Tag: social distancing

Categories : COVID PaediatricsTags : Leave a comment

COVID Controls Linked to Decline in Immunity to Life-threatening Paediatric Infections

On By ModernMedia
Photo by Kelly Sikkema on Unsplash

Scientists have uncovered a link between COVID-19 control measures and a surge in serious infections in children following the pandemic.

The findings, which come from a large European study led by researchers at Imperial, suggest that non-pharmaceutical interventions (NPIs) including lockdowns, school closures and social distancing may have inadvertently delayed the development of young children’s immunity to specific infectious diseases, leaving them more vulnerable to severe illness. 

The researchers explain that while this impact was anticipated for viral infections (such as influenza and RSV), a surge in other infections, including the bacterial infection Strep A, had not been expected.

The authors advise the need to carefully weigh the impact of restrictions on children during future pandemics and stress the importance of development and delivery of vaccines to reduce the impact of severe infections across all age groups.  

The findings are published in the journal JAMA Network Open.

Associate Professor Tom Parks from Imperial’s Department of Infectious Disease, co-lead author on the study, said: “During the COVID-19 pandemic there was huge uncertainty about the spread and severity of a new disease and difficult decisions had to be made to protect vulnerable groups, as well as to maintain the health service. Restrictions like lockdowns and social distancing played a vital role in limiting the transmission of the SARS-CoV-2 virus, which undoubtedly, saved countless lives, reduced the impact on health systems including the NHS and bought countries time to roll out vaccine programmes.

“However, our study shows they also disrupted how children built immunity during these critical early years. Children aged 3-4 tested for Strep A immunity after the pandemic were approximately a year behind children tested before the pandemic. This difference in immunity appears to have contributed to the alarming rise in severe Strep A infections seen across Europe during 2022 and 2023.” 

Strep A infections

Strep A (Group A Streptococcus) is a common type of bacteria that typically causes throat infections and scarlet fever. While most infections are mild, in rare cases Strep A can cause invasive infections which can be fatal. Each year, around half a million people, including many children and young people, die around the world because of serious Strep A infections.

Previous research has shown that while rates of Strep A infections fell dramatically during the pandemic, many countries recorded a surge in infection rates once restrictions were lifted.

In the latest study, the team examined immune responses in 452 children aged 0-4 year old across 10 European countries that participated in two EU-funded studies: PERFORM and DIAMONDS.

They found that children aged 3-4 who were exposed to NPIs during the pandemic had significantly lower levels of antibodies to Strep A compared to children of the same age who were sampled before the pandemic. The findings correspond exactly with the age group that experienced the greatest increase in life-threatening Strep A infections after NPIs were removed in England.

The researchers also found similar delays in immunity to respiratory syncytial virus (RSV), another common and potentially serious childhood infection, and a small reduction in immunity to some common cold viruses.

Professor Shiranee Sriskandan, co-director of Imperial’s Centre for Bacterial Resistance Biology and co-lead author said: “Strep A is one of the leading causes of unexpected death from sepsis in otherwise healthy children, and we know that sadly disease progression can be exceptionally rapid, making prevention – rather than intervention – our best option to reduce deaths. This study underlines the importance of immunity among young children in preventing outbreaks of serious strep A infections and highlights the value of developing a vaccine for Strep A.  

Professor Mike Levin, from Imperial’s Department of Infectious Disease, who led the DIAMONDS and PERFORM studies, said: “Many of the children who had Strep A infections also had viral infections at the same time. Children appear to have been vulnerable to several infections all at once most likely because they had encountered fewer infections and so had little chance to build up immunity.”

Source: Imperial College London

Categories : COVID Mental HealthTags :

Distressed Individuals were Strong on COVID Vaccination but Lax on Social Distancing

On By ModernMedia
COVID heat map. Photo by Giacomo Carra on Unsplash

During the COVID pandemic, individuals who were distressed, showing signs of anxiety or depression, were less likely to follow recommendations from the Centers for Disease Control and Prevention, yet they were more likely to get vaccinated than non-distressed peers.

The authors refer to this as differential distress: when people act safely in one aspect while disregarding safety in another, both in response to the same psychological distress. This creates a conundrum for those trying to determine how best to communicate risks and best practices to the public.

