One area within COVID-19 care is the ability simplify testing to get more people to know if they in fact have the virus and get the proper treatment they need. Yesterday, the FDA announced it cleared the way for marketing the first over-the-counter (OTC) antigen test for COVID-19. ACON Laboratories Flowflex COVID-19 Antigen Home Test, originally authorized for emergency use in 2021, is now the second home COVID-19 test to successfully complete a traditional FDA premarket review pathway, and the first indicated for use in children under 18. That FDA announcement followed the clearance of a molecular home test earlier this year.1
The Flowflex COVID-19 Antigen Home Test is a visually-read test cleared for OTC home use by symptomatic individuals within six days of symptom onset. It is cleared for individuals aged 14 years or older testing themselves, or adults testing individuals aged two years or older. In a study reviewed by the FDA, this test correctly identified 89.8% of positive and 99.3% of negative samples in individuals with signs and symptoms of upper respiratory infection.1
This marks the latest step forward in our efforts to help test developers provide Americans with continued options for safe and effective COVID tests that can be performed entirely at home, said Jeff Shuren, MD, JD, director of the FDAs Center for Devices and Radiological Health said in a statement . The FDA continues to proactively work with test developers that desire to market their products beyond emergency use authorities. This is part of the FDAs broader effort to advance the development and availability of at-home tests for a variety of medical conditions to expand patient access to testing.1
The FDA's clearance of the Flowflex COVID-19 Antigen Home Test marks a significant step in advancing accessible COVID-19 testing.
The rise of at-home COVID-19 testing raises concerns about accurately capturing the true incidence rates of the virus.
The use of the 510(k) premarket review pathway for the ACON Flowflex COVID-19 Antigen Home Test underscores the importance of regulatory processes in ensuring the safety and effectiveness of these at-home testing options.
As with antigen tests authorized for emergency use, this test is intended to be used at least twice over three days with at least 48 hours between tests. This means that a symptomatic individual with an initial negative test result should be re-tested once between 48 and 72 hours after the first test using an antigen test for COVID-19 or followed up with a molecular COVID-19 test.1
The FDA reviewed the ACON Flowflex COVID-19 Antigen Home Test through the 510(k) premarket review pathway. A 510(k) is a premarket submission made to the FDA to demonstrate that a new device is substantially equivalent to a legally marketed predicate device.1
Will Home Testing Miss True COVID-19 Statistics?
In earlier reporting by Contagion, there are concerns of true incidence rates of COVID-19 so aspects needed for public health reporting including appropriations of needed COVID-19 treatment resources can be achieved. A JAMAstudy sought to collect data on the frequency and results of at-home COVID-19 testing.
Investigators utilized the COVID-19 Citizen Science Study for their research. Launched in March 2020, the cohort study invited participants by word of mouth, social media, email, telephone, or patient portal. The study participants provided informed consent and baseline information, self-reporting race and ethnicity to help the investigators analyze demographic differences in unreported rest frequency and test positivity.
Each week, participants reported their recent COVID-19 testing and test results. In March 2022, the investigators asked participants to distinguish whether they tested with a Fully at-home test kit, with my own sample collection and reading of my own results or whether a health care provider collected my sample and sent it to a clinical laboratory.
To compare the self-testing with nationally reported COVID-19 testing, the investigators downloaded data from the Johns Hopkins Coronavirus Resource Center on August 15, 2022. They plotted averages of total daily tests and test positivity, fitting mixed logistic models with a random intercept for each participant. The participants testing data were controlled for time of test and demographic characteristics.
A total of 102,591 US participants enrolled in the study, 18% (n = 18642) of whom reported completing at least 1 COVID-19 diagnostic test from March 16-August 15, 2022. Of the 18,546 participants who submitted demographic information, the majority were female (67.8%; n = 12568) and non-Hispanic White (82.1%; n = 15231). The average age was 55 years.
During this study period, the proportion of COVID-19 tests conducted at home increased from 60% to more than 80%. From March until June 2022, the percentage of positive at-home tests was similar to that of officially reported tests. After June, at-home tests began to yield lower positivity rates than official tests.
According to the investigators, younger, female, non-Hispanic White individuals with higher social status were more likely than other participants to test for COVID-19 at home. However, positive at-home test results were most frequent among men and young adults.
