Medicine

CDC Study Says On-Premises Dining Linked To COVID-19 Spread (npr.org) 147

Thelasko shares a new study published by the Centers for Disease Control and Prevention. NPR reports on the key findings: As several states face criticism for lifting coronavirus-related public health restrictions, a study published Friday confirms that state-imposed mask mandates and on-premises dining restrictions help slow the spread of COVID-19. The study, published in the Centers for Disease Control and Prevention's Morbidity and Mortality Weekly Report, looked at the impact of state-issued mask mandates and on-premises dining on county-level COVID-19 cases and deaths between March 1 and Dec. 31.

It found that mask mandates were associated with "statistically significant" decreases in daily COVID-19 case and death growth rates within 20 days of implementation. In contrast, allowing on-premises dining was associated with an increase in daily cases 41 to 100 days after reopening, and an increase in daily death growth rates after 61 to 100 days. "Policies that require universal mask use and restrict any on-premises restaurant dining are important components of a comprehensive strategy to reduce exposure to and transmission of SARS-CoV-2," the study authors wrote. "Such efforts are increasingly important given the emergence of highly transmissible SARS-CoV-2 variants in the United States." The study says its analysis did not differentiate between indoor and outdoor dining.

Medicine

CVS, Walgreens Look For Big Data Reward From Covid-19 Vaccinations (wsj.com) 33

Thelasko shares a report from The Wall Street Journal: Administering Covid-19 vaccines comes with a valuable perk for retail pharmacies: access to troves of consumer data. Chains such as CVS Health Corp., Walmart Inc. and Walgreens-Boots Alliance, Inc. are collecting data from millions of customers as they sign up for shots, enrolling them in patient systems and having recipients register customer profiles.

The retailers say they are using the information to promote their stores and services, tailor marketing and keep in touch with consumers. The companies also say the information is critical in streamlining vaccinations and improving record-keeping, while ensuring only qualified people are receiving shots.

Medicine

America Authorizes Johnson & Johnson's COVID-19 Vaccine For Emergency Use (bbc.com) 118

America's Food and Drug Administration just authorized Johnson & Johnson's COVID-19 vaccine for emergency use, according to CBS News. "The vaccine is the third to be approved for use in the United States, and the first that requires only one shot..." Among people who got the vaccine in clinical trials, there were no COVID-related deaths. Phase 3 clinical trials also showed protection against multiple emerging virus variants, including a more contagious strain that was first discovered in South Africa and has since been detected in the U.S.

The vaccine can be stored at standard refrigerator temperatures for up to three months.

More from the BBC: The company has agreed to provide the U.S. with 100 million doses by the end of June. The first doses could be available to the US public as early as next week. The U.K., EU and Canada have also ordered doses, and 500 million doses have also been ordered through the Covax scheme to supply poorer nations.
Medicine

America Has Vaccinated More People Than Any Other Country in the World (axios.com) 222

Despite America's vast population of nearly 330 million people, 43.6 million Americans have already received one or both doses of a Covid-19 vaccine.

Axios writes: The U.S. has carried out more vaccinations than any country in the world, and given a first dose to a higher percentage of its population (12%) than all but five countries: Israel, the Seychelles, the UAE, the U.K. and Bahrain. In fact, the U.S. is distributing doses three times as quickly as the EU, adjusted for population, and nearly five times as quickly as Canada.

The U.S. has some major advantages over most of the world. Not only does America have the money to reserve more doses than it could possibly use, it also has the capacity to manufacture them domestically. Canada's slow rollout and the recent dispute over doses between the EU and U.K. have underlined the difficulties of relying on imports...

It also helps that the two most effective vaccines on the market were developed entirely (Moderna) or partially (Pfizer/BioNTech) in the U.S.

Their article concludes that "Despite crumbling infrastructure and chaotic politics, the U.S. remains a scientific, technological and manufacturing powerhouse."

