COPD World News

COPD World News - Week of February 11, 2021

World Health Organization weighs in on vaccine dosage delays

Geneva, Switzerland - A recent editorial published in the British Medical Journal makes a good case for why the Canadian government’s risky dose-delay strategy to compensate for its failure to procure COVID-19 vaccines is a bad idea. It adds to a wealth of emerging scientific data, which clearly demonstrates that elderly people who have gotten their first dose of vaccine should get their second within the recommended 21 or 28 days, not 16 weeks. “Concerns remain about effectiveness in older adults,” wrote Dominic Pimenta, Christian Yates, Christina Pagel and Deepti Gurdasani in the BMJ on March 18, speaking of the United Kingdom’s 12-week dose delay. The “deviation” from the recommended protocol of 21 days between doses for the Pfizer-BioNTech vaccine was intended to maximize benefit with limited supplies and to minimize hospital admissions and deaths, they noted. “At the time, Pfizer did not support the decision, stating that high efficacy could not be guaranteed.”  And indeed, delaying the second dose creates a new set of problems: “As many people in priority subgroups have not yet received a second dose, any substantial waning of protection during the 12-week interval will create problems as the U.K. starts to reopen.… This is of particular concern for older adults. The World Health Organization also weighed in on the dosage delay strategy by Britain and Canada, “urging the vaccine doses be given 21 to 28 days apart.” The U.S. Centres for Disease Control and Prevention said months ago that people could wait up to 42 days between doses, if necessary, though the agency still advises individuals to stick to the initial schedule “So what gives? How long can you go on a single shot and still stay safe? And what happens if your second shot isn’t available on time?” asked Marla Broadfoot in an article published in Scientific American on March 18. “The first dose primes immunological memory, and the second dose solidifies it,” reads the article, citing Thomas Denny, COO of the Duke Human Vaccine Institute. The first dose of the Pfizer vaccine reduces infections by about 50 per cent, and Moderna’s jab reduces it by around 80 per cent, but both shots offer 95 per cent protection after the second shot, he noted. The CDC increased the duration up to 42 days to provide scheduling flexibility, and no studies were done as to whether this reduced the vaccine’s effectiveness. “We don’t have the greatest science, at this point, to say we are 100 per cent comfortable doing a booster 35, 40 days out,” Denny added. “We are deferring to the public health concerns and the belief that anything we can do right now is better than nothing.”

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COPD World News - Week of February 4, 2021

People with long-COVID at high risk of depression and PTSD

London, UK - People living with long-COVID are at significant risk of experiencing depression and post-traumatic stress disorder (PTSD), according to research published in the European Respiratory Journal. The research is one of the first long-term follow-up studies of people who presented at hospital with COVID-19. Researchers found that a significant proportion of patients who attended hospital, whether admitted or discharged from the emergency department and regardless of disease severity, experienced an ongoing mental health burden – 14% showed signs of depression and 11% experienced PTSD. The researchers say that COVID-19 patients should be routinely monitored for psychological distress in post-COVID care to ensure that they recover both physically and mentally. Dr Swapna Mandal, Consultant Respiratory Physician at the Royal Free London NHS Foundation Trust, UK, was a lead researcher on the study. She said: “Whilst caring for COVID patients we could see the mental health effects; patients were terrified by what was happening to them and what they were seeing around them. Many people who have had COVID-19 report adverse mental health after the infection has cleared, but up to now, there have been very few long-term studies focused on this issue. “Based on these concerns, when we set up our post-COVID follow-up clinics we sought to monitor the psychological consequences among patients. We screened for depression and PTSD so that we could support our patients to get the right help and to gain insight in to how prevalent these long-term effects are.” Researchers conducted virtual follow-up care with 760 patients who presented at the Royal Free London NHS Foundation Trust, UK, with COVID-19 including those who were treated in the emergency department (112 patients), inpatient wards (558) and intensive care unit (90). The respondents’ average age was 60 years and the cohort comprised 60% male and 48% of black or minority ethnic background. Patients were followed-up at nine weeks and screened for psychological distress using the Patient Health Questionnaire 2-item scale, which assesses depression by asking about the frequency of depressed mood in the past two weeks, as well as the Trauma Screening Questionnaire, another self-report tool that is designed to identify those experiencing PTSD. The questionnaire data showed that at approximately nine weeks after discharge, a significant proportion of patients who had attended the hospital experienced varying levels of ongoing mental health burden. Around 105 patients (14%) of those receiving follow-up care showed signs of depression and 80 patients (11%) experienced symptoms of PTSD. The data also showed that patients who experienced depression or PTSD were more likely to have ongoing physical symptoms, such as breathlessness and muscle pain, and they were less likely to have returned to work at nine weeks’ follow-up. Dr Mandal said: “Our results show very clearly that among those who we provided post-COVID care for, many have experienced some level of poor mental health during their recovery. All health professionals who are involved in the care of those with long-COVID must be aware of this and should actively screen patients for symptoms, even in those with pre-existing mental health issues. It is vital that multidisciplinary clinics are established to manage all aspects of long-COVID symptoms in a holistic manner, so that patients are able to fully recover.” When the researchers accounted for others factors that can impact mental health – such as the patients’ age, sex, socioeconomic status, and ethnicity; whether they had any existing illness and related symptoms; or if they presented with worse COVID-19 symptoms – they found that the increased prevalence of depression or PTSD among long-COVID patients remained. Dr Mandal explained: “Interestingly, our data suggests there were no significant differences in the levels of depression or PTSD between ethnic groups, nor among those admitted to the ICU when compared with patients admitted to inpatient wards or those who presented at the emergency department, suggesting that disease severity does not impact the likelihood of experiencing ongoing mental health issues. “However, as our respondents included only those who had attended the emergency department or stayed in the hospital, the analysis of the relationship between mental health and disease severity is somewhat limited. Future studies should investigate this further by looking at patients who were treated in primary care settings, such as GP clinics and those who self-treated at home following doctors’ or official advice.” Professor Anita Simonds, President of the European Respiratory Society and Consultant in Respiratory and Sleep Medicine at Royal Brompton Hospital, UK, was not involved in the research. She said: “The results of this long-term study support that individuals who have had COVID-19 are at-risk of worsening mental health. Research on other long-term lung conditions like asthma and COPD suggests that addressing patients’ anxiety or mental ill health can improve their quality of life and ability to keep physically active, which may help with symptom management and recovery in the long run. Health professionals who are caring for those with long-COVID should monitor mental health and ensure patients can access local psychological services alongside respiratory rehabilitation. “Long-COVID treatment is likely to become a large burden on health systems around the world, so is it vitally important that clinics equally address the physical and mental health symptoms of long-COVID and that policymakers ensure clinics have the resources to offer this multidisciplinary care.” The researchers say they were not able to screen patients for depression or PTSD on admission to hospital, so it is not clear if some patients had pre-existing mental health issues or were undiagnosed.

