https://www.thelancet.com/pdfs/journals/lancet/PIIS0140-6736(13)62105-4.pdf

[Global health 2035: a world converging within a generation].

Challenges in ensuring global access to COVID-19 vaccines: production, affordability, allocation, and deployment.

Since its emergence in Wuhan, China, covid-19 has spread and had a profound effect on the lives and health of people around the globe. As of 4 July 2021, more than 183 million confirmed cases of covid-19 had been recorded worldwide, and 3.97 million deaths. Recent evidence has shown that a range of persistent symptoms can remain long after the acute SARS-CoV-2 infection, and this condition is now coined long covid by recognized research institutes. Studies have shown that long covid can affect the whole spectrum of people with covid-19, from those with very mild acute disease to the most severe forms. Like acute covid-19, long covid can involve multiple organs and can affect many systems including, but not limited to, the respiratory, cardiovascular, neurological, gastrointestinal, and musculoskeletal systems. The symptoms of long covid include fatigue, dyspnea, cardiac abnormalities, cognitive impairment, sleep disturbances, symptoms of post-traumatic stress disorder, muscle pain, concentration problems, and headache. This review summarizes studies of the long term effects of covid-19 in hospitalized and non-hospitalized patients and describes the persistent symptoms they endure. Risk factors for acute covid-19 and long covid and possible therapeutic options are also discussed.

https://www.bmj.com/content/bmj/374/bmj.n1648.full.pdf

Long covid-mechanisms, risk factors, and management.

Long-range and highly accurate de novo assembly from short-read data is one of the most pressing challenges in genomics. Recently, it has been shown that read pairs generated by proximity ligation of DNA in chromatin of living tissue can address this problem, dramatically increasing the scaffold contiguity of assemblies. Here, we describe a simpler approach ("Chicago") based on in vitro reconstituted chromatin. We generated two Chicago data sets with human DNA and developed a statistical model and a new software pipeline ("HiRise") that can identify poor quality joins and produce accurate, long-range sequence scaffolds. We used these to construct a highly accurate de novo assembly and scaffolding of a human genome with scaffold N50 of 20 Mbp. We also demonstrated the utility of Chicago for improving existing assemblies by reassembling and scaffolding the genome of the American alligator. With a single library and one lane of Illumina HiSeq sequencing, we increased the scaffold N50 of the American alligator from 508 kbp to 10 Mbp.

/pdf/chromosome-scale-shotgun-assembly-using-an-in-vitro-method-3n44qwgzq8.pdf

Chromosome-scale shotgun assembly using an in vitro method for long-range linkage

A Call to Action and a Lifecourse Strategy to Address the Global Burden of Raised Blood Pressure on Current and Future Generations: The Lancet Commission on Hypertension

Omicron, the SARS-CoV-2 variant responsible for a cluster of cases in South Africa and that is now spreading around the world, is the most heavily mutated variant to emerge so far and carries mutations similar to changes seen in previous variants of concern associated with enhanced transmissibility and partial resistance to vaccine induced immunity.

Daily case numbers in South Africa had been fairly low but then rose rapidly from 273 on 16 November to more than 1200 by 25 November, more than 80% of which were in the northern province of Gauteng, where the first cases were seen.

Europe’s first case of the variant was confirmed in Belgium on 26 November in a person who tested positive for covid-19 on 22 November. By 29 November cases had been reported in the Netherlands, France, Germany, Portugal, and Italy. The UK had recorded nine cases by the morning of 29 November, six of them in Scotland.

Elsewhere in the world cases have been reported in Botswana, Hong Kong, Canada, and Australia, which has had extremely tight border controls through the pandemic.

Some countries, including Japan and Israel, were quick to close their borders to all foreign travellers, while others, such as the UK and EU countries, enforced quarantine for travellers from South …

https://www.bmj.com/content/bmj/375/bmj.n2943.full.pdf

Covid-19: Omicron may be more transmissible than other variants and partly resistant to existing vaccines, scientists fear

The delta covid-19 variant (B.1.617.2), which was first detected in India, has overtaken the alpha variant, better known as the UK or Kent variant (B.1.1.7), to make it the most dominant strain circulating in the UK, Public Health England has said.

This is a concern because there is evidence that the risk of hospital admission is higher in people with the delta variant, it said. Data also indicate that the variant is spreading rapidly through England’s schools.

Public Health England’s latest weekly coronavirus data on circulating variants show there were 5472 new cases of the delta variant in the UK in the week to 26 May, bringing the total number of cases of the variant detected to 12 431.1

In the week to 2 June a total of 278 people with the delta variant attended hospital emergency departments, and …

https://www.bmj.com/content/bmj/373/bmj.n1445.full.pdf

Covid-19: Delta variant is now UK's most dominant strain and spreading through schools.

Doctors in Norway have been told to conduct more thorough evaluations of very frail elderly patients in line to receive the Pfizer BioNTec vaccine against covid-19, following the deaths of 23 patients shortly after receiving the vaccine.

“It may be a coincidence, but we aren’t sure,” Steinar Madsen, medical director of the Norwegian Medicines Agency (NOMA), told The BMJ . “There is no certain connection between these deaths and the vaccine.”

The agency has investigated 13 of the deaths so far and concluded that common adverse reactions of mRNA vaccines, such …

https://www.bmj.com/content/bmj/372/bmj.n149.full.pdf

Covid-19: Norway investigates 23 deaths in frail elderly patients after vaccination.

The SARS-CoV-2 coronavirus will not be eradicated but will become endemic, continuing to circulate in pockets of the global population for years to come and causing outbreaks in regions where it had been eliminated, scientists working in the field believe.

But the impact of the virus on the world in terms of deaths, illness, and the need for social isolation will lessen, they say, as more of the population acquires some immunity to it through exposure to the virus or from vaccination.

The predictions come from a survey carried out in January by the journal Nature of more than 100 immunologists, infectious disease researchers, and virologists working on SARS-CoV-2.1 Almost 90% of respondents said that they expected the coronavirus to become endemic, although more than a third thought that it would be possible to eliminate SARS-CoV-2 from some regions of the world.

While there would be a continual risk of covid-19 outbreaks in areas where …

https://www.bmj.com/content/bmj/372/bmj.n494.full.pdf

Covid-19 will become endemic but with decreased potency over time, scientists believe.

Middle aged women have a higher risk of experiencing a range of debilitating ongoing symptoms, such as fatigue, breathlessness, muscle pain, anxiety, depression, and “brain fog” after hospital treatment for covid-19, suggest the findings of two unpublished studies available as preprints.

Seven in 10 patients admitted to hospital with covid-19 reported “long covid” symptoms an average of five months after discharge in the larger PHOSP-COVID study, and symptoms were more prevalent in women aged 40-60.1 White ethnicity, two or more comorbidities at admission, and receiving invasive ventilation while in hospital increased the risk, but severity of acute covid-19 disease did not seem to affect the likelihood of experiencing long covid symptoms.

Only 29% of the 1077 patients studied felt fully recovered when followed up, on average five months after discharge. Over a quarter had …

https://www.bmj.com/content/bmj/372/bmj.n829.full.pdf

Ingrid Torjesen

Papers

Covid-19: Omicron may be more transmissible than other variants and partly resistant to existing vaccines, scientists fear

Covid-19: Delta variant is now UK's most dominant strain and spreading through schools.

Covid-19: Norway investigates 23 deaths in frail elderly patients after vaccination.

Covid-19 will become endemic but with decreased potency over time, scientists believe.

Covid-19: Middle aged women face greater risk of debilitating long term symptoms.