April 20, 2020
CDDEP researchers model the impact of India’s 21-day shutdown on COVID-19. Researchers at CDDEP, Johns Hopkins University, and Princeton University modeled the impact of India’s 21-day lockdown on the short term (March-April) and long term (March-December) spread of COVID-19. The study found that India’s current lockdown will significantly reduce COVID-19 hospitalizations and moderate infections compared to a lack of intervention. The temporary lockdown will buy time for health systems to prepare for the peak of the outbreak by building temporary healthcare facilities and obtaining additional personnel, hospital beds, and equipment. Long-term impacts of the shutdown will depend on the implementation of post-lockdown interventions such as continued social distancing and the immediate isolation of all individuals with respiratory illness symptoms. [CDDEP]
Public health interventions linked to improved control of COVID-19 in China. In a cohort study of 32,583 COVID-19 patients in Wuhan, China, researchers found that a series of public health interventions including movement restrictions, quarantines, and a universal symptom survey was linked to improved control of the COVID-19 outbreak. The interventions were temporally associated with a reduction in secondary transmission of the virus as well as a reduction in incidence of daily confirmed COVID-19 cases. Researchers found that the effective reproduction number of the virus ranged from more than 3.0 before January 26, less than 1.0 after February 6, and less than 0.3 after March 1, following the implementation of the various control measures. Another study found that the instantaneous reproductive numbers of COVID-19 in Beijing, Shanghai, Shenzhen, Wenzhou, and the ten Chinese provinces with the most confirmed cases have decreased significantly and remained below epidemic threshold (<1) since interventions were implemented. [JAMA, The Lancet]
Researchers observe clinical improvement of severe COVID-19 patients treated with remdesivir. Researchers observed clinical improvementin a non-randomized, uncontrolled cohort of 53 patients with severe COVID-19 who were treated with compassionate-use remdesivir, although the efficacy of the drug will need to be measured further in randomized controlled trials. The study found that 68 percent of patients who received at least one dose of remdesivir showed improvement in oxygen-support status and 47 percent were discharged from the hospital after a median follow-up of 18 days. Thirteen percent of patients died. [NEJM]
Increasing temperature or UV exposure has no effect on spread of COVID-19 in Chinese cities, study suggests. Researchers from Fudan University in Shanghai found no association between the spread of COVID-19 and temperature or ultraviolet (UV) radiation in 224 cities across China. Temperature was not significantly associated with the cumulative incidence rate or reproductive number of the novel coronavirus after adjusting for relative humidity and UV (p=0.28, 0.92, respectively), and likewise, UV was not significantly associated with the cumulative incidence rate or reproductive number of the virus after adjusting for relative humidity and temperature (p= 0.24, 0.92, respectively). Findings imply that as seasons change, increasing temperature or UV exposure may have no effect on the transmissibility of the virus, despite seasonal trends of other respiratory viruses. [European Respiratory Journal]
Globally, more than 117 million children may be at risk of missing measles vaccination due to the COVID-19 pandemic. The American Red Cross, US Centers for Disease Control and Prevention (CDC), UNICEF, UN Foundation, and the World Health Organization (WHO) released a joint statement noting that over 117 million children may be at risk for missing out on receiving measles vaccines due to the COVID-19 pandemic. Currently, 24 countries have delayed their measles vaccination campaigns and more are expected to follow suit. The WHO recommends that countries carefully weigh the impacts of delaying vaccination campaigns and continue to prioritize routine immunization services for children and at-risk adults. The guidance also recommends pausing preventative campaigns in countries with no active outbreaks of vaccine-preventable disease. [WHO]
Study reports 36% decrease in US burden of hospital-associated C. diff infections. In a surveillance study across ten US sites, researchers reported a decline in the incidence of Clostridioides difficile infections and associated hospitalizations between 2011 and 2017. After adjusting for the higher sensitivity of nucleic acid amplification tests (NAATs), age, sex, and race, the researchers estimated a 24 percent decrease in the total burden of C. diff infections, a 36 percent decrease in the national burden of health-care-associated C. diff infections, and a 24 percent decrease in the burden of hospitalizations for C. diff infections. The adjusted estimates of the burden of community-associated C. diff infections did not change significantly between 2011 and 2017. [NEJM]
High prevalence of C. auris reported across Chicago’s long-term care facilities. Researchers conducted 47 point prevalence surveys across 18 long-term care facilities in Chicago and found a high prevalence of patients colonized or infected with Candida auris in ventilator-capable skilled nursing facilities (23-71 percent). In one facility, C. auris prevalence increased from 43 to 71 percent between January and October 2018, and most patients were persistently colonized with the fungus. Nearly 40 percent of environmental samples collected from tables, chairs, bed rails, and other patient-care items within the facility were also positive for C. auris. The authors note that infection control measures are essential for containing the spread of multidrug-resistant organisms in long-term care facilities. [Clinical Infectious Diseases]
Inappropriate antibiotic prescribing common among Scottish children with viral infections. In a population-based analysis of Scottish children (<5 years old) between 2009 and 2017, researchers found that nearly 14 percent of antibiotics were inappropriately prescribed to kids with viral infections. Of the 6.1 million antibiotic prescriptions included in the study, 6.9 percent were attributable to respiratory syncytial virus (RSV), 2.4 percent to influenza, and 2.2 percent to human metapneumovirus. The study authors noted that since RSV accounted for a large proportion of inappropriate antibiotic prescriptions in children, the implementation of an RSV vaccine could significantly improve this problem. [Clinical Infectious Diseases]
Study suggests US flu vaccine protects against related hospitalizations. In an analysis of 14,573 adult patients with acute respiratory illness between 2015 and 2018, researchers estimated a 31 percent overall flu vaccine effectiveness among outpatients and a 36 percent overall effectiveness among hospital patients in the United States. The authors note that although hospitalized patients were older and had more co-morbidities on average than outpatients, vaccine effectiness estimates were similar, implying that the vaccine protected against influenza-associated hospitalizations. [Clinical Infectious Diseases]
