1
|
Ingholt MM, Simonsen L, Mamelund SE, Noahsen P, van Wijhe M. The 1919-21 influenza pandemic in Greenland. Int J Circumpolar Health 2024; 83:2325711. [PMID: 38446074 PMCID: PMC10919313 DOI: 10.1080/22423982.2024.2325711] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/21/2023] [Accepted: 02/27/2024] [Indexed: 03/07/2024] Open
Abstract
In Alaska, the 1918-20 influenza pandemic was devastating, with mortality rates up to 90% of the population, while in other arctic regions in northern Sweden and Norway mortality was considerably lower. We investigated the timing and age-patterns in excess mortality in Greenland during the period 1918-21 and compare these to other epidemics and the 1889-92 pandemic. We accessed the Greenlandic National Archives and transcribed all deaths from 1880 to 1921 by age, geography, and cause of death. We estimated monthly excess mortality and studied the spatial-temporal patterns of the pandemics and compared them to other mortality crises in the 40-year period. The 1918-21 influenza pandemic arrived in Greenland in the summer of 1919, one year delayed due to ship traffic interruptions during the winter months. We found that 5.2% of the Greenland population died of the pandemic with substantial variability between counties (range, 0.1% to 11%). We did not see the typical pandemic age-pattern of high young-adult mortality, possibly due to high baseline mortality in this age-group or remoteness. However, despite substantial mortality, the mortality impact was not standing out relative to other mortality crises, or of similar devastation reported in Alaskan populations.
Collapse
Affiliation(s)
- Mathias Mølbak Ingholt
- PandemiX Center, Department of Science and Environment, Roskilde University, Roskilde, Denmark
- Cambridge Group for the History of Population and Social Structure, Department of Geography, Downing Place, Cambridge, UK
| | - Lone Simonsen
- PandemiX Center, Department of Science and Environment, Roskilde University, Roskilde, Denmark
| | | | - Paneeraq Noahsen
- Governmental agency, National Board of Health in Greenland, Nuuk, Greenland
| | - Maarten van Wijhe
- PandemiX Center, Department of Science and Environment, Roskilde University, Roskilde, Denmark
| |
Collapse
|
2
|
Fox F, Hayes J, Whelan B, Casey D, Connolly M. Key Factors Impacting a Medical Ventilator Supply Chain During the COVID- 19 Pandemic: Lessons for Pandemic Preparedness. Disaster Med Public Health Prep 2024; 18:e65. [PMID: 38606429 DOI: 10.1017/dmp.2024.55] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 04/13/2024]
Abstract
OBJECTIVES Future pandemics may cause more severe respiratory illness in younger age groups than COVID-19, requiring many more mechanical ventilators. This publication synthesizes the experiences of diverse contributors to Medtronic's mechanical ventilator supply chain during the pandemic, serving as a record of what worked and what didn't, while identifying key factors affecting production ramp-up in this healthcare crisis. METHOD In-depth, one-on-one interviews (n = 17) were held with key Medtronic personnel and suppliers. Template analysis was used, and interview content was analyzed for signals, initiatives, actions, and outcomes, as well as influencing forces. RESULTS Key findings revealed many factors limiting ventilator production ramp-up. Supply chain strengths and weaknesses were identified. Political factors played a role in allocating ventilators and also supported production. Commercial considerations were not priority, but economic awareness was essential to support suppliers. Workers were motivated and flexible. Component shortages, space, production processes, and logistics were challenges. Legally based pressures were reported e.g., import and export restrictions. CONCLUSION Crisis response alone is not enough; preparation is essential. Coordinated international strategies are more effective than individual country responses. Supply chain resilience based on visibility and flexibility is key. This research can help public health planners and the medical device industry prepare for future healthcare crises.
Collapse
Affiliation(s)
- Frank Fox
- University of Galway, Global Health, School of Health Sciences, Galway, Ireland
| | - Jessica Hayes
- University of Galway, Global Health, School of Health Sciences, Galway, Ireland
| | - Barbara Whelan
- University of Galway, School of Nursing and Midwifery, Galway, Ireland
| | - Dympna Casey
- University of Galway, School of Nursing and Midwifery, Galway, Ireland
| | - Máire Connolly
- University of Galway, Global Health, School of Health Sciences, Galway, Ireland
| |
Collapse
|
3
|
Doran Á, Colvin CL, McLaughlin E. What can we learn from historical pandemics? A systematic review of the literature. Soc Sci Med 2024; 342:116534. [PMID: 38184966 DOI: 10.1016/j.socscimed.2023.116534] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 06/09/2023] [Revised: 12/12/2023] [Accepted: 12/19/2023] [Indexed: 01/09/2024]
Abstract
What are the insights from historical pandemics for policymaking today? We carry out a systematic review of the literature on the impact of pandemics that occurred since the Industrial Revolution and prior to Covid-19. Our literature searches were conducted between June 2020 and September 2023, with the final review encompassing 169 research papers selected for their relevance to understanding either the demographic or economic impact of pandemics. We include literature from across disciplines to maximise our knowledge base, finding many relevant articles in journals which would not normally be on the radar of social scientists. Our review identifies two gaps in the literature: (1) the need to study pandemics and their effects more collectively rather than looking at them in isolation; and (2) the need for more study of pandemics besides 1918 Spanish Influenza, especially milder pandemic episodes. These gaps are a consequence of academics working in silos, failing to draw on the skills and knowledge offered by other disciplines. Synthesising existing knowledge on pandemics in one place provides a basis upon which to identify the lessons in preparing for future catastrophic disease events.
Collapse
Affiliation(s)
- Áine Doran
- Department of Accounting, Finance and Economics, Ulster University, 2-24 York Street, Belfast, BT15 1AP, UK.
| | - Christopher L Colvin
- Department of Economics, Queen's University Belfast, Riddel Hall, 185 Stranmillis Road, Belfast, BT9 5EE, UK.
| | - Eoin McLaughlin
- Department of Accounting, Finance and Economics, Heriot-Watt University, Edinburgh, EH14 4AS, UK.
| |
Collapse
|
4
|
Routledge M, Lyon J, Vincent C, Gordon Clarke A, Shawcross K, Turpin C, Cormack H, Robson SC, Beckett A, Glaysher S, Cook K, Fearn C, Goudarzi S, Hutley EJ, Ross D. Management of a large outbreak of COVID-19 at a British Army training centre: lessons for the future. BMJ Mil Health 2023; 169:488-492. [PMID: 34772689 PMCID: PMC8594976 DOI: 10.1136/bmjmilitary-2021-001976] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/11/2021] [Accepted: 10/07/2021] [Indexed: 11/04/2022]
Abstract
INTRODUCTION The COVID-19 pandemic has posed major challenges for infection control within training centres, both civilian and military. Here we present a narrative review of an outbreak that occurred at the Royal Military Academy Sandhurst (RMAS) in January-March 2021, in the context of the circulating, highly transmissible SARS-CoV-2 variant B.1.1.7. METHODS Testing for SARS-CoV-2 was performed using a combination of reverse transcriptase PCR and Lateral Flow Devices (LFDs). Testing and isolation procedures were conducted in line with a pre-established symptom stratification system. Genomic sequencing was performed on 10 sample isolates. RESULTS By the end of the outbreak, 185 cases (153 Officer Cadets, 32 permanent staff) had contracted confirmed COVID-19. This represented 15% of the total RMAS population. This resulted in 0 deaths and 0 hospitalisations, but due to necessary isolation procedures did represent an estimated 12 959 person-days of lost training. 9 of 10 (90%) of sequenced isolates had a reportable lineage. All of those reported were found to be the Alpha lineage B.1.1.7. CONCLUSIONS We discuss the key lessons learnt from the after-action review by the Incident Management Team. These include the importance of multidisciplinary working, the utility of sync matrices to monitor outbreaks in real time, issues around Officer Cadets reporting symptoms, timing of high-risk training activities, infrastructure and use of LFDs. COVID-19 represents a vital learning opportunity to minimise the impact of potential future pandemics, which may produce considerably higher morbidity and mortality in military populations.
Collapse
Affiliation(s)
- Matthew Routledge
- Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK
- Medical Officer, 254 Medical Regiment, Cambridge, UK
| | - J Lyon
- Senior Medical Officer, Royal Military Academy Sandhurst, Camberley, UK
| | - C Vincent
- Medical Planner, HQ Army Recruiting and Initial Training Command, Pewsey, UK
| | - A Gordon Clarke
- XO, HQ Army Recruiting and Initial Training Command, Pewsey, UK
| | - K Shawcross
- Environmental Health, Medical Branch, Head Quarters Regional Command, Aldershot, UK
| | - C Turpin
- ACOS, Royal Military Academy Sandhurst, Camberley, UK
| | - H Cormack
- Chief of Staff, HQ Army Recruiting and Initial Training Command, Pewsey, UK
| | - S C Robson
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
- Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK
- School of Biological Sciences, University of Portsmouth, Portsmouth, UK
| | - A Beckett
- Centre for Enzyme Innovation, University of Portsmouth, Portsmouth, UK
| | - S Glaysher
- Research & Innovation, Queen Alexandra Hospital, Portsmouth Hospitals University NHS Trust, Portsmouth, UK
| | - K Cook
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - C Fearn
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - S Goudarzi
- School of Pharmacy & Biomedical Science, University of Portsmouth, Portsmouth, UK
| | - E J Hutley
- Defence Pathology, Royal Centre for Defence Medicine, Birmingham, UK
| | - D Ross
- Parkes Professor, Army Medical Services, Camberley, UK
| |
Collapse
|
5
|
Huang CQ, Vishwanath S, Carnell GW, Chan ACY, Heeney JL. Immune imprinting and next-generation coronavirus vaccines. Nat Microbiol 2023; 8:1971-1985. [PMID: 37932355 DOI: 10.1038/s41564-023-01505-9] [Citation(s) in RCA: 3] [Impact Index Per Article: 3.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/01/2023] [Accepted: 09/13/2023] [Indexed: 11/08/2023]
Abstract
Vaccines based on historical virus isolates provide limited protection from continuously evolving RNA viruses, such as influenza viruses or coronaviruses, which occasionally spill over between animals and humans. Despite repeated booster immunizations, population-wide declines in the neutralization of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants have occurred. This has been compared to seasonal influenza vaccinations in humans, where the breadth of immune responses induced by repeat exposures to antigenically distinct influenza viruses is confounded by pre-existing immunity-a mechanism known as imprinting. Since its emergence, SARS-CoV-2 has evolved in a population with partial immunity, acquired by infection, vaccination or both. Here we critically examine the evidence for and against immune imprinting in host humoral responses to SARS-CoV-2 and its implications for coronavirus disease 2019 (COVID-19) booster vaccine programmes.
Collapse
Affiliation(s)
- Chloe Qingzhou Huang
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Sneha Vishwanath
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - George William Carnell
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Andrew Chun Yue Chan
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK
| | - Jonathan Luke Heeney
- Laboratory of Viral Zoonotics, Department of Veterinary Medicine, University of Cambridge, Cambridge, UK.
| |
Collapse
|
6
|
Jones RP, Ponomarenko A. COVID-19-Related Age Profiles for SARS-CoV-2 Variants in England and Wales and States of the USA (2020 to 2022): Impact on All-Cause Mortality. Infect Dis Rep 2023; 15:600-634. [PMID: 37888139 PMCID: PMC10606787 DOI: 10.3390/idr15050058] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 04/29/2023] [Revised: 09/07/2023] [Accepted: 09/07/2023] [Indexed: 10/28/2023] Open
Abstract
Since 2020, COVID-19 has caused serious mortality around the world. Given the ambiguity in establishing COVID-19 as the direct cause of death, we first investigate the effects of age and sex on all-cause mortality during 2020 and 2021 in England and Wales. Since infectious agents have their own unique age profile for death, we use a 9-year time series and several different methods to adjust single-year-of-age deaths in England and Wales during 2019 (the pre-COVID-19 base year) to a pathogen-neutral single-year-of-age baseline. This adjusted base year is then used to confirm the widely reported higher deaths in males for most ages above 43 in both 2020 and 2021. During 2020 (+COVID-19 but no vaccination), both male and female population-adjusted deaths significantly increased above age 35. A significant reduction in all-cause mortality among both males and females aged 75+ could be demonstrated in 2021 during the widespread COVID-19 vaccination period; however, deaths below age 75 progressively increased. This finding arises from a mix of vaccination coverage and year-of-age profiles of deaths for the different SARS-CoV-2 variants. In addition, specific effects of age around puberty were demonstrated, where females had higher deaths than males. There is evidence that year-of-birth cohorts may also be involved, indicating that immune priming to specific pathogen outbreaks in the past may have led to lower deaths for some birth cohorts. To specifically identify the age profile for the COVID-19 variants from 2020 to 2023, we employ the proportion of total deaths at each age that are potentially due to or 'with' COVID-19. The original Wuhan strain and the Alpha variant show somewhat limited divergence in the age profile, with the Alpha variant shifting to a moderately higher proportion of deaths below age 84. The Delta variant specifically targeted individuals below age 65. The Omicron variants showed a significantly lower proportion of overall mortality, with a markedly higher relative proportion of deaths above age 65, steeply increasing with age to a maximum around 100 years of age. A similar age profile for the variants can be seen in the age-banded deaths in US states, although they are slightly obscured by using age bands rather than single years of age. However, the US data shows that higher male deaths are greatly dependent on age and the COVID variant. Deaths assessed to be 'due to' COVID-19 (as opposed to 'involving' COVID-19) in England and Wales were especially overestimated in 2021 relative to the change in all-cause mortality. This arose as a by-product of an increase in COVID-19 testing capacity in late 2020. Potential structure-function mechanisms for the age-specificity of SARS-CoV-2 variants are discussed, along with potential roles for small noncoding RNAs (miRNAs). Using data from England, it is possible to show that the unvaccinated do indeed have a unique age profile for death from each variant and that vaccination alters the shape of the age profile in a manner dependent on age, sex, and the variant. The question is posed as to whether vaccines based on different variants carry a specific age profile.
