Public torn over COVID-19 contact tracing apps, study shows

Early results from a study by researchers at Swansea University and The University of Manchester shows people are torn over whether they will use the COVID-19 contact tracing smartphone app planned for release in the UK.

The study finds:

  • Only one-third of people taking part said they will be downloading the app, with the rest either saying they will not be downloading it or are not yet sure.
  • Common concerns are that the app will infringe on people’s privacy, will stigmatise those with COVID-19, or will not be used by enough people for it to be effective.
  • Misinformation about the app and how it works is common.
  • Some people are actively avoiding COVID-19 news coverage which may be contributing to lack of information about the app and might affect whether they use it.

The researchers conducted online focus groups with UK adults across a range of gender, ethnic, age and occupational backgrounds to explore their attitudes on the proposed NHSX contact tracing app currently being trialled in the Isle of Wight.

Though the five focus groups consisted of 22 people, the researchers say because it is a qualitative study, it is likely to be indicative of general public opinion.

The research is led by Dr. Simon Williams, Senior Lecturer in People and Organisation at Swansea University, with collaborations from Dr. Kimberly Dienes and Professor Christopher Armitage of The University of Manchester’s Centre for Health Psychology, and Dr. Tova Tampe, an independent consultant at the World Health Organization (WHO).

Dr. Williams from Swansea University said: “Our study suggests that the government is far from guaranteed the level of support they need to have the kind of uptake that will make a big difference. A lot of work needs to be done to build public confidence and trust in their handling of COVID-19, and to improve communication around the app, especially after recent criticism over the handling of lockdown easing.

“The protection of privacy remains a widespread concern. People associated the app with the growth of ‘Big Brother’ surveillance. People were also concerned that uptake would not be high enough for it to be effective. The irony of course is that if enough people decide not to use it because they think others won’t, it becomes a kind of self-fulfilling prophesy.”

Dr. Dienes, lecturer in clinical and health psychology at the University of Manchester and co-author of the study said: “People who told us they would download the app indicated they would do it for the “greater good”, which means those people trusted the app and what the government is trying to achieve. Indeed, the question of whether they trusted the government had their wellbeing at heart, seemed to be at the centre of their concerns and positive intent to download.

“It seems one of the main reasons why some people are worried about privacy is they either do not have enough information or have the wrong information. For example, one of the big misconceptions is that the app allows its users to specifically identify, and even stigmatise, those with COVID-19 symptoms among their contacts and in their vicinity, which is not the case. Also, some people are starting to actively avoid news on COVID-19, because they find it too overwhelming. So, it is important that Government gets the information out there in as many ways as possible, much as they did initially with the lockdown guidance.”

Dr. Williams added: “We recommend that government should communicate as clearly as possible and using a variety of media. They should switch to a de-centralised approach, focus on reassuring the public over privacy, and promote the key message that using the app is part of a collective responsibility to stop the spread of the virus and can help save lives.”

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Right in the middle of the Abitur-exams: Covid-19-the case of Bavarian grammar school

The Coronavirus pandemic, keeps the world in breath: More than 5 million people globally have become infected with the novel Sars-CoV-2 – 178.568 of them so far in Germany.

Right in the middle of the Abitur-exams: Covid-19-the case of Bavarian grammar school

Ironically, in the midst of the Abitur-exams: A teacher of the Graf-Rasso-gymnasium Fürstenfeldbruck is positive in the Coronavirus tested. The “Münchner Merkur” citing the competent district office.

The teacher was, according to the “mercury” in the on Wednesday (20. May) will be held in German-Abitur supervisor for six students. It is supposed to have passed, there is no direct contact, which is why the students as a "Contact persons of the level 2" were classified. You don’t have to put in quarantine and could continue their baccalaureate exams.

The rest of the class and school were not affected, the tests would be normal. The teacher, according to good, said the head of the school, Doris Hübler the news portal said.

 

All messages to the Corona-crisis in Germany, Europe and the world, you will find in the News Ticker of FOCUS Online.

