong Kong.

Moreover, Hong Kong witnessed a major social upheaval before COVID-19, as a proposed bill on extradition triggered extensive social unrest for over 50 years.

As such, people in Hong Kong were polarized and mistrustful of authorities. Thus, this scenario presents a unique opportunity to investigate how political views and mistrust influence vaccination.

The present study explored COVID-19 vaccination willingness and refusal in Hong Kong. Around 18,045 individuals aged 15 or older and 1,488 children aged 10-14 were enrolled in 2009-11 and followed up until 2014.

Some of these were randomly followed up for over a decade. During COVID-19, participants were interviewed between February 2020 and May 2022. Cooperation and response rates were estimated according to standards.

Vaccine refusal in Hong Kong was compared with Singapore. The Singaporean sample was drawn from a 2016 study on mental health. The studys primary outcomes were vaccination prevalence and vaccine refusal. Refusal was described as a lack of intention to receive the vaccine.

Willingness to accept the COVID-19 vaccine was defined as having received at least one dose, scheduled an appointment for vaccination, or intent to be vaccinated.

Political views were analyzed during the 2019-20 social unrest based on whether subjects were for (pro-establishment), against (non-establishment), or neutral. Trust in vaccine information sources (media platforms, the World Health Organization [WHO], health authorities, academics, and physicians) was assessed.

COVID-19 vaccine confidence was analyzed using statements on perceived efficacy, importance, and safety of vaccines.

Vaccine misconceptions about chronic diseases, older adults, and safety were also evaluated. The team calculated the weighted prevalence of COVID-19 vaccine willingness throughout the pandemic.

Poisson regression was used to investigate the associations between political views and trust in vaccine information sources, vaccine misconceptions, vaccine refusal, and vaccine confidence.

In total, over 28,000 interviews were conducted. The median cooperation and response rates were 63.4% and 75.7%, respectively. In 2020, nearly two-thirds of Hong Kong adults were willing to vaccinate when available.

Willingness increased to over 73%, coinciding with positive vaccine trial results. Nevertheless, willingness dropped to 55% after the Hong Kong government announced that people could not choose which vaccine to receive.

Moreover, willingness reached the lowest level (43.6%) by the start of the vaccination program and media reports of adverse vaccine effects. Individuals with non-establishment political views were more likely to refuse vaccination than those with pro-establishment views. Political participation during the 2014 Occupy Central protests was associated with COVID-19 vaccine refusal.

In Hong Kong, physicians and academics were the most trusted sources of vaccine information, followed by the WHO, government authorities, and social media.

In Singapore, academics and government authorities were the most trusted sources of vaccine information, followed by traditional media, WHO, and social media. Vaccine confidence was the highest before the rollout of COVID-19 vaccines and declined to the lowest levels at the start of vaccination programs.

There was an association between low vaccine confidence and vaccine refusal. Nearly 59% of Hong Kong adults had at least one misconception about vaccines, compared to 16.6% of Singaporean adults.

Further, over 56% of participants opposed vaccination of older adults (above 80 years). Social media, family/friends, and physicians were the top sources of misconceptions regarding priority groups.

Mistrust in health authorities, low vaccine confidence, and misconceptions mediated 72.5% of the association between political views and vaccine refusal. As such, the direct association between political views and vaccine refusal was no longer significant.

Political views, mistrust in health authorities, vaccine misconceptions, and low vaccine confidence jointly accounted for about 82% of vaccine refusal in adults aged 18-59 and 69.3% in older populations ( 60 years).

The study showed that political views may have short- and long-term associations with refusal to vaccinate against COVID-19.

This association was primarily mediated by modifiable factors, such as vaccine misconceptions, low vaccine confidence, and mistrust of health authorities.

Building trust in health authorities is vital to offset vaccine refusal. Moreover, governments should prioritize the credibility of health agencies, which would help them improve vaccination coverage.

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What were the reasons for COVID-19 vaccine refusal in Hong Kong? - News-Medical.Net

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ANOTHER VIEW: Billions in coronavirus money still sitting around - Kankakee Daily Journal

Research led by Weill Cornell Graduate School of Medical Sciences shows that certain species of gut fungi, notably Candida albicans, increase in numbers during serious COVID-19 infection and appear to contribute to the excessive and damaging inflammation seen in these patients.

