Category: Corona Virus

Throughout the pandemic, one of the key questions on everyones mind was why some people avoided getting COVID, while others caught the virus multiple times.

Through a collaboration between University College London, the Wellcome Sanger Institute and Imperial College London in the UK, we set out to answer this question using the worlds first controlled challenge trial for COVID where volunteers were deliberately exposed to SARS-CoV-2, the virus that causes COVID, so that it could be studied in great detail.

Unvaccinated healthy volunteers with no prior history of COVID were exposed via a nasal spray to an extremely low dose of the original strain of SARS-CoV-2. The volunteers were then closely monitored in a quarantine unit, with regular tests and samples taken to study their response to the virus in a highly controlled and safe environment.

For our recent study, published in Nature, we collected samples from tissue located midway between the nose and the throat as well as blood samples from 16 volunteers. These samples were taken before the participants were exposed to the virus, to give us a baseline measurement, and afterwards at regular intervals.

The samples were then processed and analysed using single-cell sequencing technology, which allowed us to extract and sequence the genetic material of individual cells. Using this cutting-edge technology, we could track the evolution of the disease in unprecedented detail, from pre-infection to recovery.

To our surprise, we found that, despite all the volunteers being carefully exposed to the exact same dose of the virus in the same manner, not everyone ended up testing positive for COVID.

In fact, we were able to divide the volunteers into three distinct infection groups (see illustration). Six out of the 16 volunteers developed typical mild COVID, testing positive for several days with cold-like symptoms. We referred to this group as the sustained infection group.

Out of the ten volunteers who did not develop a sustained infection, suggesting that they were able to fight off the virus early on, three went on to develop an intermediate infection with intermittent single positive viral tests and limited symptoms. We called them the transient infection group.

The final seven volunteers remained negative on testing and did not develop any symptoms. This was the abortive infection group. This is the first confirmation of abortive infections, which were previously unproven. Despite differences in infection outcomes, participants in all groups shared some specific novel immune responses, including in those whose immune systems prevented the infection.

When we compared the timings of the cellular response between the three infection groups, we saw distinct patterns. For example, in the transiently infected volunteers where the virus was only briefly detected, we saw a strong and immediate accumulation of immune cells in the nose one day after infection.

This contrasted with the sustained infection group, where a more delayed response was seen, starting five days after infection and potentially enabling the virus to take hold in these volunteers.

In these people, we were able to identify cells stimulated by a key antiviral defence response in both the nose and the blood. This response, called the interferon response, is one of the ways our bodies signal to our immune system to help fight off viruses and other infections. We were surprised to find that this response was detected in the blood before it was detected in the nose, suggesting that the immune response spreads from the nose very quickly.

Lastly, we identified a specific gene called HLA-DQA2, which was expressed (activated to produce a protein) at a much higher level in the volunteers who did not go on to develop a sustained infection and could hence be used as a marker of protection. Therefore, we might be able to use this information and identify those who are probably going to be protected from severe COVID.

These findings help us fill in some gaps in our knowledge, painting a much more detailed picture regarding how our bodies react to a new virus, particularly in the first couple of days of an infection, which is crucial.

We can use this information to compare our data to other data we are currently generating, specifically where we are challenging volunteers to other viruses and more recent strains of COVID. In contrast to our current study, these will mostly include volunteers who have been vaccinated or naturally infected that is, people who already have immunity.

Our study has significant implications for future treatments and vaccine development. By comparing our data to volunteers who have never been exposed to the virus with those who already have immunity, we may be able to identify new ways of inducing protection, while also helping the development of more effective vaccines for future pandemics. In essence, our research is a step towards better preparedness for the next pandemic.

Excerpt from:

We finally know why some people got COVID while others didn't - The Conversation

The travel record timing is tough considering we're in the middle of a summer Covid-19 surge.

According to the CDC, cases have been rising for weeks in at least 38 states, particularly in the west and south.

Hospitalizations and deaths are also up.

The CDC says most cases are made up of 2 new variants.

The center suggests Americans 6-months and up should get updated Covid-19 and flu shots this fall.

Originally posted here:

Summer Covid-19 cases on the rise | National News | wfmz.com - 69News WFMZ-TV

June 27, 2024 Like clockwork, the summer resurgence of COVID-19 has become as expected as the changing of seasons.

Emergency rooms are seeing a 15% increase in treating people who have COVID, and hospitalizations for severe cases are up 25%. Signs of the virus that causes COVID found in the nationswastewater are also trending upward, mirroring a curve seen last summer as well.

The highest reported rates ofpositive COVID tests are in the region that includes California, Nevada, Arizona, and Hawaii, where 10% or more of tests are showing positive. The positive rate remains below 10% throughout the rest of the U.S., and less than 5% of tests are positive throughout most of the Southeastern U.S. and up the coast to Pennsylvania.

