The Indian Express
October 29, 2020
Scientists find brain abnormalities in COVID-19 patients
They said some of the EEG alterations found in COVID-19 patients may indicate damage to the brain that might not be repaired after recovering from the disease Scientists find brain abnormalities in COVID-19 patients An analysis of more than 80 studies reporting complications experienced by COVID-19 patients has revealed that about one-third of them have abnormalities in the frontal lobe of the brain, findings which shed light on the neurological symptoms of the disease. The review of studies, published in Seizure: European Journal of Epilepsy, focused on abnormalities detected using electroencephalogram (EEG) scans, which are used to evaluate the electrical activity in the brain. "We found more than 600 patients that were affected in this way. Before, when we saw this in small groups we weren't sure if this was just a coincidence, but now we can confidently say there is a connection," said Zulfi Haneef, assistant professor of neurology at Baylor College of Medicine in the US. The scientists explained that patients are recommended an EEG test when they have a slowed reaction to stimuli, followed by seizure-like events, speech issues, confusion, or an inability to wake up after sedation. From the review of studies, the researchers said the most common findings from the EEG were slowing or abnormal electrical discharge, mostly in the frontal lobe of the patients. They said some of the EEG alterations found in COVID-19 patients may indicate damage to the brain that might not be repaired after recovering from the disease. Since the brain cannot regenerate, Haneef cautioned that any damage to the organ will more than likely be permanent. "We know that the most likely entry point for the virus is the nose, so there seems to be a connection between the part of the brain that is located directly next to that entry point," he said. "Another interesting observation was that the average age of those affected was 61, one-third were female and two-thirds were males. This suggests that brain involvement in COVID-19 could be more common in older males," Haneef added. However, the scientists believe more studies are needed to validate the conclusions drawn in the review research. According to Haneef, the virus may not be directly causing the abnormal EEG readings in the brain. He said alterations in oxygen intake, heart problems related to COVID-19, or other side effects may also be involved. "These findings tell us that we need to try EEG on a wider range of patients, as well as other types of brain imaging, such as MRI or CT scans, that will give us a closer look at the frontal lobe," Haneef said. "A lot of people think they will get the illness, get well and everything will go back to normal, but these findings tell us that there might be long-term issues, which is something we have suspected and now we are finding more evidence to back that up," he added.
https://www.tribuneindia.com/news/health/scientists-find-brain-abnormalities-in-covid-19- patients-162346
High intake of vitamins A, E and D linked to fewer respiratory issues
Nutrition has key role in cutting the risk of several infections High intake of vitamins A, E and D linked to fewer respiratory issues Photo for representational purpose only. one of Indian-origin, have found that high intake of vitamins A, E, and D may be linked to fewer respiratory complaints in adults. Nutrition has a key role in cutting the risk of several infections, although exactly how it boosts immunity is complex and not fully understood, the study, published in the journal the BMJ Nutrition, Prevention & Health, reported. "Micronutrient deficiencies are often overlooked as a key contributor to the burden of malnutrition and poor health, presenting an additional layer of challenge during the Covid-19 pandemic," said study author Sumantra Ray from Imperial College London in the UK. The researchers wanted to explore whether the intake of these vitamins from both diet and supplements might be linked to the prevalence of respiratory complaints in a nationally representative sample of UK adults. They drew on information provided by 6,115 adult participants in the 2008-2016 National Diet and Nutrition Survey Rolling Programme (NDNS RP) who had completed three or more days of diet diaries. Respiratory complaints were reported by the participants and had not been diagnosed by a clinician. They were broadly defined, and included both infectious and non-infectious conditions, such as colds, chronic obstructive pulmonary disease, and asthma. The researchers looked at dietary intake only and that from diet and supplements, accounting for potentially influential factors, such as age, sex, weight (BMI), smoking, household income and total energy intake. In all, there were 33 cases of respiratory complaints. These respondents were generally older and less likely to say they regularly took vitamins A, E, C or D supplements. There was no obvious association between BMI and vitamin intake, or between BMI and respiratory complaints. But vitamin A and E intake from both diet and supplements was associated with a lower prevalence of respiratory complaints in UK adults. And vitamin D intake from supplements, but not from diet, was associated with fewer respiratory complaints, prompting the researchers to suggest that the findings add to the current scientific debate on the value of vitamin D supplementation. "Our findings are consistent with the hypothesis that supplementation is critical to ensuring adequate vitamin D status is maintained and potentially indicate that intake of vitamin D from diet alone cannot help maintain adequate vitamin D status," the authors wrote.
https://www.tribuneindia.com/news/health/high-intake-of-vitamins-a-e-and-d-linked-tofewer-respiratory-issues-162347
October 28, 2020
High-fat keto diets can prevent, reverse heart failure: Study
Heart problems? A special diet might help as researchers have found that the popular and
controversial ketogenic diet could completely prevent, or even reverse heart failure caused by
a metabolic process.