Reference
FDA Clears First COVID-19 Home Antigen Test. FDA Press release. November 9, 2023. https://content.govdelivery.com/accounts/USFDA/bulletins/37a4680
Experts have been working tirelessly to create and improve coronavirus vaccines year-over-year and this years shot is potent, Petri said. His advice is to get vaccinated for the coronavirus and the flu ahead of the holiday season.
If you get vaccinated right now, thats going to protect you at the greatest levels for about four months, he said.
Here are his answers to UVA Todays other questions about staying healthy as large gatherings with family and friends draw near.
Q. Do you have any general guidelines for people to follow as they prepare for the holidays?
A. In addition to getting vaccinated for coronavirus and the flu, be aware that there are very effective medications for COVID, the No. 1 being Paxlovid.
There are some commonsense things you can do to improve ventilation that the Centers for Disease Control and Prevention recommend. If we have nice weather, have that family gathering out on your porch or out in your yard. Or have the windows open. If you have a heat pump, if you have it on the on switch and not the auto switch, the fan runs all the time so youre going to be exchanging air faster out of your house.
Q. What is the current guidance for people who test positive for the coronavirus?
A. Number one is stay home for the first five days and then wear a mask outside for an additional five days, so youre not going to spread it inadvertently to vulnerable parts of the population.
Q. If you have the flu, what should you do?
A. If you have the flu, of course you cant test yourself at home. The reason to get diagnosed with the flu is we have medications that are very effective for treating flu. It makes sense to go to your primary care provider within the first day, maximum two days of illness, to be tested.
Officials authorised using human Covid treatments on cats in August in a desperate attempt to curb the outbreak.
The cat that tested positive in the UK is understood to have developed symptoms in Britain and has been sent for tests and treatment following isolation by its owner.
In the study, published before it has been peer-reviewed on bioRxiv, the scientists warn there is significant risk of this outbreak spreading further.
This is exemplified by the recent confirmation of a first UK-imported case with further investigations into other cases ongoing, they add.
The disease caused by the coronavirus, feline infection peritonitis (FIP), is common around the world, including in the UK.
Before the evolution of the new strain, however, the coronavirus lay dormant in cats and in most cases never caused an issue.
Around one in ten of the cats with the benign infection would go on to develop FIP when the virus mutated inside of them. Symptoms include lethargy, fever, a swollen abdomen, and inflammation. It is almost always fatal unless treated.
The new study found the recombination of canine and feline coronaviruses which includes the cat virus gaining the dog pathogens spike protein has led to the virus becoming more infectious and changing how it causes disease.
Feline infectious peritonitis (FIP) is not usually spread directly from cat to cat, study author Dr Christine Tait-Burkard told The Telegraph.
This new virus appears to spread readily and no longer relies on changes or mutations in the host.
A veterinary drug called GS-441524 can treat FIP effectively if given early but it can be expensive. Human Covid drugs, such as remdesivir and molnupiravir, are also effective, but it is illegal for vets to use these human drugs to treat a cat with FIP in the UK.
Early data shows there is no evidence the new virus can infect dogs or humans. Experts say there is no reason for worried cat owners to keep their pets inside and away from other animals just yet.
Importing cats from Cyprus to the UK is a frequent and ongoing process, the scientists say, and the Edinburgh team advises against importing or adopting a cat from Cyprus while it works on more mitigations with the Animal and Plant Health Agency (APHA).
Our evidence suggests the virus may spread directly from cat to cat by faecal contamination, just like the cat and dog coronaviruses it originated from, Dr Tait-Burkard said.
For example, if a cat uses the same litter tray, or outdoor area, as an infected cat and then licks its paws.
There is no evidence of extensive spread of FCoV-23 in the UK. Therefore, there is no immediate requirement to keep cats indoors.
If a cat shows symptoms of feline infectious peritonitis (FIP), has been diagnosed by your vet, and has been diagnosed with FCoV-23 or has links to Cyprus or recent contact with imported cats, then it should be kept strictly indoors until it has been proven that the virus has been eliminated (if the cat is undergoing treatment).
Rinsing your throat or nose with a salt water (saline) solution may help protect against severe COVID-19 infection, based on a new study presented this week at the annual meeting of the American College of Allergy, Asthma and Immunology (ACAAI) in Anaheim, California.
The research found that the risk of hospitalization for people with the virus who regularly gargled with salt water or used it as a nasal rinse (as with a neti pot) was significantly lower than for individuals in a reference group who did not follow a saline regimen.