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COPD World News - Week of March 28, 2021

Sanofi to build new vaccine plant

Toronto, ON - Today, Sanofi announced an investment of approximately C $ 925 million in a new vaccine manufacturing facility to be built at its current site in Toronto , Canada . The investment in such a facility will increase the antigen production and filling capacity for Sanofi's high-dose FLUZONE ® Quadrivalent influenza vaccine , thereby increasing its supply in Canada , the United States and Europe. “As a leader in vaccine manufacturing, we are constantly looking to the future to meet the growing demand for influenza vaccines that have demonstrated clinical superiority over standard dose vaccines. This new investment in the manufacture of the high-dose FLUZONE ® Quadrivalent vaccine will help ensure better protection of older people around the world against influenza and its complications. In addition, this vaccine will be a key resource to help fight future pandemics” said Paul Hudson, CEO of Sanofi." We salute the ongoing partnership with the Canadian authorities, who have provided us with their support to bring this major project to fruition which will make Canada - which has a solid heritage in vaccine research and development - one of our main centers in our efforts to protect and improve human health worldwide.  "In addition to manufacturing Sanofi's high-dose FLUZONE ® Quadrivalent influenza vaccine , this new manufacturing facility will strategically grow the biofabrication sector in Canada and build industrial-scale capacity to better prepare Canada for future pandemics.

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Pfizer begins early-stage study of oral COVID-19 drug

New York, NY - Pfizer Inc has started an early-stage U.S. trial of an oral COVID-19 antiviral therapy that could be prescribed to patients at the first sign of infection, the company said recently. The drugmaker, which developed the first authorized COVID-19 vaccine in the U.S. with Germany's BioNTech SA, said the antiviral candidate showed potent activity against SARS-CoV-2, the virus that causes COVID-19, in lab studies. Pfizer's candidate, named PF-07321332, is a protease inhibitor that prevents the virus from replicating in cells. Protease inhibitors have been effective at treating other viral pathogens such as HIV and hepatitis C virus, both on their own and in combination with other antivirals, the company said. Pfizer believes this class of molecules may provide well-tolerated treatments against COVID-19, as currently marketed therapeutics that work on the same lines have not reported safety concerns. The company is also studying an intravenously administered antiviral candidate in an early-stage trial in hospitalized COVID-19 patients. "Together, the two (oral and intravenous candidates) have the potential to create an end-to-end treatment paradigm that complements vaccination in cases where disease still occurs," Pfizer's Chief Medical Officer Mikael Dolsten said in a statement. Pfizer's candidate is behind two other oral antiviral therapies, which are in mid-stage trials – the first being developed by rival Merck & Co with Ridgeback Bio, and a second from Roche Holding and Atea Pharmaceuticals. Gilead Sciences' remdesivir is currently the only U.S. Food and Drug Administration-approved drug for the treatment of COVID-19. The FDA has granted an emergency authorization to intravenous therapies from Eli Lilly - bamlanivimab alone and in combination with etesevimab, and a combination therapy from Regeneron.

