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Effects of non-pharmaceutical interventions on COVID-19: A Tale of Three Models – medRxiv

Results While model 1 found that lockdown was the most effective measure in the original 11 countries, model 2 showed that lockdown had little or no benefit as it was typically introduced at a point when the time-varying reproductive number was already very low. Model 3 found that the simple banning of public events was beneficial, while lockdown had no consistent impact. Based on Bayesian metrics, model 2 was better supported by the data than either model 1 or model 3 for both time horizons.

Conclusions Inferences on effects of NPIs are non-robust and highly sensitive to model specification. Claimed benefits of lockdown appear grossly exaggerated.

https://www.medrxiv.org/content/10.1101/2020.07.22.20160341v3

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Conflicts of interest among the UK government’s covid-19 advisers – BMJ

Little is known about the interests of the doctors, scientists, and academics on whose advice the UK government relies to manage the pandemic. Attempts to discover more are frequently thwarted, finds Paul D Thacker.

https://web.archive.org/web/20201210214506/https://www.bmj.com/content/371/bmj.m4716

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Evidence of SARS-CoV-2 RNA in an Oropharyngeal Swab Specimen, Milan, Italy, Early December 2019 – CDC

We identified severe acute respiratory syndrome coronavirus 2 RNA in an oropharyngeal swab specimen collected from a child with suspected measles in early December 2019, ≈3 months before the first identified coronavirus disease case in Italy. This finding expands our knowledge on timing and mapping of novel coronavirus transmission pathways.

https://web.archive.org/web/20201209020309/https://wwwnc.cdc.gov/eid/article/27/2/20-4632_article

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Medical Tests and Bayes’ Theorem

Suppose that you are worried that you might have a rare disease. You decide to get tested, and suppose that the testing methods for this disease are correct 99 percent of the time (in other words, if you have the disease, it shows that you do with 99 percent probability, and if you don’t have the disease, it shows that you do not with 99 percent probability). Suppose this disease is actually quite rare, occurring randomly in the general population in only one of every 10,000 people.

If your test results come back positive, what are your chances that you actually have the disease?

Do you think it is approximately: (a) .99, (b) .90, (c) .10, or (d) .01?

Surprisingly, the answer is (d), less than 1 percent chance that you have the disease!

This fact may be deduced using something called Bayes’ theorem…

https://math.hmc.edu/funfacts/medical-tests-and-bayes-theorem/

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Pandemrix vaccine: why was the public not told of early warning signs? – BMJ (2018)

“We fully support the swine flu vaccination programme … The vaccine has been thoroughly tested,” they declared in a joint statement.

Except, it hadn’t. Anticipating a severe influenza pandemic, governments around the world had made various logistical and legal arrangements to shorten the time between recognition of a pandemic virus and the production of a vaccine and administration of that vaccine in the population. In Europe, one element of those plans was an agreement to grant licences to pandemic vaccines based on data from pre-pandemic “mock-up” vaccines produced using a different virus (H5N1 influenza). Another element, adopted by countries such as Canada, the US, UK, France, and Germany, was to provide vaccine manufacturers indemnity from liability for wrongdoing, thereby reducing the risk of a lawsuit stemming from vaccine related injury.

https://web.archive.org/web/20200408051329/https://www.bmj.com/content/362/bmj.k3948

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Safety and efficacy of the ChAdOx1 nCoV-19 vaccine (AZD1222) against SARS-CoV-2: an interim analysis of four randomised controlled trials in Brazil, South Africa, and the UK

Randomised control trial study showing safety and efficacy of COVID-19 vaccine has clear conflicts of interest.

Safety and efficacy of the ChAdOx1 nCoV-19 vaccine AZD1222

https://salud.edomex.gob.mx/cevece/documentos/covid/Safety%20and%20efficacy%20of%20the%20ChAdOx1%20nCoV-19%20vaccine%20AZD1222.pdf

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Nucleic acid testing (NAT) technologies that use real-time polymerase chain reaction (RT-PCR) for detection of SARS-CoV-2 – WHO

WHO has received user feedback on an elevated risk for false SARS-CoV-2 results when testing specimens using RT-PCR reagents on open systems.

As with any diagnostic procedure, the positive and negative predictive values for the product in a given testing population are important to note. As the positivity rate for SARS-CoV-2 decreases, the positive predictive value also decreases. This means that the probability that a person who has a positive result (SARS-CoV-2 detected) is truly infected with SARS-CoV-2 decreases as positivity rate decreases, irrespective of the assay specificity. Therefore, healthcare providers are encouraged to take into consideration testing results along with clinical signs and symptoms, confirmed status of any contacts, etc.

https://web.archive.org/web/20201215013928/https://www.who.int/news/item/14-12-2020-who-information-notice-for-ivd-users

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Informed consent disclosure to vaccine trial subjects of risk of COVID-19 vaccines worsening clinical disease – National Center for Biotechnology Information

COVID-19 vaccines designed to elicit neutralising antibodies may sensitise vaccine recipients to more severe disease than if they were not vaccinated. Vaccines for SARS, MERS and RSV have never been approved, and the data generated in the development and testing of these vaccines suggest a serious mechanistic concern: that vaccines designed empirically using the traditional approach (consisting of the unmodified or minimally modified coronavirus viral spike to elicit neutralising antibodies), be they composed of protein, viral vector, DNA or RNA and irrespective of delivery method, may worsen COVID-19 disease via antibody-dependent enhancement (ADE). This risk is sufficiently obscured in clinical trial protocols and consent forms for ongoing COVID-19 vaccine trials that adequate patient comprehension of this risk is unlikely to occur, obviating truly informed consent by subjects in these trials.