The counts are modest compared to previous summer COVID waves, but the rise is still large enough to translate into a meaningful increased risk.

Most U.S. states are having weekly COVID deaths, but numbers are dramatically down from the height of thousands per week earlier in the pandemic. For the week ending June 15, each U.S. state reported fewer than 10 deaths due to COVID.

But the illness still poses serious health threats, andresearch continues to show that it is more dangerous than the flu. In addition to staying up to date on vaccination, the CDC recommends practicing good hygiene, such as thorough hand-washing, and staying home and away from others if you have symptoms of a respiratory illness.Wearing a mask is still a good prevention strategy, the CDC says.

Certain groups of people, such as those who are older or who have weakened immune systems, are particularly at risk for severe and potentially life-threatening cases of COVID. Thats why knowing if you have COVID and staying home is important because you can help prevent illness in people most at risk, according to COVID expertAndy Pekosz, PhD, of the Johns Hopkins Bloomberg School of Public Health. At-home tests may have extended expiration dates that are different from the ones printed on the package. Check this FDA database to see if a test is still OK to use.

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What to Know About the Current Summer COVID Wave - WebMD

Reported coronavirus cases statewide increased by more than 100, from 794 to 911 in the week ending June 22. Thats an increase of 137 cases and a percentage increase of 17.25%.

In the 10 communities covered by The Sun Chronicle in that same period, reported cases increased by 12, from 17 to 29. Thats a percentage increase of 70.58%.

The 10 local communities covered are: Attleboro, North Attleboro, Mansfield, Norton, Plainville, Foxboro, Norfolk, Wrentham, Seekonk and Rehoboth.

Reported cases in the 10 communities have ranged from 11 to 22 for 13 weeks.

In week 14, they exceeded the 22 by 7 reported cases.

And its the 15th consecutive week the number of reported cases statewide is under 1,000 and the third consecutive week the number of reported cases has gone up, nearing the 1,000 mark.

The number of COVID-19 cases in the area and state, however, is not accurate and the figure is likely higher because of the prevalence of home-testing kits. Not all the positive cases found through home-testing are reported to health officials. Also, many people who become ill with COVID-like symptoms fever, congestion, sneezing, fatigue, body aches, and headaches dont bother testing as the virus has weakened and the symptoms caused by the virus are less severe.

The last 20 weeks statewide, the number of reported cases has gone from 4,999 to 911 cases, which is a decrease of 81.77%.

That percentage has shrunk over the last three weeks.

In the week ending June 22, three towns had zero reported cases. They were Mansfield, Plainville and Rehoboth.

There were 236 coronavirus tests administered by health professionals in the 10 communities covered by The Sun Chronicle, with 29 positives, which is a percentage of 12.28%, or 4.45 points higher than the week ending June 15.

Nationwide, the positive test percentage is 5.4%. Thats an increase of 12 tests from the 17 recorded last week, which equals 70.58%.

For context, the highest number of new cases statewide for one week was recorded on Jan. 14, 2022 at 132,557.

The highest number locally for one week was 3,463, recorded on Jan. 13, 2022.

All told, since the beginning of the pandemic in March 2020, the area has recorded 50,962 cases. Thats 25.38% of the 200,793 population in the 10 communities covered by The Sun Chronicle.

Percentages of the disease in each community range from 22% to 29% (rounded up) and the average is 24.75%

Norfolk is the lowest at 22.03% and Attleboro is the highest at 28.72%.

In the week ending June 22,, the case counts in each of the 10 communities was:

Statewide, the number was 911 confirmed cases with 313 probable cases for a total statewide of 2,159,166 confirmed and probable cases since the beginning of the pandemic in March 2020.

The number of confirmed deaths statewide for the week of June 22 was 8 and the number of probable deaths was 0.

The number of confirmed deaths statewide since the beginning of the pandemic in March 2020 is 23,490 and the number of confirmed and probable deaths is 30,002.

A recent poll for the local 10 communities reported the total number of deaths at 520. Thats a death rate of 1.02%.

Death totals per community covered by The Sun Chronicle were:

Most of the deaths were suffered by those over 65.

George W. Rhodes can be reached at 508-236-0432.

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Statewide reported coronavirus cases near 1000, with a slight rise in Attleboro area - The Sun Chronicle

All Americans ages 6 months and older should receive one of the new COVID-19 vaccines when they become available this fall, the Centers for Disease Control and Prevention said Thursday.

The recommendation comes as the nation faces a summer wave of COVID, with the number of infections rising in at least 39 states and territories.

Most Americans have acquired immunity against the coronavirus from repeat infections or vaccine doses, or both. The vaccines now offer an incremental boost, remaining effective for only a few months as immunity wanes and the virus continues to evolve.

