COVID, Volume 4, Issue 2 (February 2024) – 10 articles

The COVID-19 pandemic has had a significant impact on countries worldwide, including the United Kingdom (UK). The UK has faced numerous challenges, but its response, including the rapid vaccination campaign, has been noteworthy. While progress has been made, the study of the pandemic is important to enable us to properly prepare for future epidemics. Collaboration, vigilance, and continued adherence to public health measures will be crucial in navigating the path to recovery and building resilience for the future. In this article, we propose an overview of the COVID-19 situation in the UK using both mathematical (a nonlinear differential equation model) and statistical (time series modeling on a moving window) models on the transmission dynamics of the COVID-19 virus from the beginning of the pandemic up until July 2022. This is achieved by integrating a hybrid model and daily empirical case and death data from the UK. We partition this dataset into before and after vaccination started in the UK to understand the influence of vaccination on disease dynamics. We used the mathematical model to present some mathematical analyses and the calculation of the basic reproduction number ($R_0$). Following the sensitivity analysis index, we deduce that an increase in the rate of vaccination will decrease $R_0$. Also, the model was fitted to the data from the UK to validate the mathematical model with real data, and we used the data to calculate time-varying $R_0$. The homotopy perturbation method (HPM) was used for the numerical simulation to demonstrate the dynamics of the disease with varying parameters and the importance of vaccination. Furthermore, we used statistical modeling to validate our model by performing principal component analysis (PCA) to predict the evolution of the spread of the COVID-19 outbreak in the UK on some statistical predictor indicators from time series modeling on a 14-day moving window for detecting which of these indicators capture the dynamics of the disease spread across the epidemic curve. The results of the PCA, the index of dispersion, the fitted mathematical model, and the mathematical model simulation are all in agreement with the dynamics of the disease in the UK before and after vaccination started. Conclusively, our approach has been able to capture the dynamics of the pandemic at different phases of the disease outbreak, and the result presented will be useful to understand the evolution of the disease in the UK and future and emerging epidemics. Full article

(1) Background: This study addresses two weaknesses in current international efforts to prevent and prepare for the next pandemic: the lack of robust evidence supporting global policy measures and the corresponding extent to which those measures advance equity. (2) Methods: Using UNICEF’s publicly available but underused COVID-19 Market Dashboard database, we conducted a cross-sectional analysis of vaccine deliveries as of mid-2022 and vaccine procurement strategies used by African low- and lower middle-income countries (LMICs) over the course of the COVID-19 pandemic. (3) Results: Pooled procurement of the kind typified by COVAX (a clearinghouse for high-income-country contributions of vaccines and financing toward the end of equitable LMIC procurement) crowded out alternative strategies that must be supported in future: regional procurement, donation, and bilateral procurement (binding agreement between two parties: one seller (i.e., a national government or a vaccine manufacturer) and one recipient (i.e., national government)), which showed a significant relationship with technology transfer and advancing local production capacity. (4) Conclusions: Expanding the scope of vaccine procurement alternatives to COVAX such as regional pooled procurement and bilateral procurement can stratify risk of supply agreements not materializing in actual supply. Sharing the technology necessary to produce vaccines with LMICs can mitigate obstacles to bilateral procurement. A pooled purchase alliance to procure vaccine doses on behalf of participating countries within a given region can benefit LMICs by accounting for infrastructure limitations that these countries share. Finally, donations bolster global redistributed supply essential to LMICs. Full article

The coronavirus disease 2019 (COVID-19) pandemic prompted tens of thousands of people worldwide to migrate from cities in its early stages, leading to an increased spread of the virus. Understanding the factors driving relocation during a pandemic is crucial for effective outbreak control. We investigated how the pandemic influenced people’s aspirations and preparations to move, both domestically and internationally, surveying individuals in Greece, India, Italy, Kenya, Nigeria, Portugal, Serbia, Spain, and the United States of America. Out of 4448 eligible responses, 765 participants (17.2%) had a strong aspiration to move due to COVID-19, and 155 (3.5%) had already prepared. Those considering relocation were statistically significantly more likely to perceive moving to an area with fewer COVID-19 cases as protective against the virus (OR = 1.3, p < 0.05) or to know others who intended to relocate because of COVID-19 (OR = 1.5, p < 0.05). Conversely, a strong sense of being ‘at home’ reduced statistically significantly the strength of mobility aspirations (OR = 0.7, p < 0.01). Social alienation, social imitation, and the perceived efficacy of mobility increased aspirations to move due to COVID-19. This study emphasizes the rapid population movements at pandemic onset and their potential contribution to disease transmission, urging future pandemic planning to take account of such mobility dynamics. Full article