Their study of 810 people revealed that distress was less likely to affect older people either way, despite their higher risk for severe outcomes if infected with SARS-CoV-2. Reported in Frontiers in Psychology, the findings suggest that fear messaging, which is intended to scare people and can increase their levels of distress, may not be the most effective way to encourage people to change behaviours.

“These findings do not point to a straightforward public health messaging campaign,” said Professor Joel Myerson, study leader. “Instead, officials may have to consider more finely tailored messages for different populations in order to achieve best outcomes: more attention to CDC recommendations as well as more people getting vaccinated.”

In a previous study, the researchers looked at social distancing and hygiene behaviours across a range of demographics. The results suggested that distress was closely tied to the way people responded to recommendations about social distancing. People who were more distressed were less likely to observe social distancing recommendations, perhaps as a way to maintain social connections that can ease anxiety and depression.

In the latest work, researchers again asked people about their adherence to the latest CDC recommendations, including newer recommendations outlining when to wear a mask and suggesting that people avoid spending lots of time inside with others. The results showed similar correlations to the previous study among age, distress and behaviour changes.

In terms of public health and effective messaging, one of the most pressing issues to arise after publication of the first study was the introduction of vaccines and the perceptions around them. Looking at four categories, fully vaccinated; partially vaccinated; unvaccinated but likely to get one; unvaccinated and unlikely to get one, researchers found:

  • People who had been fully vaccinated were more likely than those who were partially vaccinated to have close interactions with others following their shots.
  • Relative to those who said they were unlikely to get vaccinated, those who said they were likely to do so thought their chance of infection was higher.
  • Depending on the person’s age, they responded differently to the same level of stress. Overall, for example, the higher level of distress someone had, the less likely they were to social distance, but the more likely they were to get vaccinated. Both of these correlations became weaker, however, as people aged.

Fear messaging that tries to scare people into following guidelines tends to be useful only for a one-time event, Green said. “Ostensibly, getting vaccinated should count as such an event.” But as breakthrough cases increase and boosters add up, vaccinations are no longer one and done; they are instead a series of events, spread out over more than a year.

Although fear-based messaging may encourage younger people to get vaccinated, it also weakens their resolve to mitigation behaviours like social distancing. Not doing both poses a greater breakthrough infection risk.

Messaging also becomes less effective as people age, just as they become more vulnerable to severe illness.

“Part of the solution to the problem of differential distress may be to avoid the distress altogether,” said Professor Leonard Green, study co-lead. This would entail forgoing the fear campaign. Instead, a gentler approach may be warranted. “Our previous work suggests that what really motivates many people to change behaviours for the better is considering how their actions can benefit, or harm, other people.”

Source: Washington University in St. Louis

Categories : COVIDTags :

COVID Hit South Africa Harder Than Expected Despite Preparedness

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New research finds African countries, assessed as being least vulnerable to an epidemic were the worst affected by COVID, particularly South Africa.

A team of researchers from the NIHR Global Health Research Unit Tackling Infections to Benefit Africa (TIBA) worked with the World Health Organization (WHO) African Region to identify factors affecting mortality rates during Africa’s first two COVID waves and the timing of the first reported cases. The study, published in the journal Nature Medicine, found that countries with greater urban populations and strong international travel links were worst affected by the pandemic. Mortality rates and levels of restrictions, such as lockdowns and travel bans, were found to be lowest in countries previously thought to be at greatest risk from COVID.

Professor Mark Woolhouse, TIBA Director, who co-led the study, said, “Our study shows very clearly that multiple factors influence the extent to which African countries are affected by COVID. These findings challenge our understanding of vulnerability to pandemics.

“Our results show that we should not equate high levels of preparedness and resilience with low vulnerability.

“That seemingly well-prepared, resilient countries have fared worst during the pandemic is not only true in Africa; the result is consistent with a global trend that more developed countries have often been particularly hard hit by COVID.”

Among 44 countries of the WHO African Region with available data, South Africa had the highest mortality rate during the first wave between May and August 2020, at 33.3 deaths recorded per 100k population. Cape Verde and Eswatini had the next highest rates at 17.5 and 8.6 deaths per 100k, respectively. At 0.26 deaths recorded per 100,000, the lowest mortality rate was in Uganda.