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COPD World News - Week of March 21, 2021

Thrombosis Canada issues statement on AstraZeneca vaccine and blood clots

Toronto, ON – Thrombosis Canada has reviewed recent reports from the United Kingdom and Europe relating to the SARS-CoV-2 (COVID-19) vaccine made by AstraZeneca and the development of a very rare type of thrombosis (blood clots) that is associated with thrombocytopenia (low blood platelets). It is the view of Thrombosis Canada that, based on all available evidence, people who receive the AstraZeneca vaccine are not at increased risk of developing blood clots when compared with the general population. However, the AstraZeneca vaccine may be associated with extremely rare cases of blood clots that occur in the brain (called cerebral sinus vein thrombosis) and are associated with low blood platelets. These blood clots were found to occur in 1 in 250,000 to 1 in 500,000 people who received the vaccine. By comparison, people who have COVID-19 are at much higher risk of developing blood clots, which occur in about 1 in 20 people who are in hospital with COVID-19 and in about 1 in 100 people who have COVID-19 but are not in hospital. “Thrombosis Canada strongly recommends that people receive vaccinations for COVID-19, including the vaccine made by AstraZeneca” says Thrombosis Canada President, Jim Douketis, “that’s what we are telling the many patients who have been asking us because of the reports from Europe. The benefits of preventing blood clots and other disease caused by COVID-19 far outweigh any possible risks, which we consider very low.” Thrombosis Canada further strongly recommends that the following groups of people receive vaccinations for COVID-19:

1)            people who have had a previous blood clot

2)            people with a family member who has developed a blood clot

3)            people with a hereditary clotting tendency (e.g., factor V Leiden mutation)

4)            people who are receiving blood thinner medications

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COPD World News - Week of March 14, 2021

COVID-19 test authorized for home use

San Diego, CA - One year into the pandemic, the FDA has authorized its first molecular COVID-19 diagnostic that can be performed completely at home and purchased without a prescription. Cue Health’s cartridge-based nasal swab test can be used solo or for children as young as two with adult supervision, regardless of whether a person is showing symptoms or suspects that they’ve been exposed directly to the coronavirus. The kit includes a single-use test and sample collecting wand as well as a battery-powered cartridge reader that connects to a smartphone app. Results are expected within 20 minutes. “For the first time, consumers can access laboratory-grade testing at home,” said Ayub Khattak, co-founder and CEO of Cue Health, which was recently named one of Fierce Medtech's 2020 Fierce 15. “With this FDA authorization, we are one step closer to achieving our mission of making molecular diagnostic testing available to anyone, anywhere, at any time through a connected healthcare delivery ecosystem,” Khattak said. In studies, Cue Health’s home test had a false-negative rate of 4% with zero false-positive results. And after raising more than $100 million in funding last year—plus a $481 million U.S. government contract to expand its manufacturing—the company said it expects to be able to produce more than 100,000 tests per day by this summer. To date, the FDA has authorized more than 330 different COVID-19 tests and sample collection kits, including molecular, antigen and antibody tests for the home, the lab and anywhere in between. The agency has also prioritized the review of diagnostics designed for the point of care as well as those that could help relieve the burden on centralized testing facilities.  The FDA also authorized Adaptive Biotechnologies’ DNA-sequencing blood test that identifies T-cell immune responses to the coronavirus to indicate a recent or prior infection—similar to an antibody test with high accuracy. This can determine whether the body’s white blood cells “remember” a previous exposure to the virus and potentially protect against a future infection.

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COPD World News - Week of March 7, 2021