For the findings, published in the journal Nature Metabolism, the research team looked at a
metabolic process that seems to be turned down in failing human hearts.
"In an animal model, drastic heart failure in mice was bypassed by switching to high fat or
"ketogenic" diets, which could completely prevent, or even reverse the heart failure," said study
author Kyle S McCommis from the Saint Louis University in the US.
"Thus, these studies suggest that consumption of higher fat and lower carbohydrate diets may
be a nutritional therapeutic intervention to treat heart failure," McCommis added.
According to the researchers, the heart's myocardium requires vast amounts of chemical energy
stored in nutrients to fuel cardiac contraction.
To maintain this high metabolic capacity, the heart is flexible and can adapt to altered metabolic
fuel supplies during diverse developmental, nutritional, or physiologic conditions.
Impaired flexibility, however, is associated with cardiac dysfunction in conditions including
diabetes and heart failure.
The mitochondrial pyruvate carrier (MPC) complex, composed of MPC1 and MPC2, is
required for pyruvate import into the mitochondria.
This study demonstrated that MPC expression is decreased in failing human and mouse hearts,
and that genetic deletion of the MPC in mice leads to cardiac remodelling and dysfunction.
"Interestingly, this heart failure can be prevented or even reversed by providing a high-fat, low
carbohydrate ketogenic diet," McCommis said.
"A 24-hour fast in mice, which is also ketogenic also provided significant improvement in heart
remodelling," McCommis added.
The findings showed that diets with higher fat content, but enough carbohydrates to limit
ketosis also significantly improved heart failure in mice lacking cardiac MPC expression.
"Our study highlights the potential of dietary interventions to enhance cardiac fat metabolism
to prevent or reverse cardiac dysfunction and remodelling in the setting of MPC-deficiency,"
the authors wrote.
Source: https://www.tribuneindia.com/news/health/high-fat-keto-diets-can-prevent-reverse-heart-
failure-study-161837
Startup develops hand-held oral cancer screening tool
Device to used for screening, detection and biopsy guidance of oral cancer
Startup develops hand-held oral cancer screening tool
OralScan, an indigenously developed hand-held imaging device for screening, detection and
biopsy guidance of oral cancer, has been developed by a startup here.
OralScan, an indigenously developed hand-held imaging device for screening, detection and
biopsy guidance of oral cancer, has been developed by a startup here.
The startup, M/s Sascan Meditech Pvt Ltd, which was incubated at TiMED, the Technology
Business Incubator of the city-based Sree Chitra Tirunal Institute for Medical Sciences &
Technology, is launching the device, a press release said.
Oral Scan, a Make-in-India initiative with seed funding from the National Initiative for
Developing and Harnessing Innovations (NIDHI) scheme of the Department of Science &
Technology (DST), Government of India, was designed and developed entirely in India and
supported by Biotechnology ignition grant of Biotechnology Industry Research Assistance
Council (BIRAC), INVENT (DST) and Kerala Startup Mission.
The company recently received investment from Unicorn India Ventures.
State Health Minister K K Shailaja, will launch OralScan at a function here on Wednesday.
An online event kickstarting the product sales and distribution network will also be held in the
presence of dignitaries, oncologists and channel partners identified across the country.
Dr Asha Kishore, Director, SCTIMST will perform the first sale to Ketan Parmar, Innovative
India, Surat.
According to Dr Subhash Narayanan, CEO of Sascan, oral cancer is a growing concern in India
with more than 80,000 fresh cases reported each year.
The disease has a high mortality rate due to the delay in detection.
Current practice relies on oral examinations using torchlight to detect early-stage cancers of
the oral cavity.
Various studies have demonstrated that this screening technique is not very reliable and often
oral potentially malignant lesions (OPMLs) go undetected in the early stages, the release said.
Even experienced clinicians find it difficult to locate the optimal site for a biopsy based on
conventional oral examination.
This leads to multiple biopsies, increased expenditure and false-negative reports which can
delay diagnosis and outcome.
Proprietary software in the device assists the surgeon in taking a biopsy from the most
appropriate site which is likely to confirm the diagnosis of malignancy.
This will avoid multiple biopsies and false-negative reports.
The device will be marketed for Rs 5.9 lakh.
This will be a one-time investment for hospitals and laboratories without any additional costs
of consumables.
Source: https://www.tribuneindia.com/news/health/startup-develops-hand-held-oral-cancer-screening-
tool-161831
Covid-19: What you need to know today
I wrote: “So, bored, tired, lonely perhaps, and physically, mentally,
and emotionally weary, we let things slip. And the virus wins.”