Collapse
Affiliation(s)
| | - Andrey Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine
| |
Collapse
|
7
|
Tobin R, Pridham G, Rutenberg AD. Modelling lifespan reduction in an exogenous damage model of generic disease. Sci Rep 2023; 13:16304. [PMID: 37770483 PMCID: PMC10539353 DOI: 10.1038/s41598-023-43005-0] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/11/2023] [Accepted: 09/18/2023] [Indexed: 09/30/2023] Open
Abstract
We model the effects of disease and other exogenous damage during human aging. Even when the exogenous damage is repaired at the end of acute disease, propagated secondary damage remains. We consider both short-term mortality effects due to (acute) exogenous damage and long-term mortality effects due to propagated damage within the context of a generic network model (GNM) of individual aging that simulates a U.S. population. Across a wide range of disease durations and severities we find that while excess short-term mortality is highest for the oldest individuals, the long-term years of life lost are highest for the youngest individuals. These appear to be universal effects of human disease. We support this conclusion with a phenomenological model coupling damage and mortality. Our results are consistent with previous lifetime mortality studies of atom bomb survivors and post-recovery health studies of COVID-19. We suggest that short-term health impact studies could complement lifetime mortality studies to better characterize the lifetime impacts of disease on both individuals and populations.
Collapse
Affiliation(s)
- Rebecca Tobin
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, B3H 4R2, Canada
- Data Science, Analytics, and Artificial Intelligence (DSAAI) program, Carlton University, Ottawa, K1S 5B6, Canada
| | - Glen Pridham
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, B3H 4R2, Canada
| | - Andrew D Rutenberg
- Department of Physics and Atmospheric Science, Dalhousie University, Halifax, NS, B3H 4R2, Canada.
| |
Collapse
|
8
|
Ugale SS, Holmes TH, Maysel-Auslender S, Boyd SD, Dekker CL, Davis MM, Maecker HT. Acute Respiratory Illness Is Associated with Memory T Cell Differentiation and Other Immune Cell Changes in an Age-Associated Manner. Immunohorizons 2023; 7:611-618. [PMID: 37707792 PMCID: PMC10590771 DOI: 10.4049/immunohorizons.2300050] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/23/2023] [Accepted: 08/25/2023] [Indexed: 09/15/2023] Open
Abstract
Respiratory viruses such as influenza are encountered multiple times through infection and/or vaccination and thus have the potential to shape immune cell phenotypes over time. In particular, memory T cell compartments may be affected, as both CD4+ and CD8+ T cell responses likely contribute to viral control. In this study, we assessed immune phenotypes using cytometry by time of flight in the peripheral blood of 22 humans with acute respiratory illness and 22 age-matched noninfected controls. In younger infected individuals (1-19 y of age), we found decreased B and NK cell frequencies and a shift toward more effector-like CD4+ and CD8+ T cell phenotypes, compared with young healthy controls. Significant differences between noninfected and infected older individuals (30-74 y of age) were not seen. We also observed a decrease in naive CD4+ T cells and CD27+CD8+ T cells as well as an increase in effector memory CD8+ T cells and NKT cells in noninfected individuals with age. When cell frequencies were regressed against age for infected versus noninfected subjects, significant differences in trends with age were observed for multiple cell types. These included B cells and various subsets of CD4+ and CD8+ T cells. We conclude that acute respiratory illness drives T cell differentiation and decreases circulating B cell frequencies preferentially in young compared with older individuals.
Collapse
Affiliation(s)
- Shreya S. Ugale
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA
| | - Tyson H. Holmes
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA
| | - Sofia Maysel-Auslender
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA
| | - Scott D. Boyd
- Department of Pathology, Stanford University School of Medicine, Stanford, CA
| | - Cornelia L. Dekker
- Department of Pediatrics, Stanford University School of Medicine, Stanford, CA
| | - Mark M. Davis
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA
| | - Holden T. Maecker
- Institute for Immunity, Transplantation, and Infection, Stanford University School of Medicine, Stanford, CA
| |
Collapse
|
9
|
Honda-Okubo Y, Sakala IG, André G, Tarbet EB, Hurst BL, Petrovsky N. An Advax-CpG55.2 adjuvanted recombinant hemagglutinin vaccine provides immunity against H7N9 influenza in adult and neonatal mice. Vaccine 2023; 41:5592-5602. [PMID: 37532610 DOI: 10.1016/j.vaccine.2023.07.061] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 05/30/2023] [Revised: 07/25/2023] [Accepted: 07/26/2023] [Indexed: 08/04/2023]
Abstract
There is a major unmet need for strategies to improve the immunogenicity and effectiveness of pandemic influenza vaccines, particularly in poor responder populations such as neonates. Recombinant protein approaches to pandemic influenza offer advantages over more traditional inactivated virus approaches, as they are free of problems such as egg adaptation or need for high level biosecurity containment for manufacture. However, a weakness of recombinant proteins is their low immunogenicity. We asked whether the use of an inulin polysaccharide adjuvant (Advax) alone or combined with a TLR9 agonist (CpG55.2) would enhance the immunogenicity and protection of a recombinant hemagglutinin vaccine against H7N9 influenza (rH7HA), including in neonatal mice. Advax adjuvant induced predominantly IgG1 responses against H7HA, whereas Advax-CpG55.2 adjuvant also induced IgG2a, IgG2b and IgG3 responses, consistent with the TLR9 agonist component inducing a Th1 bias. Advax-CpG55.2 adjuvanted rH7HA induced high serum neutralizing antibody titers in adult mice. In newborns it similarly overcame immune hypo-responsiveness and enhanced serum anti-rH7HA IgG levels in 7-day-old BALB/C and C57BL/6 mice. Immunized adult mice were protected against a lethal H7N9 virus challenge. When formulated with Advax-CpG55.2 adjuvant, greater protection was seen with rH7HA than with inactivated H7 whole virus antigen. Advax-CpG55.2 adjuvanted rH7HA represents a promising influenza vaccine platform for further development.
Collapse
Affiliation(s)
- Yoshikazu Honda-Okubo
- Vaxine Pty Ltd, Bedford Park, Adelaide, SA 5042, Australia; Flinders University, Bedford Park, Adelaide, SA 5042, Australia
| | - Isaac G Sakala
- Vaxine Pty Ltd, Bedford Park, Adelaide, SA 5042, Australia; Flinders University, Bedford Park, Adelaide, SA 5042, Australia
| | | | - E Bart Tarbet
- Institute for Antiviral Research, Department of Animal, Dairy, and Veterinary Sciences, 5600 Old Main Hill, Utah State University, Logan, UT 84322, USA
| | - Brett L Hurst
- Institute for Antiviral Research, Department of Animal, Dairy, and Veterinary Sciences, 5600 Old Main Hill, Utah State University, Logan, UT 84322, USA
| | | |
Collapse
|
10
|
Ruckstuhl MM, Bischof E, Blatch D, Buhayer A, Goldhahn J, Battegay E, Tichelli A, Ewald CY. Translational longevity medicine: a Swiss perspective in an ageing country. Swiss Med Wkly 2023; 153:40088. [PMID: 37410895 DOI: 10.57187/smw.2023.40088] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 07/08/2023] Open
Abstract
Breakthroughs in medical research in the last century have led to a significant extension of the human lifespan, resulting in a shift towards an elderly population worldwide. Due to the ongoing progress of global development towards elevated standards of living, this study specifically examines Switzerland as a representative nation to explore the socioeconomic and healthcare ramifications associated with an ageing population, thereby highlighting the tangible impact experienced in this context. Beyond the exhaustion of pension funds and medical budgets, by reviewing the literature and analysing publicly available data, we observe a "Swiss Japanification". Old age is associated with late-life comorbidities and an increasing proportion of time spent in poor health. To address these problems, a paradigm shift in medical practice is needed to improve health rather than respond to existing diseases. Basic ageing research is gaining momentum to be translated into therapeutic interventions and provides machine learning tools driving longevity medicine. We propose that research focus on closing the translational gap between the molecular mechanisms of ageing and a more prevention-based medicine, which would help people age better and prevent late-life chronic diseases.
Collapse
Affiliation(s)
- Marco M Ruckstuhl
- Laboratory of Extracellular Matrix Regeneration, Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
| | - Evelyne Bischof
- Shanghai University of Medicine and Health Sciences, Shanghai, China
- Department of Medical Oncology, Renji Hospital, School of Medicine, Shanghai Jiao Tong University, Shanghai, China
| | - Dana Blatch
- International Center for Multimorbidity and Complexity in Medicine (ICMC), University of Zurich
| | - Aliki Buhayer
- International Center for Multimorbidity and Complexity in Medicine (ICMC), University of Zurich
- Prism Scientific Sàrl, Genève, Switzerland
| | - Jörg Goldhahn
- Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zürich, Switzerland
| | - Edouard Battegay
- International Center for Multimorbidity and Complexity in Medicine (ICMC), University of Zurich
- Department of Psychosomatic Medicine, Merian Iselin Klinik, Basel, Switzerland
| | - Andre Tichelli
- Division of Haematology, University Hospital Basel, Basel, Switzerland
| | - Collin Y Ewald
- Laboratory of Extracellular Matrix Regeneration, Institute of Translational Medicine, Department of Health Sciences and Technology, ETH Zürich, Schwerzenbach, Switzerland
| |
Collapse
|
11
|
Xie Y, Tian X, Zhang X, Yao H, Wu N. Immune interference in effectiveness of influenza and COVID-19 vaccination. Front Immunol 2023; 14:1167214. [PMID: 37153582 PMCID: PMC10154574 DOI: 10.3389/fimmu.2023.1167214] [Citation(s) in RCA: 8] [Impact Index Per Article: 8.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/16/2023] [Accepted: 04/06/2023] [Indexed: 05/09/2023] Open
Abstract
Vaccines are known to function as the most effective interventional therapeutics for controlling infectious diseases, including polio, smallpox, rabies, tuberculosis, influenza and SARS-CoV-2. Smallpox has been eliminated completely and polio is almost extinct because of vaccines. Rabies vaccines and Bacille Calmette-Guérin (BCG) vaccines could effectively protect humans against respective infections. However, both influenza vaccines and COVID-19 vaccines are unable to eliminate these two infectious diseases of their highly variable antigenic sites in viral proteins. Vaccine effectiveness (VE) could be negatively influenced (i.e., interfered with) by immune imprinting of previous infections or vaccinations, and repeated vaccinations could interfere with VE against infections due to mismatch between vaccine strains and endemic viral strains. Moreover, VE could also be interfered with when more than one kind of vaccine is administrated concomitantly (i.e., co-administrated), suggesting that the VE could be modulated by the vaccine-induced immunity. In this review, we revisit the evidence that support the interfered VE result from immune imprinting or repeated vaccinations in influenza and COVID-19 vaccine, and the interference in co-administration of these two types of vaccines is also discussed. Regarding the development of next-generation COVID-19 vaccines, the researchers should focus on the induction of cross-reactive T-cell responses and naive B-cell responses to overcome negative effects from the immune system itself. The strategy of co-administrating influenza and COVID-19 vaccine needs to be considered more carefully and more clinical data is needed to verify this strategy to be safe and immunogenic.
Collapse
Affiliation(s)
- Yiwen Xie
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Xuebin Tian
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Xiaodi Zhang
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Hangping Yao
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
| | - Nanping Wu
- State Key Laboratory for Diagnosis and Treatment of Infectious Diseases, The First Affiliated Hospital, Zhejiang University School of Medicine, Hangzhou, Zhejiang, China
- Jinan Microecological Biomedicine Shandong Laboratory, Jinan, Shandong, China
- *Correspondence: Nanping Wu,
| |
Collapse
|
12
|
Portner COS, Rong EG, Ramirez JA, Wolf YI, Bosse AP, Koonin EV, Rochman ND. Host age structure reshapes parasite symbiosis: collaboration begets pathogens, competition begets virulent mutualists. Biol Direct 2022; 17:30. [DOI: 10.1186/s13062-022-00343-9] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/17/2022] [Accepted: 10/14/2022] [Indexed: 11/13/2022] Open
Abstract
Abstract
Background
Symbiotic relationships are ubiquitous in the biosphere. Inter-species symbiosis is impacted by intra-specific distinctions, in particular, those defined by the age structure of a population. Older individuals compete with younger individuals for resources despite being less likely to reproduce, diminishing the fitness of the population. Conversely, however, older individuals can support the reproduction of younger individuals, increasing the population fitness. Parasitic relationships are commonly age structured, typically, more adversely affecting older hosts.
Results
We employ mathematical modeling to explore the differential effects of collaborative or competitive host age structures on host-parasite relationships. A classical epidemiological compartment model is constructed with three disease states: susceptible, infected, and recovered. Each of these three states is partitioned into two compartments representing young, potentially reproductive, and old, post-reproductive, hosts, yielding 6 compartments in total. In order to describe competition and collaboration between old and young compartments, we model the reproductive success to depend on the fraction of young individuals in the population. Collaborative populations with relatively greater numbers of post-reproductive hosts enjoy greater reproductive success whereas in purely competitive populations, increasing the post-reproductive subpopulation reduces reproductive success.
Conclusions
We demonstrate that, in collaborative host populations, pathogens strictly impacting older, post-reproductive individuals can reduce population fitness even more than pathogens that directly impact younger, potentially reproductive individuals. In purely competitive populations, the reverse is observed, and we demonstrate that endemic, virulent pathogens can oxymoronically form a mutualistic relationship with the host, increasing the fitness of the host population. Applications to endangered species conservation and invasive species containment are discussed.
