During severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, activated macrophages, dendritic cells, neutrophils, and natural killer cells are the first defense against infection. These immune effectors trap and ingest the virus, kill infected epithelial cells, or produce anti-viral cytokines. Evidence suggests that aging, obesity, and mental illness can lead to weakened innate immunity and, thus, are all associated with elevated infection and severe disease progression of coronavirus disease 2019 (COVID-19). Innate immune defense networks play a fundamental role in suppressing viral replication, infection establishment, and viral pathogenesis of SARS-CoV-2 and other respiratory viruses.
Source:
Journal reference:
Wang, Z., et al. (2023). Role of innate immunity in SARS-CoV-2 infection. Biosafety and Health. doi.org/10.1016/j.bsheal.2023.08.005.
Data on the viral rebound and safety of nirmatrelvir/ritonavir in lung transplant (LTx) recipients are limited. The study prospectively followed four LTx recipients. Clinical characteristics, viral RNA dynamic in throat swabs, and tacrolimus blood concentration were monitored regularly. All four LTx recipients, aged 3574 years, were not vaccinated against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). They got coronavirus disease 2019 (COVID-19) after more than one week of admission during the era of Omicron.
All cases received nirmatrelvir/ritonavir (NM/r) within two days of infection, and the relative viral RNA copies dropped quickly. Viral load rebound was observed in all four cases after discontinuation of the first five days of NM/r treatment. Three of them received another 5-days antiviral therapy with NM/r. The duration of positive viral PCR testing was 25-28 days. None of them progressed into severe or critical COVID-19. Tacrolimus was stopped 12 h before NM/r and held during the 5-day course of antiviral therapy. Blood concentration of tacrolimus were maintained at a baseline level during these five days.
Tacrolimus was reinitiated at its baseline daily dose 3-4 days after NM/r therapy. However, during the second round of antiviral therapy with NM/r, the concentration of tacrolimus fluctuated wildly. In conclusion, the 5-day course of NM/r treatment was not sufficient for LTx recipients and the viral rebound was common. More data are needed to clarify whether LTx recipients with SARS-CoV-2 viral rebound could benefit from additional treatment with NM/r.
Source:
Journal reference:
Li, H., et al. (2023). Viral rebound and safety of nirmatrelvir/ritonavir for lung-transplant recipients infected with SARS-CoV-2. Biosafety and Health. doi.org/10.1016/j.bsheal.2023.08.004.
[F]ederal funding mechanisms under Bayh-Dole [had] a robust impact on COVID-19 R&D, [and] small businesses were by far the top beneficiaries of Bayh-Doles impact on innovation during the pandemic.
Source: USPTO Report
On October 23, the U.S. Patent and Trademark Offices (USPTO) Office of the Chief Economist (OCE) published a report detailing patent application filing trends at the USPTO related to COVID-19 diagnostics technologies. The OCE found that filing activity surged following the arrival of the novel coronavirus in early 2020, with much of that increase driven by small companies and research institutions. The report found further evidence suggesting that federal funding had a significant impact on driving innovation into COVID-19 diagnostics at small R&D entities.
The fourth quarter of 2021 saw the publication of 167 U.S. patent applications covering COVID-19 diagnostics technologies, according to the OCEs report. This represents 20% of the U.S. patent applications found by the OCEs keyword search methodology, the peak quarter for publication of COVID-19 diagnostic patent applications since the pandemic began. While COVID-19 diagnostics only account for 1.4% of all patent application filings in medical diagnostics, COVID-19 diagnostics represented 30% of all COVID-19-related patenting activity.
Overall, the OCEs report identified 824 U.S. patent applications covering COVID-19 diagnostics and filed between December 2019 and April 2023. Companies accounted for 58% of all filings, and of the total filings from corporate R&D applicants, 64% were filed by companies qualifying as small entities. Universities, research institutions and hospitals accounted for 27% of all COVID-19 diagnostic filings, and 82% of patent applications in this group were also filed by small entities. Perhaps surprisingly, the OCEs report noted that unaffiliated individuals accounted for 13% of COVID-19 diagnostics patent applications identified in the survey.
The major contributions of small and micro entities to innovation in COVID-19 diagnostics also runs counter to larger trends, underscoring the importance of small businesses to research and development into COVID-19 diagnostics. The OCEs report points out that only 24% of all U.S. patents issued during 2022 went to companies qualifying for small or micro entity discounts. Conversely, small entities filed the most COVID-19 diagnostics patent applications among every applicant group except for government agencies.
While government agencies were only assigned 15 of the COVID-19 diagnostics filings identified by OCE, the report assessed government interest statements on patent applications showing that federal funding significantly contributed to developments in the sector. OCE found 88 patent applications, or 10.7% of all COVID-19 diagnostics filings, containing such a statement indicating federal funding contributions to the underlying invention. Small and micro entities accounted for 81% of the filings, indicating not only that federal funding mechanisms under Bayh-Dole were having a robust impact on COVID-19 R&D, but that small businesses were by far the top beneficiaries of Bayh-Doles impact on innovation during the pandemic.
Analyzing Cooperative Patent Classification (CPC) subclass codes, the OCEs report found that nearly half of all COVID-19 diagnostics filings were classified as analyzing materials by chemical and physical properties. Aside from measuring enzymes, nucleic acids and microorganisms, no other CPC subclass was seen on more than 20% of COVID-19 diagnostics filings. The OCEs report notes a higher than expected showing for health care informatics, a CPC subclass code appearing on 12.4% of COVID-19 diagnostics filings. The report indicates that this number reflects in part the impact of in-home diagnostics tests that became popular during the pandemic.