High levels of immunoglobulin G (IgG) antibodies against fungi such as C. albicans and reprogramming of granulocyte myeloid progenitor cells were seen in patients with severe COVID-19 for as long as a year after the initial infection with SARS-CoV-2.

When model mice were colonized with samples of these fungi from patients with COVID-19, they also had an excessive immune reaction during SARS-CoV-2 infection showing high neutrophil levels and associated lung damage.

Studies have reported substantial involvement of the GI tract in the pathophysiology of several inflammatory diseases, including severe COVID-19, write Iliyan Iliev, an associate professor at Weill Cornell Medicine, and colleagues in Nature Immunology.

Patients with COVID-19 present with altered gut microbial composition and gut barrier dysfunction, which could increase the translocation of bacterial products and toxins into the circulation and exacerbate the inflammatory response systemically and at distal sites.

Much research has been and is being carried out on the gut microbiome and its effect on different diseases. Much of the attention has focused on gut bacteria, but fungal species also play an important role.

In this study, Iliev and colleagues analyzed stool samples from patients with serious COVID-19 to assess microbial composition and found abnormally high levels of C. albicans and other gastrointestinal-related fungal species (not common inhaled airborne species), as well as an associated high level of immune reactivity to these fungi.

Treatment with the drug tocilizumab, which targets the interleukin-6 (IL-6) pathway, reduced levels of C. albicans immune reactivity in both humans and mice.

IL-6 is a pleiotropic cytokine with a variety of roles in the immune system that has been linked to tissue damage and immune cell activation in severe COVID-19, explain the authors. Specifically, we found that systemic and lung neutrophilia prompted by intestinal C. albicans expansion was dependent on the IL-6 receptor.

Although it is not the only cause of inflammation in these patients, targeting any excess inflammation can be helpful for COVID-19 patients. Testing for antifungal antibodies could help tailor therapy and highlight who may benefit from antifungal or specific anti-inflammatory therapies such as those targeting the IL-6 pathway.

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Gut Fungi Can Amplify Excessive Inflammation Seen in Severe ... - Inside Precision Medicine

We show that symptomatic SARS-CoV-2 infection in England in adults is usually short-lived with most people reporting a short illness with symptom resolution within 2 weeks. However, in our study population, one in 10 people with symptomatic SARS-CoV-2 infection report symptoms for more than 4 weeks, one in 13 for more than 12 weeks (meeting the WHO definition for post COVID-19 condition (Long COVID)10), and 1 in 20 for more than 52 weeks. In our study population, 69% of those with persistent symptoms at 12 weeks still had symptoms at 52 weeks, meaning that 31% recovered within a year. We found that female sex, higher deprivation, having a pre-existing health condition, more severe symptoms at onset, and being infected when the original Wild-type variant was dominant was associated with having symptoms persisting for 12 weeks and 52 weeks. The above variables have previously been identified as risk factors for Long COVID2,7,11,12,13. We found a suggestion of lower reporting of persistent symptoms in older ages unlike another population-based study in the UK which found a positive linear association between age and Long COVID7.

The variant at the time of infection, initial severity and presence of pre-existing health conditions had the biggest impact on persistent symptoms, consistent with previous findings6,7,14,15. Compared to Wild-type, those infected when Omicron was dominant were 88% less likely to report symptoms beyond 12 weeks; this may reflect changing immunity in the population from previous exposure to the virus and vaccination. A recent case-control study conducted in the UK found lower odds of Long COVID with the Omicron versus the Delta variant, ranging from OR 02 (95% CI 02, 03) in those vaccinated >6 months prior to infection to 05 (95% CI 04, 06) in those vaccinated <3 months prior to infection16. We did not find conclusive evidence of effectiveness of vaccination against Long COVID. Vaccination reduces the severity of COVID-1917 and it may be through this indirect route that it has an impact on the risk of persistent symptoms post-infection. However, recent systematic reviews suggest that vaccination before SARS-CoV-2 infection could reduce the risk of subsequent Long COVID13,18,19.