The Associated Press reports that America's daily inoculation average "climbed to 1.7 million shots per day last week," adding "but as many as double that number of doses are soon expected to be available on average each day."
Medicine

Elon Musk Co-Authors COVID-19 Paper Accepted For Publication In 'Nature' (livemint.com) 64

Slashdot reader Rei writes: On 15 February, 2021, the paper Discrete SARS-CoV-2 antibody titers track with functional humoral stability was accepted for publication by the prestigious journal Nature — interesting not only for being a large-cohort study on COVID-19 reinfection, but for the presence of one of its coauthors: one Elon Reeve Musk. According to reporting, Musk — concerned in April 2020 with maintaining the schedule for the SpaceX crewed launch in May and wanting to make sure that an outbreak wouldn't set back plans — contacted academic researchers and worked with them to set up an antibody testing research programme. Over 4,000 SpaceX employees volunteered and were provided with periodic free testing at work to look for infection and monitor previously-infected people for reinfection. The programme gave SpaceX an advance heads up about upcoming threats, such as the growing wave in Texas in June, and continues to this day, with a new focus on mutant COVID strains.

The primary results of the study? Past infection provides a strong, although not perfect, barrier to reinfection; the level of antibodies strongly indicate the level of risk of reinfection; and this bodes well for vaccines, which tend to result in much higher antibody levels than infection.

Science

Could Drinking Coffee Lower Your Risk of Heart Failure? (nytimes.com) 73

The New York Times reports: A large analysis looked at hundreds of factors that may influence the risk of heart failure and found one dietary factor in particular that was associated with a lower risk: drinking coffee...

The analysis included extensive, decades-long data from three large health studies with 21,361 participants, and used a method called machine learning that uses computers to find meaningful patterns in large amounts of data. "Usually, researchers pick things they suspect would be risk factors for heart failure — smoking, for example — and then look at smokers versus nonsmokers," said the senior author, Dr. David P. Kao, an assistant professor of medicine at the University of Colorado. "But machine learning identifies variables that are predictive of either increased or decreased risk, but that you haven't necessarily thought of."

Using this technique, Dr. Kao and his colleagues found 204 variables that are associated with the risk for heart failure. Then they looked at the 41 strongest factors, which included, among others, smoking, marital status, B.M.I., cholesterol, blood pressure and the consumption of various foods. The analysis is in Circulation: Heart Failure. In all three studies, coffee drinking was associated more strongly than any other dietary factor with a decreased long-term risk for heart failure.

Drinking a cup a day or less had no effect, but two cups a day conferred a 31 percent reduced risk, and three cups or more reduced risk by 29 percent...

Should you start drinking coffee or increase the amount you already drink to reduce your risk for heart failure? "We don't know enough from the results of this study to recommend this," said Dr. Kao, adding that additional research would be needed.

Medicine

Pfizer-BioNTech's COVID-19 Vaccine Just Got a Lot Easier to Distribute (techcrunch.com) 67

Pfizer and BioNTech "have asked the U.S. health regulator to relax requirements for their COVID-19 vaccine to be stored at ultra-low temperatures, potentially allowing it to be kept in pharmacy freezers," reports Reuters, which adds that approval "could send a strong signal to other regulators around the world that may ease distribution of the shot in lower-income countries."

Slashdot reader FrankOVD shares more information from TechCrunch: Originally, the mRNA-based vaccine had to be maintained at ultra-low temperatures throughout the transportation chain in order to remain viable — between -76F and -112F... To date, the vaccine has relied largely on existing "cold-chain" infrastructure to be in place in order for it to be able to reach the areas where it's being used to inoculate patients... This development is just one example of how work continues on the vaccines that are already being deployed under emergency approvals by health regulators across the U.S. and elsewhere in the world. Pfizer and BioNTech say they're working on bringing those storage temp requirements down even further, so they could potentially approach the standard set by the Moderna jab....