There’s a term for this, pandemic fatigue, and as the second wave roils Europe, and the third
the US, everyone is talking about it.
“Pandemic fatigue is real — and it’s spreading.” That’s in Tuesday’s Wall Street Journal. “Sick
of Covid-19? Here’s why you might have pandemic fatigue.” That’s in the conversation.com
from October 23. “As the Coronavirus surges, a new culprit emerges: Pandemic fatigue.”
That’s from October 17’s New York Times.
And on Monday, World Health Organization (WHO) director general Tedros Adhanom
Ghebreyesus spoke of pandemic fatigue. “Working from home, children being schooled
remotely, not being able to celebrate milestones with friends and family or not being there to
mourn loved ones — it’s tough and the fatigue is real,” he said.
The problem has become serious enough for WHO to, earlier in October, release a document
titled “Pandemic fatigue: Reinvigorating the public to prevent Covid-19”. In the document,
WHO actually defined pandemic fatigue.
“Pandemic fatigue is... demotivation to follow recommended protective behaviours, emerging
gradually over time and affected by a number of emotions, experiences and perceptions,” the
document said.
It “is expressed through an increasing number of people not sufficiently following
recommendations and restrictions, decreasing their effort to keep themselves informed about
the pandemic, and having lower risk perceptions related to Covid-19,” the document added.
It would be alright if Covid fatigue involved merely how people feel; unfortunately, this also
extends to how people behave, and it is behaviour that puts them and others at risk. Still worse,
because their behaviour is directly correlated with a rise in infections, governments may be
forced to react by imposing restrictions on movement and activities, even a partial lockdown
(most countries are very averse to going down the total or hard lockdown path again). And
when this happens, a population that is already in the grip of pandemic fatigue is unlikely to
listen. That’s happening in Europe and the US, and it is happening in India too.
So, what should governments and administrators do? As WHO’s DG put it on Monday: “We
cannot give up... Leaders must balance the disruption to lives and livelihoods with the need to
protect health workers and health systems as intensive care fills up.”
Enforcement may not work in all cases and may end up being counterproductive.
The problem will be familiar to behavioral economists, though. In 2012, Niranjan
Rajadhyaksha, then Mint’s executive editor, wrote an article titled “How behavioural science
can reduce deaths on railway tracks”.
In the article, Rajadhyaksha detailed how Final Mile Consulting, a firm headed by Biju
Dominic that used behavioural economics, cognitive neurology and anthropology to shape
people’s behaviour, did this in one part of Mumbai – “The Final Mile team hung around the
most lethal crossings for several weeks, melting into the crowd,” says Dominic, “like method
actors living the character.”
“They quickly noticed that the people crossing the tracks were overconfident, one of the biases
that behavioural scientists say are hard-wired into our brains, the same bias that ensures that
equity analysts overestimate corporate earnings or cigarette smokers refuse to believe they can
be struck down by cancer” Rajadhyaksha wrote.
It’s the same overconfidence that makes people believe that they are unlikely to contract Covid-
19, or assume that they are safe because most people who do get infected are either
asymptomatic or experience only mild symptoms.
I won’t tell you how Final Mile solved the rail crossing problem. You can read about it yourself
by scanning the QR code with this column.
The WHO document actually has some interesting pointers for administrators on how to “allow
people to live their lives, but reduce the risk” — for it is the disruption to their lives that is
perhaps the biggest contributor to pandemic fatigue. This involves: differentiating “between
lower-risk and higher-risk activities”; guidelines on carrying “on with life while reducing the
risk of transmission”; proactively planning for “end-of-the-year celebrations”; avoid cancelling
all cultural events and find “creative solutions” to host them; and “avoid judgment and blame.”
It’s always toughest to protect people from themselves.
Source: https://epaper.hindustantimes.com/Home/ArticleView
October 27, 2020
Study shows how exercise stalls cancer growth through immune system
A recent study suggested that people with cancer who exercise generally have a better
prognosis than inactive patients. Now, scientists explain 'Why?'
The study is published in the journal eLife.
Researchers at Karolinska Institutet in Sweden have found a likely explanation of why exercise
helps slow down cancer growth in mice. Physical activity changes the metabolism of the
immune system's cytotoxic T cells and thereby improves their ability to attack cancer cells.
"The biology behind the positive effects of exercise can provide new insights into how the body
maintains health as well as help us design and improve treatments against cancer," said Randall
Johnson, professor at the Department of Cell and Molecular Biology, Karolinska Institutet, and
the study's corresponding author.
Prior research has shown that physical activity can prevent the health condition as well as
improve the prognosis of several diseases including various forms of cancer. Exactly how
exercise exerts its protective effects against cancer is, however, still unknown, especially when
it comes to the biological mechanisms. One plausible explanation is that physical activity
activates the immune system and thereby bolsters the body's ability to prevent and inhibit
cancer growth.