Collapse
|
13
|
Eiermann M, Wrigley-Field E, Feigenbaum JJ, Helgertz J, Hernandez E, Boen CE. Racial Disparities in Mortality During the 1918 Influenza Pandemic in United States Cities. Demography 2022; 59:1953-1979. [PMID: 36124998 PMCID: PMC9714293 DOI: 10.1215/00703370-10235825] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/19/2022]
Abstract
Against a backdrop of extreme racial health inequality, the 1918 influenza pandemic resulted in a striking reduction of non-White to White influenza and pneumonia mortality disparities in United States cities. We provide the most complete account to date of these reduced racial disparities, showing that they were unexpectedly uniform across cities. Linking data from multiple sources, we then examine potential explanations for this finding, including city-level sociodemographic factors such as segregation, implementation of nonpharmaceutical interventions, racial differences in exposure to the milder spring 1918 "herald wave," and racial differences in early-life influenza exposures, resulting in differential immunological vulnerability to the 1918 flu. While we find little evidence for the first three explanations, we offer suggestive evidence that racial variation in childhood exposure to the 1889-1892 influenza pandemic may have shrunk racial disparities in 1918. We also highlight the possibility that differential behavioral responses to the herald wave may have protected non-White urban populations. By providing a comprehensive description and examination of racial inequality in mortality during the 1918 pandemic, we offer a framework for understanding disparities in infectious disease mortality that considers interactions between the natural histories of particular microbial agents and the social histories of those they infect.
Collapse
Affiliation(s)
| | - Elizabeth Wrigley-Field
- Department of Sociology and Minnesota Population Center, University of Minnesota, Twin Cities, Minneapolis, MN, USA
| | - James J Feigenbaum
- Department of Economics, Boston University, Boston, MA, USA
- National Bureau of Economic Research, Cambridge, MA, USA
| | - Jonas Helgertz
- Institute for Social Research and Data Innovation, Minnesota Population Center, University of Minnesota, Twin Cities, Minneapolis, MN, USA
- Centre for Economic Demography and Department of Economic History, Lund University, Lund, Sweden
| | - Elaine Hernandez
- Department of Sociology, Indiana University, Bloomington, IN, USA
| | - Courtney E Boen
- Department of Sociology, Population Studies and Population Aging Research Centers, and Leonard Davis Institute of Health Economics, University of Pennsylvania, Philadelphia, PA, USA
| |
Collapse
|
14
|
Gill B, Kehler T, Schneider M. Is Covid-19 a dread risk? The death toll of the pandemic year 2020 in long-term and transnational perspective. FUTURES 2022; 142:103017. [PMID: 35967763 PMCID: PMC9364948 DOI: 10.1016/j.futures.2022.103017] [Citation(s) in RCA: 0] [Impact Index Per Article: 0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/25/2021] [Revised: 07/16/2022] [Accepted: 07/29/2022] [Indexed: 05/07/2023]
Abstract
"Dread risks" are threats that can have catastrophic consequences. To analyse this issue we use excess mortality and corresponding life years lost as simple measures of the severity of pandemic events. As such, they are more robust than figures from models and testing procedures that usually inform public responses. We analyse data from OECD countries that are already fully available for the whole of 2020. To assess the severity of the pandemic, we compare with historical demographic events since 1880. Results show that reports of high excess mortality during peak periods and local outbreaks should not be taken as representative. Six countries saw a somewhat more increased percentage of life years lost (over 7%), nine countries show mild figures (0-7%), while seven countries had life year gains of up to 7%. So, by historical standards, Covid-19 is worse than regular flu, but a far cry from the Spanish Flu, which has become the predominant frame of reference for the current pandemic. Even though the demographic impact is modest, psychological aspects of the pandemic can still lead to transformative futures, as the reactions of East Asian societies to SARS I in 2003 showed.
Collapse
Affiliation(s)
- Bernhard Gill
- Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Soziologie, Konradstrasse 6, D-80801 Muenchen, Germany
| | - Theresa Kehler
- Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Soziologie, Konradstrasse 6, D-80801 Muenchen, Germany
| | - Michael Schneider
- Ludwig-Maximilians-Universitaet Muenchen, Institut fuer Soziologie, Konradstrasse 6, D-80801 Muenchen, Germany
| |
Collapse
|
15
|
Dimka J, van Doren TP, Battles HT. Pandemics, past and present: The role of biological anthropology in interdisciplinary pandemic studies. AMERICAN JOURNAL OF BIOLOGICAL ANTHROPOLOGY 2022. [PMCID: PMC9082061 DOI: 10.1002/ajpa.24517] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Indexed: 02/06/2023]
Abstract
Biological anthropologists are ideally suited for the study of pandemics given their strengths in human biology, health, culture, and behavior, yet pandemics have historically not been a major focus of research. The COVID‐19 pandemic has reinforced the need to understand pandemic causes and unequal consequences at multiple levels. Insights from past pandemics can strengthen the knowledge base and inform the study of current and future pandemics through an anthropological lens. In this paper, we discuss the distinctive social and epidemiological features of pandemics, as well as the ways in which biological anthropologists have previously studied infectious diseases, epidemics, and pandemics. We then review interdisciplinary research on three pandemics–1918 influenza, 2009 influenza, and COVID‐19–focusing on persistent social inequalities in morbidity and mortality related to sex and gender; race, ethnicity, and Indigeneity; and pre‐existing health and disability. Following this review of the current state of pandemic research on these topics, we conclude with a discussion of ways biological anthropologists can contribute to this field moving forward. Biological anthropologists can add rich historical and cross‐cultural depth to the study of pandemics, provide insights into the biosocial complexities of pandemics using the theory of syndemics, investigate the social and health impacts of stress and stigma, and address important methodological and ethical issues. As COVID‐19 is unlikely to be the last global pandemic, stronger involvement of biological anthropology in pandemic studies and public health policy and research is vital.
Collapse
Affiliation(s)
- Jessica Dimka
- Centre for Research on Pandemics and Society Oslo Metropolitan University Oslo Norway
| | | | - Heather T. Battles
- Anthropology, School of Social Sciences The University of Auckland Auckland New Zealand
| |
Collapse
|
16
|
Wilta F, Chong ALC, Selvachandran G, Kotecha K, Ding W. Generalized Susceptible-Exposed-Infectious-Recovered model and its contributing factors for analysing the death and recovery rates of the COVID-19 pandemic. Appl Soft Comput 2022; 123:108973. [PMID: 35572359 PMCID: PMC9091070 DOI: 10.1016/j.asoc.2022.108973] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/24/2022] [Revised: 04/07/2022] [Accepted: 04/28/2022] [Indexed: 01/25/2023]
Abstract
COVID-19 is a highly contagious disease that has infected over 136 million people worldwide with over 2.9 million deaths as of 11 April 2021. In March 2020, the WHO declared COVID-19 as a pandemic and countries began to implement measures to control the spread of the virus. The spread and the death rates of the virus displayed dramatic differences among countries globally, showing that there are several factors affecting its spread and mortality. By utilizing the cumulative number of cases from John Hopkins University, the recovery rate, death rate, and the number of active, recovered, and death cases were simulated to analyse the trends and patterns within the chosen countries. 10 countries from 3 different case severity categories (high cases, medium cases, and low cases) and 5 continents (Asia, North America, South America, Europe, and Oceania) were studied. A generalized SEIR model which considers control measures such as isolation, and preventive measures such as vaccination is applied in this study. This model is able to capture not only the dynamics between the states, but also the time evolution of the states by using the fourth-order-Runge-Kutta process. This study found no significant patterns in the countries under the same case severity category, suggesting that there are other factors contributing to the pattern in these countries. One of the factors influencing the pattern in each country is the population's age. COVID-19 related deaths were found to be notably higher among older people, indicating that countries comprising of a larger proportion of older age groups have an increased risk of experiencing higher death rates. Tighter governmental control measures led to fewer infections and eventually reduced the number of death cases, while increasing the recovery rate, and early implementations were found to be far more effective in controlling the spread of the virus and produced better outcomes.
Collapse
Affiliation(s)
- Felin Wilta
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Allyson Li Chen Chong
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, 56000 Cheras, Kuala Lumpur, Malaysia
| | - Ganeshsree Selvachandran
- Department of Actuarial Science and Applied Statistics, Faculty of Business & Management, UCSI University, Jalan Menara Gading, 56000 Cheras, Kuala Lumpur, Malaysia,Corresponding author
| | - Ketan Kotecha
- Symbiosis Centre for Applied Artificial Intelligence, Symbiosis International (Deemed University), Pune 412115, India
| | - Weiping Ding
- School of Information Science and Technology, Nantong University, Nantong 226019, PR China
| |
Collapse
|
17
|
Labuda D, Harding T, Milot E, Vézina H. The effective family size of immigrant founders predicts their long-term demographic outcome: From Québec settlers to their 20th-century descendants. PLoS One 2022; 17:e0266079. [PMID: 35507549 PMCID: PMC9067642 DOI: 10.1371/journal.pone.0266079] [Citation(s) in RCA: 2] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Abstract] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 08/05/2021] [Accepted: 03/14/2022] [Indexed: 11/19/2022] Open
Abstract
Population history reconstruction, using extant genetic diversity data, routinely relies on simple demographic models to project the past through ascending genealogical-tree branches. Because genealogy and genetics are intimately related, we traced descending genealogies of the Québec founders to pursue their fate and to assess their contribution to the present-day population. Focusing on the female and male founder lines, we observed important sex-biased immigration in the early colony years and documented a remarkable impact of these early immigrants on the genetic make-up of 20th-century Québec. We estimated the immigrants’ survival ratio as a proportion of lineages found in the 1931–60 Québec to their number introduced within the immigration period. We assessed the effective family size, EFS, of all immigrant parents and their Québec-born descendants. The survival ratio of the earliest immigrants was the highest and declined over centuries in association with the immigrants’ EFS. Parents with high EFS left plentiful married descendants, putting EFS as the most important variable determining the parental demographic success throughout time for generations ahead. EFS of immigrant founders appears to predict their long-term demographic and, consequently, their genetic outcome. Genealogically inferred immigrants’ "autosomal" genetic contribution to 1931–60 Québec from consecutive immigration periods follow the same yearly pattern as the corresponding maternal and paternal lines. Québec genealogical data offer much broader information on the ancestral diversity distribution than genetic scrutiny of a limited population sample. Genealogically inferred population history could assist studies of evolutionary factors shaping population structure and provide tools to target specific health interventions.
Collapse
Affiliation(s)
- Damian Labuda
- Centre de Recherche, CHU Sainte-Justine, Université de Montréal, Montreal, Québec, Canada
- Département de Pédiatrie, Université de Montréal, Montreal, Québec, Canada
- * E-mail:
| | - Tommy Harding
- Centre de Recherche, CHU Sainte-Justine, Université de Montréal, Montreal, Québec, Canada
- Département de chimie, biochimie et physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Emmanuel Milot
- Département de chimie, biochimie et physique, Université du Québec à Trois-Rivières, Trois-Rivières, Québec, Canada
| | - Hélène Vézina
- Projet BALSAC, Université du Québec à Chicoutimi, Chicoutimi, Québec, Canada
| |
Collapse
|
18
|
Stefański M. GDP effects of pandemics: a historical perspective. EMPIRICAL ECONOMICS 2022; 63:2949-2995. [PMID: 35411126 PMCID: PMC8986453 DOI: 10.1007/s00181-022-02227-3] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Figures] [Subscribe] [Scholar Register] [Received: 07/22/2021] [Accepted: 02/21/2022] [Indexed: 06/14/2023]
Abstract
The paper estimates dynamic effects of pandemics on GDP per capita with local projections, controlling for the effects of wars and weather conditions, using a novel dataset that covers 33 countries and stretches back to the thirteenth century. On average, pandemics are found to have prolonged and highly statistically significant effects on GDP per capita-a pandemic killing 1% of the population tends to increase GDP per capita by approx. 0.3% after about 20 years. The study of a more detailed dataset available for the UK reveals that this results mainly from an increase in per capita land and a disproportionate impact of pandemics on low-productivity workers, while monetary expansion, institutional change and innovation could also play some role. At the same time, the effects of pandemics are found to vary with scale and across time and countries, with positive effects present following the Black Death and the Spanish flu pandemics, especially in Northern Europe. This suggests that only the largest and most unexpected pandemics have a positive impact on income.
Collapse
|
19
|
Koziol JA, Schnitzer JE. Déjà vu all over again: racial, ethnic and age disparities in mortality from influenza 1918-19 and COVID-19 in the United States. Heliyon 2022; 8:e09299. [PMID: 35464697 PMCID: PMC9013692 DOI: 10.1016/j.heliyon.2022.e09299] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 10/18/2021] [Revised: 12/27/2021] [Accepted: 04/14/2022] [Indexed: 11/25/2022] Open
Abstract
Background Examination of the mortality patterns in the United States among racial, ethnic, and age groups attributed to the 1918–19 influenza pandemic revealed stark disparities, causes for which could have been addressed and rectified this past century. However, these disparities have been amplified during the current COVID-19 pandemic. We have ignored the lessons of the past, and were destined to repeat its failings. Objectives Compare and contrast mortality patterns by age, race, and ethnicity attributable to the 1918–19 influenza pandemic in the United States with corresponding patterns during the COVID-19 pandemic. Methods This is a retrospective study, establishing mortality rates according to age, race and ethnicity attributable to the 1918–19 influenza pandemic in the United States and to the current COVID-19 pandemic, using mortality data published by the U.S. Public Health Service and the Centers for Disease Control and Prevention. Negative binomial regression models were used to establish rate ratios, that is, ratios of mortality rates across the various racial/ethnic groups, and associated 95% confidence intervals. Results Mortality patterns by age differ significantly between the 1918–19 influenza pandemic and the COVID-19 pandemic: with infant and young adult (25–40 years old) mortality substantially higher in the former. Disparities in mortality between racial and ethnic groups are amplified in the COVID-19 pandemic compared to the 1918–19 experience. Conclusions As we evaluate our nation's response to COVID-19 and design public policy to prepare better for coming pandemics, we cannot ignore the stark disparities in mortality rates experienced by different racial and ethnic groups. This will require a sustained resolve by society and government to delineate and remedy the causative factors, through science devoid of political interpretation and exploitation.