The new requirements open up participation to a whole host of potential new players in supporting delivery and distribution — including ride-hailing and on-demand delivery players with large networks like Amazon, which has offered President Biden's administration its support, and Uber, which is already teamed up with Moderna on vaccine education programs. This also opens the door for participation from a range of startups and smaller companies in both the logistics and the care delivery space that don't have the scale or the specialized equipment to be able to offer extreme "cold-chain" storage.

Science

How To Fall 35,000 Feet and Survive (popularmechanics.com) 131

Massachusetts-based amateur historian Jim Hamilton, who developed the Free Fall Research Page -- an online database of nearly every imaginable human plummet, documents one case of a sky diver who, upon total parachute failure, was saved by bouncing off high-tension wires. Contrary to popular belief, water is an awful choice. Like concrete, liquid doesn't compress. Hitting the ocean is essentially the same as colliding with a sidewalk, Hamilton explains, except that pavement (perhaps unfortunately) won't "open up and swallow your shattered body." Popular Mechanics: With a target in mind, the next consideration is body position. To slow your descent, emulate a sky diver. Spread your arms and legs, present your chest to the ground, and arch your back and head upward. This adds friction and helps you maneuver. But don't relax. This is not your landing pose. The question of how to achieve ground contact remains, regrettably, given your predicament, a subject of debate. A 1942 study in the journal War Medicine noted "distribution and compensation of pressure play large parts in the defeat of injury." Recommendation: wide-body impact. But a 1963 report by the Federal Aviation Agency argued that shifting into the classic sky diver's landing stance -- feet together, heels up, flexed knees and hips -- best increases survivability. The same study noted that training in wrestling and acrobatics would help people survive falls. Martial arts were deemed especially useful for hard-surface impacts: "A 'black belt' expert can reportedly crack solid wood with a single blow," the authors wrote, speculating that such skills might be transferable.

The ultimate learn-by-doing experience might be a lesson from Japanese parachutist Yasuhiro Kubo, who holds the world record in the activity's banzai category. The sky diver tosses his chute from the plane and then jumps out after it, waiting as long as possible to retrieve it, put it on and pull the ripcord. In 2000, Kubo -- starting from 9,842 feet -- fell for 50 seconds before recovering his gear. A safer way to practice your technique would be at one of the wind-tunnel simulators found at about a dozen U.S. theme parks and malls. But neither will help with the toughest part: sticking the landing. For that you might consider -- though it's not exactly advisable -- a leap off the world's highest bridge, France's Millau Viaduct; its platform towers 891 feet over mostly spongy farmland. Water landings -- if you must -- require quick decision-making. Studies of bridge-jump survivors indicate that a feet-first, knife-like entry (aka "the pencil") best optimizes your odds of resurfacing. The famed cliff divers of Acapulco, however, tend to assume a head-down position, with the fingers of each hand locked together, arms outstretched, protecting the head. Whichever you choose, first assume the free-fall position for as long as you can. Then, if a feet-first entry is inevitable, the most important piece of advice, for reasons both unmentionable and easily understood, is to clench your butt.

China

Two WHO Team Members Dispute Report China Wasn't Cooperative for Covid-19 Investigation (twitter.com) 95

Friday the New York Times (following up on reports from the Wall Street Journal) wrote that China had "refused to hand over" important raw data to a 14-member World Health Organization team investigating the origins of the coronavirus, reporting that "their Chinese counterparts were frustrated by the team's persistent questioning and demands for data."

But Saturday two of those 14 team members disputed that characterization, posting on Twitter that "This was NOT my experience" — even though the Times had quoted both of them to support its article.

First Peter Daszak, president of the U.S. national science academy's microbial threats forum, weighed in. "As lead of animal/environment working group I found trust and openness with my China counterparts. We DID get access to critical new data throughout. We DID increase our understanding of likely spillover pathways. New data included env. & animal carcass testing, names of suppliers to Huanan Market, analyses of excess mortality in Hubei, range of covid-like symptoms for months prior, sequence data linked to early cases & site visits w/ unvetted live Q&A etc. All in report coming soon!"