The reporting of current symptoms was high across all groups in our study. For example, while 669%, 549% and 546% of individuals with ongoing persistent symptoms post-COVID-19 reported currently experiencing mild fatigue, difficulty thinking or concentrating and joint pains, respectively, the prevalence of these symptoms in those who never had COVID-19 was also high, at 311%, 152% and 355%. Indeed, a high level of symptom reporting was also observed for those who had recovered from COVID-19; the prevalence of mild fatigue, difficulty thinking or concentrating and joint pains in those with asymptomatic SARS-CoV-2 infection or who had recovered from COVID-19 within 4 weeks was 383%, 213% and 344%, respectively. These findings of high symptom prevalence in comparison groups have been observed elsewhere7,20,21, and could be due to higher participation in studies of people with current symptoms. Alternatively, this may reflect the timing of our survey which included months with high levels of upper-respiratory and influenza-like illness in the population. However, our data did show that the most specific persistent symptoms following COVID-19 were loss or change of sense of smell or taste, shortness of breath, severe fatigue, and difficulty thinking or concentrating, which were nine, seven, six and five times more likely, respectively, than in other participants. Of the few studies with a COVID-19-negative comparator group, one showed that COVID-19 cases had a higher likelihood of mood disorder, anxiety, and insomnia when compared to people with influenza or respiratory tract infection22. Another study found that in comparison to community controls, COVID-19 cases had a higher prevalence of symptoms at 6- and 9-months, including fatigue, sleep difficulties, hair loss, smell disorder, taste disorder, palpitations, chest pain, and headaches23.

There were substantial differences in currently reported health and well-being between individuals reporting ongoing persistent post-COVID-19 symptoms and those who had never had COVID-19 or had recovered, consistent with published evidence7,14,24. Encouragingly, those whose symptoms had resolved, even after 52 weeks, had general health and quality of life scores similar to those with no COVID-19 history or who recovered quickly. The dyspnoea and post-exertional malaise (PEM) scales were asked of everyone reporting shortness of breath (Dyspnoea 12) or fatigue, and individuals reporting persistent symptoms following COVID-19 scored higher (i.e. worse symptoms) than others, suggesting these symptoms may be more specific. A meta-analysis of 12 studies that evaluated health-related quality of life in individuals with Long COVID reported a pooled prevalence of poor quality of life (EQ5D Visual Analogue Scale - EQVAS) of 59% (95% CI 42, 75)24. Similarly, the Long-COVID in Scotland study found that symptomatic SARS-CoV-2 infection was associated with a wide range of impaired daily activities and reduced health-related quality of life7.

A strength of our study is that we have addressed some of the limitations of existing studies by having a comparison group and including people in the general population who had severe, mild, and asymptomatic SARS-CoV-2 infections. We compared contemporaneous symptom profiles of community-based adults reporting ongoing persistent symptoms post-COVID-19 versus those who have never had COVID-19 or have recovered. Our study is the largest yet to look at these questions and goes further than previous questionnaire-based studies with COVID-19 negative8 and never-infected7 controls by identifying factors associated not only with recovery (yes/no) but rate of recovery. Indeed, our findings highlight the importance of having a comparator cohort of participants who tested negative and experienced the pandemic and national lockdowns. However, we acknowledge the possibility of misclassification bias in our comparator groups as infections may have gone undetected particularly in stages of the pandemic when free universal testing was not available in the UK.

We also recognise that the subjective nature of symptoms creates the potential for reporting and recall bias. We used information regarding presence and duration of symptoms rather than whether participants described themselves as having Long COVID to reduce potential reporting bias. The data on symptoms at the time of PCR testing were retrospective which introduces the possibility of recall bias, although we have previously shown that REACT participant reports of symptom onset date closely mirrored the epidemic curve25. There is also a risk that recall bias may have differentially affected reporting of symptoms by participants infected at different times, along with other time-varying factors, such as behaviour, seasonal weather patterns and changing pandemic restrictions, knowledge and expectations26, which may account for at least part of the association between persistent symptoms and Wild-type infection. However, studies looking at individuals with confirmed infections of different SARS-CoV-2 strains also show lower risks with more recent variants27,28.