The rate of hospitalization was much more in our reference population who did not use a salt rinse, says study coauthor Jimmy Espinoza, MD, in the department of obstetrics, gynecology, and reproductive sciences at UTHealths McGovern Medical School in Houston. The findings indicate a possible association between a saline regimen and improved respiratory symptoms from coronavirus infection. Future studies are needed to see if our results can be replicated.
Previous analysis has suggested that gargling or flushing nasal passages with salt water may promote a shedding of the virus and infected cells or possibly cause some inactivation of the infection.
Dr. Espinoza emphasizes, however, that a saline rinse is no substitute for vaccination or antiviral treatments, which are proven to be very effective.
Vaccination is so important because it definitely lowers the risk of hospitalization, and we dont pretend that this saline rinse is better than conventional antiviral medications. We think that this intervention might be helpful in improving symptoms in some people.
Espinoza, who is fully vaccinated, believes gargling with salt water helped alleviate some of his symptoms when he became infected with the coronavirus. This is just an anecdote, but I felt that gargling helped relieve my congestion and ability to breathe, which in turn improved my sleep.
For the research, 58 individuals between ages 18 and 65 who tested positive for COVID-19 between 2020 and 2022 were selected to undergo either a low- or a high-dose saline regimen for five minutes, four times a day, over the course of 14 days.
The low dose was about 1/3 teaspoon of salt dissolved in 8 ounces of warm water, while the high dose measured 1 teaspoon of salt.
The scientists excluded anyone with chronic high blood pressure because they didnt want to expose them to any additional salt absorption, which could further raise their blood pressure.
They then compared hospitalization rates of those in the treatment group with outcomes of about 9,400 people with positive SARS-CoV-2 infection who did not follow a salt rinse routine.
The hospitalization rates were 18.5 percent in the low-dose saline group and 21.4 percent in the high-dose saline group. Those numbers were significantly lower compared with the reference population, whose hospitalizations rate was nearly 60 percent.
That hospitalization rate here is very high compared with other available data. The global research firm Gallup has previously calculated the hospitalization rate for the vaccinated population to be 0.01 percent (or 1 in 10,914) and 0.89 percent (or 1 case in 112 people) for unvaccinated adults.
Espinoza noted that data was insufficient to explain why the hospital rate was so high in this study, but speculated that chronic illness and lack of vaccination may have been contributing factors that predisposed many participants to more serious sickness.
He added that when it came to vaccination, the rate was 10 percent in the control group versus about 11 percent in the low-salt group and nearly 18 percent in the high-salt group.
Researchers observed that duration of symptoms was similar between the two salt groups, at up to six to seven days. Details on symptom duration were unavailable for the reference group, so no comparison could be made for that factor.
Previous studies, however, seem to show that gargling with salt water or other solutions has some relative impact on reducing duration of symptoms and viral load, says Niraj Patel, MD, a pediatric allergy and immunology specialist with Duke Health in Durham, North Carolina.
Dr. Patel, who was not involved in the study but is a member of the American College of Allergy, Asthma, and Immunology, also emphasized that gargling with salt water is no substitute for vaccination.
Vaccination is still the No. 1 way to prevent hospitalizations and severe infection, he says.
As to why salt water may have this beneficial effect, the answer is still uncertain. Patel would like to see further research that explores how salt water may be inhibiting the replication of the virus.
He also pointed out that this study was limited in that it didnt detail much about participant health factors such as obesity, COPD, and other chronic illnesses that could have influenced results.
I advise talking to your doctor before instituting regimens like these, particularly if you have chronic diseases, says Patel.
Suffolk County reported the following information related to COVID-19 on November 7, 2023
According to CDC, hospital admission rates and the percentage of COVID-19 deaths among all deaths are now the primary surveillance metrics.
COVID-19 Hospitalizations for the week ending October 28, 2023
Daily Hospitalization Summary for Suffolk County From November 3, 2023
NOTE: HOSPITALS ARE NO LONGER REPORTING DATA TO NYSDOH ON WEEKENDS OR HOLIDAYS.
Fatalities 11/6/23
COVID-19 Case Tracker November 4, 2023
Note: As of May 11, 2023, COVID-19 Community Levels (CCLs) and COVID-19 Community Transmission Levels are no longer calculatable, according to the Centers for Disease Control and Prevention.