In this study, researchers expanded on this hypothesis by examining how the immune system's
cytotoxic T cells, that is white blood cells specialized in killing cancer cells, respond to
exercise.
They divided mice with cancer into two groups and let one group exercise regularly in a
spinning wheel while the other remained inactive. The result showed that cancer growth slowed
and mortality decreased in the trained animals compared with the untrained.
Next, the researchers examined the importance of cytotoxic T cells by injecting antibodies that
remove these T cells in both trained and untrained mice. The antibodies knocked out the
positive effect of exercise on both cancer growth and survival, which according to the
researchers demonstrates the significance of these T cells for exercise-induced suppression of
cancer.
The researchers also transferred cytotoxic T cells from trained to untrained mice with tumours,
which improved their prospects compared with those who got cells from untrained animals.
To examine how exercise influenced cancer growth, the researchers isolated T cells, blood and
tissue samples after training sessions and measured levels of common metabolites that are
produced in muscle and excreted into plasma at high levels during exertion. Some of these
metabolites, such as lactate, altered the metabolism of the T cells and increased their activity.
The researchers also found that T cells isolated from an exercised animal showed an altered
metabolism compared to T cells from resting animals.
In addition, the researchers examined how these metabolites change in response to exercise in
humans. They took blood samples from eight healthy men after 30 minutes of intense cycling
and noticed that the same training-induced metabolites were released in humans.
"Our research shows that exercise affects the production of several molecules and metabolites
that activate cancer-fighting immune cells and thereby inhibit cancer growth," said Helene
Rundqvist, senior researcher at the Department of Laboratory Medicine at the Institutet, and
the study's first author. "We hope these results may contribute to a deeper understanding of
how our lifestyle impacts our immune system and inform the development of new
immunotherapies against cancer."
Source: https://www.newkerala.com/news/2020/188243.htm
Covid-19: What you need to know today
I skipped four instalments of this column because I decided to take a short break—part birding
trip, part R&R, but all safe, masked, and socially distanced. It involved driving through rural
and semi-urban Uttar Pradesh, where no one appears to be wearing masks (and there is no
social distancing), and Uttarakhand, where most people sport them, and there is some
adherence to social distancing norms.
That India’s largest state has managed to keep its Covid-19 numbers where they are (470,270
cases till the evening of October 25; 6,882 deaths; a mere 2,032 cases on October 25 itself; and
only 27,317 active cases) despite a dependence on rapid antigen tests (which are unreliable)
and lax enforcement of both mask discipline and social distancing is truly impressive — and
also surprising.
Uttarakhand, at least the part I went to, wasn’t crowded. The state insists that all inbound
tourists register themselves, and there was a check at the point of entry to ensure this. A test
isn’t required, although I did take a reverse transcription polymerase chain reaction (RT-PCR)
one a few days before I travelled (it was negative). According to the HT dashboard (which is
also the source of the Uttar Pradesh numbers), Uttarakhand saw 221 cases on October 25, has
seen 60,376 in all, and has had 993 deaths. That means it has fewer than 5,000 active cases.
To digress, it felt good to get out of Delhi after nearly eight months. I think, when this is all
over (which must be one of the most commonly used phrases these days), it will take me some
time to get used to not wearing masks; it felt strange to walk even on jungle trails without a
mask despite there being no one else around.
The sense of normalcy in both Uttar Pradesh and Uttarakhand isn’t surprising given their
current caseloads. India itself has just around 650,000 active cases at this point. And on Sunday,
India registered a mere 46,011 cases, half the number of cases it was registering per day in the
third week of September. The last time it registered such numbers was in late July. As Dispatch
176 on October 7 first pointed out, the first wave of the coronavirus disease in India is over. It
lasted roughly seven months.
There’s no telling how long the lull will last, and how low the daily case numbers could go.
Yet, based on what’s happening in Europe — Dispatch 155, on September 11, referred to the
emergence of the second wave in Europe that is now raging through that continent — and the
US (the same column mentioned the likelihood of a third wave in the US), the respite will
likely be temporary. And based on the trajectory of the second and third waves in the US and
the second in Europe, there is a high probability that the intensity of the second wave in India
will be stronger than the first. The second wave in Europe is following the same trend seen in
the second wave in the US: it is leading to fewer deaths, and it will be interesting to see if the
number of deaths in the ongoing third wave in the US is lower even than that seen in the second.
Still, lower deaths haven’t meant fewer hospitalisations. Hospitals in many European countries
have been overwhelmed by the sheer number of people needing treatment for Covid-19, and
the same thing is beginning to happen in several US states.