Cheese cake: lightning recipe without the ground – in less than 10 minutes in the oven

Appetite cheese cake: lightning recipe without the ground – in less than 10 minutes in the oven

China's COVID-19 vaccine 'safe' in world's first completed human trial

China’s coronavirus vaccine is deemed ‘safe’ and triggers an immune response in world’s first completed human trial of 108 volunteers – but it may not ‘neutralize’ infection, expert says

  • Chinese CDCs and universities tested a candidate vaccine in 108 people
  • With results published Friday, it’s the first human trial to be completed in the world
  • It was found safe after no serious side effects were seen in any of the volunteers, though some had mild reactions, such as fever, pain and muscle aches 
  • Immune responses were seen in most patients, though more research is needed to determine if its enough to prevent infection 
  • A US vaccine expert told DailyMail.com he’s concerned, however, that the Chinese shot didn’t trigger enough ‘neutralizing’ antibodies to block the virus
  • Here’s how to help people impacted by Covid-19

A coronavirus vaccine trialled in 108 healthy volunteers in China safely triggered an immune response in the participants, a new study reveals. 

Antibody production seen in the patients is a good sign that the vaccine may protect them from infection, but it’s too soon to say for sure. 

The Chinese vaccine was the very first shot to enter clinical trials earlier this year – months ahead of human testing for the UK’s lead candidate jab – made by Oxford University – or the American lead-contender, made by biotech Moderna. 

Most of the people dosed with the vaccine had immune responses, although their levels of antibodies thought to neutralize the virus were relatively low. Researchers saw a stronger ramp-up of other immune compounds, called T-cells, that might also help fight the infection off. 

There were side effects – primarily pain, muscle aches and fever – but they subsided within 28 days, and no serious or dangerous side effects were reported. 

Promising results from the completed first human trial China’s Ad5 coronavirus vaccine place it at the front of the global race for a shot, though only by a slim margin, an expert told DailyMail.com. 

Chinese researchers have become the first to complete a human trial for a coronavirus vaccine, which was safe and triggered an immune response in participants, but a US expert worries the shot didn’t produce enough ‘neutralizing’ antibodies to block infection (file) 

The study, conducted by the collaborating universities and local CDC’s in China, recruited 108 patients ranging in age from 18 to 60, and split them into three groups the received, respectively, low, middle and high doses of the vaccine 

At the study’s start, none of the patients – who had never been infected with coronavirus – had neutralizing antibodies against SARS-CoV-2, the virus that causes COVID-19. 

Within two weeks, researchers started to see signs that their levels of antibodies were ramping up ‘moderately,’ and peaked 28 days after the volunteers got their shots, according to the study published Friday in The Lancet.

Levels of neutralizing antibodies – a type of immune cell that binds to a virus and may be able to completely block infection – were more than twice as high among the participants who got the high dose shot, compared to those given the low dose.  

While any increase in neutralizing antibodies was a significant gain over the subjects’ starting levels (zero), Dr Peter Hotez, a vaccine expert at Baylor College of Medicine in Texas, was unimpressed with the levels produced in the trial participants. 

‘The one thing not we’re not seeing is a really high neutralizing antibody titer,’ he told DailyMail.com. 

‘The question is whether we’re going to need that and whether these vaccines will be adequate to stimulate an immune response.’ 

Patients in the trial did have more robust increases in their levels of T cells, immune cells that perform a search and destroy function, rather than the blocking work done by neutralizing antibodies. 

More studies will be needed to determine whether the vaccine can protect against infection in practice. 

Encouragingly, none of the 108 patients had serious side effects. 

More than 80 percent did have some side effects, but these were mostly mild or moderate, like muscle aches, fever and pain. Most subsided within a couple of weeks, and almost all resolved by the end of the study. 

Moderna is working closely with the NIH to develop its vaccine, and is leading the US race 

The US government has placed an order for 300 million doses of AstraZeneca’s shot, developed with Oxford University 

‘That’s pretty good,’ Dr Hotez says. 

Side effect profiles may be particularly important to getting people to get vaccinated against coronavirus once one is available. 

A Reuters poll published Thursday found that a quarter of Americans were not very or not at all interested in getting a vaccine for the virus that has infected more than 1.6 million people in the US. 

