Top Infectious Disease News of the Week—April 5, 2020

#5: Influenza Vaccine Effectiveness Decreases by the Season, Report Says

There are intra-seasonal decreases in measured vaccine effectiveness (mVE) for the influenza vaccine, according to a paper published in Clinical Infectious Diseases.

Investigators from the US Centers for Disease Control and Prevention (CDC) estimated daily numbers of flu vaccines from the 2011-12 season to the 2014-15 season in order to determine the contribution of “leaky” vaccines to the observed decline of mVE. “Leaky” vaccines are those that provide partial protection in all vaccinated patients rather than complete protection in some vaccinated patients. Leaky vaccines contribute to mVE, as do risk measures that include prior cases in risk denominators, the study authors explained.

Every time mVE declines by -13%, infection risk is reduced by half to 25% among vaccinated patients with leaky vaccines, the study authors added.

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#4: The Challenges of Community Masking

On Friday, the White House Coronavirus Task Force and the US Centers for Disease Control and Prevention (CDC) released recommendations for use of cloth face coverings. The debate surrounding large-scale community facemask recommendations has been heating up in recent days and for many, there was a need to feel as if we were doing something.

The CDC’s recommendations focus on wearing cloth face coverings in public settings that don’t allow for social distancing and especially in those areas of increase community-based transmission. The agency emphasizes that social distancing is still the most important tool in this outbreak and that face coverings are only piece to infection control measures. Moreover, the CDC emphasizes that surgical masks and N-95 respirators are critical supplies for health care workers and that the recommended cloth face coverings are not of the same quality.

Many have noted that these recommendations are likely a more political move, to help address the public concern for doing more but also ensuring safety. “With the new guidance, the federal government is trying to walk a line between acknowledging the evidence for public mask use—as well as many people’s desires to take more action to combat the coronavirus—and avoiding further strain on available PPE [personal protective equipment] supplies.” With the constant stream of information on masks, it’s easy to understand why society has fixated on the topic.

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#3: Analysis: Spanish Flu Pandemic Proves Social Distancing Works

As Americans enter their second month of homebound social-distancing, politicians and other public health officials are pondering the question of just how long it will be necessary to cancel public gatherings. Some have wondered aloud whether long-term isolation is even necessary to stop the spread of the coronavirus disease 2019 (COVID-19).

In a new paper published in the Journal of the American Society of Cytopathology, Stefan E. Pambuccian, MD, MIAC, a professor and vice chair of the department of pathology and laboratory medicine at Loyola University Chicago’s Stritch School of Medicine attempts to answer those questions using the “Spanish Influenza” pandemic of 1918-1919 as a model.

In short, his answer to the question of whether social distancing works is: yes.

"The stricter the isolation policies, the lower the mortality rate," Pambuccian said, in a press release.

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#2: NEJM Editorial Says US Can Eradicate COVID-19 by Early June

The United States can eradicate coronavirus disease 2019 (COVID-19) in 10 weeks through a forceful and focused campaign, according to an editorial published in The New England Journal of Medicine.

Harvey V. Fineberg, MD, PhD, chair of the National Academies Standing Committee on Emerging Infectious Diseases and 21st Century Health Threats in Washington, DC, and president of the Gordon and Betty Moore Foundation in Palo Alto, California, outlined a way to not only flatten but “crush” the curve in 10 weeks. In a video interview with Contagion^® Editorial Director Allie Ward, he explained his motivation for penning the article (see video).

He wrote that China was able to accomplish this in Wuhan, the center of the novel coronavirus outbreak, and America can do it as well in 6 steps. This can be accomplished by early June, he added.

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#1: The Eyes Have It: Novel Coronavirus in Eye Can be Communicable

One-third of patients in a series of 38 hospitalized for coronavirus disease 2019 (COVID-19) were found to have symptoms consistent with conjunctivitis. Two of the patients yielded positive RT-PCR tests for the SARS-CoV-2 virus from both conjunctival and nasopharyngeal swabs, and 1 patient manifested the excessive tearing of epiphora as the first symptom of the viral illness.

"Because unprotected eyes were associated with an increased risk of transmission SARS-CoV-1 (in 2003 SARS outbreak), in support of our current results, our results might suggest that SARS-CoV-2 might be transmitted through the eye," warns Ping Wu, MD, Department of Ophthalmology, The First College of Clinical Medical Science, Yichang Central People's Hospital, China, and colleagues.

The investigators undertook their study after noting that there has been little previous evaluation of ocular signs and symptoms in patients infected with SARS-CoV-1 or with SARS-CoV-2, and no reported direct evidence that coronavirus causes conjunctivitis or other ocular diseases.

Read the full article.