This review provides a comprehensive summary of evidence to explore the role and value of differential diagnosis in the management of Acute Respiratory Infections (ARIs) through point-of-care (POC) rapid testing in a post-pandemic scenario, paying particular attention to coronavirus disease 2019 (COVID-19), influenza, and respiratory syncytial virus (RSV). The document builds on a review of literature and policies and a process of validation and feedback by a group of seven experts from Latin America (LATAM). Evidence was collected to understand scientific and policy perspectives on the differential diagnosis of ARIs and POC rapid testing, with a focus on seven countries: Argentina, Brazil, Chile, Colombia, Costa Rica, Mexico, and Peru. The evidence indicates that POC rapid testing can serve to improve ARI case management, epidemiological surveillance, research and innovation, and evidence-based decision-making. With multiple types of rapid tests available for POC, decisions regarding which tests to use require the consideration of the testing purpose, available resources, and test characteristics regarding accuracy, accessibility, affordability, and results turnaround time. Based on the understanding of the current situation, this document provides a set of recommendations for the implementation of POC rapid testing in LATAM, supporting decision-making and guiding efforts by a broad range of stakeholders. Full article

The recent emergence of SARS-CoV-2 in 2019 has highlighted the necessity of antiviral therapeutics for current and future emerging coronaviruses. Recently, the traditional herbal medicines baicalein, baicalin, and andrographolide have shown inhibition against the main protease of SARS-CoV-2. This provides a promising new direction for COVID-19 therapeutics, but it remains unknown whether these three substances inhibit other human coronaviruses. In this study, we describe the development of novel chimeric mouse hepatitis virus (MHV) reporters that express firefly luciferase (FFL) and the 3CLpro proteases of human coronaviruses HKU1 and OC43. These chimeric viruses were used to determine if the phytochemicals baicalein, baicalin, and andrographolide are inhibitory against human coronavirus strains HKU1 and OC43. Our data show that both baicalein and baicalin exhibit inhibition towards the chimeric MHV strains. However, andrographolide induces cytotoxicity and failed to demonstrate selective toxicity towards the viruses. This study reports the development and use of a safe replicating reporter platform to investigate potential coronavirus 3CLpro inhibitors against common-cold human coronavirus strains HKU1 and OC43. Full article

The COVID-19 pandemic has been associated with lifestyle changes, reduced access to care and potential impacts on medication self-management. Our main objectives are to evaluate the impact of the pandemic on patient adherence and access to care and long-term medications and determine its association with sociodemographic and clinical factors. This study is part of the Specchio-COVID-19 longitudinal cohort study in Geneva, Switzerland, conducted through an online questionnaire. Among the 982 participants (median age: 56; 61% female), 827 took long-term medications. There were 76 reported changes in medication dosages, of which 24 (31%) were without a physician’s recommendation, and 51 delays in initiation or premature medication interruptions, of which 24 (47%) were without a physician’s recommendation. Only 1% (9/827) of participants faced medication access issues. Participants taking a respiratory medication had a four-times greater odds of reporting more regular medication (OR = 4.27; CI 95%: 2.11–8.63) intake, whereas each year increase in age was significantly associated with 6% fewer relative risks of discontinuation (OR = 0.94; CI 95%: 0.91–0.97) and 3% fewer relative risks of changes in medication dosage (OR = 0.97; CI 95%: 0.95–1.00). Despite the limited impact of the pandemic on adherence and access to medications, our results emphasize the need for understanding patient challenges when self-managing their long-term medication, notably during public health crises. Full article

On 30 January 2020, WHO declared COVID-19 a public health emergency of global concern. COVID-19 became pandemic on 11 March 2020, and spread unprecedently. No country was prepared to face its impact. Major fears started to be expressed for Africa, where dramatic consequences were expected, due to the weakness of health systems. In this review, we related major concerns, at that time but still present, regarding the limited resources in terms of qualified physicians and researchers, as well as the scarce funds to purchase essential medical equipment and improve hospital infrastructures. The difficulties to provide proper care became an undeniable mark of inequality, highlighting the need to empower local capacity and raise preparedness against infection outbreaks. The transmissibility of genetic variants affecting African nations, the immunopathology underlying comorbidities, sequelae, and pre-existing conditions, often related to changes in iron metabolism and enhancing COVID-19 severity, were described. The obstacles in adopting standardized prevention measures were highlighted, along with testing capacity biases and inequity of healthcare access and vaccine distribution. By providing a better understanding of the COVID-19 pandemic in Africa, we draw attention to the need for collaborative efforts to leverage the quality of healthcare and research in this continent. Full article

