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In December 2019, the Coronavirus disease 2019 (COVID-19), caused by a novel coronavirus SARS-CoV-2, emerged in Wuhan, Hubei province, China1 and soon spread across the world. In this ongoing pandemic, public health concerns and the urgent need for effective therapeutic measures require a deep understanding of its epidemiology, transmissibility and pathogenesis. Here we analyzed the clinical, molecular and immunological data from 326 confirmed cases of COVID-19 in Shanghai. Genomic sequences of SARS-CoV-2 assembled from 112 quality samples together with sequences in the Global Initiative on Sharing All Influenza Data (GISAID) showed a stable evolution and suggested two major lineages with differential exposure history during the early phase of the outbreak in Wuhan. Nevertheless, they exhibited similar virulence and clinical outcomes. Lymphocytopenia, especially the reduced CD4+ and CD8+ T cell counts upon admission, was predictive of disease progression. High levels of IL-6 and IL-8 during treatment were observed in patients with severe or critical disease and correlated with decreased lymphocyte count. The determinants of disease severity seemed to stem mostly from host factors such as age, lymphocytopenia, and its associated cytokine storm, whereas viral genetic variation did not significantly affect the outcomes.

A new machine-learning framework uses reported test results and death rates to calculate estimates of the actual number of current COVID-19 infections within all 50 U.S. states and 50 countries. Jungsik Noh and Gaudenz Danuser of the University of Texas Southwestern Medical Center present these findings in the open-access journal PLOS ONE on February 8,

Since the emergence of coronavirus disease 2019 (COVID-19), unprecedented movement restrictions and social distancing measures have been implemented worldwide. The socioeconomic repercussions have fueled calls to lift these measures. In the absence of population-wide restrictions, isolation of infected individuals is key to curtailing transmission. However, the effectiveness of symptom-based isolation in preventing a resurgence depends on the extent of presymptomatic and asymptomatic transmission. We evaluate the contribution of presymptomatic and asymptomatic transmission based on recent individual-level data regarding infectiousness prior to symptom onset and the asymptomatic proportion among all infections. We found that the majority of incidences may be attributable to silent transmission from a combination of the presymptomatic stage and asymptomatic infections. Consequently, even if all symptomatic cases are isolated, a vast outbreak may nonetheless unfold. We further quantified the effect of isolating silent infections in addition to symptomatic cases, finding that over one-third of silent infections must be isolated to suppress a future outbreak below 1% of the population. Our results indicate that symptom-based isolation must be supplemented by rapid contact tracing and testing that identifies asymptomatic and presymptomatic cases, in order to safely lift current restrictions and minimize the risk of resurgence.

So many of us, including me, have been focused on the failure of the federal response to Covid-19, watching President Trump's catastrophe-by-public-policy roll out day after day since late February. I've written a lot about it in these pages. In a misplaced triumphalism, some people in states that have managed to have a relatively quiet summer with low rates of Covid-19 cases have chastised those in states with renewed outbreaks as being foolish or unheeding of scientific advice, as governors still slow-walk the response to the disease and ordinary people shun masks and flock to social gatherings. We all like to think of ourselves as different, doing the right thing, doing our part.

Globally, the USA has recorded the highest number of COVID-19 cases and deaths,1 and still needs to simultaneously respond to another looming potential pandemic. The rise in multidrug-resistant bacterial infections that are undetected, undiagnosed, and increasingly untreatable threatens the health of people in the USA and globally. In 2020 and beyond, we cannot afford to ignore antimicrobial resistance (AMR).

Case isolation and contact tracing can contribute to the control of COVID-19 outbreaks1,2. However, it remains unclear how real-world social networks could influence the effectiveness and efficiency of such approaches. To address this issue, we simulated control strategies for SARS-CoV-2 transmission in a real-world social network generated from high-resolution GPS data that were gathered in the course of a citizen-science experiment3,4. We found that tracing the contacts of contacts reduced the size of simulated outbreaks more than tracing of only contacts, but this strategy also resulted in almost half of the local population being quarantined at a single point in time. Testing and releasing non-infectious individuals from quarantine led to increases in outbreak size, suggesting that contact tracing and quarantine might be most effective as a 'local lockdown' strategy when contact rates are high. Finally, we estimated that combining physical distancing with contact tracing could enable epidemic control while reducing the number of quarantined individuals. Our findings suggest that targeted tracing and quarantine strategies would be most efficient when combined with other control measures such as physical distancing.

Research from the University of Notre Dame estimates that more than 100,000 people were already infected with COVID-19 by early March-when only 1,514 cases and 39 deaths had been officially reported and before a national emergency was declared. The study provides insight into how limited testing and gaps in surveillance during the initial phase of the epidemic resulted in so many cases going undetected. The study was published in the Proceedings of the National Academy of Sciences.

Clinical suspicion and indicated SARS-CoV-2 testing, including antibody testing, might be needed to recognize and treat adults with MIS-A. Further research is needed to understand the pathogenesis and long-term effects of this condition. Ultimately, the recognition of MIS-A reinforces the need for prevention efforts to limit spread of SARS-CoV-2. COVID-19

One of the most striking developments during the early months of the pandemic was the way state competition quickly took over. Always heralded as a textbook case of the need for global cooperation, pandemics turned out to be prime examples of global competition, albeit in an indirect and gamified version.

, we disentangle the relative contributions of three potential drivers of the observed distribution of clinical cases by age. We present a summary of the main findings, limitations and implications of