Part of the reason for the higher intensity of subsequent waves of the coronavirus disease is
obvious — they coincide with progressive easing of restrictions on movement and activities,
often encouraging people, usually the young, to indulge in irresponsible behaviour. In many
European countries, the median age of people infected in the second wave is lower than that in
the first.
The result isn’t just a spike in infection numbers but severe illnesses, and may be even deaths
in vulnerable populations. Research by Paraic Kenny of the Gundersen Medical Foundation,
Wisconsin, and others, published on pre-print server medRxiv and reported in Nature, shows a
strong correlation between the reopening of in-person education in colleges in one of the state’s
counties and an increase in coronavirus disease infections, with one of the strains (the
researchers carried out a genomic investigation) spreading to old-age homes where it infected
eight and killed two.
Source: https://epaper.hindustantimes.com/Home/ArticleView
Oxford COVID-19 vaccine trials produce robust immune response in elderly, reports Financial Times.
The findings echo data released in July which showed the vaccine generated ‘robust immune
responses’ in a group of healthy adults aged between 18 and 55
Oxford COVID-19 vaccine trials produce robust immune response in elderly, reports Financial
The COVID-19 vaccine being developed by the University of Oxford and AstraZeneca Plc
produces a robust immune response in elderly people, the group at highest risk, the Financial
Times has said on Monday, citing early results.
The vaccine triggers protective antibodies and T-cells in older age groups, the Financial Times
said, citing two people familiar with the finding, encouraging researchers as they seek evidence
that it will spare those in later life from serious illness or death from the virus.
Details of the finding are expected to be published shortly in a clinical journal, the Financial
Times said, without naming the publication.
The findings echo data released in July, which showed the vaccine generated “robust immune
responses” in a group of healthy adults aged between 18 and 55, the newspaper reported, citing
people aware of the results from so-called immunogenicity blood tests.
But the Financial Times cautioned that positive immunogenicity tests did not guarantee that
the vaccine would ultimately prove safe and effective in older people.
AstraZeneca, which is developing the vaccine with Oxford University researchers, is seen as a
frontrunner in the race to produce a vaccine to protect against COVID-19.
Oxford and AstraZeneca did not immediately respond to Reuters’ request for comments.
One of the world’s leading coronavirus vaccine candidates, called AZD1222 or ChAdOx1
nCoV-19, was developed by Oxford University scientists and licensed to AstraZeneca in April,
which took on the task of scaling trials and production.
AstraZeneca resumed the US trial of the experimental vaccine after approval by US regulators,
the company said on Friday.
It is a viral vector vaccine that uses a weakened version of a chimpanzee common cold virus
that encodes instructions for making proteins from the novel coronavirus to build immunity
against COVID-19.
Source: https://www.tribuneindia.com/news/health/oxford-covid-19-vaccine-trials-produce-robustimmune-response-in-elderly-reports-financial-times-161354
Indian, Pakistani women diagnosed with more aggressive breast cancer at younger age: Study
Indian, Pakistani women diagnosed with more aggressive breast cancer at younger age: Study
Research also has shown poor mammogram screening rates in Indian and Pakistani women
Indian and Pakistani women are diagnosed with breast cancer, including more aggressive
forms, at a younger age, according to a study that provides an insight into understanding the
risk factors influencing the disease.
The study, published in the International Journal of Cancer, examined the characteristics of
breast cancer among Indian and Pakistani-American and non-Hispanic white women in the US
using data from the National Cancer Institute's Surveillance, Epidemiology and End Results
Program.
Both, Indian and Pakistani women are diagnosed with more aggressive forms of the disease, at
a younger age, according to the researchers.
The researchers, who are part of the Rutgers School of Public Health and Rutgers Cancer
Institute of New Jersey, reviewed incidence data among Indian and Pakistani women between
1990 and 2014.
"Our results provide an insight into breast cancer in Indian and Pakistani women, suggesting
several hypotheses to guide future scientific studies to better understand the risk factors
influencing disease aetiology and prognosis," said Jaya M Satagopan, lead author and director
of the Center for South Asian Quantitative Health and Education at the Rutgers School of
Public Health.
South Asians are the fastest-growing major ethnic group in the United States with breast cancer
rates increasing within the population, but little is known about the disease in this socioculturally
unique population, according to the study.
The researchers also reviewed the disease characteristics, treatment and survival data between
2000 and 2016 for 4,900 Indian and Pakistani women and 482,250 non-Hispanic white women
with breast cancer.
They found that the occurrence of breast cancer in Indian and Pakistani women was lower than
in non-Hispanic white women, however, the number of Indian and Pakistani women diagnosed
with breast cancer increased over the years.
Indian and Pakistani women with breast cancer were more likely to be diagnosed at a younger
age and more advanced stages of the disease. Besides, they received more subcutaneous or
total mastectomies than non-Hispanic white women, it said.
