• On Covid-19, two vaccines offer more answers about the road ahead
    https://www.statnews.com/2020/11/16/with-strong-data-on-two-covid-19-vaccines-we-have-more-answers-about-the-r

    Les inconnues des #vaccins anti #sars-cov2/#Covid-19 Pfizer/BioNTech, Sputnik V et Moderna

    Durée d’efficacité ?

    Degré de protection ? Empêchent-ils toute infection ? Sinon empêchent-ils le développement de tout symptôme ou seulement des symptômes les plus graves ?

    S’ils n’empêchent pas les formes légères et/ou asymptomatiques, quel sera le degré de #contagiosité chez les positifs vaccinés ?

    Sont-ils efficaces chez les plus âgés ? Les personnes avec des facteurs de risque ? (populations les plus vulnérables) ?

    Effets secondaires à moyen et long terme ?

    • Pfizer annonce maintenant que l’efficacité de son vaccin est de 95%...

      Dr. Angela Rasmussen sur Twitter :

      “Well, we still don’t know how this vaccine will perform in a very large population of people. Basing efficacy on 170 cases out of 44,000 participants means that we can’t say with certainty if efficacy will remain at 95% in the larger population .” / Twitter
      https://twitter.com/angie_rasmussen/status/1329070736481259521

      That doesn’t mean the trial is flawed or the data is unreliable. There are limitations to extrapolating data from 170 people to the larger, more diverse population of millions of people. I don’t expect efficacy to be substantially reduced at population scale, but it may change.

      Also, it is still unclear what, if anything, has been done to look at viral loads in the vaccinated cases. This has important implications for transmission. If vaccinated people can get infected and are shedding lots of virus, they could potentially transmit to others.

  • Don’t use ’deaths of despair’ as rationale for premature reopening - STAT
    https://www.statnews.com/2020/05/31/deaths-of-despair-wrong-rationale-reopening-country-too-soon

    Following congressional testimony last week about frontline workers’ experiences during the #Covid-19 epidemic, members of the U.S. House of Representatives raised the specter of a rise in “deaths of despair” due to Covid-19 shutdowns. They implied that the country had a moral obligation to reopen quickly, if only to avoid current and future deaths from suicide, homicide, opioids, and alcohol.

    #désespoir #prétexte #déconfinement

  • San Francisco testing blitz shows #Covid-19 hit mostly low-wage workers
    https://www.statnews.com/2020/05/28/sobering-finding-covid19-struck-mostly-low-wage-essential-workers-san-fran

    One of [infectious disease specialist Diane] Havlir’s motivations for the testing was to understand how the virus was being transmitted even after the city had been locked down for six weeks. Questionnaires administered with the tests gave her an answer: 90% of those who tested positive could not work from home. Most were low-income, and most lived in households with three or more people.

    “What really comes out of these data is that low-wage essential workers are victims of this disease,” Havlir said. Many of those infected were working in food service, making deliveries, or cleaning offices despite shutdown orders. “These people were out working the entire time,” she said.

    “Anecdotally, we knew this, but the hard data is heartbreaking,” said Susana Rojas, executive director of the Calle 24 Latino Cultural District and a leader of the Latino Task Force for Covid-19 that partnered with UCSF to run the study. “Our community was out working, keeping the city moving and fed. Of course they were more exposed and getting sick.”

    The study also found that 53% of those who tested positive were asymptomatic, possibly transmitting the virus to others without realizing they had it themselves. This asymptomatic transmission is something Havlir calls the “Achilles’ heel of Covid-19 pandemic control.”

    The results have led elected officials to call for changes in the city’s response to the coronavirus. San Francisco Supervisor Hillary Ronen, whose district includes the Mission, is pushing for the city to provide replacement wages, food, supplies, and hotel rooms for those who need assistance to self-quarantine.

    “This study shows us that it actually takes resources to quarantine,” said Kirsten Bibbins-Domingo, a physician, epidemiologist, and vice dean of population health and health equity at UCSF who has been treating Covid-19 patients, a majority of them Latinx restaurant, delivery, custodial, and construction workers. “It speaks to the many ways risk happens in this pandemic.”

    #essentiels #pauvres

  • Bubonic plague hit France in 1720. Officials dithered. Sound familiar ?
    https://www.statnews.com/2020/05/25/bubonic-plague-outbreak-1720-france-officials-dithered-sound-familiar

    L’autrice est historienne et prépare un livre sur le sujet (la #peste de #Provence de 1720). Elle dresse un parallèle avec les réactions (et absences de réactions) des #Etats-Unis de Trump (mais un parallèle avec la France et d’autres pays est faisable aussi) concernant l’épidémie de #Covid-19

    Retard de réaction et désinformation (avec l’aide de médecins) des officiels pour des raisons économiques,

    The city’s primary municipal magistrate, Jean-Baptiste Estelle, owned part of the ship as well as a large portion of its lucrative cargo. He used his influence to arrange for the premature unloading of the cargo into the city’s warehouses so the goods could be sold soon thereafter at the trade fair.