Many of them said they were concerned the vaccine would be riskier than the disease itself because development is moving so fast. 

So far, the US government is supporting the development of 14 candidate vaccinations through its Operation Speed initiative. 

It’s unclear if the US is coordinating with the Chinese vaccine developers. 

In the US and UK, vaccines from Moderna and Oxford University (collaborating with AstaZeneca) are in human trials, and have shown promising early results. 

China’s completed trial puts it ahead – but not by much, says Dr Hotez. He says that all of the vaccines will need to go through large, Phase III trials before they become available, bringing their timelines close together.  

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Most physicians have seen false-negative COVID-19 test results

(HealthDay)—Most physicians believe they have seen false-negative results for a COVID-19 diagnostic test, according to the results of a recent survey.

Sermo, a social platform for physicians, has been conducting a weekly international poll. In week 7, conducted from May 3 to 5, 2020, 4,476 physicians offered their perspectives regarding false negatives and reinfection rates.

According to the results of the recent poll, more than eight in 10 physicians report they have seen some degree of false-negative test results, including 96 percent of “supertreaters” in an intensive care unit setting (physicians who have treated more than 20 COVID-19 patients) who believe they have seen COVID-19 tests produce a false negative. Just over one-third of hospital-based respondents believe that more than 20 percent of the tests have produced false negatives. Relatedly, four in 10 physicians report seeing at least one false positive. Nearly one in 10 physicians believe they have seen a patient with a reinfection, with higher rates among physicians working internationally (5 percent saw reinfections in the United States versus 15 percent in Italy and Spain and 14 percent in China).

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Drug for bone marrow cancer used in experimental COVID-19 treatment

Clinical trial underway to test if drug for rare bone marrow cancer will keep the sickest coronavirus patients off of ventilators by stopping the virus from copying itself

  • Selinexor, which is made by Karyopharm Therapeutics Inc, is currently approved treat multiple myeloma, a cancer that forms in white blood cells
  • Researchers say the drug blocks a protein that allows the virus to multiply in our cells and plays a role in the inflammatory response 
  • The goal of the trial is to see if the most critically ill coronavirus patients can be kept off of ventilators
  • More than 230 patients have been enrolled in the study across 40 hospitals in the US, Europe and Israel 
  • Here’s how to help people impacted by Covid-19

A clinical trial is underway to test if a drug for a rare bone marrow cancer works as an experimental coronavirus treatment. 

Selinexor, known by its brand name Xpovio, is made by Massachusetts-based Karyopharm Therapeutics Inc and is currently approved by the US Food and Drug Administration to treat multiple myeloma, a cancer that forms in white blood cells.

Researchers say the medication prevents the virus from replicating, or multiplying, in patients’ cells.

According to Karyopharm, the goal of the trial is to see if a low dose of the drug can keep the most critically ill patients off of ventilators.  

Selinexor (pictured) is currently approved treat multiple myeloma. Researchers say the drug blocks a protein that allows the virus to multiply in our cells and plays a role in the inflammatory response

The goal of the trial is to see if the most critically ill coronavirus patients can be kept off of ventilators. Pictured: A COVID-19 patient is attached to a ventilator in the emergency room at St Joseph’s Hospital in Yonkers, NY, April 20

Selinexor blocks the protein XPO1, which plays a role in replicating the virus throughout the body and in the body’s inflammatory response.

The team believes the drug will also help reduce the over-production of cytokines, known as a cytokine storm.

This occurs when the body attacks its own cells and tissues instead of just fighting off the virus.  

More than 230 patients have been enrolled in the second phase of the study, which is taking place in 40 hospitals across the US, Europe and Israel.  

Researchers compared patients taking 20mg of selinexor orally three times a week for two weeks to patients taking a placebo  

‘We’re encouraged by what we are seeing,’ Karyopharm CEO Dr Michael Kauffman told NBC Boston.

‘We haven’t seen any safety issues that we are worried about. So it seems to be a tolerated therapy, which is important.’

Selinexor isn’t the only cancer drug being used as an experimental treatment for COVID-19, the disease caused by the virus.