Study looks at health inequalities regarding gender

Madrid, Spain - For decades, there has been gender imbalance when talking about different medical conditions. One key factor is that the “typical patient” has often been presented as male in descriptions and associated imagery. These thoughts regarding the “textbook patient” or the “typical medical case” are what creates health discrepancies and a dismissive attitude to other groups of individuals. Men and women should be equally represented in medical literature, medical artwork, clinical trials, etc. to allow for equal representation of both genders across all platforms. Creating a definition of a patient that all genders can relate to regarding their health is extremely important for the patient's own engagement with their health. In 2020, COPD remains a substantial cause of morbidity and mortality worldwide, creating a significant burden on the quality of life of people living with the condition and their families, social aspects of life and an increasing burden on the healthcare system. In Canada, for example, COPD is the fourth most common cause of hospitalisation in men and the sixth most common cause in women. In 2019, 850 000 Canadians over the age of 35 years reported a diagnosis of COPD. In the past, COPD has been thought of as a predominately male-dominated condition, an opinion that is immensely outdated, with a lack of awareness for women developing COPD. In women, the prevalence and mortality of COPD has significantly increased with figures suggesting a two-fold increase over the past 20 years. However, the incidence of men with COPD has stabilised. A cross-sectional study published in the International Journal of Chronic Obstructive Pulmonary Disease, from Spain, looked at the gender differences in COPD by identifying numerous clinical characteristics of the female participants. Of the 1610 participants recruited in the study, 17.9% were women. The study highlighted a significant difference between genders regarding the patient's smoking status, with higher numbers of men reported as current smokers and ex-smokers and more women with COPD who had never smoked (9.1% in comparison to the male participants reported at 0.6%). It has further been suggested that women are more susceptible to the effects of tobacco smoke, and there is evidence that exposure to environmental tobacco smoke is associated with COPD and affects women more often than men. Biomass smoke exposure has been associated with COPD in rural and urban women. In regard to the diagnosis of COPD, the time taken to diagnose a woman is often longer in comparison to a man with COPD and subsequently women are often identified at a later stage within the disease process. This poses difficulties in providing optimal early treatment and improving a patient's quality of life symptomatically. A delay in diagnosis can lead to increased anxiety for the patient and disengagement with their own health. Also, many women are unaware of the key symptoms of COPD, resulting in a failure to report their symptoms to their primary care physician.

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COPD World News - Week of February 28, 2021

EU told to back vaccine passports or Google or Apple may step in

Brussels, Belgium - European Union leaders inched toward establishing bloc-wide vaccine certificates to enable countries to reopen to travel as Commission President Ursula von der Leyen warned that unless they hurry Apple Inc. and Google will step into the vacuum.   During a five-hour video call, the EU’s 27 leaders focused on how to haul their nations back to a form of normalcy after a pandemic that’s claimed more than 500,000 lives and shut down large parts of their economies. While there was broad support for certificates of some sort, leaders didn’t agree on the type of privileges they would grant. “We have all agreed that we need vaccine certificates,” German Chancellor Angela Merkel told reporters after the talks on Thursday. “In the future, it will certainly be good to have such a certificate but that will not mean that only those who have such a passport will be able to travel; about that, no political decisions have been made yet.” Europe’s leaders have been anxious to find a response after facing criticism for a vaccination program that lagged behind the U.S. and U.K. There’s also the prospect of a third wave of infections leading again to stricter lockdowns. It was the first such meeting as prime minister of Italy for Mario Draghi, the former European Central Bank president. He asked leaders to adopt a more resolute and pragmatic approach to speed up vaccinations and told them the program has to move much faster, according to an official with knowledge of the call. Draghi also called for a tougher approach against companies that don’t respect delivery commitments, suggesting that their exports from the EU could be blocked not only during the period they don’t respect accords, but also for a certain period afterward. The growing support for a digital certificate with common criteria such as vaccination, negative testing or immunity was helped by Merkel seeming to soften her stance on the matter, backing work on such a document, according to two people familiar with her remarks. But von der Leyen urged the group to move faster before U.S. tech companies fill the void. “It is important to have a European solution because otherwise others will go into this vacuum,” she said at a press briefing. “Google and Apple are already offering solutions to the World Health Organization. And this is sensitive information so we want to be very clear here that we offer a European solution.” A spokesperson from the WHO said the organization has taken a software-neutral approach to the development of a vaccination certification and “neither Google nor Apple are involved in this process.”  A person familiar with Apple’s position on the matter suggested that von der Leyen had misunderstood the situation. Apple has never discussed a possible vaccine application with the WHO or the EU, the person said on condition of anonymity. “If we as European Union don’t provide a solution, somebody else will, whether it’s going to be the U.S. big tech companies or somebody else, the solution will be provided,” Alex Patelis, chief economic adviser to Greek Prime Minister Kyriakos Mitsotakis, told Bloomberg. “Let’s get the infrastructure ready.” Countries including Germany and Belgium have come under fire from the EU commission for closing frontiers with other European nations to keep the virus under control. While they said that non-essential travel should be restricted, their summit communique included no new commitments, merely reiterating that shutting borders should be proportionate and non-discriminatory.

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COPD World News - Week of February 21, 2021