* As of 4/4/22, HHS no longer requires entities conducting COVID testing to report negative or indeterminate antigen test results. This may impact the number and interpretation of total test results reported to the state and also impacts calculation of test percent positivity. Because of this, as of 4/5/22, test percent positivity is calculated using PCR tests only. Reporting of total new daily cases (positive results) and cases per 100k will continue to include PCR and antigen tests.
COVID-19 Vaccination Information
Last updated 5/12/23
Vaccination Clinics
As of September 12, 2023, the Suffolk County Department of Health Services is not authorized to offer COVID-19 vaccines to ALL Suffolk County residents.
The department will offer the updated vaccine to only uninsured and underinsured patients through New York State's Vaccines for Children program and Vaccines for Adults program, also known as the Bridge Access Program.
Those with insurance that covers the COVID-19 vaccine are encouraged to receive their vaccines at their local pharmacies, health care providers offices, or local federally qualified health centers.
The department has ordered the updated COVID-19 vaccine and will announce when the vaccine becomes available.
FOR HEALTHCARE PROVIDERS
New York State Links
CDC COVID Data Tracker Rates of laboratory-confirmed COVID-19 hospitalizations by vaccination status
For additional information or explanation of data, click on the links provided in throughout this page.
This dashboard shows total reported doses of the updated COVID-19 vaccine, approved for use by the CDC as of September 12, 2023. The New York State Department of Health continues to urge eligible New Yorkers especially older adults at increased risk of severe illness to get their updated COVID vaccination as soon as possible for the best protection. Find a vaccine appointmenthere.
ST. PETERSBURG, Fla. With the holiday season approaching and friends and family gathering to celebrate, your risk of catching COVID or the flu goes way up. Epidemiologists warn that both viruses are deadly, especially for older adults.
According to the Centers for Disease Control and Prevention, about 80% of seasonal flu-related deaths occur in older adults, and up to 70% of flu hospitalizations happen among adults 65 years and older.
Millie Reynolds knows about the dangers of catching COVID firsthand.
I caught COVID before they even knew what it was, and it was new," said Reynolds. "And there was no vaccine, no nothing for it.
Reynolds said she went in for a typical checkup in December 2020, but when she left, her doctor called and said she needed to go to a hospital immediately because she had contracted COVID.
I remember being sat in a wheelchair, rolled down the walkway into the hospital and up to the desk, and I dont remember anything from the middle of December to the middle of March, said Reynolds.
WFTS
Reynolds declining health also impacted her husband, Richard Breedlove.
It was upsetting, said Breedlove. Because I love her a lot, and we get along really well. So, it was one of them trying times of my life that I had to go through.
About 90% of the deaths during this year, alone, are among those 65 and over, said Kathleen Cameron with the National Council on Aging. Cameronsaid older adults are more vulnerable because many have chronic health conditions and deteriorated immune systems.
The good news is that the cost associated with the vaccines have been eliminated through a law that was passed last year, said Cameron. That law shes referring to is President Bidens Inflation Reduction Act.
The National Council on Aging is helping 150 senior centers across the United States provide updated COVID and flu vaccines. The idea is to make the potentially lifesaving vaccines more accessible to diverse and hard-to-reach populations of older adults.
We have seen an uptick in Covid here, said Sally Marvin with the Sunshine Center about the older adults who attend there.
The Sunshine Center in St. Petersburg is one of the senior centers benefitting from some of that funding from the National Council on Aging.
Were partnering with Walgreens in order to help us get the shots out there for our people. So, well be having them here to administer some of the shots, said Marvin.
As for Reynolds, she just wants to live her life to the fullest with her friends and husband, which is why shes doing everything she can to protect her health.
I have gotten every booster that needed to be done, said Reynolds.
And this message to her peers on why they should get vaccinated against COVID and the flu. And not only themselves, but for other people because if they get it, they can give it to anybody else, said Reynolds.
Participants
Hospitalized patients with COVID-19 were recruited between May 2020 and March 2022 at the University Hospital Duesseldorf, Germany, to participate in the PROGNOSE study. Inclusion criterion was an ongoing infection with SARS-CoV-2, confirmed by real-time reverse-transcription polymerase chain reaction. Here, we only focus on patients with symptoms of COVID-19. Exclusion criteria were: (1) pregnancy, (2) previous or ongoing neurological conditions with possible influence on the study readouts, and (3) age<18years.