Then Thea Kølsen Fischer, a Danish epidemiologist on the team, tweeted that the Times hadn't accurately described her experience either. "We DID build up a good relationship in the Chinese/Int Epi-team! Allowing for heated arguments reflects a deep level of engagement in the room. Our quotes are intendedly twisted casting shadows over important scientific work."

Daszak reappeared to respond to her tweet, writing "Hear! Hear! It's disappointing to spend time with journalists explaining key findings of our exhausting month-long work in China, to see our colleagues selectively misquoted to fit a narrative that was prescribed before the work began. Shame on you @nytimes!"

Ironically, the next day the Times published a longer interview they'd done with Daszak, which acknowledges that Daszak "said that the visit had provided some new clues..."

The Times had even specifically asked him if China's attitude made their work difficult, to which Daszak explicitly had answered: no.
Medicine

How Our Brutal Science System Almost Cost Us a Pioneer of mRNA Vaccines (wbur.org) 116

Long-time Slashdot reader theodp writes: As the first COVID-19 vaccines arrived at Penn Medicine last year, Penn Today reported with great pride, "It was mRNA research conducted at Penn—by Drew Weissman, a professor of Infectious Diseases, and Katalin Karikó, an adjunct associate professor—that helped pave the way for the development of the Pfizer-BioNTech and Moderna COVID vaccines." While Weissman and Karikó are coronavirus vaccine heroes these days, Dr. David Scales — who studied under Weissman and Karikó 20 years ago as they worked on mRNA vaccines aimed to fight HIV — recalls How Our Brutal Science System Almost Cost Us A Pioneer Of mRNA Vaccines.

"When I got my own [COVID vaccine] shot," Scales writes, "I felt an added emotion: awe. You see, I witnessed some of the early scientific heartbreaks that came before the historic vaccine victories. And I found myself simply awestruck by the scientists I knew who persevered in spite of our system of scientific research. [...] While Weissman was an expert at designing experiments, I remember him most for his generosity. He made sure all contributors in the lab shared the credit, from the lab tech and lowly undergrad all the way to fellow researcher Karikó. Still, Karikó was struggling. Her science was fantastic, but she was less adept at the competitive game of science. She tried again and again to win grants, and each time, her applications were rejected. Eventually, in the mid-1990s, she suffered the academic indignity of demotion, meaning she was taken off the academic ladder that leads to becoming a professor. [...] But [Karikó] stuck to her passions. She was too committed to the promise of mRNA to switch to other, perhaps more easily fundable projects. Eventually, the university stopped supporting her."

"Academic science failed Karikó. But when she contacted me in 2015, I saw she had moved to the private sector, a common path for researchers when a university stops offering support. I was glad to see she had landed on her feet. And now, I watch in awe, like the rest of the world, as the technology she helped developed leads to one of the most spectacular victories in the history of science — a vaccine for a deadly pandemic developed in less than one year. So, my vaccination day was an emotional one. As the lipid-encapsulated mRNA molecules went into my arm, I reminisced about Kati and Drew, and the lab circa 2000. And I thought: You were right, Kati. You were right."

Government

Government Investigating Massive Counterfeit N95 Mask Scam (apnews.com) 95

Federal authorities are investigating a massive counterfeit N95 mask operation in which fake 3M masks were sold in at least five states to hospitals, medical facilities and government agencies. From a report: The foreign-made knockoffs are becoming increasingly difficult to spot and could put health care workers at grave risk for the coronavirus. These masks are giving first responders "a false sense of security," said Steve Francis, assistant director for global trade investigations with the Homeland Security Department's principal investigative arm. He added, "We've seen a lot of fraud and other illegal activity." Nearly a year into the pandemic, fraud remains a major problem as scammers seek to exploit hospitals and desperate and weary Americans. Federal investigators say they have seen an increase in phony websites purporting to sell vaccines as well as fake medicine produced overseas and scams involving personal protective equipment. The schemes deliver phony products, unlike fraud earlier in the pandemic that focused more on fleecing customers.
Medicine

Pfizer Is Doubling Its Output of Covid-19 Vaccines (usatoday.com) 110

31.9 million Americans have already received one or both doses of a Covid-19 vaccine — including more than 9.3 million people who have been fully vaccinated.