While the researchers found that Indian and Pakistani women were less likely to die of breast
cancer than their non-Hispanic white counterparts, their health was tracked for a shorter time.
Prior cancer research has shown that fewer Indian and Pakistani women participate in scientific
studies and that several socio-cultural factors may delay their seeking health care.
Research also has shown poor mammogram screening rates in Indian and Pakistani women,
which is linked to a lack of family support, lack of transportation, modesty, fear, beliefs that
cancer is divine punishment for past deeds, having lived in the United States for less than 10
years, low English proficiency and a lack of faith in the health system.
"Our study indicated that there are important differences in this population that justify further
studies to better understand biological, sociocultural, and system-level factors such as
interactions with the health system, affecting breast cancer screening patterns, diagnosis, risk
and survival among South Asian women, given the paucity of literature on this topic,” said the
study's senior author Elisa V Bandera, co-leader of the Cancer Prevention and Control Research
Program at Rutgers Cancer Institute of New Jersey and professor at Rutgers Robert Wood
Johnson Medical School.
The study recommends identifying strategies to better engage Indian and Pakistani women in
breast cancer studies and to improve interactions between health care providers and Indian and
Pakistani women to identify socio-cultural factors associated with screening decisions and
health care use in this population.
"As the South Asian population in the United States—and especially in New Jersey—grows,
it is imperative that we work to promote health equity in cancer prevention, screening, early
diagnosis and treatment through community engagement and a team science approach," said
Anita Kinney, director of the Center for Cancer Health Equity at Rutgers School of Public
Health and Rutgers Cancer Institute of New Jersey and professor at the Rutgers School of
Public Health, who is also one of the study's authors.
Source: https://www.tribuneindia.com/news/health/indian-pakistani-women-diagnosed-with-moreaggressive-breast-cancer-at-younger-age-study-161390
Ban on public events can bring down COVID-19 transmission rate by 24 per cent: Lancet study
Pupils at Martin-Buber-Oberschule secondary school wear protective masks against the spread
of the coronavirus disease as school resumes following the autumn holidays in Berlin on
October 26, 2020.
Ban on public events can bring down the COVID-19 reproduction number ‘R’ number—a key
measure of virus transmission—by 24 per cent in less than a month, according to a modelling
study published in The Lancet journal.
An R value above 1 indicates a growing outbreak, whereas an R value below 1 indicates a
shrinking outbreak.
The research using data from 131 countries suggests that individual measures, including
closure of schools and workplaces, ban on public events and gatherings of more than 10 people,
requirements to stay at home, and internal movement limits, are associated with a reduction in
transmission of SARS-CoV-2.
However, combined measures are more effective at reducing transmission, the researchers said.
“We found that combining different measures showed the greatest effect on reducing the
transmission of COVID-19. As we experience a resurgence of the virus, policymakers will
need to consider combinations of measures to reduce the R number,” said Professor Harish
Nair from the University of Edinburgh, UK.
“Our study can inform decisions on which measures to introduce or lift, and when to expect to
see their effects, but this will also depend on the local context—the R number at any given
time, the local healthcare capacity, and the social and economic impact of measures,” Nair said.
When looking at the measures individually, a ban on public events was associated with the
greatest reduction in R -- 24 per cent reduction after 28 days—which the researchers suggest
may be because they are likely to prevent super spreader events and it was often the first
measure to be introduced in countries.
The measures most strongly associated with an increase in R were lifting bans on gatherings
of more than ten people and re-opening of schools, according to the researchers.
Although reopening schools was associated with a 24 per cent increase in the R by day 28, the
researchers caution that they were unable to account for different precautions some countries
implemented for reopening schools, for example limiting class sizes, distancing measure,
routine deep cleaning, personal handwashing, face masks, and thermal temperature checks on
arrival.
They said these are essential for safer school reopening and should be taken into account when
interpreting this finding.
“We found an increase in R after reopening schools but is not clear whether the increase is
attributable to specific age groups, where there may be substantial differences in adherence to
social distancing measures within and outside classrooms,” Nair added.
“Furthermore, more data are needed to understand the specific role of schools in increased
SARS-CoV-2 transmission through robust contact tracing,” he said.
The study, however, does not account for other potentially influential factors that have an
impact on R—including, among other things, compliance with the interventions, changes in
population behaviour, sub-national differences in R, or the effects of contact tracing and
isolation – all of which vary by context.
Using the R number as a proxy for transmission also has limitations, as it is difficult to estimate
accurately, particularly when prevalence is low, the researchers said.
In this modelling study, data on daily country-level estimates of R were linked with data on
what measures those countries had in place from January 1, 2020 to July 20, 2020.
The timeline of each country was divided into individual phases when all measures remained
the same in that country.