Chimerix, a company based in North Carolina is planning a clinical trial to test if  drug derived from the blood thinner heparin for a form of leukemia reduces bleeding and inflammation in coronavirus patients.

Additionally, a clinical trial is underway at Stanford Medicine to see if a drug called interferon-lambda – used to treat other viruses, and cancer – can keep people who have recently tested positive for coronavirus out of the hospital.  

‘We all need to work as hard as we possibly can and as fast as we can to study all different approaches and try to knock this thing on its head so we can help people recover and can move on,’ Kauffman told NBC Boston. 

In the US, there are currently more than 1.4 million confirmed cases of the virus and more than 85,000 deaths. 

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There’s no evidence chloroquine helps treat or prevent COVID-19

In new Practice Points, the American College of Physicians (ACP) says that evidence does not support the use of chloroquine or hydroxychloroquine alone or in combination with azithromycin to prevent COVID-19 after infection with novel coronavirus (SARS-CoV-2), or for treatment of patients with COVID-19. The ACP Practice Points also state that physicians, in light of known harms and very uncertain evidence of benefit, may choose to treat the hospitalized COVID-19 positive patients with chloroquine or hydroxychloroquine alone or in combination with azithromycin in the context of a clinical trial using shared and informed decision-making with patients and their families. “Should Clinicians Use Chloroquine or Hydroxychloroquine Alone or In Combination with Azithromycin for the Prophylaxis or Treatment of COVID-19? Living Practice Points from the American College of Physicians (Version 1)” was published today in Annals of Internal Medicine.

The ACP Practice Points provide rapid clinical advice based on a concise summary of the best available evidence on the benefits and harms of the use of chloroquine or hydroxychloroquine alone or in combination with azithromycin for the prophylaxis or treatment of COVID-19. The Practice Points are based on a rapid systematic review conducted by the University of Connecticut Health Outcomes, Policy, and Evidence Synthesis Group.

ACP Practice Points are developed by ACP’s Scientific Medical Policy Committee and provide advice to improve the health of individuals and populations and promote high value care based on the best available evidence derived from assessment of scientific work (e.g. clinical guidelines, systematic reviews, individual studies). ACP Practice Points aim to address the value of screening and diagnostic tests and therapeutic interventions for various diseases, and consider known determinants of health, including but not limited to genetic variability, environment, and lifestyle.

“With the rapid emergence of COVID-19, physicians and clinicians have found themselves managing the frontlines of the pandemic with a paucity of evidence available to inform treatment decisions,” said Jacqueline W. Fincher, MD, MACP, president, ACP. “ACP rapidly developed its Practice Points as concise, synthesized summaries of the current state of evidence in order to address urgent questions related to the transmission, diagnosis, and treatment of COVID-19. As such, these Practice Points give frontline physicians guidance to provide patients with the care based on the best available evidence.”

Chloroquine and hydroxychloroquine are used to manage other major ailments with a known benefit and are in short supply in the United States. These medications also have known harms in non-COVID patients such as cardiovascular effects; diarrhea; abnormal liver function; rash; headache; ocular issues; and anemia.

Using chloroquine or hydroxychloroquine, with or without azithromycin, to prevent or treat COVID-19 infection began to receive attention following preliminary reports from in vitro and human studies. While several studies are planned or underway, the Practice Points provide details about the lack of and/or insufficient current research about the benefits and harms for prevention and treatment of COVID-19.

At this time, the authors of the Practice Points have identified that chloroquine or hydroxychloroquine alone or in combination with azithromycin to prevent COVID-19 after infection with novel coronavirus (SARS-CoV-2), or for treatment of patients with COVID-19 should not be used. The Practice Points also state that the drugs may only be used to treat hospitalized COVID-19 positive patients in the context of a clinical trial following shared and informed decision-making between clinicians and patients (and their families) that includes a discussion of known harms of chloroquine and hydroxychloroquine and very uncertain evidence of benefit for COVID-19 patients.