Still, across every age group, a vast majority of Americans who were hospitalized for COVID did not receive one of the shots offered last fall, according to data presented at a meeting Thursday of the CDCs Advisory Committee on Immunization Practices.

Dr. Mandy Cohen, the agencys director, accepted the unanimous advice of the panel on Thursday to recommend another round of immunizations.

Professionals and the public in general do not understand how much this virus has mutated, said Carol Hayes, the committees liaison to the American College of Nurse-Midwives. You need this years vaccine to be protected against this years strain of the virus.

A vaccine by Novavax will target JN.1, the variant that prevailed for months in the winter and spring. The shots to be made by Pfizer and Moderna are aimed at KP.2, which until recently seemed poised to be the dominant variant.

But KP.2 appears to be giving way to two related variants, KP.3 and LB.1, which now account for more than half of new cases. All three variants, descendants of JN.1, are together nicknamed FLiRT, after two mutations in the viruss genes that contain those letters.

The mutations are thought to help the variants evade some immune defenses and spread faster as a result, but there is no evidence that the variants cause more severe illness.

Emergency department visits related to COVID in the week ending June 15 increased by nearly 15%, and deaths by nearly 17%, over the previous weeks totals. Hospitalizations also appear to be increasing, but the trends are based on data from a subset of hospitals that still report figures to the CDC even though the requirement to do so ended in May.

COVID is still out there, and I dont think its ever going away, Dr. Steven P. Furr, the president of the American Academy of Family Physicians, said in an interview.

The biggest risk factor for severe illness is age. Adults ages 65 and older account for two-thirds of COVID hospitalizations and 82% of in-hospital deaths. Yet, only about 40% of Americans in that age group were immunized with a COVID vaccine offered last fall.

This is an area where theres a lot of room for improvement and could prevent a lot of hospitalizations, said Dr. Fiona Havers, a CDC researcher who presented the hospitalization data.

Although younger adults are much less likely to become severely ill, there are no groups completely without risk, CDC researchers said. Children particularly those younger than 5 are also vulnerable, but only about 14% were immunized against COVID last fall.

Many parents mistakenly believe that the virus is harmless in children, said Dr. Matthew Daley, a panelist and senior investigator at Kaiser Permanente Colorado.

Because the burden was so high in the oldest age groups, we lost sight of the absolute burden in pediatric age groups, Daley said.

Even if children do not become ill themselves, they can fuel circulation of the virus, especially once they return to school, Furr said.

Theyre the ones that, if theyre exposed, are more likely to bring it home to their parents and to their grandparents, he said. By immunizing all groups, youre more likely to prevent the spread.

Among children, infants younger than 6 months have been hardest hit by COVID, according to data presented at the meeting. But they are not eligible for the new shots.

It is critical that pregnant persons get vaccinated, not only to protect themselves but also to protect their infants until they are old enough to be vaccinated, Dr. Denise Jamieson, one of the panelists and the dean of the Carver College of Medicine at the University of Iowa, said in an interview.

Among both children and adults, vaccine coverage was lowest among the groups most at risk of COVID: Native Americans, Black Americans and Hispanic Americans.

In surveys, most Americans who said they probably or definitely would not receive the shots last fall cited unknown side effects, not enough studies, or distrust of the government and pharmaceutical companies.

The CDC has said that the vaccines are linked to only four serious side effects, but thousands of Americans have filed claims for other medical injuries they say were caused by the shots.

At the meeting, CDC researchers said they had, for the first time, detected that Pfizers COVID vaccine may have led to four additional cases of Guillain-Barr syndrome, a rare neurological condition, per 1 million doses administered to older adults. (The numbers available for Moderna and Novavax vaccines were too small for analysis.)

The risk may not turn out to be real, but even if it is, the incidence of GBS is comparable to the rate observed with other vaccines, the researchers said.

The CDC has also investigated a potential risk of stroke after vaccination, but the findings thus far are inconclusive, agency scientists said. In any case, the benefit from the vaccines outweighs the potential harms, they said.

The panelists bemoaned the sharp drop in health care providers who counsel patients about the importance of COVID vaccination. Nearly half of providers said they did not recommend the shots because they believed their patients would refuse.

There has also been increasing physical and verbal abuse in hospitals and health care settings, said Dr. Helen Keipp Talbot, a professor of medicine at Vanderbilt University and the committees chair.

Some of our physicians may not be recommending it due to concerns about safety of them and their staff, she said.

Although the panelists unanimously recommended COVID vaccination for people of all ages this time, they debated the feasibility of universal recommendations in the future. The vaccines are much pricier than other shots, and they are most cost-effective when given to older adults.

