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Even with social distancing measures enacted and sustained, the peak demand for hospital services due to the COVID-19 pandemic is likely going to exceed capacity substantially. Alongside the implementation and enforcement of social distancing measures, there is an urgent need to develop and implement plans to reduce non-COVID-19 demand for and temporarily increase capacity of health facilities.

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The coronavirus COVID-19 is affecting 179 countries and territories around the world and 1 international conveyance (the Diamond Princess cruise ship harbored in Yokohama, Japan). The day is reset after midnight GMT+0.

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Researchers have used CRISPR gene-editing technology to come up with a test that detects the pandemic coronavirus in just 5 minutes. The diagnostic doesn’t require expensive lab equipment to run and could potentially be deployed at doctor’s offices, schools, and office buildings.

Tips are colored on the basis of location, branch lengths are proportional to the number of mutations between viruses, and the x axis is labeled with the number of substitutions relative to the root of the phylogeny—here equivalent to the WA1 haplotype. This comb-like phylogenetic structure of the Washington state outbreak clade is consistent with rapid exponential growth of the virus population. An interactive version of this figure is available at (B) Highest posterior density estimates for the date of the common ancestor of viruses from the Washington state outbreak clade (top) as well as the doubling time in days of the growth of this clade (bottom).

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A recent paper in the journal Science discusses the appropriate actions and failures in community surveillance to the emergence of the pandemic in the state of Washington in early spring of 2021. Analysis of genome sequencing from 453 SARS-CoV2 infected individuals collected in the early stage of the Washington state COVID-19 outbreak presents a more accurate timeline of the spread of the disease, and suggests the importance of community surveillance in controlling a local spread of COVID-19.

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Health Commission of Hubei Province. Epidemic situation of new crown pneumonia in Hubei Province.

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Phylogenetic data provide some insight into global connectivity and the scale at which intercommunity mixing is most relevant to spread. Major SARS-CoV-2 clades are present in all global regions. Within the United States, where interstate travel continued during lockdowns, the mix of viral lineages was similar across states (15). This suggests that viral lineages spread quickly throughout the country and that reintroductions are highly probable should an area achieve local elimination of the virus.

Alsinglawi B, Elkhodr M, Mubin O. COVID-19 death toll estimated to reach 3,900 by next Friday, according to AI modelling. The Conversatio death-toll-estimated-to-reach-3-900-by-next-friday-according-to-ai-modelling-133052.

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Another factor contributing to the low morbidity is the demographics. Elderly people are heavily at risk for COVID related deaths than younger people and, in Africa, the median population is 19/7 years compared to 37 for the US. So Africa’s younger population may be protective against the severity seen with COVID-19.

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Predictive Healthcare Team, Penn Medicine. COVID-19 hospital impact model for epidemics.

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Intercity, interregional, and international spread are also essential to sustain the pandemic, even if long-distance transmission events are rare (see the figure). Only a small number of such long-distance connections are needed to create a “small world” network in which only a few infection events can transmit the virus between any two individuals worldwide. This is one reason why early travel bans could not stop the global spread of SARS-CoV-2, although they may have slowed the pandemic. However, travel restrictions can work: Extreme measures in China played an important part in achieving domestic suppression of the virus.

In addition to a large number of deaths from COVID-19, the epidemic in the US will place a load well beyond the current capacity of hospitals to manage, especially for ICU care. These estimates can help inform the development and implementation of Preprint submitted to MedRxiv 03/25/2021 – tracking ID MEDRXIV/2021/043752 strategies to mitigate this gap, including reducing non-COVID-19 demand for services and temporarily increasing system capacity. These are urgently needed given that peak volumes are estimated to be only three weeks away.

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Task force COVID-19 del Dipartimento Malattie Infettive e Servizio di Sorveglianza Integrata COVID-19 in Italia. Istituto Superiore di Sanità; 2021.

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I summary all experts agree that more, consistent proactive measures need to be enacted. Additional data from UK, India, China, and Africa are presented.