Scottish study suggests COVID vaccine reduces risk of hospitalizations

London, UK - Scotland’s vaccination drive appears to be markedly reducing the risk of hospitalisation for COVID-19, suggesting that both the Pfizer-BioNtech and Oxford-AstraZeneca shots are highly effective in preventing severe infections, preliminary study findings showed on Monday. Results of the study, reported recently by Reuters, which covered the entire Scottish population of 5.4 million people, showed that by the fourth week after the initial dose, the Pfizer and AstraZeneca vaccines were found to reduce the risk of hospitalisation by up to 85% and 94% respectively. “These results are very encouraging and have given us great reasons to be optimistic for the future,” said Aziz Sheikh, a professor at the University of Edinburgh’s Usher Institute who co-led the study. Sheikh cautioned at a media briefing that the results are preliminary data, yet to be peer-reviewed by independent scientists, but added: “I am very encouraged. We now have national evidence ... that vaccination provides protection against COVID-19 hospitalisations.” He said he expected other countries using the same two vaccines and a similar strategy - such as England and Wales for example - would see a similar positive impact in reducing the number of people being hospitalised with COVID-19. Data for the vaccines’ effect in Scotland was gathered between Dec. 8 and Feb. 15. Researchers said that during this period, 1.14 million vaccines were administered and 21% of Scotland’s population had received a first dose. Among those aged 80 years and over - one of the highest risk groups for COVID-19 - vaccination was associated with an 81% reduction in hospitalisation risk in the fourth week, when the results for both vaccines were combined. Jim McMenamin, Public Health Scotland’s COVID-19 incident director, said the findings are particularly important “as we move from expectation to firm evidence of benefit from vaccines”.

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COPD World News - Week of February 14, 2021

Pfizer Canada head says company 'extremely committed' to meeting vaccine delivery targets

Montreal, PQ - The head of Pfizer Canada says the pharmaceutical giant is entirely focused on meeting its upcoming delivery targets and that it's possible the company could continue to accelerate shipments of its COVID-19 vaccine to the country. "Pfizer is extremely committed to meeting its contractual obligations, and we have every intention of meeting the four million commitment by the end of March that the prime minister has been talking about," Pfizer president Cole Pinnow said Sunday on Rosemary Barton Live. "As long as we're honouring our contract, we don't really feel that it's value added to talk about hypotheticals," Pinnow said, when asked by CBC Chief Political Correspondent Rosemary Barton about potential penalties for missed deadlines. The early months of Canada's COVID-19 inoculation campaign have been beset by disruptions to the delivery schedule. But on Friday, Prime Minister Justin Trudeau announced the country's vaccine supply would see a boost in the months ahead. Pfizer is now set to deliver 2.8 million more shots between April and June than originally planned. Deliveries previously earmarked for later in the year have also been moved up, meaning Canada will receive 6.2 million more doses than expected between July and August. Four million extra doses of the Moderna vaccine are also expected to arrive this summer. Most at risk, first in line: Public health experts say racialized Canadians should be prioritized for vaccines As far as the Pfizer-BioNTech product is concerned, Pinnow said it's not outside the realm of possibility that the company's deliveries to Canada could be shifted forward again. "We're going to continue to look for opportunities to accelerate delivery. We recognize that we want to bring back as much vaccine to Canadians as soon as possible." Pfizer's shipments to Canada dropped in recent weeks as the company's manufacturing plant in Puurs, Belgium, underwent upgrades to increase the production of its vaccine.  The company told the Globe and Mail last November that Canada would be sent doses from Pfizer's plant in Kalamazoo, Mich., but the company backtracked on that statement earlier this year. "We were working to accelerate the delivery to Canada of [the vaccine], based upon the accelerated review process that Health Canada had put in place," Pinnow told Barton. "So as part of that, we re-evaluated what our supply chain plan was going to be." A driver pulls his truck out of the Pfizer plant in Puurs, Belgium, on Dec. 21, 2020. Work to scale up manufacturing operations at the facility is now complete. (Valentin Bianchi/The Associated Press) When he was U.S. president, Donald Trump signed an executive order late last year aimed at ensuring Americans are given priority for receiving vaccines developed or procured by the United States government. "There was some uncertainty with the prior administration, and so we wanted to have confidence in where we were sourcing the product, and we felt that Belgium really provided us with more certainty at the time," Pinnow said. Canada is projected to receive 40 million doses of the Pfizer-BioNTech vaccine by September — the federal government's target month to vaccinate all Canadians seeking a jab. But under the agreement the country has signed with the pharmaceutical company, Canada can receive up to 76 million doses in total. "We're always open to talking about incremental demand or incremental supply," Pinnow said.

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COPD World News - Week of February 7, 2021