Collapse
Affiliation(s)
- James A Koziol
- Proteogenomics Research Institute for Systems Medicine, La Jolla, California, United States
| | - Jan E Schnitzer
- Proteogenomics Research Institute for Systems Medicine, La Jolla, California, United States
| |
Collapse
|
20
|
Jones RP, Ponomarenko A. Trends in Excess Winter Mortality (EWM) from 1900/01 to 2019/20-Evidence for a Complex System of Multiple Long-Term Trends. INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2022; 19:ijerph19063407. [PMID: 35329098 PMCID: PMC8953800 DOI: 10.3390/ijerph19063407] [Citation(s) in RCA: 5] [Impact Index Per Article: 2.5] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 02/02/2022] [Revised: 03/01/2022] [Accepted: 03/03/2022] [Indexed: 11/16/2022]
Abstract
Trends in excess winter mortality (EWM) were investigated from the winter of 1900/01 to 2019/20. During the 1918–1919 Spanish flu epidemic a maximum EWM of 100% was observed in both Denmark and the USA, and 131% in Sweden. During the Spanish flu epidemic in the USA 70% of excess winter deaths were coded to influenza. EWM steadily declined from the Spanish flu peak to a minimum around the 1960s to 1980s. This decline was accompanied by a shift in deaths away from the winter and spring, and the EWM calculation shifted from a maximum around April to June in the early 1900s to around March since the late 1960s. EWM has a good correlation with the number of estimated influenza deaths, but in this context influenza pandemics after the Spanish flu only had an EWM equivalent to that for seasonal influenza. This was confirmed for a large sample of world countries for the three pandemics occurring after 1960. Using data from 1980 onward the effect of influenza vaccination on EWM were examined using a large international dataset. No effect of increasing influenza vaccination could be discerned; however, there are multiple competing forces influencing EWM which will obscure any underlying trend, e.g., increasing age at death, multimorbidity, dementia, polypharmacy, diabetes, and obesity—all of which either interfere with vaccine effectiveness or are risk factors for influenza death. After adjusting the trend in EWM in the USA influenza vaccination can be seen to be masking higher winter deaths among a high morbidity US population. Adjusting for the effect of increasing obesity counteracted some of the observed increase in EWM seen in the USA. Winter deaths are clearly the outcome of a complex system of competing long-term trends.
Collapse
Affiliation(s)
- Rodney P. Jones
- Healthcare Analysis & Forecasting, Wantage OX12 0NE, UK
- Correspondence:
| | - Andriy Ponomarenko
- Department of Biophysics, Informatics and Medical Instrumentation, Odessa National Medical University, Valikhovsky Lane 2, 65082 Odessa, Ukraine;
| |
Collapse
|
21
|
Mankowski N, Al-Qurayshi Z, Souza S, Campbell B, Beighley A, Denson J, Mauldin B, Bojanowski C, Friedlander P, Zifodya J. The effect of race, socioeconomic status, and comorbidity on patients afflicted with COVID 19: A Local Perspective. Ann Epidemiol 2021; 64:83-87. [PMID: 34562588 PMCID: PMC8457904 DOI: 10.1016/j.annepidem.2021.09.013] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 02/09/2021] [Revised: 09/15/2021] [Accepted: 09/17/2021] [Indexed: 01/17/2023]
Abstract
PURPOSE The aim of this study is to further examine the associations of race, socioeconomic factors, and comorbidity with COVID-19 health outcomes. METHODS This is a retrospective cohort study of 309 PCR confirmed COVID-19 positive adults who presented to Tulane Medical Center in New Orleans, LA, from March 9 to May 29, 2020. The primary outcomes investigated were need for invasive mechanical ventilation (IMV) and in-hospital mortality. A multivariate analysis was performed to determine socioeconomic and medical risk factors for IMV and in-hospital mortality. RESULTS Compared to white patients, Black patients were more likely to present younger, female, obese, unemployed, and underinsured. However, when controlled for common risk factors, Black and white patients had similar risk for IMV and mortality. Increased age (≥65 years), obesity, and increased comorbidity were associated with increased risk for IMV and mortality. CONCLUSIONS Race and socioeconomic factors may increase risk for COVID-19 infection but did not affect health outcomes within the hospital setting. Therefore, the higher rates of COVID-19 infection and mortality in vulnerable populations may be better explained by lower socioeconomic status, with subsequent higher comorbidity, in these populations. Community health initiatives should be prioritized in response to the COVID-19 pandemic.
Collapse
Affiliation(s)
| | - Zaid Al-Qurayshi
- Department of Otolaryngology - Head & Neck Surgery, University of Iowa Hospitals and Clinics, Iowa City, IA
| | - Spenser Souza
- Department of Otolaryngology - Head & Neck Surgery, University of California-San Francisco School of Medicine, San Francisco, CA
| | | | - Adam Beighley
- Tulane University School of Medicine, New Orleans, LA
| | - Joshua Denson
- Section of Pulmonary Diseases, Critical Care and Environmental Medicine, Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Brandon Mauldin
- Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Christine Bojanowski
- Section of Pulmonary Diseases, Critical Care and Environmental Medicine, Department of Medicine, Tulane University School of Medicine, New Orleans, LA
| | - Paul Friedlander
- Department of Otolaryngology-Head and Neck Surgery, Tulane University School of Medicine, New Orleans, LA
| | - Jerry Zifodya
- Section of Pulmonary Diseases, Critical Care and Environmental Medicine, Department of Medicine, Tulane University School of Medicine, New Orleans, LA.
| |
Collapse
|
22
|
Chandra S, Christensen J. Tracking Pandemic Severity Using Data on the Age Structure of Mortality: Lessons From the 1918 Influenza Pandemic in Michigan. Am J Public Health 2021; 111:S149-S155. [PMID: 34314202 DOI: 10.2105/ajph.2021.306303] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/04/2022]
Abstract
Objectives. To test whether distortions in the age structure of mortality during the 1918 influenza pandemic in Michigan tracked the severity of the pandemic. Methods. We calculated monthly excess deaths during the period of 1918 to 1920 by using monthly data on all-cause deaths for the period of 1912 to 1920 in Michigan. Next, we measured distortions in the age distribution of deaths by using the Kuiper goodness-of-fit test statistic comparing the monthly distribution of deaths by age in 1918 to 1920 with the baseline distribution for the corresponding month for 1912 to 1917. Results. Monthly distortions in the age distribution of deaths were correlated with excess deaths for the period of 1918 to 1920 in Michigan (r = 0.83; P < .001). Conclusions. Distortions in the age distribution of deaths tracked variations in the severity of the 1918 influenza pandemic. Public Health Implications. It may be possible to track the severity of pandemic activity with age-at-death data by identifying distortions in the age distribution of deaths. Public health authorities should explore the application of this approach to tracking the COVID-19 pandemic in the absence of complete data coverage or accurate cause-of-death data.
Collapse
Affiliation(s)
- Siddharth Chandra
- Siddharth Chandra is with the Asian Studies Center and James Madison College at Michigan State University, East Lansing, with a courtesy appointment in the Department of Epidemiology and Biostatistics. Julia Christensen is with James Madison College at Michigan State University, East Lansing
| | - Julia Christensen
- Siddharth Chandra is with the Asian Studies Center and James Madison College at Michigan State University, East Lansing, with a courtesy appointment in the Department of Epidemiology and Biostatistics. Julia Christensen is with James Madison College at Michigan State University, East Lansing
| |
Collapse
|
23
|
Ribeiro SP, Reis AB, Dáttilo W, Silva AVCDECE, Barbosa EAG, Coura-Vital W, Góes-Neto A, Azevedo VAC, Fernandes GW. From Spanish Flu to Syndemic COVID-19: long-standing sanitarian vulnerability of Manaus, warnings from the Brazilian rainforest gateway. AN ACAD BRAS CIENC 2021; 93:e20210431. [PMID: 34378637 DOI: 10.1590/0001-3765202120210431] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [Abstract] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/22/2021] [Accepted: 06/19/2021] [Indexed: 12/24/2022] Open
Abstract
A second deadlier wave of COVID-19 and the causes of the recent public health collapse of Manaus are compared with the Spanish flu events in that city, and Brazil. Historic sanitarian problems, and its hub position in the Brazilian airway network are combined drivers of deadly events related to COVID-19. These drivers were amplified by misleading governance, highly transmissible variants, and relaxation of social distancing. Several of these same factors may also have contributed to the dramatically severe outbreak of H1N1 in 1918, which caused the death of 10% of the population in seven months. We modelled Manaus parameters for the present pandemic and confirmed that lack of a proper social distancing might select the most transmissible variants. We succeeded to reproduce a first severe wave followed by a second stronger wave. The model also predicted that outbreaks may last for up to five and half years, slowing down gradually before the disease disappear. We validated the model by adjusting it to the Spanish Flu data for the city, and confirmed the pattern experienced by that time, of a first stronger wave in October-November 1918, followed by a second less intense wave in February-March 1919.
Collapse
Affiliation(s)
- Sérvio P Ribeiro
- Universidade Federal de Ouro Preto, Núcleo de Pesquisas em Ciências Biológicas - NUPEB, St. Três, 408-462, Bauxita, 35400-000 Ouro Preto, MG, Brazil.,Universidade Federal de Ouro Preto, Laboratory of Ecology of Diseases and Forests, Departamento de Biodiversidade, Evolução e Meio Ambiente, St. Quatro, 786, Bauxita, 35400-000 Ouro Preto, MG, Brazil.,Universidade Federal de Minas Gerais, Laboratory of Physiology of Hematophagous Insects, Departamento de Parasitologia, Ave. Pres. Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Alexandre B Reis
- Universidade Federal de Ouro Preto, Núcleo de Pesquisas em Ciências Biológicas - NUPEB, St. Três, 408-462, Bauxita, 35400-000 Ouro Preto, MG, Brazil.,Universidade Federal de Ouro Preto, Laboratory of Imunopatology, Departamento de Análises Clínicas, St. Três, 408-462, Bauxita, 35400-000 Ouro Preto, MG, Brazil
| | - Wesley Dáttilo
- Instituto de Ecología AC, Red de Ecoetología, Carretera Antigua a Coatepec, 351, El Haya, Xalapa, Veracruz, 91070 Mexico
| | - Alcides V C DE Castro E Silva
- Universidade Federal de Ouro Preto, Laboratory of Complexity Science, Departamento de Física, St. Quatro, 786, Bauxita, 35400-000 Ouro Preto, MG, Brazil
| | - Eduardo Augusto G Barbosa
- Centro Federal de Educação Tecnológica de Minas Gerais, Programa de Pós-Graduação em Modelagem Matemática e Computacional, 30510-000 Belo Horizonte, MG, Brazil
| | - Wendel Coura-Vital
- Universidade Federal de Ouro Preto, Núcleo de Pesquisas em Ciências Biológicas - NUPEB, St. Três, 408-462, Bauxita, 35400-000 Ouro Preto, MG, Brazil.,Universidade Federal de Ouro Preto, Laboratory of Epidemiology and Citology, Departamento de Análises Clínicas, St. Nove, 27, Bauxita, 35400-000 Ouro Preto, MG, Brazil
| | - Aristóteles Góes-Neto
- Universidade Federal de Minas Gerais, Laboratory of Molecular and Computational Biology of Fungi, Departamento de Microbiologia, Ave. Pres. Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Vasco A C Azevedo
- Universidade Federal de Minas Gerais, Laboratory of Cell and Molecular Genetics, Departamento de Genética, Ecologia e Evolução, Ave. Pres. Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| | - Geraldo Wilson Fernandes
- Universidade Federal de Minas Gerais, Laboratory of Evolutionary Ecology and Biodiversity, Departamento de Genética, Ecologia e Evolução, Ave. Pres. Antônio Carlos, 6627, Pampulha, 31270-901 Belo Horizonte, MG, Brazil
| |
Collapse
|
24
|
Aburto JM, Kashyap R, Schöley J, Angus C, Ermisch J, Mills MC, Dowd JB. Estimating the burden of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality in England and Wales: a population-level analysis. J Epidemiol Community Health 2021. [PMID: 33468602 DOI: 10.1101/2020.07.16.20155077] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 05/14/2023]
Abstract
BACKGROUND Deaths directly linked to COVID-19 infection may be misclassified, and the pandemic may have indirectly affected other causes of death. To overcome these measurement challenges, we estimate the impact of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality from week 10 of 2020, when the first COVID-19 death was registered, to week 47 ending 20 November 2020 in England and Wales through an analysis of excess mortality. METHODS We estimated age and sex-specific excess mortality risk and deaths above a baseline adjusted for seasonality with a systematic comparison of four different models using data from the Office for National Statistics. We additionally provide estimates of life expectancy at birth and lifespan inequality defined as the SD in age at death. RESULTS There have been 57 419 (95% prediction interval: 54 197, 60 752) excess deaths in the first 47 weeks of 2020, 55% of which occurred in men. Excess deaths increased sharply with age and men experienced elevated risks of death in all age groups. Life expectancy at birth dropped 0.9 and 1.2 years for women and men relative to the 2019 levels, respectively. Lifespan inequality also fell over the same period by 5 months for both sexes. CONCLUSION Quantifying excess deaths and their impact on life expectancy at birth provide a more comprehensive picture of the burden of COVID-19 on mortality. Whether mortality will return to-or even fall below-the baseline level remains to be seen as the pandemic continues to unfold and diverse interventions are put in place.