At an individual level, the Affordable Care Act requires insurers, including Medicare and Medicaid, to cover vaccines recommended by the advisory committee at no cost. But up to 30 million Americans do not have health insurance.

The Bridge Access Program, a federal initiative that makes the vaccines available to underinsured and uninsured Americans, will end in August.

Unless the price of the vaccines drops, the cost of immunizing all Americans may not be sustainable, the panelists said.

As more and more of society is exposed either to vaccine or disease, it will become much less cost-effective, Talbot said. We will need to have a less expensive vaccine to make this work.

This article originally appeared in The New York Times.

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New Covid shots recommended for Americans six months and older this fall - Kathimerini English Edition

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The number of people who are hospitalised and are diagnosed with coronavirus has almost doubled since the end of May, Gikas Magiorkinis, a professor of epidemiology and a member of the expert committee advising the Ministry of Health, said on Saturday.

Intubations are currently at low levels, however it is too early to draw safe conclusions, as they usually have long hospitalizations, he told Praktoreio FM radio.

Based on the data we have, there is a significant possibility that we are experiencing a phase of exponential growth, that is, we will see hospitalizations continue to increase, but we do not expect anything dramatic that will put pressure on the health system, he continued.

This year, there is an upward trend in the epidemiological curve compared to the same period last year when it was downward, Magiorkinis said. The rise in hospsitalizations in the summer of 2023 happened 4 to 5 weeks later compared to 2024. So, there is a shift to the trend to appear earlier. Its too early to say for sure, but we have a significant chance that increased circulation [of Covid-19] will start earlier this summer, he added.

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Covid-19 hospitalizations have doubled since May, expert says - Kathimerini English Edition

Close to 677 million people in India required treatment against tropical diseases such as dengue, chikungunya, and snakebite envenoming in 2021, yet global research about these ailments continues to be heavily underfunded compared to illnesses such as HIV/AIDS. These diseases are termed as Neglected Tropical Diseases (NTDs) by the World Health Organization (WHO).

NTDs primarily affect populations in tropical and subtropical regions, and they have historically received less attention and fewer resources. The affected populations are typically among the poorest in the world. These diseases contribute to a cycle of poverty, as they cause long-term disability, social stigma, and economic burden, which in turn hinders economic development and attracts less commercial investment in treatments and research. They also lead to other health problems such as anaemia, blindness, chronic pain, infertility and disfigurement.

Chart 1 |The chart shows the annual research and development funding for NTDs in 2022 ($, adjusted for inflation). Research and development for NTDs (blue) have been historically underfunded compared to diseases like HIV/AIDS, tuberculosis, and malaria.

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The COVID-19 pandemic received a total research funding of $4.22 billion in 2022. HIV/AIDS, tuberculosis and malaria received funding in the range of $600 million to $1.35 billion that year. Whereas, diseases such as dengue, chikungunya, leprosy and snakebite envenoming received funding in the range of $10 million to $80 million.

Map 2 |The map shows the estimated number of people requiring treatment against NTDs in 2021.

With 677 million people requiring treatments, India tops the charts followed by Nigeria with 139 million, Indonesia with 79 million, Ethiopia with 71 million and Bangladesh with 56 million. Congo, Philippines, Tanzania, Uganda and Pakistan are the other nations in the top ten list. The geographic spread clearly shows that most of the disease burden in the case of NTDs is shouldered by countries in Asia and Africa. Mexico is the only non-Asian, non-African country with a higher share of burden featuring high (14th) on the list. Deaths due to NTDs in Europe, Oceania and North America (except Mexico) are few and far between.

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India tops the charts in terms of dengue deaths with 17,500 such fatalities recorded in 2019. India also tops the charts in leprosy cases with over one lakh cases in 2022. With over 50,000 deaths due to venomous snakes in 2019, the mortality in India is much higher than the distant second Pakistan (2,000 fatalities).

Chart 3 |The chart shows the technologies on which the global research and development funding for infectious diseases was spent.

Most of the global research funding was focused on finding vaccines to counter COVID-19. A sharp increase in vaccine funding to the tune of $5.2 billion was recorded in 2020. In 2022, research funding dropped across all technologies including vaccines. Research money for new drugs, basic research, biologicals and diagnostic platforms declined in 2022.

A lot can be done to alleviate the health burden caused by NTDs. Many can be managed with inexpensive existing interventions or new technologies developed through research. However, these diseases still suffer from a lack of adequate funding, research and development, and global attention. The success of certain initiatives demonstrates what can be achieved with deliberate effort. Examples include the near-eradication of Guinea worm disease and the elimination of river blindness, lymphatic filariasis, and trachoma in many countries.

