• Rapid response

    COVID-19 vaccines: July update on research

    There are almost 150 coronavirus vaccine candidates under development. Only 19 of these are now being tested in humans. Many types of vaccines are rapidly progressing through clinical trials. Only two vaccine candidates have announced large scale Phase 3 trials, involving several thousands of people. Only one candidate has been approved for restricted human use. Measuring a reduction in COVID-19 levels is an obstacle for Phase 3 clinical trials, as they require a high infection rate among the tested population to prove vaccine efficacy. International agreements with countries where SARS-CoV-2 infection rates are still high are facilitating those trials. Future challenges in vaccine development include a better understanding of COVID-19 immunity and development of vaccination strategies.

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    COVID-19 therapies

    This article was updated on 1 May and again on 6 July. Since its original publication on 17 April, the number of COVID-19 clinical trials has increased from 524 to 2,378. There is no cure for COVID-19. Researchers are testing existing drugs to see if they act against SARS-CoV-2 or alleviate the symptoms of the disease. New drugs are also in development, but this is at a very early stage. Results from trials on existing drugs have already been reported with some positive findings. Dexamethasone is a cheap steroid drug that reduces the risk of death of ventilated patients by 35% and by 20% for patients requiring oxygen therapy. Remdesivir is an antiviral drug; there is good evidence that it can reduce the length of time that hospitalised COVID-19 patients are ill. Negative findings are valuable because they allow researchers to focus on other drugs; there is good evidence that hydroxychloroquine does not offer any benefits to treat COVID-19 patients. Research to see if it might have a protective effect for at-risk groups, such as healthcare workers, is ongoing. There are numerous trials in progress to test a range of drugs that act on the immune system.

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    Contact tracing apps for COVID-19

    Contact tracing apps could be used to control the COVID-19 outbreak. Most of them work by automatically registering another smartphone when it is too close for an extended period of time. Then if a user tests positive for Coronavirus in the future, the contact tracing app notifies these contacts. Some countries like Singapore and Australia have already adopted or rolled out their own contact tracing apps. Concerns have been raised about misuse of personal data. Initial data suggests there has been slow uptake of this new technology by users, and it's unclear if contact tracing apps have had or will have an effect on the pandemic.

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    COVID-19 and social distancing: the 2 metre advice

    An infected person produces respiratory droplets when talking, coughing and sneezing. These are responsible for the transmission of virus between people. Droplets can travel up to 2m, with finer aerosols containing smaller viral particles travelling even further. Numerous complex and interacting factors influence how they move and settle onto surfaces, and how infectious they are. The further away a person is, the fewer droplets they will be exposed to and so their risk of being infected with the virus reduces. The advice on 2 m distancing is a risk assessment based on relative not absolute risk; 2 m does not represent zero risk. Measures to mitigate the increased risk of reducing physical distancing include ventilation, physical barriers (screens and face coverings), reduced building occupancy and enhanced cleaning. These will vary according to the context. The wider range of social distancing practices will need to be maintained to contain viral transmission even if the 2 m advice changes. Social distancing and other public health measures are likely to be needed long-term, until a vaccine or more effective treatments for COVID-19 are available. There are numerous knowledge gaps about SARS-CoV-2 transmission; research to address them will inform policy-making.

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    Antibody tests for COVID-19

    There is insufficient scientific evidence to know whether the presence of SARS-CoV-2 antibodies confers protection from subsequent infections, and if so at what level. Antibodies are only one part of the immune response to infection. Tests that detect SARS-CoV-2 antibodies are available. They can determine whether someone has had COVID-19. Tests can reveal those who are unaware that they had COVID-19 because they had mild or no symptoms. Test samples must be analysed in a laboratory – no home tests are authorised for use in the UK. The Government provides antibody tests for NHS and social care staff, hospital patients and care home residents. Commercial test kits are available for private use. These are of varying quality and results must be interpreted with caution. A positive test does not necessarily mean that someone will be protected from subsequent infections. There are concerns that access to private tests of variable quality will discourage the public from practising effective public health measures. Antibody tests are an important tool to understand the spread of the virus and how many people in a population have been infected. They are being used in infection surveillance surveys in the UK and elsewhere.

