SARS-like viruses may jump from animals to people hundreds of thousands of times a year

Study pinpoints Asian regions that could spark the next coronavirus pandemic

Kai Kupferschmidt

Science | September 15, 2021

Horseshoe bat exits a cave at dusk
A horseshoe bat (Rhinolophus affinis) exits a cave at dusk, in Perak state in Malaysia, one of the countries where severe acute respiratory syndrome–related viruses may frequently infect people.FLETCHER & BAYLIS/SCIENCE SOURCE

Only two new coronaviruses have spread globally the past 2 decades: SARS-CoV, which caused an outbreak of severe acute respiratory syndrome (SARS) in 2003, and SARS-CoV-2, the virus that causes COVID-19. But that may just be the tip of the iceberg of undetected infections with related viruses emerging from bats, a new paper claims. In a preprint published yesterday researchers estimate that an average of 400,000 people are likely infected with SARS-related coronaviruses every year, in spillovers that never grow into detectable outbreaks.

Although that number comes with big caveats, “It should be eye-opening to the entire scientific community that we don’t know very much about the frequency of zoonotic spillover,” says virologist Angela Rasmussen of the University of Saskatchewan, who was not involved in the work. That needs to change, she says, “because otherwise we grossly underestimate it.”

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COVID vaccine immunity is waning — how much does that matter?

As debates about booster shots heat up, what’s known about the duration of vaccine-based immunity is still evolving.

Elie Dolgin

Nature | September 17, 2021

Illustration of antibodies (y-shaped) responding to an infection with the SARS-CoV-2 virus.
For those vaccinated against COVID-19, antibody levels eventually wane, but this is not the whole story.Credit: Kateryna Kon/Science Photo Library

Six months ago, Miles Davenport and his colleagues made a bold prediction. On the basis of published results from vaccine trials and other data sources, they estimated that people immunized against COVID-19 would lose approximately half of their defensive antibodies every 108 days or so. As a result, vaccines that initially offered, say, 90% protection against mild cases of disease might only be 70% effective after 6 or 7 months1.

“It felt a little bit out on a limb at the time,” says Davenport, a computational immunologist at the University of New South Wales in Sydney, Australia. But on the whole, his group’s predictions have come true.

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Seizing the moment to rethink health systems

Kojo Nimako, DrPH & Prof Margaret E Kruk, MD

The Lancet | Open Access | Published: September 07, 2021 | DOI:https://doi.org/10.1016/S2214-109X(21)00356-9

Summary

The COVID-19 pandemic has made vivid the need for resilient, high-quality health systems and presents an opportunity to reconsider how to build such systems. Although even well resourced, well performing health systems have struggled at various points to cope with surges of COVID-19, experience suggests that establishing health system foundations based on clear aims, adequate resources, and effective constraints and incentives is crucial for consistent provision of high-quality care, and that these cannot be replaced by piecemeal quality improvement interventions. We identify four mutually reinforcing structural investments that could transform health system performance in resource-constrained countries: revamping health provider education, redesigning platforms for care delivery, instituting strategic purchasing and management strategies, and developing patient-level data systems. Countries should seize the political and moral energy provided by the COVID-19 pandemic to build health systems fit for the future.

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Youth versus pandemics: the role of future generations in the pandemic treaty

Iris Martine Blom, Letícia Nunes Campos, Mohamed El Amine Youcef Ali, Muhammad Mikail Athif Zhafir Asyura, Daniel Zeymer von Metnitz, Bernice Limann, Eglė Janušonytė

The Lancet | Open Access | Published:July 28, 2021 | DOI:https://doi.org/10.1016/S2214-109X(21)00307-7

The 74th World Health Assembly (WHA)—the highest-level decision-making event on global health—opened on May 24, 2021, and a new pandemic treaty set up by the EU and its 27 member states was introduced. The aim of the treaty is to strengthen and coordinate WHO preparedness and response to health emergencies.12 If adopted, a WHO convention will be developed, starting in November 2021, after a special session of the WHA.3 The draft decision follows the Global Health Summit that took place on May 21, 2021, and which brought together leaders of the G20. The treaty is intended to address the shortcomings of the existing International Health Regulations, which the current pandemic has exposed, and includes creating a mechanism by which the WHO can coordinate a stronger emergency response, through enforcing international rules with incentives and penalties.4

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Rogue antibodies involved in almost one-fifth of COVID deaths

Diana Kwon

Nature | August 31, 2021

Medical workers in protective equipment take care of a COVID-19 patient on a ventilator at Yokohama City Seibu Hospital.
Physicians treat a person with COVID-19 at a hospital in Japan.Credit: Yasuyoshi Chiba/AFP via Getty

Antibodies that turn against elements of our own immune defences are a key driver of severe illness and death following SARS-CoV-2 infection in some people, according to a large international study. These rogue antibodies, known as autoantibodies, are also present in a small proportion of healthy, uninfected individuals — and their prevalence increases with age, which may help to explain why elderly people are at higher risk of severe COVID-19.