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Covid-19: The lost lessons of Tamiflu – BMJ

While the truth about Tamiflu emerged only after years of exhaustive work by the Cochrane review group and investigative journalists, the machinations behind remdesivir’s rapid climb were evident at an early stage. On 29 April, the same day as a trial was published showing no significant effect of remdesivir among patients in hospital, remdesivir’s manufacturer rushed out interim findings of a more favourable trial by press release and with full White House honours. The much vaunted but minimal benefits shown in severely ill people were used to justify FDA approvals and worldwide purchase. Now a much larger trial has found little or no benefit in hospital patients, and a BMJ Rapid Recommendation, produced in collaboration with the World Health Organization and Magic App, has come down against use of remdesivir in patients with covid-19 of any severity.

…Science by press release, on the basis of interim or ad hoc analyses, and without access to the data, also afflicts our knowledge about the covid-19 candidate vaccines. Patients and the public deserve better than this. So do health professionals. Pandemic or no pandemic, decisions must be based on scrutiny of the full data from trials that are independent of drug and vaccine manufacturers.

https://web.archive.org/web/20201205164516/https://www.bmj.com/content/371/bmj.m4701

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John Kerry reveals Biden’s devotion to radical ‘Great Reset’ movement – The Hill

At a panel discussion about the Great Reset hosted by the World Economic Forum in mid-November, former Secretary of State John Kerry – Biden’s would-be special presidential envoy for climate – firmly declared that the Biden administration will support the Great Reset and that the Great Reset “will happen with greater speed and with greater intensity than a lot of people might imagine.”

https://web.archive.org/web/20201205141023/https://thehill.com/opinion/energy-environment/528482-john-kerry-reveals-bidens-devotion-to-radical-great-reset-movement

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Leaks reveal two-thirds of private hospital capacity went unused by NHS – HSJ

  • Two-thirds of the private sector capacity that was block-purchased by NHS England was left unused over the summer
  • Unprecedented block contracts in place for almost all the private hospital capacity, thought to be worth around £400m per month
  • Comes as waiting times for elective care and diagnostic tests have steeply increased
  • Capacity to carry out chemotherapy treatment was among that not fully used
  • Insiders blame confusion and communication over contracts, and some argue the contracts were not needed

https://www.hsj.co.uk/finance-and-efficiency/leaks-reveal-two-thirds-of-private-hospital-capacity-went-unused-by-nhs/7029000.article

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UK Economic and fiscal outlook – UK Office for Budget Responsibility

The coronavirus pandemic has delivered the largest peacetime shock to the global economy on record. It has required the imposition of severe restrictions on economic and social life; driven unprecedented falls in national income; fuelled rises in public deficits and debt surpassed only in wartime; and created considerable uncertainty about the future.

…GDP is set to fall by 11 per cent this year – the largest drop in annual output since the Great Frost of 1709.

https://obr.uk/docs/ExecSumm_November_2020.pdf

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Public needs to prep for vaccine side effects – Science

Most people will escape “severe” side effects, defined as those that prevent daily activity. Fewer than 2% of recipients of the Pfizer and Moderna vaccines developed severe fevers of 39°C to 40°C. But if the companies win regulatory approvals, they’re aiming to supply vaccine to 35 million people worldwide by the end of December. If 2% experienced severe fever, that would be 700,000 people.

Other transient side effects would likely affect even more people. The independent board that conducted the interim analysis of Moderna’s huge trial found that severe side effects included fatigue in 9.7% of participants, muscle pain in 8.9%, joint pain in 5.2%, and headache in 4.5%. In the Pfizer/BioNTech vaccine trial, the numbers were lower: Severe side effects included fatigue (3.8%) and headache (2%).