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    Immunity to COVID-19

    Scientific understanding of the immune response to COVID-19 is incomplete but numerous research studies are underway. There is little evidence to suggest that exposure to other coronaviruses can confer protection against SARS-CoV-2. There is very good evidence that it takes at least 14 days to develop an antibody response to SARS-CoV-2. A significant proportion of people exposed to SARS-CoV-2 make very little or no detectable antibodies at all. There is insufficient scientific evidence to know whether the presence of SARS-CoV-2 antibodies confers protection from subsequent infections, and if so at what level. The duration of immunity is not clear; long-term monitoring of this in large studies will be needed to provide clarity. Antibodies are only one part of the immune response to infection, which is complex, and understanding the overall immune response to COVID-19 is very important. Additional high-quality research evidence is needed in order to indicate the likelihood of future outbreaks of disease, how often and when they are likely to occur, and to inform the development of any future immunisation programmes.

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    COVID-19 in children

    There is very good evidence that children who have COVID-19 are much less likely to develop severe symptoms and much less likely to die from the disease than people in older age groups. There is good evidence that children under 13 years old are less susceptible to developing clinical disease (this means having recognisable signs and symptoms) than adults. It is not yet clear whether this is also the case for older children. There is some research indicating that children aged 13 years and under may be less susceptible to infection than adults, but the confidence in this evidence is low. There is insufficient research to say whether this is the case for older children. There is some evidence to suggest that children transmit the virus less than adults, but more research is needed to reduce uncertainty. Pregnant women are not more likely to contract the virus. Transmission of the virus from mothers to babies is low. Some babies born to COVID-19 positive mothers will develop an infection; these babies are not at increased risk of severe disease.

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    COVID-19 and international approaches to exiting lockdown

    The UK Government announced its approach to exiting lockdown on 10 May in a statement by the Prime Minister and in a report published on 11 May. Current models suggest that 5.38% of the UK population has been infected with COVID-19. To lift restrictions the World Health Organisation has outlined key criteria that should guide decision making, such as ensuring that health systems can identify, isolate, test, trace contacts and quarantine COVID-19 cases. Several countries have eased measures with varying success including, Austria, France, Germany, Italy, Spain and China. Other countries such as Sweden and South Korea have taken alternative routes.

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    Mental health and well-being during the COVID-19 outbreak

    Initial reports suggest we should expect a sharp rise in levels of depression, anxiety and loneliness. The pandemic could have implications for those already suffering from addiction, OCD, and eating disorders. Concerns have prompted a number of initiatives supporting mental well-being. These include guidance from the World Health Organisation (WHO) and Public Health England (PHE), resources from the devolved administrations, and formation of the Help Hub, a service set up by volunteer therapists.

  • Rapid response

    Models of COVID-19: Part 3

    Following measures by the UK Government, a survey was conducted on the 18 of March to assess public attitudes. 77% of respondents were worried about an outbreak and while 93% reported taking protective measures, only 50% were avoiding social events, 36% were avoiding public transport, and 31% were avoiding going out. A study on the global impact of COVID-19 estimated that an unmitigated epidemic would infect 7.0 billion out of the world’s 7.8 billion people. This would lead to 40 million global deaths in 2020. The latest modeling estimates that as of 27 about 4% of the population of the UK has been infected with coronavirus.The UK has strengthened capacity of the NHS to deal with COVID-19 by building field hospitals, but there is still a shortage of intensive care beds and intensive care nurses. Various testing strategies are being explored for healthcare workers and the wider community. Testing each case and their contacts might require as many as 60,000 tests per day.

  • Rapid response

    Face masks, face coverings and COVID-19

    This article goes over the types of masks that exist. It explores how effective are they at preventing transmission of coronavirus, according to the latest research. It reviews the advice on masks and face coverings from public health organisations, and presents official guidance from several nations. This is part of our rapid response content on COVID-19. You can view all our reporting on this topic under COVID-19.

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    COVID-19 misinformation

    According to a recent study from Ofcom, 46% of respondents have encountered false or misleading coronavirus information since the lockdown. Most cases of misinformation are found on social media. Misinformation can lead to public mistrust, endangerment of public health, as well as hate crime and exploitation. Different approaches are being implemented to fight misinformation including content moderation, myth-busting, and a focus on education.

  • Rapid response

    Vaccines for COVID-19

    Who is working on a vaccine to prevent COVID-19 (coronavirus disease)? When might a COVID-19 vaccine become available? This is part of our rapid response content on COVID-19. You can view all our reporting on this topic under COVID-19. This article will be updated as the research progresses.

  • Rapid response

    Models of COVID-19: Part 2

    What can Wuhan tell us about the COVID-19 pandemic? How might different suppression and mitigation strategies affect coronavirus transmission? This breakdown of the Imperial College models is part of our rapid response content on COVID-19. This article will be updated as the research progresses.

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