The analysis included 790 phases from 131 countries and the authors used a model to measure
the association between which measures were in place and changes in the R.
Source: https://www.tribuneindia.com/news/health/ban-on-public-events-can-bring-down-covid-19-
transmission-rate-by-24-per-cent-lancet-study-161419
Air pollution may hinder India’s fight against COVID-19, say scientists
Increase in 1 microgram per cubic metre in PM 2.5 associated with an 8 pc rise in COVID-19
death rate: Study
Air pollution may hinder India’s fight against COVID-19, say scientists
A pollution and Covid mascot launched in New Delhi. Tribune photo: Mukesh Aggarwal
The causal link between air pollution and COVID-19 cases is yet to be established conclusively
but long-term exposure will certainly make people more vulnerable to lung infections, warn
scientists as the skies over large parts of north India, including Delhi, turn smoky and the air
quality deteriorates rapidly.
Their concerns come amid several global studies pointing to the possible connection between
higher air pollution levels and increased COVID-19 cases and deaths.
A study by researchers at Harvard University in the US in September showed that an increase
of only 1 microgram per cubic metre in PM 2.5 is associated with an 8 per cent increase in the
COVID-19 death rate.
“Given the current limited literature, the surge of PM2.5 level in Delhi may be associated with
increased COVID-19 cases... Although the literature is relatively sparse at this stage,” Xiao
Wu, corresponding author of the Harvard study, told PTI.
He said the relationship between long-term air pollution and COVID-19 has been documented
in many studies, which indicate that adverse health impacts of air pollution can make people
prone to the infection or exacerbate the severity of COVID-19 symptoms once infected.
This is interesting, especially considering COVID-19 causes viral pneumonia and acute
respiratory distress syndrome, and severe inflammation to the heart and circulatory system, the
scientist said.
Another study by the University of Cambridge in April found an association between living in
an area of England with high levels of air pollution and the severity of COVID-19, caused by
the SARS-CoV-2 virus.
“Based on our findings, I would expect to see an association between higher levels of air
pollution in India and COVID-19 in the winter, similar with what we found in England,” said
Marco Travaglio, corresponding author of the Cambridge study.
“If the levels of air pollution have been consistently above the legal limits for several months
or years before this coming winter, I would expect to see a relationship between those levels
and COVID-19 burden across different parts of India in November and thereafter,” Travaglio
told PTI.
He noted that a key component of PM2.5 toxicity is its composition which may vary
considerably between countries.
“Nonetheless, the WHO legal limits for PM2.5 are currently set at 10 μg/m³ (microgrammes
per cubic metre) annual mean. Levels beyond 500 μg/m³ are extremely high and may have
considerable impact on people’s health in relation to COVID-19 but also beyond it,” said
Travalgo.
The level of small particulate matter (PM2.5) levels in Delhi have averaged around 180-340
μg/m³ in the past few weeks while that of bigger pollution particles (PM10) has hovered
between 120 and 450 during the time.
Long-term exposure to chronically high PM2.5 levels weakens the ability of the lungs to fend
off infections, therefore making people more susceptible to COVID-19, the scientists said.
In addition, studies from Italy have shown that traces of SARS-CoV-2 RNA, the genetic
material of the virus, can be found on pollution particles, meaning that increased air pollution
may act as a vehicle to increase COVID-19 transmission in highly polluted places.
The air quality in north India is expected to deteriorate further from November to February due
to several factors such as stubble burning, festive fireworks and low wind speed conditions
which lead to an uptick in vehicular and industrial pollution being trapped in the lower
atmosphere.
“In view of this evidence, high levels of PM2.5 in Delhi may lead to a higher number of
COVID-19 cases,” Travalgo added.
Studies in humans have shown that toxic air particles can penetrate airways and cause
widespread infiltration of lung cells.
This chronic state of inflammation may induce or aggravate health conditions such as asthma,
chronic obstructive pulmonary disease, cardiovascular diseases and diabetes, experts said.
Because these conditions have been widely found to be associated with increased risk of
contracting COVID-19 or incurring into critical illness, it is likely that air pollution acts as a
risk factor to increase the susceptibility to COVID-19.
India has the world’s second-highest caseload of over 7.9 million and the third-highest death
toll with more than 115,000 from the novel coronavirus.
The National Centre for Disease Control (NCDC) has warned that Delhi is likely to report
around 15,000 COVID-19 cases daily in winter because of the prevalence of respiratory
illnesses during this season that worsen the symptoms of the disease. On Sunday, the national
capital recorded 4,136 fresh COVID-19 cases, the highest single-day spike in 38 days.
D J Christopher, head of pulmonary medicine at the Christian Medical College in Tamil Nadu,
noted that the increased severe form of COVID-19 among patients would lead to increased
ICU hospitalisations, thereby increasing the burden of the healthcare system.