South Africa also recorded the highest mortality rate during the second wave between December 2020 and February 2021, at 55.4 deaths per 100,000. Eswatini and Botswana recorded rates of 39.8 and 17.7 deaths per 100,000, respectively. The lowest rate was in Mauritius, which recorded no deaths during the second wave.

“The early models which predicted how COVID would lead to a massive number of cases in Africa were largely the work of institutions not from our continent. This collaboration between researchers in Africa and Europe underlines the importance of anchoring analysis on Africa’s epidemics firmly here,” said Dr. Matshidiso Moeti, WHO Regional Director for Africa and co-author. “We can no longer focus our understanding of disease transmission purely on the characteristics of a virus—COVID operates within a social context which has a major impact on its spread.”

Countries with high rates of HIV were also more likely to have higher mortality rates. This may be because people with HIV often have other health conditions that put them at greater risk from COVID, the team suggests.

The weak association between mortality rate and the timing or severity of government-imposed social restrictions shows the varied impact and enforcement across the region, making a consistent impact pattern difficult to discern. Restrictions during peaks of infection are well documented to have interrupted transmission in the region.

The findings show that the earliest recorded cases of COVID were in countries where most people live in urban areas, with strong international travel links and greater testing capacity. Algeria was the first of 47 African countries to report a case, on 25 February 2020. Most countries had recorded cases by late March 2020, with Lesotho the last to report one, on 14 May 2020.

Higher death rates were observed during the second wave, compared with the first. The infection peak during the second wave was also higher, with 675 deaths across the continent on 18 January 2021 compared with 323 during the first wave peak on 5 August 2020. Potential under-reporting was accounted for in the analysis.

Source: University of Edinburgh

Categories : COVIDTags :

As Lockdowns Ease, Masks and Social Distancing are Still Needed

On By ModernMedia

A new model suggests that as lockdowns ease, other control measures such as mask use must be enhanced in order to prevent additional COVID outbreaks.

The mathematical model, developed by scientists at the Universities of Cambridge and Liverpool, provides general insights about how COVID will spread under different potential control scenarios.

They considered ‘non spatial’ control measures involving facemasks, handwashing and metre-scale social distancing can all limit the number of virus particles being spread between people. The other, ‘spatial’ control measures included lockdown and travel restrictions, which reduce how far virus particles can spread. Different combinations of COVID control measures showed that non-spatial control needs to be ramped up as lockdown is lifted.

“More effective use of control measures like facemasks and handwashing would help us to stop the pandemic faster, or to get better results in halting transmission through the vaccination programme. This also means we could avoid another potential lockdown,” said Dr. Yevhen Suprunenko, a Research Associate in the University of Cambridge’s Department of Plant Sciences and first author of the paper. The authors stress that their predictions rely on such non-spatial control measures being implemented effectively.

Their model took into account the socio-economic impact of the measures. The costs of spatial measures of lockdown increased over time, while costs for non-spatial measures decreased due to falling prices and greater availability of items such as masks, and usage becoming a habit.

“Measures such as lockdowns that limit how far potentially infected people move can have a stronger impact on controlling the spread of disease, but methods that reduce the risk of transmission whenever people mix provide an inexpensive way to supplement them,” explained co-author Dr Stephen Cornell at the University of Liverpool.

The model was derived from identifying control strategies for plant diseases threatening staple crops. Instead of the usual computer simulation model, mathematical approach allowed the authors to identify insights on how to control newly emerging infectious diseases of plants and animals.

“Our new model will help us study how different infectious diseases can spread and become endemic. This will enable us to find better control strategies, and stop future epidemics faster and more efficiently,” said co-author Professor Chris Gilligan in the University of Cambridge’s Department of Plant Sciences.

Source: Medical Xpress

Journal information: Analytical approximation for invasion and endemic thresholds, and the optimal control of epidemics in spatially explicit individual-based models, Journal of the Royal Society Interface,rsif.royalsocietypublishing.or … .1098/rsif.2020.0966