But that’s a higher rate of severe reactions than people may be accustomed to. “This is higher reactogenicity than is ordinarily seen with most flu vaccines, even the high-dose ones,” says Arnold Monto, an epidemiologist at the University of Michigan School of Public Health.

https://web.archive.org/web/20201126203444/https://science.sciencemag.org/content/370/6520/1022

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No evidence for increased transmissibility from recurrent mutations in SARS-CoV-2 – Nature

COVID-19 is caused by the coronavirus SARS-CoV-2, which jumped into the human population in late 2019 from a currently uncharacterised animal reservoir. Due to this recent association with humans, SARS-CoV-2 may not yet be fully adapted to its human host. This has led to speculations that SARS-CoV-2 may be evolving towards higher transmissibility. The most plausible mutations under putative natural selection are those which have emerged repeatedly and independently (homoplasies). Here, we formally test whether any homoplasies observed in SARS-CoV-2 to date are significantly associated with increased viral transmission. To do so, we develop a phylogenetic index to quantify the relative number of descendants in sister clades with and without a specific allele. We apply this index to a curated set of recurrent mutations identified within a dataset of 46,723 SARS-CoV-2 genomes isolated from patients worldwide. We do not identify a single recurrent mutation in this set convincingly associated with increased viral transmission. Instead, recurrent mutations currently in circulation appear to be evolutionary neutral and primarily induced by the human immune system via RNA editing, rather than being signatures of adaptation. At this stage we find no evidence for significantly more transmissible lineages of SARS-CoV-2 due to recurrent mutations.

https://web.archive.org/web/20201125121534/https://www.nature.com/articles/s41467-020-19818-2

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No evidence for increased transmissibility from recurrent mutations in SARS-CoV-2 – Nature

We do not identify a single recurrent mutation in this set convincingly associated with increased viral transmission. Instead, recurrent mutations currently in circulation appear to be evolutionary neutral and primarily induced by the human immune system via RNA editing, rather than being signatures of adaptation. At this stage we find no evidence for significantly more transmissible lineages of SARS-CoV-2 due to recurrent mutations.

https://web.archive.org/web/20201125121534/https://www.nature.com/articles/s41467-020-19818-2

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Facemasks in the COVID-19 era: A health hypothesis – NCBI

Many countries across the globe utilized medical and non-medical facemasks as non-pharmaceutical intervention for reducing the transmission and infectivity of coronavirus disease-2019 (COVID-19). Although, scientific evidence supporting facemasks’ efficacy is lacking, adverse physiological, psychological and health effects are established. Is has been hypothesized that facemasks have compromised safety and efficacy profile and should be avoided from use. The current article comprehensively summarizes scientific evidences with respect to wearing facemasks in the COVID-19 era, providing prosper information for public health and decisions making.

…The data suggest that both medical and non-medical facemasks are ineffective to block human-to-human transmission of viral and infectious disease such SARS-CoV-2 and COVID-19, supporting against the usage of facemasks. Wearing facemasks has been demonstrated to have substantial adverse physiological and psychological effects.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7680614/

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COVID-19 in children: analysis of the first pandemic peak in England – BMJ

Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%–34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%–45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children.

Children accounted for a very small proportion of confirmed cases despite the large numbers of children tested. SARS-CoV-2 positivity was low even in children with ARI. Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2.

https://web.archive.org/web/20201124224223if_/https://adc.bmj.com/content/105/12/1180

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A billion people have no legal identity – but a new app plans to change that – World Economic Forum

Ensuring everyone has a legal identity, including birth registration, by 2030 is one of the United Nations’ Sustainable Development Goals (SDGs). It prompted the World Bank to launch its Identification for Development (ID4D) initiative in 2014.

The latest data from the Bank shows there are just over 987 million people in the world who have no legal identity, down from 1.5 billion in 2016. The majority live in low-income countries where almost 45% of women and 28% of men lack a legal ID.

…Thompson’s app uses blockchain to preserve the user’s digital identity from interference, making it accessible only to the person whose ID it holds. As a digital solution, it goes with the grain of how many people in emerging economies manage their finances using smartphones.

http://archive.today/2021.01.02-174558/https://www.weforum.org/agenda/2020/11/legal-identity-id-app-aid-tech/

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Post-lockdown SARS-CoV-2 nucleic acid screening in nearly ten million residents of Wuhan, China – Nature

Stringent COVID-19 control measures were imposed in Wuhan between January 23 and April 8, 2020. Estimates of the prevalence of infection following the release of restrictions could inform post-lockdown pandemic management. Here, we describe a city-wide SARS-CoV-2 nucleic acid screening programme between May 14 and June 1, 2020 in Wuhan. All city residents aged six years or older were eligible and 9,899,828 (92.9%) participated. No new symptomatic cases and 300 asymptomatic cases (detection rate 0.303/10,000, 95% CI 0.270–0.339/10,000) were identified. There were no positive tests amongst 1,174 close contacts of asymptomatic cases. 107 of 34,424 previously recovered COVID-19 patients tested positive again (re-positive rate 0.31%, 95% CI 0.423–0.574%). The prevalence of SARS-CoV-2 infection in Wuhan was therefore very low five to eight weeks after the end of lockdown.

https://www.nature.com/articles/s41467-020-19802-w

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Predictive performance of international COVID-19 mortality forecasting models – medRxiv

The Imperial model had larger errors, about 5-fold higher than other models by six weeks. This appears to be largely driven by the aforementioned tendency to overestimate mortality. At twelve weeks, MAPE values were lowest for the IHME-MS-SEIR (23.7%) model, while the Imperial model had the most elevated MAPE (98.8%). Predictive performance between models was generally similar for median absolute errors (MAEs) 

https://www.medrxiv.org/content/10.1101/2020.07.13.20151233v5.full