Reinfection by Gamma variant in Manaus, Brazil
Reinfection by the SARS-CoV-2 Gamma variant in blood donors in Manaus, Brazil
[Preprint.] We tested serial blood samples from unvaccinated repeat blood donors in Manaus for the presence of anti-SARS-CoV-2 IgG antibody. From 3,655 repeat blood donors, 238 met all inclusion criteria, and 223 had enough residual sample volume to perform both serological assays. Using a strict serological definition of reinfection, we found 13.6% (95% CI 7.0% - 24.5%) of all presumed Gamma infections that were observed in 2021 were reinfections. If we also include cases of probable or possible reinfections, these percentages increase respectively to 22.7% (95% CI 14.3% - 34.2%) and 39.3% (95% CI 29.5% - 50.0%). Reinfection due to Gamma is common and may play a significant role in epidemics where Gamma is prevalent, highlighting the continued threat variants of concern pose even to settings previously hit by substantial epidemics.
Large-Scale Screening of Asymptomatic Persons for SARS-CoV-2 Variants of Concern and Gamma Takeover, Brazil
We performed a large-scale screening campaign aiming to provide a safer environment for employees of Federal University in Curitiba, Brazil. A total of 12,558 examinations were processed. Detection of the Gamma variant occurred on January 21, 2021, <2 weeks after the collapse of the healthcare system in Manaus. Prevalence of the Gamma variant was 9.1% on this date and increased to 42.9% 2 weeks later. A possible explanation for this scenario is the increased transmission of this variant in >20% compared with the wild-type transmission rate, which is supported by the observation of a reproduction number of 1.5 in Paraná. This increase in cases could be correlated with the subsequent collapse of the Curitiba city healthcare system and a surge of coronavirus disease deaths in the Paraná state. When testing activities resumed after the healthcare collapse, all cases became Gamma variant, completely displacing B1.1.28/P.2 VOI and wild-type cases in 3 months.
Mental health and physical symptoms of people quarantined during the COVID-19 outbreak
In January 2021, a small COVID-19 outbreak occurred in Beijing city, China, and close contacts were found in some schools. To evaluate the mental health of students and teachers, a visual analogue scale and generalized anxiety disorder-2 scale were used to evaluate the stress, anxiety and depression. Of the 401 participants (118 male vs 283 female), 277 people were students, including 55 children and 222 adolescents, and 124 were teachers. Children are more susceptible to mental health problems than adolescents because they are afraid of COVID-19 infection, frustration, boredom, and being alone without parents and companions. The scores of stress, anxiety and depression of children higher than each score of adolescents (p<0.05). The stress score of girls (2.13) are higher than boys (1.56, p<0.05). In addition, teachers have higher psychosocial stress than students. For physical symptoms, eighty-two people (20.4 %) had insomnia symptoms or poor sleep, and others had mild cold symptoms, such as Nasal congestion, stuffy nose, conscious fever and body pain. We noticed that 44 teachers have the insomnia symptom with the incidence of 35.48 %, which higher than adolescent (16.22 %) and children (2.36 %). Specific strategies should be considered to improve psychosocial status and sleep according to their age, sex and causes.
COVID-19 and beyond: how lessons and evidence from implementation research can benefit health systems’ response and preparedness for COVID-19 and future epidemics
In this article, we argue that just as learning from previous epidemics and coordinated preparation informed Africa’s response to COVID-19, knowledge, innovations and resources from recent implementation research can be leveraged to mitigate the pandemic’s effects and inform recovery efforts. As an example, we present the proven model and multifaceted approach of the Innovating for Maternal and Child Health in Africa Initiative and describe how such a model could be readily applied to building the robust and equitable systems needed to tackle future stresses and shocks, such as epidemics, on health systems while maintaining essential routine services.
Impact of scaling up SARS-CoV-2 vaccination on COVID-19 hospitalizations in Spain
We analyzed the Spanish public registry for associations between calendar vaccination scale up and incidence of COVID-19 hospitalizations by age, gender and vaccine modality. A total of 363,960 COVID-19 hospitalizations were recorded in Spain during the study period, with three peaks in March 2020, November 2020 and January 2021. COVID-19 hospitalizations increased exponentially with age in all three peaks of SARS-CoV-2 infection in Spain. Early massive vaccination of people above 60-years precluded a fourth wave of COVID-19 hospitalizations during the spring of 2021.