Also read:Indias health research is not aligned with its disease burden | Data

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Diseases with higher burden in Asia and Africa lack research funding: Data - The Hindu

Baseline regression

Table 2 reports the baseline regression results of the influence of the publics science literacy level on co-production in the fight against COVID-19. With the test logic of econometrics starting from the general to the specific cases, a series of control variables were gradually included in the regression model.

Model (1) only included the core explanatory variables without the addition of any control variables, and the science literacy was significantly positive at 1%. In model (2), six control variables at the objective level of the city were added based on (1), and the science literacy was still significantly positive at 1%. On the basis of (2), model (3) further included three subjective control variablessuch as the publics government trust in the modeland the science literacy was still significantly positive at 1%, consistent with the results of the previous two regression steps. The determination coefficient increased from 0.38 to 0.59, and the fitting degree was thus improved. This indicated that the higher the level of the citys science literacy, the more the co-production against the pandemic. The coefficient of science literacy gradually increased from 0.117 to 0.142, indicating that science literacys influence was increasingly apparent. Model (3) demonstrates that every 1% increase in the publics science literacy can increase the per capita search volume of COVID-19-related keywords by the public by 14.2%, that is, public co-production against the pandemic increased by 14.2%, which verifies H1.

To further address the potential endogeneity problem in the model, a 2SLS model was used to accurately estimate the impact of public science literacy on the public co-production, with the ratio of urban R&D personnel to the annual average population in 2017 as the instrumental variable.

As demonstrated in Table 3, (1) and (2) reported the results of the two-stage regression with the instrumental variable. The regression results of the first stage (1) indicated that the regression coefficient of the proportion of R&D personnel in the city was significantly positive at the 1% level, which denoted that the higher the ratio of urban R&D personnel in the city, the higher the publics science literacy in the city. The correlation hypothesis of the instrumental variable is valid. Meanwhile, the partial R2 is 0.32, and the F-statistic of the significance test is 32.68. The instrumental variable has strong explanatory power. The results of the second stage (2) regression demonstrated that after addressing the endogeneity problem, the positive influence of the publics science literacy on co-production was still significantly positive at 1%. Specifically, with the increase of science literacy by 1%, public co-production increased by 42.5%, which was about three times that of the baseline regression result, which indicated that the promoting effect of the publics science literacy on co-production during COVID-19 may be underestimated due to the endogeneity problem. It was verified that science literacy contributes to promoting co-production against the pandemic. Thus, H1 is supported.

To test the moderating effect of regional educational levels, the proportion of urban secondary school students (Edu_c) was used to measure educational level. The intersection term of regional education level and science literacy was added into the regression model, along with a series of control variables. As illustrated in Table 4, no control variables were added to model (1); only objective control variables were added to model (2), and subjective control variables were further added to model (3). The results demonstrated that the coefficient of the intersection term gradually increased from 0.471 to 1.049, and the significance level gradually rose. The intersection term of model (3) was significantly positive at the 5% level, and the determination coefficient was 0.69, which was better than that of model (3). The coefficient of the interaction term gradually increased from 0.038 to 0.046, and the significance level gradually increased; the determination coefficient increased from 0.51 to 0.62, and the degree of fitting was improved. Model (3) illustrated that the intersection term was significantly positive at the 5% level.

Similar to the approach for testing the moderating effect of regional education level, the number of discredited people (Capacity_c) of the city was used to measure the local government capacity. The greater the number, the worse the local government capacity. As demonstrated in models (4), (5), and (6), the coefficient of the interaction term gradually decreased from 0.009 to 0.020, and the significance level gradually became higher. The interaction term of the model (6) was significantly negative at 1% level.

Figure 3 shows the separate plotting of the moderating effects of regional education level and local government capacity on the publics scientific literacy and co-production in the fight against COVID-19. In the left graph, when Edu_c is greater than 0, the marginal effect is significantly positive within the 95% confidence interval. This means that the marginal effect of the publics science literacy on co-production of fight against COVID-19 gradually increases with the increase of the proportion of the number of students in the city. In the figure on the right, when Capacity_c is <11.77 (The natural logarithmic value of 129,000 is about 11.7, so the number of discredited people at the provincial level in the city is 129,000), the marginal effect is significantly negative within the 95% confidence interval. This means that when the number of provincial-level discredited people in the city is less than 129,000, the marginal effect of the publics science literacy on co-production in the fight against the pandemic gradually increases as the number of discredited people decreases.

Controls were applied for GRP, income level, science and technology level, number of foundations, government network transparency, digital government development level, publics government trust, social trust, and social justice. The dashed line was at a marginal effect of zero. Full regression estimates are provided in Table 4 models with 95% confidence interval.

Both the regression results and the moderating effect graphs indicate that the level of urban education and the local government capacity have a positive impact on the effectiveness of the publics science literacy in promoting co-production fight against COVID-19, supporting hypothesis H2 and H3.