And now USA Today reports: Pfizer expects to nearly cut in half the amount of time it takes to produce a batch of COVID-19 vaccine from 110 days to an average of 60 as it makes the process more efficient and production is built out, the company told USA TODAY. As the nation revs up its vaccination programs, the increase could help relieve bottlenecks caused by vaccine shortages.

"We call this 'Project Light Speed,' and it's called that for a reason," said Chaz Calitri, Pfizer's vice president for operations for sterile injectables, who runs the company's plant in Kalamazoo, Michigan. "Just in the last month we've doubled output."

The increased speed and capacity is not unexpected, said Robert Van Exan, president of Immunization Policy and Knowledge Translation, a vaccine production consulting firm. "Nobody's ever produced mRNA vaccines at this scale, so you can bet your bottom dollar the manufacturers are learning as they go. I bet you every day they run into some vaccine challenge and every day they solve it, and that goes into their playbook," he said...

As soon as vials of vaccine began coming off the production line, engineers started analyzing how production could work faster and better. "We made a lot of really slick enhancements," he said. Production is getting faster. For example, making the DNA that starts the vaccine process first took 16 days; soon it will take nine or 10. Though quality control and testing has accelerated, company officials say FDA regulations and best manufacturing practices are still being met. Along with improving speed, Pfizer also is increasing output by adding manufacturing lines in all three plants.

As the vaccine effort continues, more efficiencies are expected.

Across America a bout 20.6 million doses of the Pfizer vaccine have already been administered.
Medicine

'Nature' Urges More Masks, Air Purifiers, and Ventilation Instead of Disinfecting Surfaces (nature.com) 164

"Catching the coronavirus from surfaces is rare. The World Health Organization and national public-health agencies need to clarify their advice," urges an editorial in Nature (shared by long-time Slashdot reader AmiMoJo): A year into the pandemic, the evidence is now clear. The coronavirus SARS-CoV-2 is transmitted predominantly through the air — by people talking and breathing out large droplets and small particles called aerosols.

Catching the virus from surfaces — although plausible — seems to be rare. Despite this, some public-health agencies still emphasize that surfaces pose a threat and should be disinfected frequently. The result is a confusing public message when clear guidance is needed on how to prioritize efforts to prevent the virus spreading... People and organizations continue to prioritize costly disinfection efforts, when they could be putting more resources into emphasizing the importance of masks, and investigating measures to improve ventilation. The latter will be more complex but could make more of a difference.

Now that it is agreed that the virus transmits through the air, in both large and small droplets, efforts to prevent spread should focus on improving ventilation or installing rigorously tested air purifiers. People must also be reminded to wear masks and maintain a safe distance. At the same time, agencies such as the WHO and the CDC need to update their guidance on the basis of current knowledge. Research on the virus and on COVID-19 moves quickly, so public-health agencies have a responsibility to present clear, up-to-date information that provides what people need to keep themselves and others safe.