Collapse
Affiliation(s)
- Jose Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Ridhi Kashyap
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| | - Jonas Schöley
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Colin Angus
- ScHARR, University of Sheffield, Sheffield, UK
| | - John Ermisch
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| | - Melinda C Mills
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| |
Collapse
|
25
|
Aburto JM, Kashyap R, Schöley J, Angus C, Ermisch J, Mills MC, Dowd JB. Estimating the burden of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality in England and Wales: a population-level analysis. J Epidemiol Community Health 2021; 75:735-740. [PMID: 33468602 PMCID: PMC7818788 DOI: 10.1136/jech-2020-215505] [Citation(s) in RCA: 70] [Impact Index Per Article: 23.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/01/2020] [Revised: 12/08/2020] [Accepted: 12/16/2020] [Indexed: 12/03/2022]
Abstract
BACKGROUND Deaths directly linked to COVID-19 infection may be misclassified, and the pandemic may have indirectly affected other causes of death. To overcome these measurement challenges, we estimate the impact of the COVID-19 pandemic on mortality, life expectancy and lifespan inequality from week 10 of 2020, when the first COVID-19 death was registered, to week 47 ending 20 November 2020 in England and Wales through an analysis of excess mortality. METHODS We estimated age and sex-specific excess mortality risk and deaths above a baseline adjusted for seasonality with a systematic comparison of four different models using data from the Office for National Statistics. We additionally provide estimates of life expectancy at birth and lifespan inequality defined as the SD in age at death. RESULTS There have been 57 419 (95% prediction interval: 54 197, 60 752) excess deaths in the first 47 weeks of 2020, 55% of which occurred in men. Excess deaths increased sharply with age and men experienced elevated risks of death in all age groups. Life expectancy at birth dropped 0.9 and 1.2 years for women and men relative to the 2019 levels, respectively. Lifespan inequality also fell over the same period by 5 months for both sexes. CONCLUSION Quantifying excess deaths and their impact on life expectancy at birth provide a more comprehensive picture of the burden of COVID-19 on mortality. Whether mortality will return to-or even fall below-the baseline level remains to be seen as the pandemic continues to unfold and diverse interventions are put in place.
Collapse
Affiliation(s)
- Jose Manuel Aburto
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Ridhi Kashyap
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| | - Jonas Schöley
- Interdisciplinary Centre on Population Dynamics, University of Southern Denmark, Odense, Denmark
| | - Colin Angus
- ScHARR, University of Sheffield, Sheffield, UK
| | - John Ermisch
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| | - Melinda C Mills
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| | - Jennifer Beam Dowd
- Leverhulme Centre for Demographic Science, Department of Sociology and Nuffield College, University of Oxford, Oxford, UK
| |
Collapse
|
26
|
Oidtman RJ, Arevalo P, Bi Q, McGough L, Russo CJ, Vera Cruz D, Costa Vieira M, Gostic KM. Influenza immune escape under heterogeneous host immune histories. Trends Microbiol 2021; 29:1072-1082. [PMID: 34218981 DOI: 10.1016/j.tim.2021.05.009] [Citation(s) in RCA: 11] [Impact Index Per Article: 3.7] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Subscribe] [Scholar Register] [Received: 04/19/2021] [Revised: 05/28/2021] [Accepted: 05/31/2021] [Indexed: 11/30/2022]
Abstract
In a pattern called immune imprinting, individuals gain the strongest immune protection against the influenza strains encountered earliest in life. In many recent examples, differences in early infection history can explain birth year-associated differences in susceptibility (cohort effects). Susceptibility shapes strain fitness, but without a clear conceptual model linking host susceptibility to the identity and order of past infections general conclusions on the evolutionary and epidemic implications of cohort effects are not possible. Failure to differentiate between cohort effects caused by differences in the set, rather than the order (path), of past infections is a current source of confusion. We review and refine hypotheses for path-dependent cohort effects, which include imprinting. We highlight strategies to measure their underlying causes and emergent consequences.
Collapse
Affiliation(s)
- Rachel J Oidtman
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Philip Arevalo
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Qifang Bi
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Lauren McGough
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | | | - Diana Vera Cruz
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Marcos Costa Vieira
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA
| | - Katelyn M Gostic
- Department of Ecology and Evolution, University of Chicago, Chicago, IL, USA.
| |
Collapse
|
27
|
van Niekerk G, van der Merwe M, Engelbrecht AM. Diabetes and susceptibility to infections: Implication for COVID-19. Immunology 2021; 164:467-475. [PMID: 34115881 PMCID: PMC8446942 DOI: 10.1111/imm.13383] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/27/2021] [Revised: 05/20/2021] [Accepted: 06/07/2021] [Indexed: 11/29/2022] Open
Abstract
A number of mechanisms have been proposed to explain the well‐established link between diabetic status and an increased susceptibility to infection. Notably, diabetes has been shown to be one of the strongest factors influencing healthcare outcome in COVID‐19 infections. Though it has long been noted that lymphocytes upregulate insulin receptors following immune activation, until recently, this observation has received little attention. Here, we point out key findings implicating dysregulated insulin signalling in immune cells as a possible contributing factor in the immune pathology associated with diabetes. Mechanistically, insulin, by activating the PI3K/Akt/mTOR pathway, regulates various aspects of both myeloid cells and lymphocytes, such as cell survival, metabolic reprogramming and the polarization and differentiation of immune cells. PI3K signalling is also supressed by immune checkpoint proteins, suggesting that insulin signalling may antagonize peripheral tolerance. Remarkably, it has also recently been shown that, following insulin binding, the insulin receptor translocates to the nucleus where it plays a key role in regulating the transcription of various immune‐related genes, including pathways involved in viral infections. Taken together, these observations suggest that dysregulated insulin signalling may directly contribute to a defective immune response during COVID‐19 infections.
Collapse
Affiliation(s)
- Gustav van Niekerk
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Michelle van der Merwe
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| | - Anna-Mart Engelbrecht
- Department of Physiological Sciences, Stellenbosch University, Stellenbosch, South Africa
| |
Collapse
|
28
|
Richardson S, Gitlin J, Kozel Z, Levy S, Rahman H, Hirsch JS, McGinn T, Diefenbach MA. In-Hospital 30-Day Survival Among Young Adults With Coronavirus Disease 2019: A Cohort Study. Open Forum Infect Dis 2021; 8:ofab233. [PMID: 34183983 PMCID: PMC8135976 DOI: 10.1093/ofid/ofab233] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/11/2020] [Accepted: 05/05/2021] [Indexed: 01/10/2023] Open
Abstract
BACKGROUND Our objective was to characterize young adult patients hospitalized with coronavirus disease 2019 (COVID-19) and identify predictors of survival at 30 days. METHODS This retrospective cohort study took place at 12 acute care hospitals in the New York City area. Patients aged 18-39 hospitalized with confirmed COVID-19 between March 1 and April 27, 2020 were included in the study. Demographic, clinical, and outcome data were extracted from electronic health record reports. RESULTS A total of 1013 patients were included in the study (median age, 33 years; interquartile range [IQR], 28-36; 52% female). At the study end point, 940 (92.8%) patients were discharged alive, 18 (1.8%) remained hospitalized, 5 (0.5%) were transferred to another acute care facility, and 50 (4.9%) died. The most common comorbidities in hospitalized young adult patients were obesity (51.2%), diabetes mellitus (14.8%), and hypertension (13%). Multivariable analysis revealed that obesity (adjusted hazard ratio [aHR], 2.71; 95% confidence interval [CI], 1.28-5.73; P = .002) and Charlson comorbidity index score (aHR, 1.20; 95% CI, 1.07-1.35; P = .002) were independent predictors of in-hospital 30-day mortality. CONCLUSIONS Obesity was identified as the strongest negative predictor of 30-day in-hospital survival in young adults with COVID-19.
Collapse
Affiliation(s)
- Safiya Richardson
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - Jordan Gitlin
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - Zachary Kozel
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - Sera Levy
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
| | - Husneara Rahman
- Biostatistics Unit, Feinstein Institutes for Medical Research, Northwell Health, Great Neck, New York, USA
| | - Jamie S Hirsch
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
- Department of Information Services, Northwell Health, New Hyde Park, New York, USA
| | - Thomas McGinn
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| | - Michael A Diefenbach
- Institute of Health System Science, Feinstein Institutes for Medical Research, Northwell Health, Manhasset, New York, USA
- Donald and Barbara Zucker School of Medicine at Hofstra/Northwell, Northwell Health, Hempstead, New York, USA
| |
Collapse
|
29
|
van Doren TP, Sattenspiel L. The 1918 influenza pandemic did not accelerate tuberculosis mortality decline in early-20th century Newfoundland: Investigating historical and social explanations. AMERICAN JOURNAL OF PHYSICAL ANTHROPOLOGY 2021; 176:179-191. [PMID: 34009662 DOI: 10.1002/ajpa.24332] [Citation(s) in RCA: 6] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/28/2020] [Revised: 02/26/2021] [Accepted: 05/03/2021] [Indexed: 12/15/2022]
Abstract
OBJECTIVES The selective mortality hypothesis of tuberculosis after the 1918 influenza pandemic, laid out by Noymer and colleagues, suggests that acute exposure or pre-existing infection with tuberculosis (TB) increased the probability of pneumonia and influenza (P&I) mortality during the 1918 influenza pandemic, leading to a hastened decline of TB mortality in post-pandemic years. This study describes cultural determinants of the post-pandemic TB mortality patterns in Newfoundland and evaluates whether there is support for this observation. MATERIALS AND METHODS Death records and historical documents from the Provincial Archives of Newfoundland and Labrador were used to calculate age-standardized island-wide and sex-based TB mortality, as well as region-level TB mortality, for 1900-1939. The Joinpoint Regression Program (version 4.8.0.1) was used to estimate statistically significant changes in mortality rates. RESULTS Island-wide, females had consistently higher TB mortality for the duration of the study period and a significant shift to lower TB mortality beginning in 1928. There was no similar predicted significant decline for males. On the regional level, no models predicted a significant decline after the 1918 influenza pandemic, except for the West, where significant decline was predicted in the late-1930s. DISCUSSION Although there was no significant decline in TB mortality observed immediately post-pandemic, as has been shown for other Western nations, the female post-pandemic pattern suggests a decline much later. The general lack of significant decrease in TB mortality rate is likely due to Newfoundland's poor nutrition and lack of centralized healthcare rather than a biological interaction between P&I and TB.
Collapse
Affiliation(s)
- Taylor P van Doren
- Department of Anthropology, University of Missouri, Columbia, Missouri, USA
| | - Lisa Sattenspiel
- Department of Anthropology, University of Missouri, Columbia, Missouri, USA
| |
Collapse
|
30
|
Gillezeau C, Alpert N, Caltabiano M, Flores R, Taioli E. Informing the global COVID-19 response by estimating excess deaths in Italy during the COVID-19 and 1918 influenza pandemics. J Med Virol 2021; 93:5239-5240. [PMID: 33913538 PMCID: PMC8242433 DOI: 10.1002/jmv.27052] [Citation(s) in RCA: 1] [Impact Index Per Article: 0.3] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 01/29/2021] [Revised: 04/09/2021] [Accepted: 04/26/2021] [Indexed: 12/01/2022]
Affiliation(s)
- Christina Gillezeau
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Naomi Alpert
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | | | - Raja Flores
- Department of Thoracic Surgery, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| | - Emanuela Taioli
- Institute for Translational Epidemiology, Icahn School of Medicine at Mount Sinai, New York, New York, USA
| |
Collapse
|
31
|
Rioux M, Francis ME, Swan CL, Ge A, Kroeker A, Kelvin AA. The Intersection of Age and Influenza Severity: Utility of Ferrets for Dissecting the Age-Dependent Immune Responses and Relevance to Age-Specific Vaccine Development. Viruses 2021; 13:678. [PMID: 33920917 PMCID: PMC8071347 DOI: 10.3390/v13040678] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/13/2021] [Revised: 04/09/2021] [Accepted: 04/11/2021] [Indexed: 02/06/2023] Open
Abstract
Many factors impact the host response to influenza virus infection and vaccination. Ferrets have been an indispensable reagent for influenza virus research for almost one hundred years. One of the most significant and well-known factors affecting human disease after infection is host age. Another significant factor is the virus, as strain-specific disease severity is well known. Studying age-related impacts on viral infection and vaccination outcomes requires an animal model that reflects both the physiological and immunological changes that occur with human aging, and sensitivity to differentially virulent influenza viruses. The ferret is uniquely susceptible to a plethora of influenza viruses impacting humans and has proven extremely useful in studying the clinical and immunological pictures of influenza virus infection. Moreover, ferrets developmentally have several of the age-related physiological changes that occur in humans throughout infancy, adulthood, old age, and pregnancy. In this review, we discuss ferret susceptibility to influenza viruses, summarize previous influenza studies using ferrets as models of age, and finally, highlight the application of ferret age models in the pursuit of prophylactic and therapeutic agents to address age-related influenza disease severity.
Collapse
Affiliation(s)
- Melissa Rioux
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H4R2, Canada; (M.R.); (A.G.)
| | - Magen E. Francis
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK S7N5E3, Canada; (M.E.F.); (C.L.S.); (A.K.)
| | - Cynthia L. Swan
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK S7N5E3, Canada; (M.E.F.); (C.L.S.); (A.K.)
| | - Anni Ge
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H4R2, Canada; (M.R.); (A.G.)
| | - Andrea Kroeker
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK S7N5E3, Canada; (M.E.F.); (C.L.S.); (A.K.)
| | - Alyson A. Kelvin
- Department of Microbiology and Immunology, Faculty of Medicine, Dalhousie University, Halifax, NS B3H4R2, Canada; (M.R.); (A.G.)
- Vaccine and Infectious Disease Organization (VIDO), University of Saskatchewan, Saskatoon, SK S7N5E3, Canada; (M.E.F.); (C.L.S.); (A.K.)
- Department of Pediatrics, Division of Infectious Disease, Faculty of Medicine, Dalhousie University, Halifax, NS B3K6R8, Canada
- The Canadian Center for Vaccinology (IWK Health Centre, Dalhousie University and the Nova Scotia Health Authority), Halifax, NS B3K6R8, Canada
- Department of Biochemistry, College of Medicine, University of Saskatchewan, 107 Wiggins Road, Saskatoon, SK S7N5E5, Canada
| |
Collapse
|
32
|
Abstract
Purpose
The Spanish Flu 1918–1920 saw a high degree of excess mortality among young and healthy adults. The purpose of this paper is a further exploration of the hypothesis that high mortality risk during The Spanish Flu in Copenhagen was associated with early life exposure to The Russian Flu 1889–1892.
Design/methodology/approach
Based on 37,000 individual-level death records in a new unique database from The Copenhagen City Archives combined with approximate cohort-specific population totals interpolated from official censuses of population, the author compiles monthly time series on all-cause mortality rates 1916–1922 in Copenhagen by gender and one-year birth cohorts. The author then analyses birth cohort effects on mortality risk during The Spanish Flu using regression analysis.