Whether the baseline regression results are affected by sample selection needs to be further tested. As demonstrated in Table 5, owing to a small number of outliers in the explained variables, the explained variables in models (1) and (2) were, respectively, treated with bilateral tail reduction and bilateral censoring at the 5% quantile to avoid the deviation of coefficient estimation, and all control variables were added to perform regression estimation. Additionally, this study further replaced the data and the publics science literacy at the city level with those at the provincial level and added all control variables, as demonstrated in the model (3). Clearly, the coefficients of science literacy are all significantly positive at 1% level, and the baseline regression results are still robust.

The results of the baseline regression are the embodiment of the total effect, and the unique properties of different stages and regions may affect the manifestation of science literacy. This section analyzes the heterogeneity of the stage of the pandemic, geographical location, and city size in terms of the two dimensions of time and space.

With the continuous development of the pandemic situation, the external conditions and the publics willingness in co-production may change. To further explore the dynamic changes of the publics anti-pandemic efforts, this section studies separate regression testing across all stages - including Stage I: Swift Response to the Public Health Emergency (27 December 201919 January 2020), Stage II: Initial Progress in Containing the Virus (20 January20 February 2020), Stage III: Newly Confirmed Domestic Cases on the Chinese Mainland Drop to Single Digits (21 February17 March 2020), and Stage IV: Wuhan and Hubei-An Initial Victory in a Critical Battle (18 March28 April 2020); various models that joined all control variables.

As demonstrated in Table 6, the science literacy coefficients of stages I, II, III, and IV were 0.160, 0.132, 0.152, and 0.160, respectively; they were all significantly positive at 1% level, which indicated that the publics science literacy to the pandemic was effective in all stages. The science literacy coefficient first decreased and then increased. The science literacy coefficient was the same in stages I and IV, and the promoting effect of science literacy on the co-production was relatively obvious, which indicated that the promoting effect of the publics science literacy in different stages was different. In general, the promoting effect of science literacy was statistically significant in the whole process of the fight against the pandemic in each stage, which further verified the correctness of H1.

China is a country with vast territory, and heterogeneity in different regions will affect the publics willingness and cost of co-production in response to the pandemic. The sample cities, based on different characteristics in different geographical locations, were classified into three subregions: eastern, central, and western regions. Specifically, the eastern region includes cities in Beijing, Tianjin, Hebei, Liaoning, Shanghai, Jiangsu, Zhejiang, Fujian, Shandong, Guangdong, and Hainan; the central region includes cities in Shanxi, Jilin, Heilongjiang, Henan, Hubei, Hunan, and Anhui; the western region includes cities in Inner Mongolia, Chongqing, Sichuan, Guangxi, Guizhou, Yunnan, Shaanxi, Gansu, Qinghai, Ningxia, and Xinjiang. Thereafter, subsample regression was performed. All control variables were added to each model.

As demonstrated in Table 7, models (1), (2), and (3) reflect the differences in the publics anti-pandemic effort based on scientific knowledge in the cities across regions. The science literacy coefficients of cities in eastern, central, and western regions were 0.141, 0.250, and 0.193, respectively, and all of them were significantly positive at 1%, which further supported H1. The estimated coefficient of 0.141 in the eastern region was smaller than that in the central and western regions. It is reasonable to suspect that the promoting effect of the publics science literacy is smaller in the eastern region and relatively larger in the central and western regions.

To answer the aforementioned questions, we further explore the differences between regions. By adding the intersection terms of regional dummy variables and science literacy (E_MS_L, E_WS_L, and E_MWS_L), the difference test of regression coefficient between eastern and central, eastern and western, and eastern and central and western regions, was conducted. The results demonstrated that the coefficients of the interaction terms were all significantly positive, which indicated that a statistically significant difference existed in the coefficient of science literacy between the eastern region and other regions, and the science literacy in the central and western regions played a more evident role in the promotion of the public co-production against the pandemic.