‘Multilayered approach’ to COVID-19 still needed as vaccine rollout continues

Boston, MA - It is still important for people who have been vaccinated against COVID-19 to wear masks and practice social distancing, experts said. “It remains important to practice well-established, evidence-based prevention measures,” Joshua Barocas, MD, an assistant professor of medicine at Boston University School of Medicine and infectious diseases physician at Boston Medical Center, said during an Infectious Diseases Society of America press briefing. IDSA experts encouraged continued mask wearing as vaccines continue to be distributed. According to the CDC, more than 27 million people in the United States have received at least one dose of COVID-19 vaccine, and more than 6.4 people have received the full two doses. The vaccine rollout, plus emerging real-world clinical trial data on vaccine effectiveness, has created “an encouraging period of time,” Barocas said, although he stressed that inequities in vaccine distribution will need to be worked out. “Vaccines do offer true risk reduction, and that is the good news, but it is important to remember that only a very small portion of the population has actually been vaccinated,” Barocas said. “People with the greatest need for protection have not been at the front of the line, and we know that there are existing and growing inequities in who has been vaccinated. Black and Latinx people, who are at the highest risk of infection currently, have been and are still the least likely to be vaccinated.” Barocas likened mask wearing to armor in a jousting match, noting that although it may not guarantee protection, it is still safer than to not wear it. He said that a “multilayered approach,” including mask wearing, social distancing and other proven mitigation efforts, will be needed even as vaccination continues.  Ricardo Franco, MD, an assistant professor of medicine at the University of Alabama at Birmingham and an associate scientist at the University of Alabama at Birmingham’s Center for AIDS Research, said during the briefing that emerging SARS-CoV-2 variants demonstrate the need for mitigation efforts, even among those who are vaccinated.  “The emergence of these variants only brings greater urgency. Once production of vaccines and provisions of supplies reach ideal capacity, we will only have optimal vaccine distribution when we inject greater resources to local health departments and we find creative ways to leverage retail stores and pharmacies to administer these vaccines,” he said. “It is also very important to quickly report the number of vaccine shots given back to the CDC, so we know in real time which locales are in need of allocation of additional vaccine vials in a timely manner.” The percentage of the population that needs to be vaccinated to achieve herd immunity is unclear, Franco said, and is a “moving target” driven by the population being studied, the vaccines being used and how a given population is prioritized for distribution. He also noted that vaccine hesitancy is a “concerning element” of distribution that may further increase the amount of time that mask wearing and social distancing will be necessary. “We need to remain committed to using all the tools we have,” Franco said.

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COPD World News - Week of January 31, 2021

The devastating toll of the COVID-19 pandemic on children

London, UK - From increasing rates of mental health problems to concerns about rising levels of abuse and neglect and the potential harm being done to the development of babies, the pandemic is threatening to have a devastating legacy on the nation's young. The closure of schools is, of course, damaging to children's education. But schools are not just a place for learning. They are places where kids socialise, develop emotionally and, for some, a refuge from troubled family life. Prof Russell Viner, president of the Royal College of Paediatrics and Child Health, perhaps put it most clearly when he told MPs on the Education Select Committee earlier this month: "When we close schools we close their lives." He says the pandemic has caused a range of harms to children across the board from being isolated and lonely to suffering from sleep problems and reduced physical activity. But it's not just the closure of schools. The stress the pandemic has put on families, with rising levels of unemployment and financial insecurity combined with the stay-at-home orders, has put strain on households up and down the land. The NSPCC says the amount of counselling for loneliness provided by its Childline service has risen by 10% since the pandemic started. Neil Homer, who has been volunteering for the service since 2009, has never known anything like it. "It's had a devastating impact," he says. The experience of this 16-year-old is typical of the calls that come in. "I feel really sad and lonely. Most days I find myself just lost in my own thoughts and feeling numb." Mental health problems on the rise Unsurprisingly, there are clear signs the upheaval in children's lives is having an impact on children's mental health. The Mental Health of Children and Young People in England 2020 report, which is produced by NHS Digital and the Office for National Statistics, is the official stocktake of the state of children's well-being. It has been tracking more than 3,000 young people over the last four years. Its latest findings, published in the autumn, found overall one in six children aged five to 16 had a probable mental health disorder, up from one in nine three years previously. Older girls had the highest rates. Children involved in the research cited family tensions and financial concerns as well as feeling isolated from friends and fear about the virus for causing their distress. Older teenagers and adolescents have been affected too as they have seen their prospects shrink. The Youth Index, published in January by the Prince's Trust in partnership with YouGov, has been tracking the well-being of young people aged 16 to 25 for 12 years. It found more than half of young people were always or often feeling anxious - the highest level ever recorded. Jonathan Townsend, of The Prince's Trust, fears young people are "losing all hope for their future". At the opposite end of the age spectrum, health visitors, who support parents and babies during the early years, are worried about the impact on newborns. Research shows the first two to three years of a baby's life is the most crucial period of human development. This has become known as the 1,001 days agenda. If children fall behind, they can find themselves at a lifelong disadvantage. The Institute of Health Visiting says services have been badly hit during the pandemic with these specialist nurses pulled away from their duties to help out on the Covid front line. In some areas, health visitor numbers have dropped by half. This and the social distancing rules mean for a lot of parents the only support they have received has been online. Meanwhile, the absence of baby and parent groups, and the friendships that naturally develop from them, has meant the babies of the pandemic have not benefited from the stimulus of social contact that is vital to their development. Alison Morton, head of the Institute of Health Visiting, says this has been an "invisible" cost of the pandemic, but one that will have a lasting impact, particularly in the most deprived areas. Babies and children, she says, are being "harmed" by what she says is the secondary indirect impact of the virus.