    The number of infections and deaths began to climb within days, and the threat to the economy of this major commercial port became all too real. Instead of undertaking emergency measures to try to contain the infection, officials launched an elaborate campaign of misinformation, going as far as hiring doctors to diagnose the disease as only a malignant fever instead of the plague.

    It wasn’t until two months after the first cases of bubonic plague appeared in Marseille that appropriate measures were undertaken. These included trade embargoes, quarantines, the prompt burial of corpses, the distribution of food and aid, and disinfection campaigns using fire, smoke, vinegar, or herbs. And the Grand Saint-Antoine was burned and sunk off the coast of Marseille.

    But by then it was too late. The epidemic went on to spread from town to town, and over the next two years took as many as 126,000 lives in Provence.

    This might sound familiar. The Trump administration’s slow response in acknowledging the Covid-19 pandemic has resulted in more deaths than may have otherwise resulted if the threat of the infection had been taken seriously from the very beginning. Instead, the president spent those crucial early weeks downplaying the risk of the coronavirus outbreak (in fact, he continues to do so). And when appropriate measures came, they came too late. What began as an outbreak turned into a massive public health crisis that is now far more difficult to track and contain.

    Rejeter la faute sur un pays étranger, en l’occurrence le Levant de l’époque (cette version est maintenue par Wikipedia français, même si la fin de la page rectifie un peu)

    Then, as now, people viewed diseases as coming from faraway lands, from “them,” not “us.” By the 1700s, the plague was sometimes even referred to as “la peste Levantina” or the Levantine plague, referring to the region of the world occupied by present-day Syria, Lebanon, Jordan, Israel, Palestine, and much of Turkey.

    Yet recent genetic studies have revealed that plague outbreaks throughout the early modern period of Europe, roughly between 1500 and 1800, could actually have come from plague reservoirs within the continent rather than on trade ships from the Levant. Such a possibility, though, would never have entered the minds of people living in Provence, who instead adopted an Orientalist narrative that survives to this day. Efforts to call SARS-CoV-2, the virus that causes Covid-19, the Chinese virus or Wuhan virus stem from a long history of epidemiological scapegoating — when, in fact, genetic testing recently revealed that most cases of Covid-19 in New York came from Europe, not Asia.

    L’épidémie a frappé essentiellement les plus pauvres,

    Then, as now, the idea that disease does not discriminate and affects everyone equally could not be further from the truth. During the Great Plague of Provence, wealthy residents in cities not only in France but all over Europe who worried that the plague would spread to their own regions, swiftly departed for the countryside, leaving in their wake both social and economic ruin. In the last few weeks, New Yorkers have done much the same thing, departing for destinations less affected by Covid-19.

    In 1720, one British observer remarked on the plague’s unequal effects: “‘Tis worthy of our Notice that in contagious…visitations…, the Weight of the Judgment generally falls heaviest upon the poor; not that it is more immediately sent…to them, but their unhappy Circumstances…expose them to it… The Rich, allarm’d by the Danger of the Infection, fly the infected Ground… By this means Trade stops, Employment ceases, and the Poor wanting Work, must of consequence have their Subsistance [sic] cut off. This immediately reduces Thousands of Families to inexpressible Misery and Distress.”

    Today, too, it is the poor, along with racial and ethnic minorities, who are suffering disproportionately from the health-related and economic effects of the pandemic in the United States and other countries.

    A l’époque, comme aujourd’hui, les fausses informations étaient nombreuses,

    Rampant misinformation is another theme that unites the Great Plague of Provence and the Covid-19 pandemic. In the 1720s, rumors and paranoia became a problem not only in France but all over Europe, as well as in the colonies in the Americas and Asia, as people struggled to separate fact from fiction. Many even complained of the dangers of lies during public health crises, as when one person protested in 1721: “Another great Cause of our present Terrors of the Plague is, the giving a too hasty Belief to every idle, ill-grounded Story concerning it…Thus we are liable to the Whimsey of every petulant News-Writer, who are made the Instruments of designing men, to bring the Plague amongst us, or drive it away again, as it may serve a wicked Turn.”

    Where social media platforms and right-wing populist outlets serve to amplify misinformation today, local newspapers, pamphlets, and old-fashioned word of mouth provided the disservice in the eighteenth century. While more limited in reach, the evils were the same.

    d’autres parallèles...,

    There are many other parallels between the two outbreaks, including the difficulty of obtaining accurate numbers of infections and deaths, the hiring of partisan doctors to support the government’s false claims, or the ways in which opportunists have often exploited disasters to achieve objectives that may not have been attainable before the emergency.

    Et une issue qui reste à se vérifier aujourd’hui,

    Here’s a final lesson that can be drawn from the Great Plague of Provence and the history of disease: No matter how terrible or how traumatic the pandemic, for the survivors things always go back to normal — or at least a reconfigured version of normal. For better or worse, people forget more quickly than perhaps they should, and the episode becomes a subject only for historians.