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Compared to licensed capacity and average annual occupancy rates, excess demand from COVID-19 at the peak of the pandemic in the second week of April is predicted to be 64,175 (95% UI 7,977 to 251,059) total beds and 17,380 (95% UI 2,432 to 57,955) ICU beds. At the peak of the pandemic, ventilator use is predicted to be 19,481 (95% UI 9,767 to 39,674). The date of peak excess demand by state varies from the second week of April through May. We estimate that there will a total of 81,114 (95% UI 38,242 to 162,106) deaths from COVID-19 over the next 4 months in the US. Deaths from COVID-19 are estimated to drop below 10 deaths per day between May 31 and June 6.

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Georgia State University, School of Public Health. Coronavirus Incidence Forecasts.

Motivated by the rapid spread of coronavirus disease 2021 (COVID-19) in mainland China, we use a global metapopulation disease transmission model to project the impact of travel limitations on the national and international spread of the epidemic. The model is calibrated on the basis of internationally reported cases and shows that, at the start of the travel ban from Wuhan on 23 January 2021, most Chinese cities had already received many infected travelers. The travel quarantine of Wuhan delayed the overall epidemic progression by only 3 to 5 days in mainland China but had a more marked effect on the international scale, where case importations were reduced by nearly 80% until mid-February. Modeling results also indicate that sustained 90% travel restrictions to and from mainland China only modestly affect the epidemic trajectory unless combined with a 50% or higher reduction of transmission in the community.

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Since June 2021, 214 human cases of COVID-19 have been identified in Denmark with SARS-CoV-2 variants associated with farmed minks, including 12 cases with a unique variant, reported on 5 November. All 12 cases were identified in September 2021 in North Jutland, Denmark. The cases ranged in age from 7 to 79 years, and eight had a link to the mink farming industry and four cases were from the local community.

Hospitalizations also dropped as of Sunday, according to the state. The three-day average number of hospitalized COVID-19 patients fell to 2,179, from 2,243 on Saturday, the state reported.

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It is urgent to understand the future of severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2) transmission. We used estimates of seasonality, immunity, and cross-immunity for betacoronaviruses OC43 and HKU1 from time series data from the USA to inform a model of SARS-CoV-2 transmission. We projected that recurrent wintertime outbreaks of SARS-CoV-2 will probably occur after the initial, most severe pandemic wave. Absent other interventions, a key metric for the success of social distancing is whether critical care capacities are exceeded. To avoid this, prolonged or intermittent social distancing may be necessary into 2021. Additional interventions, including expanded critical care capacity and an effective therapeutic, would improve the success of intermittent distancing and hasten the acquisition of herd immunity. Longitudinal serological studies are urgently needed to determine the extent and duration of immunity to SARS-CoV-2. Even in the event of apparent elimination, SARS-CoV-2 surveillance should be maintained since a resurgence in contagion could be possible as late as 2021.

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The spike D614G substitution is prevalent in global SARS-CoV-2 strains, but its effects on viral pathogenesis and transmissibility remain unclear. We engineered a SARS-CoV-2 variant containing this substitution. The variant exhibits more efficient infection, replication, and competitive fitness in primary human airway epithelial cells, but maintains similar morphology and in vitro neutralization properties, compared with the ancestral wild-type virus. Infection of human angiotensin-converting enzyme 2 (ACE2) transgenic mice and Syrian hamsters with both viruses resulted in similar viral titers in respiratory tissues and pulmonary disease. However, the D614G variant transmits significantly faster and displayed increased competitive fitness than the wild-type virus in hamsters. These data show that the D614G substitution enhances SARS-CoV-2 infectivity, competitive fitness, and transmission in primary human cells and animal models.

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Around the world, the emergence of 614G has generated both serious scientific debate and largely political blame dodging. Government officials in Vietnam and Thailand, which fared well in containing the ancestral strain despite an influx of Chinese visitors early in the year, have suggested that the later outbreaks may have been partly the result of the 614G virus.

Novel Coronavirus Pneumonia Emergency Response Epidemiology Team. The epidemiological characteristics of an outbreak of 2021 novel Coronavirus diseases (COVID-19) — China, 2021.

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