Findings
The author finds support for hypotheses relating early life exposure to The Russian Flu to mortality risk during The Spanish Flu. Some indications of possible gender heterogeneity during the first wave of The Spanish Flu – not found in previous studies – should be a topic for future research based on data from other countries.
Originality/value
Due to lack of individual-level death records with exact dates of birth and death, previous studies on The Spanish Flu in Denmark and many other countries have relied on data with lower birth cohort resolutions than the one-year birth cohorts used in this study. The analysis in this paper illustrates how archival Big Data can be used to gain new insights in studies on historical pandemics.
Collapse
|
33
|
Anifandis G, Tempest HG, Oliva R, Swanson GM, Simopoulou M, Easley CA, Primig M, Messini CI, Turek PJ, Sutovsky P, Ory SJ, Krawetz SA. COVID-19 and human reproduction: A pandemic that packs a serious punch. Syst Biol Reprod Med 2021; 67:3-23. [PMID: 33719829 DOI: 10.1080/19396368.2020.1855271] [Citation(s) in RCA: 10] [Impact Index Per Article: 3.3] [Reference Citation Analysis] [Abstract] [Key Words] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Indexed: 12/13/2022]
Abstract
The COVID-19 pandemic has led to a worldwide health emergency that has impacted 188 countries at last count. The rapid community transmission and relatively high mortality rates with COVID-19 in modern times are relatively unique features of this flu pandemic and have resulted in an unparalleled global health crisis. SARS-CoV-2, being a respiratory virus, mainly affects the lungs, but is capable of infecting other vital organs, such as brain, heart and kidney. Emerging evidence suggests that the virus also targets male and female reproductive organs that express its main receptor ACE2, although it is as yet unclear if this has any implications for human fertility. Furthermore, professional bodies have recommended discontinuing fertility services during the pandemic such that reproductive services have also been affected. Although increased safety measures have helped to mitigate the propagation of COVID-19 in a number of countries, it seems that there is no predictable timeline to containment of the virus, a goal likely to remain elusive until an effective vaccine becomes available and widely distributed across the globe. In parallel, research on reproduction has been postponed for obvious reasons, while diagnostic tests that detect the virus or antibodies against it are of vital importance to support public health policies, such as social distancing and our obligation to wear masks in public spaces. This review aims to provide an overview of critical research and ethics issues that have been continuously emerging in the field of reproductive medicine as the COVID-19 pandemic tragically unfolds.Abbreviations: ACE2: angiotensin- converting enzyme 2; ART: Assisted reproductive technology; ASRM: American Society for Reproductive Medicine; CCR9: C-C Motif Chemokine Receptor 9; CDC: Centers for Disease Control and Prevention; COVID-19: Coronavirus disease 2019; Ct: Cycle threshold; CXCR6: C-X-C Motif Chemokine Receptor 6; ELISA: enzyme-linked immunosorbent assay; ESHRE: European Society of Human Reproduction and Embryology; ET: Embryo transfer; FSH: Follicle Stimulating Hormone; FFPE: formalin fixed paraffin embedded; FYCO1: FYVE And Coiled-Coil Domain Autophagy Adaptor 1; IFFS: International Federation of Fertility Societies; IUI: Intrauterine insemination; IVF: In vitro fertilization; LH: Luteinizing Hormone; LZTFL1: Leucine Zipper Transcription Factor Like 1; MAR: medically assisted reproduction services; MERS: Middle East Respiratory syndrome; NGS: Next Generation Sequencing; ORF: Open Reading Frame; PPE: personal protective equipment; RE: RNA Element; REDa: RNA Element Discovery algorithm; RT-PCR: Reverse=trascriptase transcriptase-polymerase chain reaction; SARS: Severe acute respiratory syndrome; SARS-CoV-2: Severe Acute Respiratory Syndrome Coronavirus 2; SLC6A20: Solute Carrier Family 6 Member 20; SMS: Single Molecule Sequencing; T: Testosterone; TMPRSS2: transmembrane serine protease 2; WHO: World Health Organization; XCR1: X-C Motif Chemokine Receptor.
Collapse
Affiliation(s)
- George Anifandis
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Helen G Tempest
- Department of Human and Molecular Genetics, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA.,Biomolecular Sciences Institute, Florida International University, Miami, FL, USA
| | - Rafael Oliva
- Molecular Biology of Reproduction and Development Research Group, Institut d'Investigacions Biomèdiques August Pi I Sunyer (IDIBAPS), Department of Biomedical Sciences, Faculty of Medicine and Health Sciences, Universitat De Barcelona, and Hospital Clinic from Barcelona, Spain
| | - Grace M Swanson
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA
| | - Mara Simopoulou
- Department of Experimental Physiology, School of Health Sciences, Faculty of Medicine, National and Kapodistrian University of Athens, Athens, Greece, Athens, Greece
| | - Charles A Easley
- Department of Environmental Health Science, College of Public Health, University of Georgia, Athens, GA, USA.,Regenerative Bioscience Center, University of Georgia, Athens, GA, USA
| | - Michael Primig
- Inserm, EHESP, Irset (Institut De Recherche En Santé, Environnement Et Travail), Rennes, France
| | - Christina I Messini
- Department of Obstetrics and Gynecology, School of Health Sciences, Faculty of Medicine, University of Thessaly, Larisa, Greece
| | - Paul J Turek
- It is a private Clinic, The Turek Clinic, Beverly Hills, CA, USA
| | - Peter Sutovsky
- Division of Animal Sciences and the Department of Obstetrics, Gynecology and Women's Health, University of Missouri, Columbia, MO, USA
| | - Steve J Ory
- It is a private Clinic, IVF Florida Reproductive Institutes, Margate, FL, USA.,Department of Obstetrics and Gynecology, Herbert Wertheim College of Medicine, Florida International University, Miami, FL, USA
| | - Stephen A Krawetz
- Department of Obstetrics and Gynecology, Wayne State University School of Medicine, Detroit, Michigan, USA.,Center for Molecular Medicine and Genetics, Wayne State University School of Medicine, Detroit, Michigan, USA.,Department of Obstetrics and Gynecology and Center of Molecular Medicine and Genetics, C.S. Mott Center for Human Growth and Development, Wayne State University, Detroit, MI, USA
| |
Collapse
|
34
|
Aydemir D, Dağlıoğlu G, Candevir A, Kurtaran B, Bozdogan ST, Inal TC, Ulusu NN. COVID-19 may enhance risk of thrombosis and hemolysis in the G6PD deficient patients. NUCLEOSIDES NUCLEOTIDES & NUCLEIC ACIDS 2021; 40:505-517. [PMID: 33719907 DOI: 10.1080/15257770.2021.1897457] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Subscribe] [Scholar Register] [Indexed: 12/12/2022]
Abstract
COVID-19 has become a major public health problem since December, 2019 and no highly effective drug has been found until now. Numbers of infected people and deaths by COVID-19 are increasing every day worldwide, therefore self-isolation and protection are highly recommended to prevent the spread of the virus and especially to protect major risk groups such as the elderly population and people with comorbidities including diabetes, hypertension, cancer, cardiovascular diseases and metabolic syndrome. On the other hand, young people without any secondary disease have died by COVID-19 as well. In this study we compared two male patients infected by COVID-19 at the same age and one of them was diagnosed with G6PD deficiency. Both COVID-19 and G6PD deficiency enhance the risk of hemolysis and thrombosis. Serum biochemistry, hemogram and immunological parameters showed that risk of hemolysis and thrombosis may increase in the G6PD deficient patient infected by COVID-19.
Collapse
Affiliation(s)
- Duygu Aydemir
- Koc University School of Medicine, Istanbul, Turkey.,Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| | - Gulcin Dağlıoğlu
- Faculty of Medicine, Hospital Central Laboratory, Cukurova University, Adana, Turkey
| | - Aslihan Candevir
- Faculty of Medicine, Infectious Disease and Clinic Microbiology, Cukurova University, Adana, Turkey
| | - Behice Kurtaran
- Faculty of Medicine, Department of Infectious Diseases, Cukurova University, Adana, Turkey
| | - Sevcan Tan Bozdogan
- Faculty of Medicine, Head of Medical Genetics Department, Cukurova University, Adana, Turkey
| | - Tamer Cevat Inal
- Faculty of Medicine, Department of Medical Biochemistry, Cukurova University, Adana, Turkey
| | - Nuriye Nuray Ulusu
- Koc University School of Medicine, Istanbul, Turkey.,Koc University Research Center for Translational Medicine (KUTTAM), Istanbul, Turkey
| |
Collapse
|
35
|
Jecker NS, Wightman AG, Diekema DS. Vaccine ethics: an ethical framework for global distribution of COVID-19 vaccines. JOURNAL OF MEDICAL ETHICS 2021:medethics-2020-107036. [PMID: 33593876 PMCID: PMC7887861 DOI: 10.1136/medethics-2020-107036] [Citation(s) in RCA: 14] [Impact Index Per Article: 4.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Subscribe] [Scholar Register] [Received: 10/31/2020] [Revised: 01/17/2021] [Accepted: 01/19/2021] [Indexed: 05/05/2023]
Abstract
This paper addresses the just distribution of vaccines against the SARS-CoV-2 virus and sets forth an ethical framework that prioritises frontline and essential workers, people at high risk of severe disease or death, and people at high risk of infection. Section I makes the case that vaccine distribution should occur at a global level in order to accelerate development and fair, efficient vaccine allocation. Section II puts forth ethical values to guide vaccine distribution including helping people with the greatest need, reducing health disparity, saving the most lives and promoting narrow social utility. It also responds to objections which claim that earlier years have more value than later years. Section III puts forth a practical ethical framework to aid decision-makers and compares it with alternatives.
Collapse
Affiliation(s)
- Nancy S Jecker
- University of Washington School of Medicine, Department of Bioethics and Humanities, Seattle, Washington, USA
| | - Aaron G Wightman
- Seattle Children's Hospital and Research Institute, Treuman Katz Center for Pediatric BIoethics, Seattle, Washington, USA
| | - Douglas S Diekema
- Seattle Children's Hospital and Research Institute, Treuman Katz Center for Pediatric BIoethics, Seattle, Washington, USA
| |
Collapse
|
36
|
The Influence of Immune Immaturity on Outcome After Virus Infections. THE JOURNAL OF ALLERGY AND CLINICAL IMMUNOLOGY-IN PRACTICE 2021; 9:641-650. [PMID: 33551039 PMCID: PMC8042246 DOI: 10.1016/j.jaip.2020.11.016] [Citation(s) in RCA: 2] [Impact Index Per Article: 0.7] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/16/2020] [Revised: 11/10/2020] [Accepted: 11/11/2020] [Indexed: 12/15/2022]
Abstract
Maturation of the adaptive immune response is typically thought to improve outcome to virus infections. However, long-standing observations of natural infections with old viruses such as Epstein-Barr virus and newer observations of emerging viruses such as severe acute respiratory syndrome coronavirus 2 responsible for COVID-19 suggest that immune immaturity may be beneficial for outcome. Mechanistic studies and studies of patients with inborn errors of immunity have revealed that immune dysregulation reflecting inappropriate antibody and T-cell responses plays a crucial role in causing bystander inflammation and more severe disease. Further evidence supports a role for innate immunity in normally regulating adaptive immune responses. Thus, changes in immune responses that normally occur with age may help explain an apparent protective role of immune immaturity during virus infections.
Collapse
|
37
|
Abstract
The Covid-19 death rate increases exponentially with age, and the main risk factors are having underlying conditions such as hypertension, diabetes, cardiovascular disease, severe chronic respiratory disease and cancer. These characteristics are consistent with the multi-step model of disease. We applied this model to Covid-19 case fatality rates (CFRs) from China, South Korea, Italy, Spain and Japan. In all countries we found that a plot of log(CFR) against log(age) was approximately linear with a slope of about 5. We also conducted similar analyses for selected other respiratory diseases. SARS showed a similar log–log age-pattern to that of Covid-19, albeit with a lower slope, whereas seasonal and pandemic influenza showed quite different age-patterns. Thus, death from Covid-19 and SARS appears to follow a distinct age-pattern, consistent with a multi-step model of disease that in the case of Covid-19 is probably defined by comorbidities and age producing immune-related susceptibility.
Collapse
|
38
|
van Doren TP. The 1918 Influenza Pandemic Has Lessons for COVID-19: An Anthropology Student Perspective. Am J Public Health 2021; 111:79-80. [PMID: 33326261 PMCID: PMC7750610 DOI: 10.2105/ajph.2020.306021] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.7] [Reference Citation Analysis] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 01/03/2023]
Affiliation(s)
- Taylor P van Doren
- Taylor P. van Doren is a PhD candidate in the Department of Anthropology, University of Missouri, Columbia
| |
Collapse
|
39
|
Ellison-Hughes GM, Colley L, O'Brien KA, Roberts KA, Agbaedeng TA, Ross MD. The Role of MSC Therapy in Attenuating the Damaging Effects of the Cytokine Storm Induced by COVID-19 on the Heart and Cardiovascular System. Front Cardiovasc Med 2020; 7:602183. [PMID: 33363221 PMCID: PMC7756089 DOI: 10.3389/fcvm.2020.602183] [Citation(s) in RCA: 14] [Impact Index Per Article: 3.5] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 09/02/2020] [Accepted: 11/17/2020] [Indexed: 01/08/2023] Open
Abstract
The global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) that causes coronavirus disease 2019 (COVID-19) has led to 47 m infected cases and 1. 2 m (2.6%) deaths. A hallmark of more severe cases of SARS-CoV-2 in patients with acute respiratory distress syndrome (ARDS) appears to be a virally-induced over-activation or unregulated response of the immune system, termed a "cytokine storm," featuring elevated levels of pro-inflammatory cytokines such as IL-2, IL-6, IL-7, IL-22, CXCL10, and TNFα. Whilst the lungs are the primary site of infection for SARS-CoV-2, in more severe cases its effects can be detected in multiple organ systems. Indeed, many COVID-19 positive patients develop cardiovascular complications, such as myocardial injury, myocarditis, cardiac arrhythmia, and thromboembolism, which are associated with higher mortality. Drug and cell therapies targeting immunosuppression have been suggested to help combat the cytokine storm. In particular, mesenchymal stromal cells (MSCs), owing to their powerful immunomodulatory ability, have shown promise in early clinical studies to avoid, prevent or attenuate the cytokine storm. In this review, we will discuss the mechanistic underpinnings of the cytokine storm on the cardiovascular system, and how MSCs potentially attenuate the damage caused by the cytokine storm induced by COVID-19. We will also address how MSC transplantation could alleviate the long-term complications seen in some COVID-19 patients, such as improving tissue repair and regeneration.