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COPD World News - Week of January 24, 2021

The pandemic has exposed a crisis in Canada’s long-term care homes

Toronto, ON - In late December the Tendercare Living Centre in Toronto became the site of an angry demonstration. Forty-eight of the home’s 200-odd residents had died from covid-19. Survivors’ relatives gathered to demand that it employ more staff. A doctor said the home had mixed infected with uninfected residents and had too little oxygen to treat the sick. She described it as a war zone. A hospital took over its management. By mid-January, 74 residents had died. The toll at Tendercare Living was an extreme example of a widespread problem. Deaths in Canada from covid-19 are about half those in the European Union as a share of population. Nearly three-quarters of the 14,000 Canadian deaths to mid-December took place in care homes. A study by the Canadian Institute for Health Information found that deaths in Canadian long-term care homes by late May were 25% higher than the average among 17 members of the OECD, a rich-country club, as a share of their populations. On December 31st The Toronto Star, Canada’s largest-circulation newspaper, published an editorial that took up the full front page decrying needless death in the long-term care system. It is “as if we have allowed [old people] to be put into coffins and buried alive before our very eyes”, the newspaper wrote. The crisis may soon subside. In Ontario, the most populous province (of which Toronto is the capital), all long-term care residents are due to be vaccinated by mid-February. But the problems highlighted by the pandemic will not disappear quickly. Canada consigns too many old people to institutions, one reason why such a high proportion of covid-19 deaths has taken place in them. They are poorly regulated, and many are badly designed. The problems will grow more pressing as the population ages. The share of Canadians older than 65 is expected to rise from a sixth to a quarter by 2041. In its treatment of old people Canada is an “international outlier”, says a recent report by Queen’s University’s School of Policy Studies. Canada spends less than most rich countries on long-term care: 1.3% of GDP (including the cost of compulsory insurance) compared with 1.7% on average by members of the OECD. That money is skewed towards institutions such as Tendercare Living rather than towards helping people remain in their own houses. In Canada 42% of people over 80 who need constant care are in institutions, compared with an OECD average of 30%. Denmark, which passed a law in 1987 that effectively barred construction of collective facilities, spends less on institutions than on home care, which is much cheaper. Canada, by contrast, spends six times more on institutional care. “We don’t do [home care] well. We default to institutional care,” says Fred Horne, a former health minister of the western province of Alberta.

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COPD World News - Week of January 17, 2021

Guelph student creates Covid-19 vaccination calculator

Guelph, ON - Jasmine Mah, a University of Guelph graduate, and Steven Wooding, a U.K. physicist, paired up and created an online tool that projects a date range for when a Canadian could expect to receive their double dose. The estimated timeline is based on factors such as your age, or whether you work in health care or with seniors in long-term care or live in an Indigenous community, all groups prioritized for Stage One of the federal rollout. Mah said she created the calculator  Vaccine Queue Calculator for Canada ( after hearing people talk about the pandemic being over because of the availability of vaccines. “I think people might be a little too over optimistic,” said Mah. “Yes, vaccines have been approved but we still have a ways to go. I don’t want people to let their guard down too early. We still have to be careful,” said the 28-year-old, who lives in Los Angeles with her husband, a Canadian doing post-doctoral work at a university there as well as in the U.K.  “Because I’m Canadian this topic was really important for me,” said Mah, who graduated from Guelph in 2018 with a masters in science. “I wanted to be a part of this and help people figure out when they are going to get their vaccine.” Mah has collaborated on calculators before, including one that estimated how much hand sanitizer a person would need to buy based on their usage.  The vaccine calculator is based on an earlier one done by Wooding for the U.K., which began delivering the vaccine about a week before Canada. The pair used the federal government’s vaccine rollout plan, which includes broad estimates of how many doses will be delivered in three-month timelines in 2021, as well as population and employment data from Statistics Canada.  In some cases, studies were used to determine, for instance, how many people in Canada live in long-term-care homes. And wherever possible, Mah said they tried to reduce the amount of double-counting in the priority categories so for instance, if someone was 80 years or older and lived in a long-term-care home, they aren’t counted twice.

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COPD World News - Week of January 10, 2021