  • Imbalanced Host Response to #SARS-CoV-2 Drives Development of %COVID-19: Cell
    https://www.cell.com/cell/abstract/S0092-8674(20)30489-X

    #Coronavirus hijacks cells in unique ways that suggest how to treat it - STAT
    https://www.statnews.com/2020/05/21/coronavirus-hijacks-cells-in-unique-ways

    SARS-CoV-2 blocks one virus-fighting set of genes but allows another set to launch, a pattern never seen with other viruses. Influenza and the original SARS virus (in the early 2000s), for instance, interfere with both arms of the body’s immune response — what tenOever dubs “call to arms” genes and “call for reinforcement” genes.

    The first group of genes produces interferons. These proteins, which infected cells release, are biological semaphores, signaling to neighboring cells to activate some 500 of their own genes that will slow down the virus’ ability to make millions of copies of itself if it invades them. This lasts seven to 10 days, tenOever said, controlling virus replication and thereby buying time for the second group of genes to act.

    This second set of genes produce their own secreted proteins, called chemokines, that emit a biochemical “come here!” alarm. When far-flung antibody-making B cells and virus-killing T cells sense the alarm, they race to its source. If all goes well, the first set of genes holds the virus at bay long enough for the lethal professional killers to arrive and start eradicating viruses.

    “[...].

    SARS-CoV-2, however, uniquely blocks one cellular defense but activates the other, he and his colleagues reported in a study published last week in Cell. They studied healthy human lung cells growing in lab dishes, ferrets (which the virus infects easily), and lung cells from Covid-19 patients. In all three, they found that within three days of infection, the virus induces cells’ call-for-reinforcement genes to produce cytokines. But it blocks their call-to-arms genes — the interferons that dampen the virus’ replication.

    The result is essentially no brakes on the virus’s replication, but a storm of inflammatory molecules in the lungs, which is what tenOever calls an “unique” and “aberrant” consequence of how SARS-CoV-2 manipulates the genome of its target.

  • Cats can catch #Covid-19 from other cats. The question is: Can we?
    https://www.statnews.com/2020/05/13/cats-can-catch-covid-19-from-one-another-study-finds-the-question-is-can-w

    ... the researchers suggested people should be aware of the possibility of transmission from cats to people, and keep cats away from anyone in a household who is suspected of being sick with Covid-19. “I think it’s good practice to have this in people’s minds,” Halfmann said. He and his co-authors also urged people not to abandon cats or give them up for adoption because of such concerns.

    They also advised cat owners to keep their cats indoors.

    “Cats are still much more likely to get Covid-19 from you, rather than you get it from a cat,” Keith Poulsen, director of the Wisconsin Veterinary Diagnostic Laboratory, said in a statement.

  • Prévisions du Center for Infectious Disease Research and Policy (#CIDRAP) étasunien concernant le devenir du #sars-cov2
    https://www.cidrap.umn.edu/sites/default/files/public/downloads/cidrap-covid19-viewpoint-part1_0.pdf

    Covid-19’s future : small outbreaks, monster wave, or ongoing crisis - STAT
    https://www.statnews.com/2020/05/01/three-potential-futures-for-covid-19

    La #pandémie de #COVID-19 pourrait durer 2 ans, la 2e vague pourrait être pire – rapport | FR24 News France
    https://www.fr24news.com/fr/a/2020/05/la-pandemie-de-covid-19-pourrait-durer-2-ans-la-2e-vague-pourrait-etre-pir

    Le rapport du CIDRAP propose trois scénarios possibles qui pourraient se produire dans le futur de la pandémie de COVID-19.

    Le premier scénario verrait la vague actuelle de la pandémie suivie d’une série de petites vagues répétitives sur une période d’un à deux ans, diminuant progressivement en 2021. Les vagues peuvent varier géographiquement et dépendre de mesures d’atténuation. Ces vagues pourraient nécessiter la réintroduction périodique de mesures telles que les fermetures et les réglementations en matière de distanciation sociale.

    Le deuxième scénario voit la vague actuelle suivie d’une vague encore plus grande à l’automne ou à l’hiver de cette année et une ou plusieurs vagues ultérieures plus petites l’année prochaine. Cela nécessiterait le rétablissement des mesures de verrouillage et de distanciation sociale à l’automne pour tenter de réduire la propagation du virus et éviter que les systèmes de santé ne soient submergés. Ceci est similaire à ce qui s’est produit lors de la pandémie de grippe espagnole de 1918 et de la pandémie de 1957-58.

    Le troisième scénario voit la vague actuelle de la pandémie suivie d’une transmission continue et de la survenue de cas, mais sans schéma de vague clair. Cela n’a pas été vu dans les pandémies de grippe passées, mais pourrait se produire avec COVID-19. Cela ne nécessiterait probablement pas la réintroduction de mesures de distanciation sociale, mais les cas et les décès continueront.

    Le rapport du CIDRAP a souligné que, quel que soit le scénario qui se produise réellement, les gouvernements doivent être prêts pour au moins 18 à 24 mois supplémentaires « d’activité COVID-19 importante », ajoutant qu’il était probable que le virus finira par prendre une forme saisonnière avec une diminution gravité au fil du temps.