Collapse
Affiliation(s)
- Georgina M. Ellison-Hughes
- Faculty of Life Sciences & Medicine, Centre for Human and Applied Physiological Sciences, School of Basic and Medical Biosciences, King's College London Guy's Campus, London, United Kingdom
| | - Liam Colley
- School of Sport, Health, and Exercise Sciences, Bangor University, Bangor, United Kingdom
| | - Katie A. O'Brien
- Department of Physiology, Development, and Neuroscience, University of Cambridge, Cambridge, United Kingdom
| | - Kirsty A. Roberts
- Research Institute for Sport and Exercise Sciences, Liverpool John Moores University, Liverpool, United Kingdom
| | - Thomas A. Agbaedeng
- Faculty of Health & Medical Sciences, Centre for Heart Rhythm Disorders, School of Medicine, The University of Adelaide, Adelaide, SA, Australia
| | - Mark D. Ross
- School of Applied Sciences, Edinburgh Napier University, Edinburgh, United Kingdom
| |
Collapse
|
40
|
Farsalinos K, Poulas K, Kouretas D, Vantarakis A, Leotsinidis M, Kouvelas D, Docea AO, Kostoff R, Gerotziafas GT, Antoniou MN, Polosa R, Barbouni A, Yiakoumaki V, Giannouchos TV, Bagos PG, Lazopoulos G, Izotov BN, Tutelyan VA, Aschner M, Hartung T, Wallace HM, Carvalho F, Domingo JL, Tsatsakis A. Improved strategies to counter the COVID-19 pandemic: Lockdowns vs. primary and community healthcare. Toxicol Rep 2020; 8:1-9. [PMID: 33294384 PMCID: PMC7713637 DOI: 10.1016/j.toxrep.2020.12.001] [Citation(s) in RCA: 59] [Impact Index Per Article: 14.8] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 11/25/2020] [Revised: 12/01/2020] [Accepted: 12/01/2020] [Indexed: 02/08/2023] Open
Abstract
COVID-19 pandemic mitigation strategies are mainly based on social distancing measures and healthcare system reinforcement. However, many countries in Europe and elsewhere implemented strict, horizontal lockdowns because of extensive viral spread in the community which challenges the capacity of the healthcare systems. However, strict lockdowns have various untintended adverse social, economic and health effects, which have yet to be fully elucidated, and have not been considered in models examining the effects of various mitigation measures. Unlike commonly suggested, the dilemma is not about health vs wealth because the economic devastation of long-lasting lockdowns will definitely have adverse health effects in the population. Furthermore, they cannot provide a lasting solution in pandemic containment, potentially resulting in a vicious cycle of consecutive lockdowns with in-between breaks. Hospital preparedness has been the main strategy used by governments. However, a major characteristic of the COVID-19 pandemic is the rapid viral transmission in populations with no immunity. Thus, even the best hospital system could not cope with the demand. Primary, community and home care are the only viable strategies that could achieve the goal of pandemic mitigation. We present the case example of Greece, a country which followed a strategy focused on hospital preparedness but failed to reinforce primary and community care. This, along with strategic mistakes in epidemiological surveillance, resulted in Greece implementing a second strict, horizontal lockdown and having one of the highest COVID-19 death rates in Europe during the second wave. We provide recommendations for measures that will reinstate primary and community care at the forefront in managing the current public health crisis by protecting hospitals from unnecessary admissions, providing primary and secondary prevention services in relation to COVID-19 and maintaining population health through treatment of non-COVID-19 conditions. This, together with more selective social distancing measures (instead of horizontal lockdowns), represents the only viable and realistic long-term strategy for COVID-19 pandemic mitigation.
Collapse
Affiliation(s)
- Konstantinos Farsalinos
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, Panepistimiopolis, 26500, Greece
- School of Public Health, University of West Attica, L Alexandras 196A, Athens, 11521, Greece
| | - Konstantinos Poulas
- Laboratory of Molecular Biology and Immunology, Department of Pharmacy, University of Patras, Panepistimiopolis, 26500, Greece
| | - Dimitrios Kouretas
- Department of Biochemistry and Biotechnology, University of Thessaly, Larisa, 41500, Greece
| | | | - Michalis Leotsinidis
- Lab. of Public Health, Medical School, University of Patras, University Campus, 26504, Greece
| | - Dimitrios Kouvelas
- Laboratory of Clinical Pharmacology, School of Medicine, Aristotle University of Thessaloniki, 54124, Thessaloniki, Greece
| | - Anca Oana Docea
- Department of Toxicology, University of Medicine and Pharmacy of Craiova, 200349, Craiova, Romania
| | - Ronald Kostoff
- School of Public Policy, Georgia Institute of Technology, Gainesville, VA, 20155, USA
| | - Grigorios T. Gerotziafas
- Sorbonne Université, INSERM, UMR_S 938, Group de recherche « Cancer-Hemostasis-Angiogenesis », Centre de recherche Saint-Antoine, CRSA, Centre de Thrombose, Tenon-Saint Antoine, University Hospitals, Assistance publique Hôpitaux de Paris, France
| | - Michael N. Antoniou
- Gene Expression and Therapy Group, King's College London, Department of Medical and Molecular Genetics, School of Basic & Medical Biosciences, 8th Floor, Tower Wing, Guy's Hospital, Great Maze Pond, London, SE1 9RT, UK
| | - Riccardo Polosa
- Department of Clinical and Experimental Medicine, University of Catania, Via S. Sofia, 97 95131, Catania, Italy
- Centro Prevenzione Cura Tabagismo, Center of Excellence for the Acceleration of Harm Reduction, University of Catania, 95123, Catania, Italy
| | - Anastastia Barbouni
- School of Public Health, University of West Attica, L Alexandras 196A, Athens, 11521, Greece
| | - Vassiliki Yiakoumaki
- Department of History, Archaeology and Social Anthropology, University of Thessaly, 38221, Volos, Greece
| | - Theodoros V. Giannouchos
- Pharmacotherapy Outcomes Research Center, College of Pharmacy, University of Utah, Salt Lake City, UT, USA
| | - Pantelis G. Bagos
- Department of Computer Science and Biomedical Informatics, University of Thessaly, Lamia, 35100, Greece
| | - George Lazopoulos
- Department of Cardiac Surgery, University Hospital of Heraklion, Crete, Greece
| | - Boris N. Izotov
- Department of Analytical Toxicology, Pharmaceutical Chemistry and Pharmacognosy, Sechenov University, 119991, Moscow, Russia
| | - Victor A. Tutelyan
- Federal Research Centre of Nutrition, Biotechnology and Food Safety, Moscow, Russian Federation
| | - Michael Aschner
- Department of Molecular Pharmacology, Albert Eisntein College of Medicine, 1300 Morris Park Avenue Bronx, NY, 10461, USA
| | - Thomas Hartung
- Center for Alternatives to Animal Testing, Johns Hopkins Bloomberg School of Public Health, Baltimore, MD, 21205, USA
- Department of Pharmacology and Toxicology, University of Konstanz, 78464, Konstanz, Germany
| | - Heather M. Wallace
- Institute of Medical Sciences, School of Medicine, Medical Sciences and Nutrition, University of Aberdeen, Aberdeen, UK
| | - Félix Carvalho
- UCIBIO, REQUIMTE, Laboratory of Toxicology, Department of Biological Sciences, Faculty of Pharmacy, University of Porto, 4050-313, Porto, Portugal
| | - Jose L. Domingo
- Laboratory of Toxicology and Environmental Health, School of Medicine, IISPV, Universitat Rovira i Virgili, Reus, Catalonia, Spain
| | - Aristides Tsatsakis
- Department of Analytical Toxicology, Pharmaceutical Chemistry and Pharmacognosy, Sechenov University, 119991, Moscow, Russia
- Department of Forensic Sciences and Toxicology, Faculty of Medicine, University of Crete, 71003, Heraklion, Greece
| |
Collapse
|
41
|
Marston HR, Shore L, White P. How does a (Smart) Age-Friendly Ecosystem Look in a Post-Pandemic Society? INTERNATIONAL JOURNAL OF ENVIRONMENTAL RESEARCH AND PUBLIC HEALTH 2020; 17:E8276. [PMID: 33182413 PMCID: PMC7664882 DOI: 10.3390/ijerph17218276] [Citation(s) in RCA: 21] [Impact Index Per Article: 5.3] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 09/28/2020] [Revised: 11/02/2020] [Accepted: 11/03/2020] [Indexed: 12/24/2022]
Abstract
COVID-19 has impacted not only the health of citizens, but also the various factors that make up our society, living environments, and ecosystems. This pandemic has shown that future living will need to be agile and flexible to adapt to the various changes in needs of societal populations. Digital technology has played an integral role during COVID-19, assisting various sectors of the community, and demonstrating that smart cities can provide opportunities to respond to many future societal challenges. In the decades ahead, the rise in aging populations will be one of these challenges, and one in which the needs and requirements between demographic cohorts will vary greatly. Although we need to create future smart age-friendly ecosystems to meet these needs, technology still does not feature in the WHO eight domains of an age-friendly city. This paper extends upon Marston and van Hoof's 'Smart Age-friendly Ecosystem' (SAfE) framework, and explores how digital technology, design hacking, and research approaches can be used to understand a smart age-friendly ecosystem in a post-pandemic society. By exploring a series of case studies and using real-life scenarios from the standpoint of COVID-19, we propose the 'Concept of Age-friendly Smart Ecologies (CASE)' framework. We provide an insight into a myriad of contemporary multi-disciplinary research, which are capable to initiate discussions and bring various actors together with a positive impact on future planning and development of age-friendly ecosystems. The strengths and limitations of this framework are outlined, with advantages evident in the opportunity for towns, regions/counties, provinces, and states to take an agile approach and work together in adopting and implement improvements for the greater benefits of residents and citizens.
Collapse
Affiliation(s)
- Hannah Ramsden Marston
- Health & Wellbeing Strategic Research Area, School of Health, Wellbeing & Social Care, The Open University, Milton Keynes, Buckinghamshire MK7 6HH, UK
| | - Linda Shore
- Mi:Lab, Department of Design Innovation, Maynooth University, W23 F2H6 Co. Kildare, Ireland;
| | - P.J. White
- DesignCORE, Humanities, Institute of Technology Carlow, R93 V960 Carlow, Ireland;
| |
Collapse
|
42
|
Sornette D, Mearns E, Schatz M, Wu K, Darcet D. Interpreting, analysing and modelling COVID-19 mortality data. NONLINEAR DYNAMICS 2020; 101:1751-1776. [PMID: 33020681 PMCID: PMC7527427 DOI: 10.1007/s11071-020-05966-z] [Citation(s) in RCA: 18] [Impact Index Per Article: 4.5] [Reference Citation Analysis] [Abstract] [Key Words] [Grants] [Track Full Text] [Subscribe] [Scholar Register] [Received: 04/28/2020] [Accepted: 09/16/2020] [Indexed: 05/05/2023]
Abstract
We present results on the mortality statistics of the COVID-19 epidemic in a number of countries. Our data analysis suggests classifying countries in five groups, (1) Western countries, (2) East Block, (3) developed Southeast Asian countries, (4) Northern Hemisphere developing countries and (5) Southern Hemisphere countries. Comparing the number of deaths per million inhabitants, a pattern emerges in which the Western countries exhibit the largest mortality rate. Furthermore, comparing the running cumulative death tolls as the same level of outbreak progress in different countries reveals several subgroups within the Western countries and further emphasises the difference between the five groups. Analysing the relationship between deaths per million and life expectancy in different countries, taken as a proxy of the preponderance of elderly people in the population, a main reason behind the relatively more severe COVID-19 epidemic in the Western countries is found to be their larger population of elderly people, with exceptions such as Norway and Japan, for which other factors seem to dominate. Our comparison between countries at the same level of outbreak progress allows us to identify and quantify a measure of efficiency of the level of stringency of confinement measures. We find that increasing the stringency from 20 to 60 decreases the death count by about 50 lives per million in a time window of 20 days. Finally, we perform logistic equation analyses of deaths as a means of tracking the dynamics of outbreaks in the "first wave" and estimating the associated ultimate mortality, using four different models to identify model error and robustness of results. This quantitative analysis allows us to assess the outbreak progress in different countries, differentiating between those that are at a quite advanced stage and close to the end of the epidemic from those that are still in the middle of it. This raises many questions in terms of organisation, preparedness, governance structure and so on.