Medicine

How is Alaska Leading the Nation in Vaccinating Residents? With Boats, Ferries, Planes and Snowmobiles. (washingtonpost.com) 58

Alaska, the state with the largest land mass in the nation, is leading the country in a critical coronavirus measure: per capita vaccinations per capita vaccinations. From a report: About 13 percent of the people who live in Alaska have already gotten a shot. That's higher than states such as West Virginia, which has received a lot of attention for a successful vaccine rollout and has inoculated 11 percent of its people. But the challenge for Alaska has been how to get vaccines to people across difficult, frigid terrain -- often in remote slivers of the state? "Boats, ferries, planes, snowmobiles -- Alaskans will find a way to get it there," said the state's chief medical officer, Anne Zink, 43. Alaskans are being vaccinated on fishing boats, inside 10-seater planes and on frozen landing strips. Doctors and nurses are taking white-knuckle trips to towns and villages across the state to ensure residents are protected from the coronavirus. Contributing to Alaska's quick speed in getting the vaccine to its residents is a federal partnership that allows the state, which has more than 200 indigenous tribes, to receive additional vaccines to distribute through the Indian Health Service.
Medicine

23andMe Is Going Public As It Pushes Further Into Healthcare 16

23andMe is becoming a publicly-traded company through a merger with Virgin's VG Acquisition. Engadget reports: The deal values 23andMe at about $3.5 billion and should give the company the finances it wants to boost its personal healthcare and therapeutics plans. It should have over $900 million in cash, for instance. The merger is expected to close in the second quarter of 2021 and will have private $25 million investments from both 23andMe chief Anne Wojcicki and Virgin's Sir Richard Branson.

While 23andMe didn't say much about how its strategy might change by going public, it was keen to promote its contributions to genetic research and its involvement in therapeutic programs for conditions like cardiovascular disease and respiratory issues. As Sir Branson suggested, the public offering could help 23andMe "revolutionize" personalized medicine.
Medicine

Apple Watch Can Help Track Parkinson's Disease Symptoms, Research Shows (movementdisorders.org) 9

According to a new study, the Apple Watch can be used to monitor symptoms of Parkinson's disease. STAT reports: Researchers at Apple, working with specialists who treat Parkinson's, designed a system that uses the Apple Watch to detect the motor symptoms that are a hallmark of the neurological disease. By monitoring resting tremors and other involuntary movements, the researchers were able to identify the characteristic "on" and "off" patterns of medication's effects. Their findings were published Wednesday in Science Translational Medicine.

The new system, called the Motor Fluctuations Monitor for Parkinson's disease (MM4PD), uses the Apple Watch's accelerometer and gyroscope data to detect the presence of resting tremor or dyskinesia. Resting tremors, which can affect the hands, legs, and other parts of the body, are a common symptom of Parkinson's. Dyskinesia, another type of involuntary movement, is a frequent side effect of medication used to treat the disease. The algorithms underlying the model were developed using data from a pilot study with 118 people in which researchers matched subject's smartwatch data to a scoring system called MDS-UPDRS Part III, the gold standard by which motor symptoms of Parkinson's are measured.

The authors say that the measurements helped spot symptoms missed in regular care and identified changes after subjects underwent surgery for deep brain stimulation. The paper also suggests the tool helped pinpoint people who slipped on medication adherence, as well as cases in which a person might benefit from a modified medication regimen.

Medicine

Israel's Vaccination Drive Reduces Covid Cases Among Older Citizens (bloomberg.com) 71

Israel's vaccination drive has reduced confirmed Covid-19 cases among older Israelis, Prime Minister Benjamin Netanyahu said on Thursday. From a report: Netanyahu cited a 45% drop in confirmed cases and a 26% decline in hospitalizations of seriously ill patients among people age 60 and older in the past 16 days. Israel's vaccination drive, which began in late December, started with this age group, and more than 80% have had at least one dose of the Pfizer-BioNTech vaccine. Further reading: Israel Is Now The First Country Where Vaccinations Are Starting To Curb The Pandemic.
Medicine

There's a Curious Effect Urban Trees Might Have On Depression (sciencealert.com) 81

omfglearntoplay shares a report from ScienceAlert: There's already a long list of reasons to like trees, we know. Warding off depression could be the latest entry on that list, based on a study of 9,751 residents in Leipzig, Germany. For a more consistent measure, researchers used antidepressant prescriptions rather than self-reporting to gauge the mental health of communities, and then cross-referenced these statistics with the numbers of street trees in each area. They reported that more local foliage within 100 meters (328 feet) of the home was associated with a reduced likelihood of being prescribed antidepressants -- findings that could be very useful indeed for city planners, health professionals, and governments.

