COVID-19 has prompted unprecedented government action around the world. We introduce the Oxford COVID-19 Government Response Tracker (OxCGRT), a dataset that addresses the need for continuously updated, readily usable and comparable information on policy measures. From 1 January 2020, the data capture government policies related to closure and containment, health and economic policy for more than 180 countries, plus several countries' subnational jurisdictions. Policy responses are recorded on ordinal or continuous scales for 19 policy areas, capturing variation in degree of response. We present two motivating applications of the data, highlighting patterns in the timing of policy adoption and subsequent policy easing and reimposition, and illustrating how the data can be combined with behavioural and epidemiological indicators. This database enables researchers and policymakers to explore the empirical effects of policy responses on the spread of COVID-19 cases and deaths, as well as on economic and social welfare.

A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).

A robust serological test to detect neutralizing antibodies to SARS-CoV-2 is urgently needed to determine not only the infection rate, herd immunity and predicted humoral protection, but also vaccine efficacy during clinical trials and after large-scale vaccination. The current gold standard is the conventional virus neutralization test requiring live pathogen and a biosafety level 3 laboratory. Here, we report a SARS-CoV-2 surrogate virus neutralization test that detects total immunodominant neutralizing antibodies targeting the viral spike (S) protein receptor-binding domain in an isotype- and species-independent manner. Our simple and rapid test is based on antibody-mediated blockage of the interaction between the angiotensin-converting enzyme 2 (ACE2) receptor protein and the receptor-binding domain. The test, which has been validated with two cohorts of patients with COVID-19 in two different countries, achieves 99.93% specificity and 95-100% sensitivity, and differentiates antibody responses to several human coronaviruses. The surrogate virus neutralization test does not require biosafety level 3 containment, making it broadly accessible to the wider community for both research and clinical applications.

/pdf/a-sars-cov-2-surrogate-virus-neutralization-test-based-on-mgzo1tw5ch.pdf

A SARS-CoV-2 surrogate virus neutralization test based on antibody-mediated blockage of ACE2-spike protein-protein interaction.

An effective rollout of vaccinations against COVID-19 offers the most promising prospect of bringing the pandemic to an end. We present the Our World in Data COVID-19 vaccination dataset, a global public dataset that tracks the scale and rate of the vaccine rollout across the world. This dataset is updated regularly and includes data on the total number of vaccinations administered, first and second doses administered, daily vaccination rates and population-adjusted coverage for all countries for which data are available (169 countries as of 7 April 2021). It will be maintained as the global vaccination campaign continues to progress. This resource aids policymakers and researchers in understanding the rate of current and potential vaccine rollout; the interactions with non-vaccination policy responses; the potential impact of vaccinations on pandemic outcomes such as transmission, morbidity and mortality; and global inequalities in vaccine access.

/pdf/a-global-database-of-covid-19-vaccinations-ip9yikdjqm.pdf

A global database of COVID-19 vaccinations.

Objective To determine the diagnostic accuracy of
 serological tests for coronavirus disease-2019
 (covid-19). Design Systematic review and meta-analysis. Data sources Medline, bioRxiv, and medRxiv from 1 January to
 30 April 2020, using subject headings or
 subheadings combined with text words for the
 concepts of covid-19 and serological tests for
 covid-19. Eligibility criteria and data
 analysis Eligible studies measured sensitivity or
 specificity, or both of a covid-19 serological
 test compared with a reference standard of viral
 culture or reverse transcriptase polymerase chain
 reaction. Studies were excluded with fewer than
 five participants or samples. Risk of bias was
 assessed using quality assessment of diagnostic
 accuracy studies 2 (QUADAS-2). Pooled sensitivity
 and specificity were estimated using random
 effects bivariate meta-analyses. Main outcome measures The primary outcome was overall sensitivity and
 specificity, stratified by method of serological
 testing (enzyme linked immunosorbent assays
 (ELISAs), lateral flow immunoassays (LFIAs), or
 chemiluminescent immunoassays (CLIAs)) and
 immunoglobulin class (IgG, IgM, or both).
 Secondary outcomes were stratum specific
 sensitivity and specificity within subgroups
 defined by study or participant characteristics,
 including time since symptom onset. Results 5016 references were identified and 40 studies
 included. 49 risk of bias assessments were carried
 out (one for each population and method
 evaluated). High risk of patient selection bias
 was found in 98% (48/49) of assessments and high
 or unclear risk of bias from performance or
 interpretation of the serological test in 73%
 (36/49). Only 10% (4/40) of studies included
 outpatients. Only two studies evaluated tests at
 the point of care. For each method of testing,
 pooled sensitivity and specificity were not
 associated with the immunoglobulin class measured.
 The pooled sensitivity of ELISAs measuring IgG or
 IgM was 84.3% (95% confidence interval 75.6% to
 90.9%), of LFIAs was 66.0% (49.3% to 79.3%), and
 of CLIAs was 97.8% (46.2% to 100%). In all
 analyses, pooled sensitivity was lower for LFIAs,
 the potential point-of-care method. Pooled
 specificities ranged from 96.6% to 99.7%. Of the
 samples used for estimating specificity, 83%
 (10 465/12 547) were from populations tested
 before the epidemic or not suspected of having
 covid-19. Among LFIAs, pooled sensitivity of
 commercial kits (65.0%, 49.0% to 78.2%) was lower
 than that of non-commercial tests (88.2%, 83.6% to
 91.3%). Heterogeneity was seen in all analyses.
 Sensitivity was higher at least three weeks after
 symptom onset (ranging from 69.9% to 98.9%)
 compared with within the first week (from 13.4% to
 50.3%). Conclusion Higher quality clinical studies assessing the
 diagnostic accuracy of serological tests for
 covid-19 are urgently needed. Currently, available
 evidence does not support the continued use of
 existing point-of-care serological tests. Study registration PROSPERO CRD42020179452.