The findings, published on 19 August in Science Immunology1, provide robust evidence to support an observation made by the same research team last October. Led by immunologist Jean-Laurent Casanova at the Rockefeller University in New York City, the researchers found that around 10% of people with severe COVID-19 had autoantibodies that attack and block type 1 interferons, protein molecules in the blood that have a critical role in fighting off viral infections2.

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Kids and COVID: why young immune systems are still on top

Innate immunity might be the key to why children have fared better with the virus. But the Delta variant poses fresh unknowns.

Smriti Mallapaty

Nature | September 07, 2021

Children and adults play with bubbles in a park in a built up area of New York
After extremely low case rates in New York City early this summer, the number of children testing positive for SARS-CoV-2 has begun to rise. Credit: Spencer Platt/Getty

Early last year, children’s hospitals across New York City had to pivot to deal with a catastrophic COVID-19 outbreak. “We all had to quickly learn — or semi-learn — how to take care of adults,” says Betsy Herold, a paediatric infectious-disease physician who heads a virology laboratory at the Albert Einstein College of Medicine. The reason: while hospitals across the city were bursting with patients, paediatric wards were relatively quiet. Children were somehow protected from the worst of the disease.

Data collected by the US Centers for Disease Control and Prevention from hospitals across the country suggest that people under the age of 18 have accounted for less than 2% of hospitalizations due to COVID-19 — a total of 3,649 children between March 2020 and late August 2021. Some children do get very sick, and more than 420 have died in the United States, but the majority of those with severe illness have been adults — a trend that has been borne out in many parts of the world.

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WHO Plan on COVID-19 Origin Tracing Is Politicized, China Says

teleSUR | August 02, 2021

The SARS-CoV-2 virus.
The SARS-CoV-2 virus. | Photo: Twitter/ @zhang_heqing

The work plan continues to consider the hypothesis that the virus may have escaped from a Chinese laboratory. The WHO-China joint mission report, however, clearly concluded that a “lab leak is extremely unlikely.”

The work plan of the World Health Organization (WHO) on the second phase of investigation into the origins of COVID-19 is politicized and lacks a spirit of cooperation, a spokesperson for the Chinese Embassy in Britain said Sunday.

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Social determinants of mental health and the COVID-19 pandemic in low-income and middle-income countries

Adalberto Campo-Arias & Claudia Teresa De Mendieta

The Lancet | Open Access | Published: June 24, 2021 | DOI:https://doi.org/10.1016/S2214-109X(21)00253-9

Together with non-communicable diseases, the COVID-19 pandemic has become a syndemic, especially in the most vulnerable or excluded groups.1 Women with young children are one such group, since they are at a greater risk of meeting the criteria for a mental disorder or psychological distress. Psychological distress is highly sensitive to social inequalities and therefore cannot be entirely medicalised.2

In their cohort study in The Lancet Global Health, Andrés Moya and colleagues3 show the effect of the pandemic on the emotional wellbeing of a large sample of displaced caregivers from Tumaco, a small Colombian city with high rates of social inequalities. The majority of the population is Afro-Colombian, and the city was historically abandoned by the Colombian State, leaving weak infrastructure and high rates of unemployment and poverty. People internally displaced by conflict also face social stigmatisation.4 Moya and colleagues found substantial increases in anxiety, depression, and parenting stress after the onset of the pandemic among fragile and conflict-affected mothers with young children in Tumaco, Colombia.

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How the Delta variant achieves its ultrafast spread

Sara Reardon

Nature | July 21, 2021

People wait for admission outside the emergency ward of a hospital tending to Covid-19 patients, Indonesia.
A queue at a hospital in Surabaya, Indonesia, that treats people with COVID-19. Indonesia has been hard hit by the Delta variant.Credit: Juni Kriswanto/AFP/Getty

Since first appearing in India in late 2020, the Delta variant of SARS-CoV-2 has become the predominant strain in much of the world. Researchers might now know why Delta has been so successful: people infected with it produce far more virus than do those infected with the original version of SARS-CoV-2, making it very easy to spread.

According to current estimates, the Delta variant could be more than twice as transmissible as the original strain of SARS-CoV-2. To find out why, epidemiologist Jing Lu at the Guangdong Provincial Center for Disease Control and Prevention in Guangzhou, China, and his colleagues tracked 62 people who were quarantined after exposure to COVID-19 and who were some of the first people in mainland China to become infected with the Delta strain.

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Pandemic pressures made parents consider quitting academia

Holly Else

Nature | June 28, 2021

Research scientists work on the development of replicating RNA vaccine at the University of Washington School of Medicine
Medical researchers working on a single-dose COVID-19 vaccine.

The stress of balancing work and home life during the COVID-19 pandemic has left many medical scientists with children questioning their future careers, and women are the hardest hit, according to a survey at a US university.

The study, published on 15 June in JAMA Network Open, concluded that an increase in reported work–life stress since the start of the pandemic “may disproportionately decrease the long-term retention and promotion of junior and midcareer women faculty”1.

Last September, Susan Matulevicius, the assistant dean for faculty wellness at the University of Texas Southwestern Medical Center in Dallas, and her colleagues sent a survey about work–life balance to the more than 3,000 members of academic staff in the university’s faculty of medicine. Just over one-third responded.

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