The size of a city affects the difficulty of urban governance and challenges the level of governmental governance. Unlike small and medium-sized cities, large cities are more difficult to govern due to their large population, complicated public affairs, and diverse service demands, and various problems will become more prominent. On the contrary, larger cities have stronger incentives to innovate management models with refined management, improved institutional norms, diversified technical means, and higher enthusiasm of the public to participate in urban governance (Zou and Zhao, 2022). Therefore, the scale of the city may also affect the effectiveness of the role of the publics science literacy in co-production, and still the role of science literacy in the promotion of co-production in those cities is not known. In China, the urban hierarchy is relatively complex, mainly consisting of municipalities directly under the central government, provincial capital cities, sub-provincial cities, prefectural level cities and county-level cities. In comparison to most prefectural level cities, municipalities directly under the central government, provincial capital cities, and sub-provincial cities possess unique advantages in terms of economy, politics, culture, and population. In this paper, they are referred to as large cities, including Beijing, Tianjin, Shanghai, Chongqing, Dalian, Qingdao, Ningbo, Xiamen, Shenzhen, Shijiazhuang, Shenyang, Nanjing, Hangzhou, Fuzhou, Jinan, Guangzhou, Haikou, Taiyuan, Changchun, Harbin, Zhengzhou, Wuhan, Changsha, Hefei, Nanchang, Hohhot, Chengdu, Nanning, Guizhou, Kunming, Xian, Lanzhou, Xining, Yinchuan, Urumqi, Lhasa, a total of 36 cities, and all the rest cities are considered non-large cities. Therefore, this paper divided the sample into two subsamples according to aforementioned categorization; large city, and non-large city; and conducted the subsample regression, after adding all the control variables.

As demonstrated in Table 8, models (1) and (2) reflect the differences in the publics co-production based on science literacy in cities of different scales. The science literacy coefficient of large cities was 0.082, and the significance level was 5%. The science literacy coefficient of non-large cities was 0.260, with a significance level of 1%, which also supported H1. The estimated coefficient of 0.082 for large cities was about one-third of that for non-large cities.

To further verify the statistical significance of the difference in the promotion effect of science literacy, the intersection term (L_CityS_L) was added to the model to test the difference. The results demonstrated that the coefficient of the interaction term was significantly positive, indicating that the promoting effect of science literacy on co-production against COVID-19 was stronger in non-large cities but weaker in large cities.

The above results provide us with many interesting findings. The publics science literacy plays an important role in promoting co-production in the fight against pandemic, and there are significant differences in the performance of the effect of this role in different temporal and spatial dimensions. We also found that regional education level and local government capacity can positively moderate the relationship between the two, verifying the previous hypotheses H1, H2, and H3.

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The mass public's science literacy and co-production during the COVID-19 pandemic: empirical evidence from 140 ... - Nature.com

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In a recent study published in the journal Nature Human Behaviour, researchers used a large, binational cohort (total n = 4,731,778) to investigate the short- and long-term associations between SARS-CoV-2 infections and subsequent adverse neuropsychiatric outcomes. They used exposure-driven propensity score matching to compare their samples outcomes against the general population and individuals with a non-SARS-CoV-2 respiratory infection.

Study: Short- and long-term neuropsychiatric outcomes in long COVID in South Korea and Japan. Image Credit:Kateryna Kon/ Shutterstock

Study findings revealed that COVID-19 survivors were at significantly heightened risk of developing cognitive deficits, insomnia, encephalitis, and at least four other neuropsychiatric sequelae. Specific conditions included Guillain-Barr syndrome (aHR, 4.63), cognitive deficit (aHR, 2.67), insomnia (aHR, 2.40), anxiety disorder (aHR, 2.23), encephalitis (aHR, 2.15), ischaemic stroke (aHR, 2.00), mood disorder (aHR, 1.93), and nerve/nerve root/plexus disorder (aHR, 1.47). Encouragingly, vaccination was observed to attenuate the neuropsychiatric effects of the infection. These results are particularly interesting to clinicians and healthcare policymakers as they imply that the early management of COVID-19 may help their patients short- and long-term mental health.

The severe acute respiratory syndrome coronavirus 2 (SARSCoV2) caused coronavirus disease 2019 (COVID-19) pandemic remains one of the worst disease events in recorded human history, infecting approximately 700 million individuals and claiming more than 7 million lives in the three years since its discovery. Unfortunately for its survivors, the condition has been observed to induce long-term physical and psychological ailments that persist well past the diseases primary infection.

This colloquially termed long-COVID has been loosely defined as a multisystemic illness of persistent or newly developed COVID-19 symptoms or comorbidities that remains present for three or more months following recovery from the primary SARS-CoV-2 infection. Alarmingly, the number of long-COVID patients is estimated to be between 18% and 70% of COVID-19 survivors, with recorded numbers (more than 65 million confirmed patients) assumed to be but a fraction of its undocumented global prevalence. Long-COVID thus represents one of the most oppressive healthcare concerns of the modern age.

Long-COVID is a recently described and, therefore, relatively poorly understood disease. A growing body of research demonstrates the association between long-COVID and neuropsychiatric conditions such as depression, insomnia, anxiety, and cognitive dysfunction, with durations often exceeding six months. Unfortunately, previous studies aiming to evaluate psychiatric risks in COVID-19 survivors versus the general populace suffer from small sample sizes, limited follow-up durations, and, most notably, highly biased hospital-derived cohorts. The outcomes of such studies are confounding, thereby damping Long-COVID management and mitigation efforts.

