News Scan for Feb 22, 2021

News brief

Australia releases One Health action plan for antimicrobial resistance

The Australian government late last week released a One Health Master Action Plan (OHMAP) to support the country's 2o20 antimicrobial resistance (AMR) strategy.

The plan highlights areas the Australian government and other stakeholders need to focus on to achieve the seven objectives of the 202o AMR strategy, which established a 20-year vision to minimize the development and spread of AMR in humans, animals, and the environment. The objectives include clear governance for AMR initiatives, prevention and control of infections, greater public awareness of AMR, appropriate antibiotic use and stewardship practices, integrated surveillance, and a strong collaborative research agenda across all sectors.

To achieve these goals, the action plan calls for the creation of sustainable funding for AMR initiatives based on evidence of the economic and societal costs of drug-resistant infections, the adoption of evidence-based and nationally consistent standards for infection prevention and control, and the development of coordinated, evidence-based antibiotic prescribing guidelines across all sectors. It also calls for the creation of a One Health communication strategy, a national One Health surveillance system, and a national AMR research and development agenda.

"By implementing a One Health approach with the OHMAP guiding the way, Australia can minimise the development and spread of antimicrobial resistance and ensure the continued availability of effective antimicrobials," the plan states. "This will help achieve a healthier future for Australians."
Feb 19 Australia One Health Master Action Plan
Mar 13, 2020, Australia's National Antimicrobial Resistance Strategy

Ebola infects 1 more in Guinea; 2 more deaths in DRC

Guinea added one more confirmed case to its Ebola total, the World Health Organization (WHO) African regional office said in an update on Twitter yesterday, which raises its total to eight cases, four of them lab-confirmed. So far, 348 contacts have been identified, of whom 91% are being monitored.

Today, the WHO said poor weather in Conakry has delayed the arrival of Ebola vaccine supplies sent by the WHO, which were due to arrive yesterday, with vaccination beginning today. For now, the 11,000 vaccine doses are in transit in Dakar.

The country is battling a recurrence of the disease that was first announced on Feb 14 and is occurring in the same area where West Africa's massive outbreak of 2014-2016 began.

Elsewhere, two more deaths were reported in earlier announced cases in the Democratic Republic of the Congo (DRC), according to media reports, including one from Agence France-Presse (AFP). The latest deaths would bring the country's fatality count to four.

So far, the official total in the DRC's recurrence is six cases, according the WHO, which said 736 contacts have been identified, including 73% who are being monitored. So far, 259 people have been vaccinated.

Media reports from the DRC quoting provincial health officials say a seventh case has been detected in North Kivu province, the daughter of an earlier confirmed case.
Feb 21 WHO African regional office tweet on latest Guinea update
Feb 22 WHO African regional office tweet on vaccine delay
Feb 21 AFP report
Feb 21 WHO African regional office tweet on DRC update
Feb 22 7sur7 report

COVID-19 Scan for Feb 22, 2021

News brief

Flu vaccine associated with lower COVID likelihood, hospitalizations

People who received their flu vaccine were less likely to test positive for COVID-19, and if they were infected with the virus, they were less likely to need hospitalization, mechanical ventilation, or a longer hospital stay, according to a study published today in the American Journal of Infection Control.

The researchers created a retrospective cohort of 27,201 patients who were tested for COVID-19 from Feb 27 to Jul 15, 2020, in the Michigan Medicine healthcare system. Of those, they found that 12,997 (47.8%) were vaccinated against the flu between Aug 1, 2019, to Jul 15, 2020. Of that number, 525 (4.0%) tested positive for coronavirus. Of the 14,204 (52.%) not vaccinated, 693 (4.9%) got COVID-19.

Using adjusted multivariable logistic regression analysis, the researchers found that those who received the flu vaccine had a 0.76 odds ratio (OR) of getting infected with COVID-19 (95% confidence interval [CI], 0.68 to 0.86; P < 0.001).

The flu-vaccinated group also had lower likelihood of COVID-19–related hospitalizations (OR, 0.58; 95% CI, 0.46 to 0.73; P < 0.001), mechanical ventilation (OR, 0.45; 95% CI, 0.27 to 0.78; P = 0.004), and long hospital stay (approximately 12 vs 16 average days, vaccinated vs unvaccinated; risk ratio, 0.76; 95% CI, 0.65 to 0.89, P < 0.001). No significant differences were found when looking at adjusted odds for intensive care or mortality.

The researchers suggest that the better COVID outcomes in the flu-vaccinated group could be due to the vaccine's possible heterologous immune effects, but more research is needed to understand behavioral and sociodemographic differences in those who get the flu vaccine.

Still, they conclude, "Until the COVID-19 vaccine becomes widely available, the influenza vaccine should be promoted to reduce the burden of disease during this pandemic."
Feb 22 Am J Infect Control study

Persistent COVID-19 symptoms detailed months after recovery

One third of symptomatic COVID-19 patients continued to experience symptoms about 5.6 months after their infection began, according to a research letter published late last week in JAMA Network Open. The researchers noted that their study was purely descriptive because of the small participant number.

University of Washington researchers received 117 surveys from COVID-19 patients between August and November 2020. Of these, 11 (6.2%) were asymptomatic, 150 (84.7%) were outpatients with mild symptoms, and 16 (9.0%) needed hospitalization.

The most common symptom reported was fatigue or loss of smell or taste (both were 13.6% of symptomatic participants), but 13.0% reported other symptoms such as brain fog (2.3%). Overall, 32.7% of outpatients and 31.3% of hospitalized patients reported at least one lingering symptom.

More than a third (35.3%) of people who had high blood pressure or diabetes experienced at least one ongoing symptom. Quality of life decreased for 30.7% of outpatients and hospitalized patients, and 7.9% reported that their COVID-19 symptom(s) negatively affected at least one daily living activity, most commonly household chores.

Survey responses came in a median of 169 days (range, 31 to 300) after illness onset in the COVID-19 group. Continuing symptoms occurred across all age ranges, with the least reported in participants 18 to 39 (26.6%) and the most in those 65 and older (43.3%).

A 21-person, healthy control group also took the survey a median of 87 days after enrollment, and 4.8% reported at least 1 persistent COVID symptom.

"To our knowledge, this study presents the longest follow-up symptom assessment after COVID-19 infection," the researchers write. "Our research indicates that the health consequences of COVID-19 extend far beyond acute infection, even among those who experience mild illness."
Feb 19 JAMA Netw Open research letter