Patients with neurological preconditions that only affected some assessments (e.g., dementia) were excluded only for confounded investigations (e.g., neuropsychology). Study participation did not influence the clinical treatment, which was performed according to the best medical care available at the time of examination.
The study was approved by the ethical committee of the medical faculty of the Heinrich-Heine-University Dsseldorf (Study-Number 2020-979) and carried out in accordance with the declaration of Helsinki. Informed written consent was provided prior to participation by the patient or, in case of inability to consent, by relatives and post-hoc by the patient.
Since there is no COVID-19 specific score for classification of neurological symptoms and disability yet, the following established disability scores were adjusted to the COVID-19 pathology and determined by neurological examination: (1) Expanded Disability Status Scale (EDSS) based on the following Functional Systems (FS): brainstem, pyramidal, cerebral, cerebellar, sensory14, (2) Modified Rankin Scale15, (3) INCAT disability score16, (4) Barthel Index17. All scores are described in detail in the Supplementary Methods. The clinical status of the patient at the time of examination was assessed by the WHO clinical progression scale (WHO score), documenting disease severity from 0 (uninfected) to 10 (dead)18.
Blood samples were collected as part of the clinical routine during or shortly after admission, and the following laboratory markers were analyzed: C-reactive protein, urea, lymphocytes, procalcitonin, troponin, ferritin, lactate dehydrogenase, and D-dimers. At admission, the level of consciousness was assessed by the Glasgow Coma Scale19.
The neuropsychological assessment consisted of the Montreal Cognitive Assessment (MoCA, version 7)20 as a screening battery for mild cognitive impairment and the Symbol Digit Modalities Test (SDMT)21 as a measure of information processing speed (IPS). Delirium was assessed using the 4 As Test22 and Confusion Assessment Method for use in intensive care unit (ICU) patients23. MoCA and SDMT scores were transformed into demographically adjusted z-scores (see Supplementary Methods)24,25. In case of language barriers, neuropsychological assessment was limited to the SDMT or cancelled.
The EA included NCS of the right tibial, sural and ulnar nerves, BR of the bilateral ocular orbicular muscle, SSR, and motor and somatosensory evoked potentials (MEP/SSEP) to/from all extremities. If the right side could not be assessed in the NCS (e.g., due to an intravenous line) or patients specifically reported symptoms on the left side requiring clinical examination, the left side was measured instead. MEP were recorded from bilateral tibialis anterior and 1st dorsal interosseus muscles. Supramaximal stimuli of bilateral medial and tibial nerves with at least 200 averages were used for SSEP, recording responses at the poplitea/Erbs point, C5/T12 and Cp/Cz, respectively.
All measurements were carried out with a Nihon Kohden Neuropack X1 (Nihon Kohden Corporation, Tokyo, Japan) and AgAgCl surface electrodes (2820mm [MEP, SSR, and NCS]/ 2015mm [BR], Ambu, Ballerup, Denmark) and subdermal needle electrodes (SSEP/120.4mm, Ambu, Ballerup, Denmark) were used for recordings. MEP were evoked by single pulse transcranial magnetic stimulation via a standard circular coil (90mm outer diameter, The Magstim Company Ltd., Whitland, UK) connected to a Magstim 200 (The Magstim Company Ltd., Whitland, UK).
All EA were evaluated based on the clinical norms of the University Hospital Dsseldorf (Supplementary Tables S1S5) and affections were classified into PNS, CNS, and ANS (multiple selection possible).
PNS affection was defined as any abnormality in the NCS (distal motor latency [DML], F-wave latency, compound muscle action potential [CMAP], sensory nerve action potential [SNAP], motor/sensory conduction velocity [mCV/sCV]) or the following abnormalities in the BR: (1) R1, iR2 and cR2 exclusively delayed on one side, or (2) R1 and iR2 delayed on one side and cR2 delayed on the other side. Axonal pathology was defined as a reduction in CMAP/SNAP amplitude, whereas demyelinating pathology was defined as a reduction in mCV/sCV or prolongation of DML or F-wave latency.
CNS affection was defined as (1) reduced N20 and/or P40 in the SSEP and normal peripheral response (defined as normal N10 in the SSEP, if available, or as normal latency measured in the NCS), (2) increased central motor conduction time (CMCT) in the MEP, (3) increased cortical latency in the MEP and normal peripheral response (measured in the NCS), (4) delayed R1 exclusively on one side in the BR, (5) delayed R2 exclusively on one side in the BR, 6) delayed R2 on both sides in the BR.