Canada's vaccine rollout is slower than other countries

Regina, SK - Canada is falling behind in its initial rollout of COVID-19 vaccines at a critical time in the pandemic, and experts say our most vulnerable populations are being left at risk. Despite having months to prepare for the deployment of the initial shipment of vaccines to those most threatened by COVID-19 in long-term care facilities, a consistent rollout plan has yet to fully materialize on the ground.  "It just seems to be chaos right now," said Alyson Kelvin, an assistant professor at Dalhousie University and a virologist at the Canadian Centre for Vaccinology evaluating Canadian vaccines with the VIDO-InterVac lab in Saskatoon.  "We know who is a vulnerable population, so we need a strategy of actually vaccinating them." Long-term care residents were largely left out of Canada's initial rollout of the Pfizer-BioNTech vaccine, which requires storage temperatures of –80 to –60 C, in favour of waiting for the more easily transportable Moderna vaccine and vaccinating health-care workers first. But once thawed, the Pfizer-BioNTech vaccine can be used for up to five days at basic refrigeration temperatures — meaning it could be taken out of distribution hubs across the country and brought into long-term care facilities directly during that window of time.  A registered pharmacy technician prepares COVID-19 vaccines in Toronto on Dec. 15. (Evan Mitsui/CBC) "We treated the Pfizer vaccine with as much care and respect as possible and that really created all these hub sites," said Dr. Zain Chagla, an infectious diseases physician at St. Joseph's Healthcare Hamilton and an associate professor at McMaster University. "And I think that did hinder some of the innovation and the ability to do things elsewhere." The federal government has deployed almost 500,000 doses of both the Pfizer-BioNTech and Moderna vaccines to distribution sites across the country since mid-December, but the actual rollout of vaccinations is up to the individual provinces and territories.  Quebec took the bold step of actually putting its vaccine distribution centres inside long-term care facilities, making it easier to inoculate residents as quickly as possible.   British Columbia made the decision to move the Pfizer-BioNTech vaccine from its distribution sites almost immediately into long-term care homes to inoculate residents and staff upon receiving its first doses. Andy Yoon, 77, of Abbotsford, B.C., became the first long-term care resident in the Fraser Health region to receive the COVID-19 vaccine on Dec. 24. (Submitted by Fraser Health) Yet Ontario decided against bringing the Pfizer-BioNTech vaccine directly into long-term care homes initially, despite other provinces doing so, and is only now doing so more than three weeks after receiving its first shipment.  Dr. Vera Etches, Ottawa's medical officer of health, announced Tuesday the city would be transporting the Pfizer-BioNTech vaccine out of its distribution hub at the Ottawa Hospital and directly into long-term care residences, after vaccine-handling criteria from Pfizer were changed. Despite receiving 53,000 doses of the Moderna vaccine last week, which is much easier to bring into long-term care residences, only 3,000 doses have actually been administered in Ontario as of Tuesday. Ontario has pledged to vaccinate all residents, health-care workers and essential caregivers at long-term care homes in the hardest hit regions of Toronto, Peel, York and Windsor-Essex by Jan. 21, but has not set a deadline for the rest of the province.  To date, fewer than 1,000 long-term care residents have been vaccinated in Ontario. "The provincial health-care systems aren't experts in newly emerging viruses, brand new speedy vaccine platforms and pandemics," said Kelvin. For that reason, ongoing communication from the federal government to the provinces and territories and local level is essential, she said. "To leave each province and territory to have to come up with their own plan, when they're not experts in this, I think is a failure."  Kelvin said putting experts with relevant backgrounds in long-term care at the helm of vaccine rollouts across the country could have mitigated some of the missteps made so far. "We need somebody who's knowledgeable about long-term care facilities in Canada and their current functioning states," she said.

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COPD World News - Week of January 3, 2021

Symptom-less cases in schools could be key driver in spread of Covid-19

London, UK – Up to 70% of schoolchildren infected with coronavirus may not know they have it until after a positive test result. A key factor in the spread of Covid-19 in schools is symptomless cases. Most scientists believe that between 30% and 40% of adults do not display any Covid symptoms on the day of testing, even if they have been infected. For children, however, this figure is higher. “It is probably more like 50% for those in secondary school while for boys and girls in primary school, around 70% may not be displaying symptoms even though they have picked up the virus,” says Professor Martin Hibberd of the London School of Hygiene and Tropical Medicine. hat is a large proportion of symptom-free disease-carriers within a population. What is not yet known is just how much infection is being passed on by this cohort of young symptom-free carriers. It is a critically important issue, and one that will play a key role in determining the effect of Covid-19 on the people of Britain in the next few weeks, say researchers. Unfortunately a definitive answer on the infectiousness of young people remains tantalisingly out of reach, although there is evidence to suggest that people who don’t display symptoms of Covid-19 may have lower viral loads, which means they are less likely to infect others. This tendency correlates with age, so younger children have lower viral loads. As a result, they are less likely to display symptoms – and also less likely to pass on the virus. “It’s a real possibility but we cannot yet be sure,” says Hibberd. One solution to the problem is to increase testing in schools. This would require the widespread deployment of rapid testing, particularly with the lateral flow method, which is easily administered and gives results in less than half an hour. It is less accurate than the standard PCR swab test, however, and there have been concerns about a high level of false negative results leading to the continued spread of the new, more infectious, variant of the coronavirus. However, scientists point out that rapid tests are better at spotting individuals with high viral loads than those with lower ones. “We know that a high viral load is a key issue affecting the virus’s transmission, so even if we can’t detect every carrier, we are most likely to pick up those children who are more likely to transmit,” says Hibberd. “And frequent testing using other technologies – such as isothermal amplification (Lamp) testing – could further reduce the rate of false negatives. However, we have to be sure that we have a competent testing system in place in schools before we can be sure of that.”

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