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Steep decline in organ transplants amid COVID-19 outbreak

France and the United States, two countries hit hard by the novel coronavirus, have experienced a tremendous reduction in the number of organ donations and solid organ (kidney, liver, heart, and lung) transplant procedures since the onset of the COVID-19 pandemic, according to a new study. By early April, transplant centers in both countries were conducting far fewer deceased donor transplants compared to just one month earlier, with the number of procedures dropping by 91 percent in France and 50 percent in the United States.

The international team of transplant scientists, including experts from the Perelman School of Medicine at the University of Pennsylvania and Paris Transplant Group, attribute much of the overall decline to a steep reduction in the number of kidney transplants specifically. However, they also reported a substantial drop in the number of heart, lung and liver transplants. The analysis was published today in The Lancet.

“Our findings point to the far-reaching and severe ripple effects of the COVID-19 outbreak on health care, including life-saving organ transplants,” said study co-author Peter Reese, MD, MSCE, an associate professor of Medicine and Epidemiology at Penn. “Organs from deceased donors represent a time-limited opportunity, as they must be procured and used rapidly. However, in order to protect the safety of their patients, centers must now carefully vet all donors to ensure there is minimal risk of COVID-19.”

The steep reduction in organ donations and transplant procedures exacerbates the worldwide shortage of transplantable organs and need for transplants. In the United States, there are more than 112,000 people on the national transplant waiting list. While the number of living donor kidney and liver transplants continues to increase, the vast majority of organ transplant procedures involve organs from deceased donors. Of the nearly 40,000 transplants performed in the United States in 2019, more than 32,000 involved organs from deceased donors.

Many transplant centers, including the Penn Transplant Institute (PTI), continue to perform many life-saving organ transplants during the pandemic, but the outbreak has posed unique challenges for both organ procurement and transplantation. A number of centers nationwide, including the PTI, are not using organs from deceased donors with evidence of recent infection or exposure.

To quantify the impact of the COVID-19 outbreak on organ donation and transplantation, investigators analyzed validated national data from three federal agencies, including the United Network for Organ Sharing (UNOS), to study trends in France and the United States.

The team observed a strong link between the surge of COVID-19 infections and significant decline in donated organs and overall solid organ transplants. In the United States, the number of recovered organs dropped from more than 110 a day on March 6 to fewer than 60 per day on April 5, investigators found. During the same timeframe, the number of transplanted kidneys dropped from nearly 65 a day to about 35 per day. Researchers also observed that regions with fewer COVID-19 cases, or limited exposure to the disease, also experienced a significant reduction in transplant rates—suggesting a global and nationwide effect beyond the local infection prevalence.

The investigators hypothesize that France may have experienced a larger drop in transplants because of a coordinated national effort to reduce clinical and commercial activity. Whereas, in the United States, individual states had discretion to impose restrictions and hospital practice may have varied to a greater degree.

“These international comparisons of transplant activity will be very important as the COVID-19 pandemic evolves,” said co-author Alexandre Loupy, MD, Ph.D., a nephrologist at the Department of Nephrology and Kidney Transplantation at Necker Hospital in Paris and Head of the Paris Transplant Group. “Some transplant systems may develop best practices to support organ procurement and transplant that can be shared across borders. We have a lot of work ahead to restore our invaluable infrastructure of donation and transplant surgery.”

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COVID-19 activity levels begin to rebound

Activity levels during lockdown in Britain’s busiest regions including Greater London, Greater Manchester and the West Midlands have begun to rebound following successive week-by-week declines, according to new UCL analysis of geographical data.

Combining in-app mobile data with demographic indicators, the researchers found that activity levels—defined as the number of unique mobile devices used per hour in each study area—declined during the first five weeks of lockdown, but have ticked up since the 19th April.

Professor James Cheshire, UCL Geography and deputy director of the ESRC Consumer Data Research Centre, said: “Our analysis suggests that people have been adhering to the lockdown rules and taking them very seriously over the first month or so. But by early May, we’ve started to see a shift with more activity in recent days. It may be that people have started to increase their movements in anticipation of the government announcement expected this weekend for easing lockdown.”