ANS affection was defined as pathological latencies in the SSR. Please refer to Supplementary Tables S1S5 for applied cut-offs for each assessment.
Since the primary goal of the study was to investigate the unknown prevalence of (sub)clinical neurological affections, sample size was based on the number of patients willing to participate rather than statistical power calculation.
Clinical and demographic differences between surviving and deceased patients were assessed by Fishers exact test for categorical data and MannWhitney-U-test for continuous variables with non-normal distribution. P-values<0.05 were considered significant. Prevalence rates were calculated using crosstabulations (1) considering all patients, including those with missing data, and (2) including only patients who underwent the respective assessments. Exploratively, statistical analyses were repeated excluding patients with diabetes mellitus (DM) as the most prevalent potential confounding factor.
The relationship between abnormalities in the EA and death was assessed by Firth logistic regression models. Firth logistic regression models were also calculated for all predictive parameters for the patients outcome of the 4C Deterioration Model and 4C Mortality Score26,27, as well as for the WHO score18, sedation, and the Modified Rankin Scale15. Due to the exploratory nature of the study, we did not correct for multiple testing.
To avoid confounding influences of sedation, regression analyses were repeated excluding sedated patients. Further, age and sex were included as potentially confounding factors. All analyses were repeated using the raw data of the EA as independent factor.
Probabilities of mortality were estimated using KaplanMeier analysis and Cox proportional hazard models were used to compare the probability of death between patients with and without pathological findings in the EA. Again, analyses were conducted separately for the whole sample and, subsequently, only for non-sedated patients.
All analyses were conducted using R Studio (version 2021.09.1+372), except for KaplanMeier analysis and Cox proportional hazard models which were conducted using IBM SPSS Statistics (version 26).
TOPEKA The Kansas Department of Commerce today announced 15 Kansas communities would receive their share of $2 million from the Community Development Block Grant-COVID Resiliency (CDBG-CVR) competitive grant program. This program was funded via the Coronavirus Aid, Relief, and Economic Security (CARES) Act.
CDBG-CVR was designed to empower Kansas businesses to enhance their resiliency in the face of future community illnesses and public health emergencies.
These grants will be a game-changer for many Kansas businesses, Lieutenant Governor and Secretary of Commerce David Toland said. This investment in pandemic resiliency not only will help retain jobs but help our state attract new businesses, further boosting our emerging economy.
The grants support a wide range of projects, including technology and infrastructure upgrades, professional development, and other initiatives aimed at preventing future closures due to public health crises. The awardee communities will distribute their funds to local businesses previously identified in their proposals.
The CDBG-CVR competitive grant program focused on the following key areas:
The 15 awardees represent a diverse range of businesses across Kansas, each with projects that align with the programs objectives.
Fourteen communities each will receive $141,642 for distribution. They include the cities of Baldwin City, Holton, Horton, McPherson, Smith Center and WaKeeney, as well as Cloud, Graham, Lincoln, Mitchell, Rawlins, Rooks, Smith and Sumner counties. The city of Columbus was awarded $17,000.
The grants will help businesses survive challenging times and position them for long-term success.
CDBG-CVR is the fourth and final round of the Kansas CDBG-CV program, which has had a profound impact, providing essential assistance to 1,356 small businesses across the state. Since 2020, the program has disbursed more than $16.1 million in grant funds, demonstrating Commerces commitment to supporting the resilience of local enterprises. These investments were key to small business survival during and after the COVID-19 pandemic.
The Kansas Department of Commerce works tirelessly to advance the economic well-being of the state by promoting job creation, workforce development and business growth, Community Development Director Kayla Savage said. Through grants like CDBG-CVR, the department seeks to create a thriving and prosperous Kansas for all.
The Kansas Department of Commerce extends its congratulations to the awardees and commends their dedication to business resiliency.
The MRC Centre for Global Infectious Disease Analysis at Imperial College London has been redesignated as WHO's Collaborating Centre (CC) for Infectious Disease Modelling.