“The lung is the gateway to the body and takes the first impact from inhaled pollutants. It causes
an inflammatory response which damages the lung and makes it more susceptible to
infections,” Christopher told PTI.
‘Let us hope the numbers are not so high. There is a chance of hospital beds getting filled and
shortage of ICU beds,” he added.
Prof Rajneesh Bhardwaj concurred, saying there is growing scientific evidence that airborne
respiratory droplets carrying the virus travel and contaminate the air after an infected person
coughs. He added that pollutionmay help this airborne droplet to remain suspended for a longer
time and may increase the spread of COVID-19.
“PM2.5 are finer particles which remain suspended in the air for a long time and hence droplet
or viral particles can cling on to these particles to increase the risk. They may increase the
number of cases as pollution increases especiallywith large PM2.5 levels,” Bhardwaj, associate
professor at the Indian Institute of Technology-Bombay, told PTI.
He said the government should make contingent plans to deal with an expected large number
of cases and warned that any healthcare system can be overwhelmed by a larger number of
cases.
According to pulmonologist Anurag Agarwal, however, the relation between air pollution and
COVID-19 cases is very complex. While in general high air pollution increases risk of
respiratory infections, it is difficult to say much more, he said.
“Studies finding more infections and deaths in areas with high pollution have tried to
statistically adjust for higher population density in polluted cities. Such adjusted correlations
are interesting but do not represent proof,” Agarwal, director of the CSIR Institute of Genomics
and Integrative Biology, told PTI.
“Nevertheless, it is clear that air pollution is bad for health and COVID-19 is more dangerous
in unhealthy people. So the message is clear - we must take steps to reduce air pollution for
many reasons,” he added.
Source : https://www.tribuneindia.com/news/health/air-pollution-may-hinder-indias-fight-againstcovid-
19-say-scientists-161422
October 13, 2020
Second Covid vaccine trial paused over unexplained illness
The company declined to reveal any more details about the illness, citing the participant's
privacy.
A late-stage study of Johnson &Johnson's COVID-19 vaccine candidate has been paused while
the company investigates whether a study participant's “unexplained illness” is related to the
shot.
The company said in a statement on Monday evening that illnesses, accidents and other socalled
adverse events “are an expected part of any clinical study, especially large studies,” but
that its physicians and a safety monitoring panel would try to determine what might have
caused the illness.
The pause is at least the second such hold to occur among several vaccines that have reached
large-scale final tests in the US.
The company declined to reveal any more details about the illness, citing the participant's
privacy.
Temporary stoppages of large medical studies are relatively common. Few are made public in
typical drug trials, but the work to make a coronavirus vaccine has raised the stakes on these
kinds of complications.
Companies are required to investigate any serious or unexpected reaction that occurs during
drug testing. Given that such tests are done on tens of thousands of people, some medical
problems are a coincidence. In fact, one of the first steps the company said it will take is to
determine if the person received the vaccine or a placebo.
The halt was first reported by the health news site STAT.
Final-stage testing of a vaccine made by AstraZeneca and Oxford University remains on hold
in the US as officials examine whether an illness in its trial poses a safety risk. That trial was
stopped when a woman developed severe neurological symptoms consistent with transverse
myelitis, a rare inflammation of the spinal cord, the company has said. That company's testing
has restarted elsewhere.
Johnson & Johnson was aiming to enrol 60,000 volunteers to prove if its single-dose approach
is safe and protects against the coronavirus. Other vaccine candidates in the US require two
shots.
https://www.tribuneindia.com/news/health/second-covid-vaccine-trial-paused-overunexplained-
illness-155100
Pfizer modifies protocol for virus vaccine study
Diversity aimed at providing information on how safe and effective the experimental vaccine
is in people of different ages and backgrounds
Drugmaker Pfizer has again modified the protocol for its late-stage study of its vaccine against
the new coronavirus, this time to include more young participants.
The company said on Monday that it's received permission from the Food and Drug
Administration to include adolescents aged 12 through 15 in its global COVID-19 vaccine
study.
New York-based Pfizer originally planned for 30,000 participants, but in September expanded
that to 44,000 people. That increase was made to boost diversity in the trial population,
specifically by including 16- and 17-year-old teens, as well as stable patients with some
common chronic infections: hepatitis B, hepatitis C and HIV.
Pfizer's trial also includes significant numbers of Hispanic, Black, Asian and Native American
participants, plus many people aged 56 through 85. The diversity is aimed at providing
information on how safe and effective the experimental vaccine is in people of different ages
and backgrounds.
https://www.tribuneindia.com/news/health/pfizer-modifies-protocol-for-virus-vaccine-study-
155095
October 12, 2020
October 08, 2020
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