The data was supplied by Huq Industries and the UCL analysis shows that across the busiest UK regions between 16-22 March, there was roughly a 20% decline in activity compared to the week before lockdown; by 23-30 March, there was a 36% decline; and by the 13th of April, almost a 50% decline in activity. Activity began to increase from the 20th April and is now back to roughly 60% of pre-lockdown levels.

London had seen the biggest reduction in activity, with levels down 70% between the 13th and 19th April rebounding slightly to a smaller reduction of 63% in the week ending 3rd May. The week of the 13th was also quietest for Greater Manchester and the West Midlands with 46% and 50% reductions in normal activity respectively. Both have seen a rise in activity levels and now report reductions of only 30% compared to those pre-lockdown.

Regional activity levels have declined the most in areas dominated by workplaces of professionals, the financial sector, leisure and tourism. Today activity levels are highest in areas dominated by routine occupations, construction, domestic workers, manual helpers, and others employed in the health sectors.

Professor Cheshire said: “The findings further highlight a divide between those in jobs that can be done from home and those with jobs that must be carried out on site, with activity levels suggesting that those working in financial services in particular are in a better position to work remotely. This will have important implications for transport planning as operators seek staggered working hours mixed with homeworking where possible to reduce peak demand.”

The research also reveals for the first time that traditional high streets and local shopping areas have seen lower relative declines in activity compared to major centers and out of town areas.

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Early government intervention is key to reducing the spread of COVID-19

Early and strict governmental intervention is a key factor in reducing the spread of COVID-19 cases. That’s the conclusion reached by a team of researchers comparing outbreaks of the novel coronavirus between the Chinese province of Hunan and Italy in a new paper published in Frontiers in Medicine.

While Hunan and Italy are similar in population size—about 60-70 million people each—the scope of the epidemic in each location has differed dramatically. At time of publication, Italy has the second-most confirmed deaths after the United States and ranks third in total confirmed infections, according to the Johns Hopkins University Coronavirus Resource Center. There are just over 1,000 confirmed cases in Hunan.

The research team, based in China, used data from the John Hopkins database through April 2 to map infection trends in both Hunan and Italy. They modified a standard mathematical model known as a susceptible-infected-removed (SIR) model to account for the effects of different epidemic prevention measures at different periods in time.

“It should be noted that in actual situations, the speed of transmission can be changed through many interventions, such as personal protective measures, community-level isolation and city blockade,” said lead author Dr. Wangping Jia with the Chinese PLA General Hospital in Beijing.

The paper’s extended SIR (eSIR) model found that under current measures there could be a total of 3,369 (the mean in a possible range of 840-8,013) infected cases in Hunan, with the endpoint of the epidemic having already occurred around March 3. In contrast, total infected cases in Italy are projected to be 182,051 (the mean in a possible range of 116,114-274,378) with an end date around August 6.

The authors speculated that the disparate trends could be due to a couple of reasons. For instance, Italy may not have implemented preventive measures soon enough, as the eSIR model demonstrated that taking action earlier in the case of Hunan drastically reduced infection rates.

The authors noted that “from China’s experience, various control measures, including the early detection and isolation of individuals with symptoms, traffic restrictions, medical tracking, and entry or exit screening, can well prevent the further spread of COVID-19.”

The paper did not specifically address mortality rates because a number of factors can affect these predictions, according to Jia, such as bed capacity of intensive care units, as well as a patient’s age, sex and any underlying health conditions such as cardiovascular disease, hypertension and diabetes.

“Accurate patient-specific data are urgent needs for the prediction of the total deaths,” he said.

The Italian government recently announced it would begin to ease lockdown measures beginning May 4—three months earlier than the eSIR model advises.

“We think it is too early to ease restrictions starting around May 4,” Jia said. “The potential second wave may come if restrictions are eased three months earlier. Italy is not in the end period of the COVID-19 epidemic.”

The authors concede that the current study has several limitations. First, due to the limited amount of testing, it’s likely the number of infected people in Italy and elsewhere is higher than the official count. The eSIR model does not incorporate the disease’s incubation period, which could make it less accurate. And there may be other factors that could throw off the estimate, such as the influence of “super spreaders” of the disease on a population.

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