The Centre's mission is to serve as an international resource and centre of excellence for research and training in epidemiological analysis and modelling of infectious diseases. Building on decades of collaboration with WHO, it undertakes applied collaborative work at global, regional and state levels to support response operations and policy planning against infectious disease threats. The CC will operate under refreshed terms of reference to meet the latest global challenges, following its last objectives set in April 2019.
Over the term of its status as a CC, the Centre will provide rapid analysis of urgent infectious disease problems, notably outbreaks and events of international concern, from parasitic diseases to emerging viral infections, and from chronic infections such as tuberculosis and hepatitis to acute severe respiratory and viral haemorrhagic diseases such as coronavirus disease (COVID-19) and Ebola virus disease.
As well as offering technical assistance to WHO infectious disease programmes, it will contribute to WHO information products, coordinate expertise and build capacity in mathematical modelling. The Centre's research among WHO Member States within the European Region has helped to define appropriate health and immunization standards and meet global emerging threats head-on to reduce or negate risks around the world.
"By collaborating with such specialized institutions like the MRC Centre for Global Infectious Disease Analysis, we strive to strengthen surveillance and outbreak investigations," explained Dr Nahoko Shindo, Unit Head, Emergency Preparedness, WHO.
"Without fit-for-purpose analysis, surveillance data are just numbers. Modelling results help us to understand the transmission dynamics and impact as well as to develop containment or mitigation strategies in the near term in evolving outbreak situations and over the longer term for eradication planning."
The Centre houses the Vaccine Impact Modelling Consortium (VIMC) and produces estimates of vaccine impact across 12 pathogens in 112 countries. These estimates formed a substantial input to the Immunisation Agenda 2030 impact estimates, specifically Impact Goal indicator 1.1. VIMC collaborates closely with the Immunisation Analysis and Insights Unit within WHO, which serves as a data hub and analytics engine for immunization data and analytics.
"COVID-19 was not the first pandemic. We worked closely prior to and during the 2009 [H1N1] influenza pandemic with Imperial College London. Mathematical/statistical analysis and modelling are crucial and incredibly powerful tools to understand the unfolding situation and for testing the impacts of different interventions -- for example, vaccination, specific antimicrobial agents and public health measures by simulation," said Dr Shindo.
"As a long-standing WHO CC, we have collaborated with colleagues across the organization to support the generation of scientific evidence to guide policy development," added Professor Azra Ghani, Director of the MRC Centre for Global Infectious Disease Analysis, Co-Director of the WHO CC and a member of the WHO Malaria Policy Advisory Group.
"Researchers across our WHO CC -- ranging from PhD students to full professors -- have found this engagement both stimulating and fruitful in ensuring that the research we undertake has a meaningful impact on health interventions worldwide."
Based in the WHO European Region, the Centre's impact extends far beyond Europe. During multiple Ebola epidemics in the Democratic Republic of Congo (DRC) in 2018, 2020 and 2021 and in Guinea in 2021, members of the WHO CC provided real-time analytic support both remotely and through researchers deployed to WHO headquarters and in the field.
The Centre rapidly characterised transmissibility and severity levels and projected the potential scale of each epidemic from an early stage, giving regular updates enabling quantitative monitoring and evaluation of progress made in epidemic control. Its work was crucial for funding mobilization and logistical planning. It contributed to evidence considered by WHO in declaring the 2018--19 epidemic in DRC a Public Health Emergency of International Concern (PHEIC).
The team at the Centre also served to help combat and control malaria through reducing vector risks and by supporting policy development and the uptake of novel vector-control tools to reduce malaria transmission. The work ranged from comparing the effectiveness of novel types of insecticide-treated net, to supporting national malaria programmes to help optimise their allocation of resources and adopt new tools.
In 2022, the Centre collaborated with WHO Europe to model the mpox (formerly monkey pox) global epidemic, working closely with four country-level teams to disentangle the drivers of the rise and fall in cases, estimate the potential for future outbreaks and quantify how successfully outbreaks can be mitigated through vaccinations. The modelling report produced was submitted to the International Health Regulations Emergency Committee and was considered part of the evidence base in the decision to end the mpox PHEIC.
"Without a doubt, the entire world is a safer place from epidemic and pandemic-prone infections due directly to the outcome of this collaboration between the MRC and WHO. We are proud to foster these types of relationships that can enable informed policy-making, and we are delighted that this relationship will continue to enable the Centre to continue in these critical efforts," said Dr Richard Pebody, Programme Manager for Infectious Hazards, WHO Europe.
