Spread of a Novel SARS-CoV-2 Variant Across Europe In Summer 2020https://medicalxpress.com/news/2020-10-sars-cov-variant-europe-summer.ampResearchers at the University of Basel, ETH Zürich in Basel and the SeqCOVID-Spain consortium analyzed and compared virus genome sequences collected from COVID-19 patients all across Europe to trace the evolution and spread of the pathogen (see box). Their analysis suggests that the variant originated in Spain during the summer. The earliest evidence of the new variant is linked to a super-spreading event among agricultural workers in the north-east of Spain. The variant moved into the local population, expanding quickly across the country, and now accounts for almost 80% of the sequences from Spain.
The researchers believe that the variant's expansion was facilitated by loosening travel restrictions and social distancing measures in summer.
From July, 20A.EU1 moved with travelers as borders opened across Europe, and has now been identified in twelve European countries. It has also been transmitted from Europe to Hong Kong and New Zealand. While initial introductions of the variant were likely from Spain directly, the variant may then have continued to spread onward from secondary countries.
Currently, 20A.EU1 accounts for 90% of sequences from the UK, 60% of sequences from Ireland, and between 30 and 40% of sequences in Switzerland and the Netherlands. This makes this variant currently one of the most prevalent in Europe. It has also been identified in France, Belgium, Germany, Italy, Latvia, Norway, and Sweden.
The new variant was first identified by Hodcroft during an analysis of Swiss sequences using the 'Nextstrain' platform, developed jointly by the University of Basel and the Fred Hutchinson Cancer Research center in Seattle, Washington. 20A.EU1 is characterized by mutations that modify amino-acids in the spike, nucleocapsid, and ORF14 proteins of the virus.
Though the present state of knowledge does not indicate 20A.EU1's spread was due to a change in transmissibility, the authors are currently working with virology labs to examine any potential impact the spike mutation, known as S:A222V, may have on the SARS-CoV-2 virus' phenotype. They also hope to soon receive access to data that would allow them to assess any clinical implications of the variant.
Emma B Hodcroft et al.
Emergence and spread of a SARS-CoV-2 variant through Europe in the summer of 2020, (2020).
https://www.medrxiv.org/content/10.1101/2020.10.25.20219063v1-------------------------------------------
NY Death Rates Have Dropped for Seriously Ill Covid Patientshttps://www.nytimes.com/2020/10/29/health/Covid-survival-rates.htmlSurvival rates have improved with medical advances and less crowded hospitals, studies say. But the latest record-breaking surge in infections could reverse the gains.
Though the virus has been changing slowly as it spreads, and some have speculated that it has become more easily transmissible, most scientists say there is no solid evidence that it has become either less virulent, or more virulent. As elderly people sheltered inside and took precautions to avoid infection, however, more of the hospitalized patients were younger adults, who were generally healthier and more resilient. By the end of August, the average patient was under 40.
Were the lower death rates simply a function of the demographic changes, or a reflection of real progress and medical advances in treatment that blunted the impact of the new pathogen?
Researchers at NYU Langone Health who zeroed in on this question, analyzing the outcomes of more than 5,000 patients hospitalized at the system's three hospitals from March through August, concluded the improvement was real, not just a function of changing demographics. Even when they controlled for differences in the patients’ age, sex, race, underlying health problems and severity of Covid symptoms — like blood oxygen levels at admission — they found that
death rates had dropped significantly, to 7.6 percent in August, down from 25.6 percent in March.
“This is still a high death rate, much higher than we see for flu or other respiratory diseases,” ... “not only deadly — 10 times more deadly probably than a bad influenza — but it also has long-term complications. You don’t have that from the flu.”While the studies evaluated the death rate, they did not assess the burden of what Dr. Phillips called “post-Covid syndrome,” which leaves many patients with lasting respiratory and neurologic problems, cardiac complications, and other lingering issues.
“It’s relatively easy to measure death, but that doesn’t capture all the other health issues,” said Dr. Preeti Malani, an infectious disease expert at the University of Michigan. Many hospital patients face grueling and protracted recoveries and may require long-term care, while even those who had mild bouts of disease are often left with continuing health problems, like headaches, chronic fatigue or cognitive problems. “It will take a long time to understand the full clinical spectrum of this disease.”
https://www.journalofhospitalmedicine.com/jhospmed/article/230561/hospital-medicine/trends-covid-19-risk-adjusted-mortality-rates?channel=327----------------------------------------
It May Be Time to Reset Expectations On When We’ll Get a Covid-19 Vaccinehttps://www.statnews.com/2020/10/29/it-may-be-time-to-reset-expectations-on-when-well-get-a-covid-19-vaccine/The ambitious drive to produce Covid-19 vaccine at warp speed seems to be running up against reality. We all probably need to reset our expectations about how quickly we’re going to be able to be vaccinated.
Pauses in clinical trials to investigate potential safety issues, a slower-than-expected rate of infections among participants in at least one of the trials, and signals that an expert panel advising the Food and Drug Administration may not be comfortable recommending use of vaccines on very limited safety and efficacy data appear to be adding up to a slippage in the estimates of when vaccine will be ready to be deployed.
https://www.statnews.com/2020/10/23/fda-shows-signs-of-cold-feet-over-emergency-authorization-of-covid-19-vaccines/“Could be January, could be later. We don’t know,” Fauci, director of the National Institute of Allergy and Infectious Diseases, said in an online interview with JAMA editor Howard Bauchner.
---------------------------------------
Dr. Fauci Warns of a ‘Whole Lot of Pain’ Due to Coronavirus Pandemic In the Coming Monthshttps://www.jsonline.com/story/news/2020/10/28/wisconsin-coronavirus-state-reports-3-815-new-cases-45-deaths/6059382002/https://www.nbcnews.com/politics/2020-election/battleground-states-trump-grapples-surging-opponent-coronavirus-n1245027In the Midwest, cases and hospitalizations are surging at record numbers. Wisconsin had a 7-day positivity rate of 28% while Minnesota reported its highest number of Covid-19 hospitalizations to-date. Hospitalizations have tripled in less than three weeks in El Paso, Texas. Joel Hendricks, the Chief Medical Officer at El Paso's University Medical Center even warned about the possibility of rationing hospital care there during an interview with NBC'S Gabe Gutierrez.
"Rationing of care is the worst thing doctors ever want to talk about," said Hendricks. "Having said that, we have looked at that, we're in the process of looking at that."... "There is very little appetite for a lockdown in this country," said Fauci. "There's going to be major pushback both from above and at the local level, however, what Melbourne did, what Australia did as a country, was very successful."
... Cities like New York and Philadelphia are more equipped to deal with the surge, whereas locations in the northwest and heartland are going to have a more difficult time with the pandemic.
"They never had the kind of hospital and intensive care facility and flexibility that some of the larger hospitals in larger cities have," said Fauci, director of the National Institute of Allergy and Infectious Diseases. "They're concerned that if the trajectory continues, they may be in a position where they are going to be strapped for things like intensive care beds," said Fauci.
-------------------------------------