The reduction in antidepressant use linked to street trees was particularly prominent in socioeconomically disadvantaged groups. While it's important not to take such findings too far, the results do hint that urban trees could act as a simple and affordable way of boosting mental health and assist in closing health inequality gaps across society.
The research has been published in Scientific Reports.
Biotech

Researchers Try Using CRISPR To Genetically Engineer Zika-Resistant Mosquitoes (cornell.edu) 31

A new research study at the University of Missouri is using CRISPR gene-editing technology to produce mosquitoes that are unable to replicate Zika virus and therefore cannot infect a human through biting. Slashdot reader wooloohoo shared an announcement from Cornell's Alliance for Science: Alexander Franz, an associate professor in the MU College of Veterinary Medicine, collaborated with researchers at Colorado State University... Their work was recently published in the journal Viruses. Franz added that the genetic modification is inheritable, so future generations of the altered mosquitoes would be resistant to Zika virus as well... "[W]e are simply trying to expand the toolbox and provide a solution by genetically modifying the mosquitoes to become Zika-resistant while keeping them alive at the same time."

Franz' research is designed to help prevent another outbreak of Zika virus disease from occurring while also addressing concerns that have some have raised about reducing populations of mosquitoes, which are a food source for some animals...

The study was funded by the National Institutes of Health.

Medicine

Why Scientists Are Very Worried About the Variant From Brazil (npr.org) 207

An anonymous reader quotes a report from NPR: New coronavirus variants seem to be cropping up everywhere. There's one from the U.K., which is more contagious and already circulating in the United States. There's one from South Africa, which is forcing Moderna and Pfizer to reformulate their COVID-19 vaccines and create "booster" shots, just to make sure the vaccines maintain their efficacies. But for some scientists, the most worrying variant might be the newest one. A variant called P.1, which emerged in early December in Manaus, Brazil, and by mid-January had already caused a massive resurgence in cases across the city of 2 million people. [...] The concern with P.1 is twofold: scientists don't understand why the variant has spread so explosively in Brazil, and the variant carries a particularly dangerous set of mutations.

While the variant from the U.K. took about three months to dominate the outbreak in England, P.1 took only about a month to dominate the outbreak in Manaus. In addition, Manaus had already been hit extremely hard by the virus back in April. One study estimated that the population should have reached herd immunity and the virus shouldn't be able to spread easily in the community. So why would the city see an even bigger surge 10 months later? Could P.1 be evading the antibodies made against the previous version of the virus, making reinfections easier? Could it just be significantly more contagious? Could both be true? "While we don't *know* exactly why this variant has been so apparently successful in Brazil, none of the explanations on the table are good," epidemiologist Bill Hanage, at Harvard University, wrote on Twitter.

Reinfections are a serious concern for several reasons. First off, like the variant from South Africa, P.1 carries a cluster of mutations along the surface of the virus where antibodies -- especially the potent antibodies -- like to bind. "They are kind of the major targets of the immune system," says virologist Penny Moore at the National Institute for Communicable Diseases in South Africa and the University of KwaZulu-Natal. "So when we see a whole lot of mutations in [those surfaces], it raises the possibility that the mutations might be conferring immune escape." That is, the mutations are helping the virus evade antibodies or escape recognition by them. In essence, the mutations are providing the virus with a type of invisibility cloak. And thus, now we have a game of "cat and mouse," says virologist Ravi Gupta, between the virus and the vaccine. The virus finds ways around the vaccine (and our immune system), says Gupta, and so the manufacturers have to reformulate the vaccines (or else we run the risk of getting infected twice).

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