Collapse
Affiliation(s)
- Didier Sornette
- Tokyo Tech World Research Hub Initiative (WRHI), Institute of Innovative Research, Tokyo Institute of Technology, Yokohama, 226-8502 Japan
- Institute of Risk Analysis, Prediction and Management (Risks-X), Academy for Advanced Interdisciplinary Studies, Southern University of Science and Technology (SUSTech), Shenzhen, 518055 China
- Department of Management, Technology and Economics, ETH Zurich, Scheuchzerstrasse 7, 8092, Zurich, Switzerland
| | - Euan Mearns
- Department of Management, Technology and Economics, ETH Zurich, Scheuchzerstrasse 7, 8092, Zurich, Switzerland
| | - Michael Schatz
- Department of Management, Technology and Economics, ETH Zurich, Scheuchzerstrasse 7, 8092, Zurich, Switzerland
| | - Ke Wu
- Institute of Risk Analysis, Prediction and Management (Risks-X), Academy for Advanced Interdisciplinary Studies, Southern University of Science and Technology (SUSTech), Shenzhen, 518055 China
- Department of Management, Technology and Economics, ETH Zurich, Scheuchzerstrasse 7, 8092, Zurich, Switzerland
| | | |
Collapse
|
43
|
Abstract
To put estimates of COVID-19 mortality into perspective, we estimate age-specific mortality for an epidemic claiming for illustrative purposes 1 million US lives, with results approximately scalable over a broad range of deaths. We calculate the impact on period life expectancy (down 2.94 y) and remaining life years (11.7 y per death). Avoiding 1.75 million deaths or 20.5 trillion person years of life lost would be valued at $10.2 to $17.5 trillion. The age patterns of COVID-19 mortality in other countries are quite similar and increase at rates close to each country's rate for all-cause mortality. The scenario of 1 million COVID-19 deaths is similar in scale to that of the decades-long HIV/AIDS and opioid-overdose epidemics but considerably smaller than that of the Spanish flu of 1918. Unlike HIV/AIDS and opioid epidemics, the COVID-19 deaths are concentrated in a period of months rather than spread out over decades.
Collapse
Affiliation(s)
| | - Ronald D Lee
- Department of Demography, University of California, Berkeley, CA 94720
| |
Collapse
|
44
|
Computational and Transcriptome Analyses Revealed Preferential Induction of Chemotaxis and Lipid Synthesis by SARS-CoV-2. BIOLOGY 2020; 9:biology9090260. [PMID: 32882823 PMCID: PMC7564677 DOI: 10.3390/biology9090260] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Figures] [Subscribe] [Scholar Register] [Received: 07/27/2020] [Revised: 08/20/2020] [Accepted: 08/26/2020] [Indexed: 12/27/2022]
Abstract
The continuous and rapid emergence of new viral strains calls for a better understanding of the fundamental changes occurring within the host cell upon viral infection. In this study, we analyzed RNA-seq transcriptome data from Calu-3 human lung epithelial cells infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) compared to five other viruses namely, severe acute respiratory syndrome coronavirus (SARS-CoV), Middle East Respiratory Syndrome (SARS-MERS), influenzavirus A (FLUA), influenzavirus B (FLUB), and rhinovirus (RHINO) compared to mock-infected cells and characterized their coding and noncoding RNA transcriptional portraits. The induction of interferon, inflammatory, and immune response was a hallmark of SARS-CoV-2 infection. Comprehensive bioinformatics revealed the activation of immune response and defense response to the virus as a common feature of viral infection. Interestingly however, the degree of functional categories and signaling pathways activation varied among different viruses. Ingenuity pathways analysis highlighted altered conical and casual pathways related to TNF, IL1A, and TLR7, which are seen more predominantly during SARS-CoV-2 infection. Nonetheless, the activation of chemotaxis and lipid synthesis was prominent in SARS-CoV-2-infected cells. Despite the commonality among all viruses, our data revealed the hyperactivation of chemotaxis and immune cell trafficking as well as the enhanced fatty acid synthesis as plausible mechanisms that could explain the inflammatory cytokine storms associated with severe cases of COVID-19 and the rapid spread of the virus, respectively.
Collapse
|
45
|
Hakes NA, Choi J, Spain DA, Forrester JD. Lessons from Epidemics, Pandemics, and Surgery. J Am Coll Surg 2020; 231:770-776. [PMID: 32828842 PMCID: PMC7441012 DOI: 10.1016/j.jamcollsurg.2020.08.736] [Citation(s) in RCA: 4] [Impact Index Per Article: 1.0] [Reference Citation Analysis] [Track Full Text] [Download PDF] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/13/2020] [Revised: 07/13/2020] [Accepted: 08/05/2020] [Indexed: 01/25/2023]
Affiliation(s)
- Nicholas A Hakes
- Department of Surgery, Stanford Hospital and Clinics, Stanford University, Stanford, CA
| | - Jeff Choi
- Department of Surgery, Stanford Hospital and Clinics, Stanford University, Stanford, CA.
| | - David A Spain
- Department of Surgery, Stanford Hospital and Clinics, Stanford University, Stanford, CA
| | - Joseph D Forrester
- Department of Surgery, Stanford Hospital and Clinics, Stanford University, Stanford, CA
| |
Collapse
|
46
|
Shanks GD. COVID-19 versus the 1918 influenza pandemic: different virus, different age mortality patterns. J Travel Med 2020; 27:5850342. [PMID: 32490524 PMCID: PMC7313895 DOI: 10.1093/jtm/taaa086] [Citation(s) in RCA: 8] [Impact Index Per Article: 2.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Download PDF] [Journal Information] [Submit a Manuscript] [Subscribe] [Scholar Register] [Received: 05/05/2020] [Revised: 05/21/2020] [Accepted: 05/25/2020] [Indexed: 02/04/2023]
Abstract
The influenza pandemic of 1918-19 and the SARS-CoV 2 pandemic of 2020 had markedly different age mortality patterns. Influenza in 1918 particularly killed young adults whereas the elderly are most at risk from COVID-19. Mortality depends on complex host-pathogen interactions specific to the viral and human population’s history of infection.
Collapse
Affiliation(s)
- G Dennis Shanks
- Australian Defence Force Malaria and Infectious Diseases Institute, Enoggera, Australia.,School of Public Health, University of Queensland, Brisbane, Australia
| |
Collapse
|
47
|
Arevalo P, McLean HQ, Belongia EA, Cobey S. Earliest infections predict the age distribution of seasonal influenza A cases. eLife 2020; 9:e50060. [PMID: 32633233 PMCID: PMC7367686 DOI: 10.7554/elife.50060] [Citation(s) in RCA: 40] [Impact Index Per Article: 10.0] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Grants] [Track Full Text] [Download PDF] [Figures] [Journal Information] [Subscribe] [Scholar Register] [Received: 07/10/2019] [Accepted: 06/29/2020] [Indexed: 12/02/2022] Open
Abstract
Seasonal variation in the age distribution of influenza A cases suggests that factors other than age shape susceptibility to medically attended infection. We ask whether these differences can be partly explained by protection conferred by childhood influenza infection, which has lasting impacts on immune responses to influenza and protection against new influenza A subtypes (phenomena known as original antigenic sin and immune imprinting). Fitting a statistical model to data from studies of influenza vaccine effectiveness (VE), we find that primary infection appears to reduce the risk of medically attended infection with that subtype throughout life. This effect is stronger for H1N1 compared to H3N2. Additionally, we find evidence that VE varies with both age and birth year, suggesting that VE is sensitive to early exposures. Our findings may improve estimates of age-specific risk and VE in similarly vaccinated populations and thus improve forecasting and vaccination strategies to combat seasonal influenza.
Collapse
Affiliation(s)
- Philip Arevalo
- Department of Ecology and Evolutionary Biology, University of ChicagoChicagoUnited States
| | - Huong Q McLean
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research InstituteMarshfieldUnited States
| | - Edward A Belongia
- Center for Clinical Epidemiology and Population Health, Marshfield Clinic Research InstituteMarshfieldUnited States
| | - Sarah Cobey
- Department of Ecology and Evolutionary Biology, University of ChicagoChicagoUnited States
| |
Collapse
|
48
|
Lee CC, Liu Y, Lu KT, Wei C, Su K, Hsu WT, Chen SC. Comparison of influenza hospitalization outcomes among adults, older adults, and octogenarians: a US national population-based study. Clin Microbiol Infect 2020; 27:435-442. [PMID: 32325126 DOI: 10.1016/j.cmi.2020.04.013] [Citation(s) in RCA: 3] [Impact Index Per Article: 0.8] [Reference Citation Analysis] [Abstract] [Key Words] [MESH Headings] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 12/15/2019] [Revised: 04/08/2020] [Accepted: 04/12/2020] [Indexed: 11/19/2022]
Abstract
OBJECTIVES This study sought to more fully elucidate the age-related trends in influenza mortality with a secondary goal of uncovering implications for treatment and prevention. METHODS In this retrospective cohort analysis of data from the Nationwide Readmission Database, patients with influenza as a primary or secondary discharge diagnosis were separated into three age groups: 55 638 adults aged 20-64 years, 36 862 adults aged 65-79 years and 41 806 octogenarians aged ≥80 years. Propensity score (PS) weighting was performed to isolate age from other baseline differences. Crude and PS-weighted hazard ratios (HR) were calculated from the in-hospital all-cause 30-day mortality rate. Admission threshold bias was minimized by comparison of influenza with bacterial pneumonia mortality. RESULTS Adults aged 20-64 years experienced higher in-hospital 30-day mortality compared with older adults aged 65-79 years (HR 0.66; 95% CI 0.55-0.79). Octogenarians had the highest mortality rate, but this was statistically insignificant compared with the adult cohort (HR 1.09; 95% CI 0.94-1.27). This trend was not explained by admission threshold bias: the 30-day mortality rate due to in-hospital bacterial pneumonia increased consistently with age (older adult HR 1.45; 95% CI 1.32-1.59; octogenarian HR 1.99; 95% CI 1.82-2.18). CONCLUSIONS Adults aged 20-64 years and octogenarians were more likely to experience all-cause 30-day mortality during influenza hospitalization compared with older adults aged 65-79 years. These data emphasize the importance of prevention and suggest the need for more tailored treatment interventions based on risk stratification that includes age.
Collapse
Affiliation(s)
- C-C Lee
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - Y Liu
- Department of Health Care Organization and Policy, University of Alabama at Birmingham, School of Public Health, Birmingham, AL, USA
| | - K-T Lu
- Department of Medicine, College of Medicine, National Taiwan University, Taipei, Taiwan
| | - C Wei
- Harvard Medical School, Boston, MA, USA
| | - K Su
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan
| | - W-T Hsu
- Department of Epidemiology, Harvard T.H. Chan School of Public Health, Boston, MA, USA
| | - S-C Chen
- Department of Emergency Medicine, National Taiwan University Hospital, Taipei, Taiwan.
| |
Collapse
|
49
|
Thompson RN, Thompson CP, Pelerman O, Gupta S, Obolski U. Increased frequency of travel in the presence of cross-immunity may act to decrease the chance of a global pandemic. Philos Trans R Soc Lond B Biol Sci 2020; 374:20180274. [PMID: 31056047 DOI: 10.1098/rstb.2018.0274] [Citation(s) in RCA: 28] [Impact Index Per Article: 7.0] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Indexed: 11/12/2022] Open
Abstract
The high frequency of modern travel has led to concerns about a devastating pandemic since a lethal pathogen strain could spread worldwide quickly. Many historical pandemics have arisen following pathogen evolution to a more virulent form. However, some pathogen strains invoke immune responses that provide partial cross-immunity against infection with related strains. Here, we consider a mathematical model of successive outbreaks of two strains-a low virulence (LV) strain outbreak followed by a high virulence (HV) strain outbreak. Under these circumstances, we investigate the impacts of varying travel rates and cross-immunity on the probability that a major epidemic of the HV strain occurs, and the size of that outbreak. Frequent travel between subpopulations can lead to widespread immunity to the HV strain, driven by exposure to the LV strain. As a result, major epidemics of the HV strain are less likely, and can potentially be smaller, with more connected subpopulations. Cross-immunity may be a factor contributing to the absence of a global pandemic as severe as the 1918 influenza pandemic in the century since. This article is part of the theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: approaches and important themes'. This issue is linked with the subsequent theme issue 'Modelling infectious disease outbreaks in humans, animals and plants: epidemic forecasting and control'.
Collapse
Affiliation(s)
- R N Thompson
- 1 Mathematical Institute, University of Oxford , Andrew Wiles Building, Radcliffe Observatory Quarter, Woodstock Road, Oxford OX2 6GG , UK.,2 Department of Zoology, University of Oxford , South Parks Road, Oxford OX1 3PS , UK.,3 Christ Church, University of Oxford , St Aldate's, Oxford OX1 1DP , UK
| | - C P Thompson
- 2 Department of Zoology, University of Oxford , South Parks Road, Oxford OX1 3PS , UK
| | - O Pelerman
- 4 The Chaim Rosenberg School of Jewish Studies, Tel Aviv University , Tel Aviv 69978 , Israel
| | - S Gupta
- 2 Department of Zoology, University of Oxford , South Parks Road, Oxford OX1 3PS , UK
| | - U Obolski
- 2 Department of Zoology, University of Oxford , South Parks Road, Oxford OX1 3PS , UK.,5 School of Public Health , Tel Aviv University, Tel Aviv , Israel.,6 Porter School of the Environment and Earth Sciences, Tel Aviv University , Israel
| |
Collapse
|
50
|
Shanks GD. Anomalies of the 1919 influenza pandemic remain unexplained after 100 years. Intern Med J 2020; 49:919-923. [PMID: 31295783 DOI: 10.1111/imj.14344] [Citation(s) in RCA: 5] [Impact Index Per Article: 1.3] [Reference Citation Analysis] [Abstract] [Key Words] [Track Full Text] [Journal Information] [Subscribe] [Scholar Register] [Received: 03/04/2019] [Revised: 04/09/2019] [Accepted: 04/09/2019] [Indexed: 11/26/2022]
Abstract
The modern world's most lethal single event, the 1918-1921 influenza pandemic, remains an anomaly which is still unexplained. The pandemic's unprecedented mortality was very unevenly distributed with young adults and isolated populations worst affected. Australia was the last continent involved with about 12 000 influenza deaths in 1919. Most cases were clinically unremarkable and recovered quickly, but a small minority developed severe tracheobronchitis compromising oxygenation and immune defences usually dying in the second week of illness. Histopathology showed massive destruction of the respiratory epithelium with evidence of secondary bacterial invasion. No simple explanation (e.g. hypervirulent virus) is consistent with these observations.
Collapse
Affiliation(s)
- G Dennis Shanks
- Australian Defence Force Malaria and Infectious Diseases Institute, Brisbane, Queensland, Australia.,School of Public Health, University of Queensland, Brisbane, Queensland, Australia
| |
Collapse
|