While psychotherapy incorporating equine interaction (PIE) has proven to be a viable therapeutic intervention, it is not a common mental health service found on college campuses. Nevertheless, with the rise of mental health challenges on campuses after the COVID-19 pandemic, a need for effective therapeutic solutions is warranted. Therefore, the objective of this study was to determine the effect of a collegiate recovery community (CRC) PIE program for substance abuse disorder (SUD) compared to that of traditional cognitive behavioral therapy (CBT) and to determine whether physiological synchronization occurs between the human and horse during the therapy process. College-aged adults were recruited during the COVID-19 pandemic for two types of short-term SUD therapeutic interventions, CRC-PIE and CBT. Both groups completed a self-reporting survey assessing emotional safety. Vital signs measurements for human and horse participants within the CRC-PIE were collected prior to and after the first and last therapeutic sessions. Results concluded that although emotional safety did not improve significantly for PIE participants by the last therapy session (p = 0.85), emotional safety scores were significantly different between therapy types, with lower post-therapy scores for PIE (p = 0.04). As for physiological measures for PIE participants, respiratory rates (Human: p = 0.01; Horse: p = 0.01) and pain rating scores (Human: p = 0.03; Horse: p = 0.01) significantly decreased post-therapy and a strong positive correlation (R = 0.73, R² = 0.53) associated with vital signs was observed between humans and horses. This human–horse physiological synchronization during the therapeutic intervention suggests that the horse may be a viable tool within campus CRC programs for the development of therapeutic alliances within the therapy process. Full article

(1) Background: The coronavirus disease 2019 (COVID-19) pandemic significantly affected the population worldwide, with varying responses implemented to control its spread. This study aimed to compare the epidemic data compiled by the World Health Organization (WHO) to understand the impact of the measures adopted by each country on the mortality rate. (2) Methods: The increase or decrease in the number of confirmed cases was understood in logarithmic terms, for which logarithmic growth rates “K” were used. The mortality rate was calculated as the percentage of deaths from the confirmed cases, which was also used for logarithmic comparison. (3) Results: Countries that effectively detected and isolated patients had a mortality rate 10 times lower than those who did not. Although strict lockdowns were once effective, they could not be implemented on an ongoing basis. After their cancellation, large outbreaks occurred because of medical breakdowns. The virus variants mutated with increased infectivity, which impeded the measures that were once effective, including vaccinations. Although the designs of mRNA vaccines were renewed, they could not keep up with the virus mutation rate. The only effective defence lies in steadily identifying and isolating patients. (4) Conclusions: these findings have crucial implications for the complete containment of the pandemic and future pandemic preparedness. Full article

Background: Several studies have linked coronavirus disease 2019 (COVID-19) risk to age and ABO blood groups. Variations in plasma angiotensin-converting enzyme 2 (ACE2) levels and blood counts have been reported, suggesting an association between disease severity and low lymphocyte levels. Aim: this study aimed to understand how these factors relate to COVID-19 in Ghanaian patients, considering geographical and demographic differences. Methods: Participants were recruited from six hospitals in Kumasi, Ghana, between June 2020 and July 2021. Nasopharyngeal swabs were taken to test for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), and blood samples were collected for complete blood count testing, ABO/Rhesus typing, and assessment of plasma ACE2 levels. Demographic and COVID-19 severity data were gathered, and IBM SPSS version 25.0 was used for analysis. Results: Overall, 515 patients were enrolled, out of which 55.9% (n = 288/515) were males and 50.3% (n = 259/515) tested positive for SARS-CoV-2. The median age was 37 years (IQR = 26–53). Age was significantly associated with SARS-CoV-2 infection (p = 0.002). The severe COVID-19 group was the oldest (70 years, IQR = 35–80) and presented with anaemia (haemoglobin, g/dL: 9.55, IQR = 7.85–11.93), leukocytosis (WBC × 10³/μL: 15.87, IQR = 6.68–19.80), neutrophilia (NEUT × 10⁶/μL: 14.69, IQR = 5.70–18.96) and lymphocytopenia (LYMPH × 10⁶/μL: 0.47, IQR = 0.22–0.66). No association was found between SARS-CoV-2 positivity and ABO (p = 0.711) or Rh (p = 0.805) blood groups; no association was also found between plasma ACE2 levels and SARS-CoV-2 status (p = 0.079). However, among COVID-19 participants, plasma ACE2 levels were significantly reduced in the moderate illness group (40.68 ng/mL, IQR = 34.09–48.10) compared with the asymptomatic group (50.61 ng/mL, IQR = 43.90–58.61, p = 0.015). Conclusions: While there may be no real association between the ABO blood group, as well as plasma ACE2 levels, and SARS-CoV-2 infection in Ghanaian patients, older individuals are at a higher risk of severe disease. Anaemia, and leukocytosis with lymphocytopenia may be indicators of poor disease progression. Full article