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Weekly Digest: Lockdowns linked to reduced mobility, reduced novel coronavirus transmission; Studies do not support hydroxychloroquine as COVID-19 treatment; Anti-vaccine views may dominate Facebook in 10 years.

Weekly Digest: Lockdowns linked to reduced mobility, reduced novel coronavirus transmission; Studies do not support hydroxychloroquine as COVID-19 treatment; Anti-vaccine views may dominate Facebook in 10 years.

COVID-19

Lockdowns linked to reduced mobility, reduced novel coronavirus transmissionIn a cross-country analysis on the link between non-pharmaceutical interventions and COVID-19 transmission, researchers at CDDEP found that lockdowns significantly reduced physical mobility, while national school closures did not. The study found that countries with higher incomes, larger populations, and better health preparedness measures had greater delays in implementing mitigation measures (national school closures, lockdowns, and travel bans), while countries with greater population density, more democratic political systems, lower case detection capacity, and later arrival of the first novel coronavirus cases were more likely to implement these measures. [MedRxiv]

Studies do not support hydroxychloroquine as COVID-19 treatment. In the first randomized controlled trial assessing hydroxychloroquine as a treatment for COVID-19, researchers found that the drug did not significantly improve clinical outcomes among hospitalized COVID-19 patients in China. The probability that patients tested negative for the novel coronavirus at day 28 of the trial did not differ significantly between the group randomized to receive hydroxychloroquine (n=53) compared to the group randomized to receive the standard of care (n=56) (85.4 vs. 81.3 percent). Adverse events were recorded more frequently among the hydroxychloroquine group compared to control (9 vs. 30 percent). In a large, multi-national observational study, researchers found the use of chloroquine and hydroxychloroquine, used alone or with macrolide antibiotics, was linked to increased mortality rates and heart arrhythmias among COVID-19 patients. [BMJ, The Lancet]

Nearly 25,000 deaths linked to COVID-19 in NYC. Researchers from the New York City Department of Health and Mental Hygiene estimated that 24,172 excess deaths occurred in NYC as a result of the COVID-19 pandemic between March 11 and May 2, 2020. Of these, 22 percent were not identified as COVID-19-associated deaths, indicating that they could be either directly or indirectly associated with the pandemic. Looking at total reported deaths compared to seasonal expected baseline deaths allowed researchers to understand the burden of the outbreak without limitations related to underreporting of the disease. [CDC MMWR]

Social distancing may be needed through 2022. In a modeling analysis published in Science, researchers reported that social distancing may be required into 2022 to prevent health care systems from reaching capacity. The study used US time series data on seasonality, immunity, and cross-immunity from other coronaviruses to model the future of the SARS-CoV-2 pandemic. Authors suggest that surveillance of the novel coronavirus should be maintained regardless if the outbreak diminishes, as a resurgence could occur through 2024. [Science]

COVID-19 vaccine proves safe in early trial. An experimental vaccine against novel coronavirus has proven safe and immunogenic in a phase 1 trial, supporting continued assessment of the vaccine. According to interim results, the vaccine, mRNA-1273, elicited an immune response in all study participants across three dose-levels. At day 43 of the trial, the vaccine elicited neutralizing antibodies among all eight individuals for which data was available, and no serious adverse events were reported. Moderna, the US-based vaccine developer, anticipates a phase 3 trial will begin in July to assess the efficacy of the vaccine against COVID-19. [Moderna] 

COVID-19 misinformation common on YouTube. Researchers in Canada analyzed 69 of the highest-viewed YouTube videos on COVID-19 and found that 27.5 percent of which contained misleading information on the virus. Collectively, the 19 videos that contained inaccurate information were viewed over 62 million times. The study found that government and professional videos were more reliable than consumer, internet news, and entertainment news videos, but only accounted for 11 percent of COVID-19-related YouTube videos and 10 percent of views. Authors urge public health agencies to utilize YouTube to disseminate accurate COVID-19 information to the public. [BMJ Global Health]

COVID-19 risk factors similar across primary care and hospital settingsIn a cross-sectional analysis of nearly 4,000 patients, researchers found that risk factors for a positive COVID-19 test result among primary care patients were similar to those identified among hospital patients, including deprivation, living in a densely populated area, and chronic kidney disease. The study found that male sex, older age, black race, living in an urban area, and obesity were all significantly associated with a positive test result for the novel coronavirus among primary care patients (p<0.05), although smoking and chronic conditions other than kidney disease were not. [The Lancet Infectious Diseases]

Novel coronavirus cases become growing problem outside of major US cities. [CDDEP]

Drug Resistance and Global Health

Use of antibiotics with high resistance potential increases in India. In a time series analysis including nearly 4,000 patients, researchers found that prescribing of antibiotics with a high resistance potential (Watch antibiotics) increased significantly between 2008 and 2017 at two Indian hospitals (p<0.05). Watch antibiotics accounted for 29 and 40 percent of total antibiotic prescriptions at the two hospitals, respectively, leading the authors to suggest that physicians may be under-prescribing antibiotics with a low resistance potential (Access antibiotics). [BMC Infectious Diseases]

ASP improves antibiotic prescribing for UTIs in US nursing homes. US researchers found that an antimicrobial stewardship program (ASP) implemented at 12 nursing homes was tied to a 27 percent reduction in inappropriate antibiotic prescribing for urinary tract infections (UTIs). The study also found that rates of Clostridioides difficile and overall antibiotic prescribing were lower in the nursing homes randomized to receive the intervention compared to controls (adjusted incidence rate ratio= 0.35, 0.83, respectively). The ASP consisted of an introductory webinar, educational cards, and clinical vignettes, and results suggest that similar low-intensity ASPs can successfully improve antibiotic prescribing for UTIs in nursing homes.  [JAMA Internal Medicine]

Study predicts anti-vaccine views may dominate Facebook in 10 years. In a cluster analysis including nearly 100 million Facebook users, researchers predicted that in a decade, anti-vaccination groups could dominate over pro-vaccination groups on the social media platform. The study found that while anti-vaccine pages are smaller in size, they are highly connected with undecided clusters of Facebook users and growing more quickly than pro-vaccine pages. Authors note that these results can inform new strategies to promote the spread of reliable health information through social media. [Nature]

Life expectancy increases globally, inequalities persist. An annual report by the World Health Organization (WHO) highlights an increase in global life expectancy, which includes a 21 percent rise (11 years) in low-income countries and a 4 percent rise (3 years) in high-income countries between 2000 and 2016. The report notes a lack of progress in areas such as immunization coverage, prevention and treatment of non-communicable diseases, and access to health services. Authors of the report emphasize that in the midst of the COVID-19 pandemic, now more than ever countries need to invest in health care systems and implement comprehensive data and health information systems. [WHO]