We used validated instruments to assess mental health29,30, quality of life31. dyspnoea32, and fatigue33 but recognise the limitations of self-reporting and floor and ceiling effects (i.e, if a higher percentage of individuals achieve either maximum or minimum scores). The PHQ-9 scale used is a diagnostic tool for depression. However, some of the somatic questions have been found to be strongly correlated with symptoms that are common in Long COVID, including fatigue, sleep disruption and brain fog34. As such, by using this scale we might be overestimating the level of depression. This issue was raised by Reem et al. who suggest the PHQ-235 screening criteria may be more appropriate for Long COVID as they do not include somatic items and simply require a score of 3 or more from the first two questions of PHQ-934. The percentage of participants in our study across all COVID-19 categories with a PHQ-2 score 3 was lower than the percentage with PHQ-910 and the difference was more marked in those with ongoing persistent symptoms post-COVID-19 (Supplementary Table7, Supplementary Table8).

Our questionnaire response rate was 346%; response rates in the Long-COVID in Scotland Study and a Dutch population-based cohort were 16% and 33-39%, respectively7,8. Like these studies, our participants were more likely to be female, older, of white ethnicity and from the least deprived areas compared with the general adult population. These issues might cause selection bias in our study; however, we did not observe substantial differences between those invited and those who participated in the study on the measured sociodemographic characteristics (Supplementary Table1).

A further limitation is that we do not present estimates for the population prevalence of persistent symptoms. To do so would require weighting but production of weights is far from straightforward given the composition of our sample. The probability of being in the sample was dependent upon the composition of the base population, varying response rates by sociodemographic group and across REACT-1 and REACT-2 rounds. We also oversampled participants who tested positive for SARS-CoV-2 and who reported persistent symptoms. Producing weights that take account of all these factors would involve making extensive assumptions which would likely introduce unknown biases.

In summary, our study provides timely data about the effect and implications of the pandemic on adults in England with and without ongoing persistent symptoms following COVID-19. Although COVID-19 is usually of short duration, some adults experience persistent and burdensome illness, although a sizeable proportion still recover after a prolonged period. Differences in symptoms and recovery are being further explored in an in-depth interview study with REACT participants to further understand the varying presentations and trajectories of post-COVID conditions36.

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Long-term health impacts of COVID-19 among 242,712 adults in ... - Nature.com

During the coronavirus pandemic, the Dutch government was so focused on keeping acute care available that it was blind to the other effects of its coronavirus policy. By focusing its policy on available ICU places, the government ignored other issues like health problems due to delayed care, Long Covid, and broader social problems. That is the conclusion of the Dutch Safety Board (OVV) in its third and final report on the Netherlands handling of the pandemic. The third report focused on the period from January 2020 to September 2022.

During the coronavirus crisis, the Cabinet stuck to the chosen short-term strategy for too long, the OVV concluded. That approach meant that new risks and resulting damage were insufficiently included in the crisis approach.

Spurred by images from Bergamo in Italy, where hospitals overflowed and there were so many Covid-19 deaths that there werent enough coffins in March 2020, the Cabinet wanted to prevent coronavirus patients from not having access to hospital care at all times. If there was no room in the ICUs, doctors would have to decide who to save - an almost impossible task from an ethical point of view. In the end, it never came to that.

As the coronavirus crisis continued, the governments strategy remained unchanged even while other problems emerged. Social unrest grew due to the lockdowns, the possible introduction of a policy allowing only vaccinated people access to things like the catering industry, and the curfew. The unrest regularly devolved into violent riots. But, these problems did not play a role in developing coronavirus measures. The Cabinet did not adjust the strategy accordingly, the OVV said.

The OVV also criticized the government for neglecting overworked healthcare workers and delayed care. The Cabinet did not sufficiently pick up signals from healthcare workers and continued to rely on their resilience. That is especially risky in a long-term crisis.

In future health crises, the OVV advised the government to examine more often whether it was still on the right course. Regularly check whether the chosen goal is still the right one. With national crises, the OVV recommended spreading responsibility over the entire Cabinet - in the coronavirus pandemic, the Minister of Health had most of the burden. Explain dilemmas and risks more clearly, and also look at the social consequences of pandemic measures, not just the health risks.