The present binational (South Korea and Japan) study aims to assess the relative risk of adverse neuropsychiatric outcomes in COVID-19 survivors versus the general populace. It also compares this risk between the former cohort and survivors of another respiratory infection (ARI). For this study, primary exposure comprised the onset of laboratory-confirmed COVID-19 (or ARI), while the primary outcome consisted of diagnosing one of 13 groups of neuropsychiatric disorders.

The study dataset was divided between discovery and validation. The discovery dataset was obtained from the K-COV-N cohort, a population-based, nationally representative summation of the South Korean National Health Information Database (n = 10,027,506). The validation dataset was derived from the Japanese claims-based cohort (JMDC; n = 12,218,680). Both datasets included patient-level age (>20 years), sex, income, medical history, region of residence, and insurance claims data. All participant outcomes were recorded using the World Health Organizations (WHOs) International Statistical Classification of Diseases and Related Health Problems (ICD-10) codes.

The study methodology used exposure-driven propensity score matching to establish baseline-corrected comparisons between COVID-19 survivors and the general populace or ARI. This served the dual purpose of evaluating the robustness of observations and generalizing study findings across the large binational sample cohort.

Statistical analyses included the computation of Cox proportional hazards regression models (adjusted hazards ratios [aHR]) to estimate short-term, long-term, and overall neuropsychiatric risk between included sample subgroups (SARS-CoV-2 infection and ARI), thereby inducing reverse causation. Covariates were accounted for by including Charlson comorbidity indices, smoking status, physical activity levels, alcohol consumption, and body mass indices (BMIs) of included participants.

The discovery and validation cohorts initially comprised 10,027,506 and 12,218,680 participants, respectively. Exclusion of individuals with incomplete health records, a previous history of neuropsychiatric disorders, COVID-19 and ARI coinfections, and multiple confirmed COVID-19 reinfections resulted in a final sample size of 4,731,778 participants. The mean age of study participants was found to be 48.4 years, with 50.1% of individuals being male.

Exposure-driven propensity score matching results suggested a 1:4 ratio for COVID-19 versus the general population (discovery/South Korean sample), 1:2 for COVID-19 versus the general population (validation/Japanese sample), and 1:1 across both COVID-19 versus ARI (discovery and validation) comparisons.

Short-term (<30 days following infection recovery) risk assessments revealed that COVID-19 survivors had a substantially elevated risk of neuropsychiatric events (aHR = 2.35) compared to the general populace, with some conditions, particularly encephalitis (aHr = 12.34), Guillain-Barr syndrome (aHR = 11.89) and insomnia (aHR = 5.36) presenting alarmingly increased risk. These findings were consistent (albeit attenuated) with those observed in SARS-CoV-2 infection versus ARI comparisons, with the former presenting an aHR of 1.36 compared to the latter.

Long-term risk assessments similarly revealed that COVID-19 survivors were significantly more likely to retain neuropsychiatric disorders for longer than 30 days when compared to the general populace and ARI (aHR = 1.71 and 1.60, respectively).

Guillain-Barr syndrome had the highest hazard ratio post-COVID-19 diagnosis (aHR, 4.63; 95% CI, 1.6612.98), followed by cognitive deficit (aHR, 2.67; 95% CI, 1.395.15), insomnia (aHR, 2.40; 95% CI, 2.152.69), anxiety disorder (aHR, 2.23; 95% CI, 2.082.40), encephalitis (aHR, 2.15; 95% CI, 1.183.94), ischaemic stroke (aHR, 2.00; 95% CI, 1.642.44), mood disorder (aHR, 1.93; 95% CI, 1.772.09) and nerve/nerve root/ plexus disorder (aHR, 1.47; 95% CI, 1.361.59).

Time attenuation evaluations revealed that while South Korean individuals returned to near general populace risk levels in 12 months following initial infection recovery, the same was not valid for the Japanese cohort. Encouragingly, the patient-level risk of neuropsychiatric events was strongly associated with infection severity and vaccination status risks were lower in mild SARS-CoV-2 infections and when multiple vaccinations were received.

The present study establishes the link between COVID-19 infections and a subsequently heightened risk of neuropsychiatric sequelae development in South Korean and Japanese natives. Furthermore, it is the first to compare this risk between COVID-19 survivors, the general population, and other respiratory infections. While time attenuation results highlight Japanese individuals as having persistent risk even after 12 months of COVID-19 recovery, insights into the associations between infection severity/vaccination status and risk can better equip clinicians and healthcare policymakers to manage their patients and this silent global pandemic.

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New study links COVID-19 to lasting neuropsychiatric issues, highlights vaccination benefits - News-Medical.Net