https://www.bmj.com/content/bmj/370/bmj.m2516.full.pdf

Diagnostic accuracy of serological tests for covid-19: systematic review and meta-analysis.

The human milk microbiome changes over lactation and is shaped by maternal weight and mode of delivery

Developing antibody tests for SARS-CoV-2.

As the COVID-19 pandemic lingers, the possibility of 'pandemic fatigue' has raised worldwide concerns. Here, we examine whether there was a gradual reduction in adherence to protective behaviours against COVID-19 from March through December 2020, as hypothesized in expectations of fatigue. We considered self-report behaviours from representative samples of the populations of 14 countries (N = 238,797), as well as mobility and policy data for 124 countries. Our results show that changes in adherence were empirically meaningful and geographically widespread. While a low-cost and habituating behaviour (mask wearing) exhibited a linear rise in adherence, high-cost and sensitizing behaviours (physical distancing) declined, but this decline decelerated over time, with small rebounds seen in later months. Reductions in adherence to physical distancing showed little difference across societal groups, but were less intense in countries with high interpersonal trust. Alternative underlying mechanisms and policy implications are discussed.

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A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue.

Objective: To provide an early global assessment of the impact of government stringency measures on the rate of growth in deaths from COVID-19. We hypothesized that the overall stringency of a government9s interventions and the speed of implementation would affect the growth and level of deaths related to COVID-19 in that country.
Design: Observational study based on an original database of global governmental responses to the COVID-19 pandemic. Daily data was collected on a range of containment and closure policies for 170 countries from January 1, 2020 until May 27, 2020 by a team of researchers at Oxford University, UK. These data were combined into an aggregate stringency index (SI) score for each country on each day (range: 0-100). Regression was used to show correlations between the speed and strength of government stringency and deaths related to COVID-19 with a number of controls for time and country-specific demographic, health system, and economic characteristics. 
Interventions: Nine non-pharmaceutical interventions such as school and work closures, restrictions on international and domestic travel, public gathering bans, public information campaigns, as well as testing and contact tracing policies. 
Main outcomes measures: The primary outcome was deaths related to COVID-19, measured both in terms of maximum daily deaths and growth rate of daily deaths. 
Results: For each day of delay to reach an SI 40, the average daily growth rate in deaths was 0.087 percentage points higher (0.056 to 0.118, P<0.001). In turn, each additional point on the SI was associated with a 0.080 percentage point lower average daily growth rate (-0.121 to -0.039, P<.001). These daily differences in growth rates lead to large cumulative differences in total deaths. For example, a week delay in enacting policy measures to SI 40 would lead to 1.7 times as many deaths overall. 
Conclusions: A lower degree of government stringency and slower response times were associated with more deaths from COVID-19. These findings highlight the importance of non-pharmaceutical responses to COVID-19 as more robust testing, treatment, and vaccination measures are developed.

/pdf/global-assessment-of-the-relationship-between-government-25259gil41.pdf

Global Assessment of the Relationship between Government Response Measures and COVID-19 Deaths

Research on the contents of milk and how breast-feeding benefits a growing child is surprising scientists.

/pdf/development-mother-s-milk-a-rich-opportunity-5gqxx7ydxj.pdf

Anna Petherick

Papers

A global panel database of pandemic policies (Oxford COVID-19 Government Response Tracker).

Developing antibody tests for SARS-CoV-2.

A worldwide assessment of changes in adherence to COVID-19 protective behaviours and hypothesized pandemic fatigue.

Global Assessment of the Relationship between Government Response Measures and COVID-19 Deaths

Development: Mother's milk: A rich opportunity