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Dutch gov't blind to long-term consequences of coronavirus ... - NL Times

GRANT PECK, Associated Press

17 hours ago

File - Family members and colleagues wait to welcome released prisoners from Insein Prison in Yangon, Myanmar Tuesday, Aug. 1, 2023. Military-ruled Myanmar on Tuesday, Oct. 24, 2023, allowed prisoners to have visitors from outside, a right that had been suspended for 3 1/2 years due to the coronavirus pandemic, the military's information office and prison officials said. (AP Photo/Thein Zaw)

BANGKOK (AP) Military-ruled Myanmar on Tuesday allowed prisoners to have family visitors from outside, a right that had been suspended for 3 years because of the coronavirus pandemic, the militarys information office and prison officials said.

The rule allowing visitors carries detailed conditions, but its the first opportunity for many of the thousands of political detainees who have been locked up for opposing the militarys 2021 seizure of power to meet with their family members.

Visitors must be able to provide proof of COVID-19 vaccinations and a household relationship to the prisoner being met. Further documentation is required from the visitors local administration offices and police precincts.

A family member of a prisoner convicted of incitement and high treason for protesting military rule told The Associated Press that she was allowed to meet her son for about 20 minutes in a large room after waiting for about two hours with more than 100 other visitors. She visited a prison in Thayarwaddy township in Bago region, about 95 kilometers (60 miles) north of Yangon, the countrys biggest city.

She said she was happy to see her son again after more than a year and to be able to bring him medicine and money, since she last saw him at his trial in August last year.

Visitors had to speak to the prisoners through two wire mesh dividers about a foot (30 centimeters) apart, the woman said.

She spoke on the condition of anonymity because of concern about being identified since the military prefers to be the sole source of information on sensitive subjects.

The mother said she was told by the prison authorities that the inmates would be allowed to receive visitors once a month. Before the pandemic, they were allowed to meet their families at least twice a month.

The Assistance Association for Political Prisoners, a group that keeps detailed tallies of arrests and casualties linked to the repression of the military government, said that 25,337 people had been arrested since the 2021 takeover, and 19,616 of them, including ousted national leader Aung San Suu Kyi, were still in detention as of Tuesday.

Tun Kyi, a senior member of the Former Political Prisoners Society, a mutual support group, said any easing of prison conditions should be regarded as an effort by the military government to score political points and ease international pressure. Many Western nations apply economic and diplomatic sanctions on the countrys ruling generals because of their 2021 takeover and record of human rights abuses.

There is nothing to be happy or welcome about this case, which is intended to ease international pressure, Tun Kyi said.

Family visitation rights were suspended after the coronavirus pandemic began in early 2020. Most sectors of society gradually reduced or dropped testing requirements and other virus-fighting measures since 2022, but family visits to prisoners had remained banned.

Although prisons, in Myanmar as elsewhere, saw the coronavirus spread easily because of crowding and poor hygienic conditions, the continuation of the ban on visits had been widely seen as meant to demoralize political prisoners and highlight the punishment awaiting those who challenge military rule. Protests against the armys takeover were initially nonviolent, but after they were suppressed with deadly force, an armed resistance movement arose, which now operates throughout much of the country.

The total number of prisoners held in Myanmar, not only political detainees, isnt publicly known. There are about 66 prisons and 48 labor camps in Myanmar. Prison Department officials from Yangon, Magway region and Mon state told the AP on Tuesday that the visits have already begun. They spoke on condition of anonymity because they werent authorized to release information.

The militarys information office said in a statement sent to journalists that the in-person meetings with inmates at the prisons have been allowed to begin, but visitors must have been vaccinated twice for coronavirus and must be included in the same official household lists as the prisoners. It said other details of the visiting rules are posted on signboards in front of the prisons.

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Myanmar reinstates family visits to prisoners to end a ban started during the pandemic - ABC27

Wenstrup Announces Subpoena After NIH Stonewalls Investigation ...  House Committee on Oversight and Reform |

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Wenstrup Announces Subpoena After NIH Stonewalls Investigation ... - House Committee on Oversight and Reform |

The Influence of the COVID-19 Pandemic on Seasonal Influenza ...  Cureus

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The Influence of the COVID-19 Pandemic on Seasonal Influenza ... - Cureus

Gastrointestinal Manifestations and Outcomes of COVID-19: A ...  Cureus

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Gastrointestinal Manifestations and Outcomes of COVID-19: A ... - Cureus