IATA Medical Contact Group - COVID-19, Monkeypox, other outbreaks

COVID-19

COVID numbers have been surging in both Russia and also in China (>500% increase in two weeks in China, although absolute numbers are still low).

A pre-print publication from Maryland, showing that viral shedding (measured as RNA copies) into exhaled breath aerosol was significantly greater during infections with Alpha, Delta, and Omicron than with other variants (such as the ancestral Wuhan strain, and Gamma).  For participants with Delta and Omicron, their fine aerosol contained on average five times the amount of virus that was detected in their larger, coarse aerosol. There were no statistically significant differences in rates of shedding between Alpha, Delta, and Omicron infections. (However the highest shedder, who had an Omicron infection, and shed 1000 times more viral RNA copies than the maximum observed for Delta and Alpha).   Lai et al:  https://www.medrxiv.org/content/10.1101/2022.07.27.22278121v2.full

Study of unawareness of infection:  In this study in Los Angeles of adults with evidence of seroconversion during a regional Omicron variant surge, 56% reported being unaware of any recent Omicron infection; low rates of Omicron variant infection awareness may be a key contributor to rapid transmission of the virus within communities.  Joung et al: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2795246

The US CDC published its Summary of Guidance for Minimizing the Impact of COVID-19 on Individual Persons, Communities, and Health Care Systems https://www.cdc.gov/mmwr/volumes/71/wr/mm7133e1.htm?s_cid=mm7133e1_x

On treatments:  Efficacy results from the “COVID-OUT” Phase III trial investigating Metformin, Fluvoxamine and Ivermectin as outpatient treatments has shown that all of the three candidates failed to achieve statistical improvement in multiple endpoints (source: Airfinity).

A pre-print study on medRxiv quoted in Nature:  To determine the frequency of rebound in the absence of Paxlovid treatment, Li et al (Boston analysed data from hundreds of people in a randomized trial of COVID-19 antibody drugs.  More than one-quarter of participants who were infected with SARS-CoV-2 reported a rebound in their symptoms, while 1 in 8 saw the virus return to high levels1. Yet, just 1–2% of people had both features of rebound (symptoms and high viral levels). https://www.nature.com/articles/d41586-022-02121-z

An article from Italy in JAMA on long COVID associated with reduced long COVID risk amongst HCW vaccinated – compared with unvaccinated, the rate was 25% (2 doses) and 16% (3 doses).  The article cautions that causality cannot be determined from the data.  Risk was also greater in females, and those older or with co-morbidities. Azzolini et al: https://jamanetwork.com/journals/jama/fullarticle/2794072

Monkeypox

Based on cases for which the WHO has detailed case data, 98.5% are male and 96.9% have self-identified as Men who have Sex with Men (MSM). 1.5%of cases are female. Additionally, 0.5% of cases are reported to be aged 0-17 and 0.1% of cases were aged 0-4. Most of the cases in children have been reported in the African Region. (Source: BlueDot). 

WHO announced that the  Congo Basin (Central African) clade will be referred to as Clade I and the and West African clade as Clade II. Additionally, Clade II consists of two subclades, Clade IIa and Clade IIb, and the current global outbreak is largely due to Clade IIb. 

 

Best wishes,
David Powell

IATA Medical Advisor