The OCEs report also reflects the fact that COVID-19 diagnostics inventions are not always separate and distinct from COVID-19 vaccines and therapeutics. For example, 8.6% of public filings for COVID-19 diagnostics fell into the CPC subclass for specific therapeutic activity of chemical compounds or medicinal preparations.
Analyzing international patent filing data available through the Derwent World Patent Index, the OCEs report found that the largest number of patent families related to COVID-19 diagnostics were filed at the China National Intellectual Property Administration (CNIPA). The CNIPA saw 2,643 patent families covering COVID-19 diagnostics during the pandemic, far more than the 784 such patent families filed at the second-place USPTO. Patent Cooperation Treaty (PCT) international filings accounted for 35% of the COVID-19 diagnostics filings tracked by the OCEs survey, with that number expected to rise due to the 30-month national phase period under PCT for selecting additional countries for national filings.
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Suffolk County reported the following information related to COVID-19 on October 23, 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 14, 2023
Daily Hospitalization Summary for Suffolk County From October 20, 2023
NOTE: HOSPITALS ARE NO LONGER REPORTING DATA TO NYSDOH ON WEEKENDS OR HOLIDAYS.
Fatalities occurring in Suffolk County (Data showing fatalities by place of residence is archived as of 10/12/23 and is no longer being updated)
COVID-19 Case Tracker October 20, 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.
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In a recent study published in JAMA Network Open, researchers examined the willingness to accept the coronavirus disease 2019 (COVID-19) vaccine and reasons for hesitancy in Hong Kong.
Study:COVID-19 Vaccination Willingness and Reasons for Vaccine Refusal. Image Credit:Anishka Rozhkova/Shutterstock.com
Hong Kong has been exemplary in its response to the COVID-19 pandemic until the highest daily mortality was recorded in the city. COVID-19 deaths per capita in Hong Kong are also far higher than in other high-income Asia-Pacific economies.
Hong Kongs poor vaccination coverage in older populations might account for the observed COVID-19 mortality.
Specifically, over 82% of older adults 80 were non-vaccinated or had only received one vaccine dose, compared to 6.7% in England, 9% in Singapore, and 2.9% in New Zealand. A possible explanation for vaccine refusal could be the sustained periods of zero-COVID, i.e., no local cases, in Hong Kong.
Moreover, Hong Kong witnessed a major social upheaval before COVID-19, as a proposed bill on extradition triggered extensive social unrest for over 50 years.
As such, people in Hong Kong were polarized and mistrustful of authorities. Thus, this scenario presents a unique opportunity to investigate how political views and mistrust influence vaccination.
The present study explored COVID-19 vaccination willingness and refusal in Hong Kong. Around 18,045 individuals aged 15 or older and 1,488 children aged 10-14 were enrolled in 2009-11 and followed up until 2014.
Some of these were randomly followed up for over a decade. During COVID-19, participants were interviewed between February 2020 and May 2022. Cooperation and response rates were estimated according to standards.
Vaccine refusal in Hong Kong was compared with Singapore. The Singaporean sample was drawn from a 2016 study on mental health. The studys primary outcomes were vaccination prevalence and vaccine refusal. Refusal was described as a lack of intention to receive the vaccine.
Willingness to accept the COVID-19 vaccine was defined as having received at least one dose, scheduled an appointment for vaccination, or intent to be vaccinated.
Political views were analyzed during the 2019-20 social unrest based on whether subjects were for (pro-establishment), against (non-establishment), or neutral. Trust in vaccine information sources (media platforms, the World Health Organization [WHO], health authorities, academics, and physicians) was assessed.
COVID-19 vaccine confidence was analyzed using statements on perceived efficacy, importance, and safety of vaccines.
Vaccine misconceptions about chronic diseases, older adults, and safety were also evaluated. The team calculated the weighted prevalence of COVID-19 vaccine willingness throughout the pandemic.
Poisson regression was used to investigate the associations between political views and trust in vaccine information sources, vaccine misconceptions, vaccine refusal, and vaccine confidence.
In total, over 28,000 interviews were conducted. The median cooperation and response rates were 63.4% and 75.7%, respectively. In 2020, nearly two-thirds of Hong Kong adults were willing to vaccinate when available.
Willingness increased to over 73%, coinciding with positive vaccine trial results. Nevertheless, willingness dropped to 55% after the Hong Kong government announced that people could not choose which vaccine to receive.
Moreover, willingness reached the lowest level (43.6%) by the start of the vaccination program and media reports of adverse vaccine effects. Individuals with non-establishment political views were more likely to refuse vaccination than those with pro-establishment views. Political participation during the 2014 Occupy Central protests was associated with COVID-19 vaccine refusal.
In Hong Kong, physicians and academics were the most trusted sources of vaccine information, followed by the WHO, government authorities, and social media.
In Singapore, academics and government authorities were the most trusted sources of vaccine information, followed by traditional media, WHO, and social media. Vaccine confidence was the highest before the rollout of COVID-19 vaccines and declined to the lowest levels at the start of vaccination programs.
There was an association between low vaccine confidence and vaccine refusal. Nearly 59% of Hong Kong adults had at least one misconception about vaccines, compared to 16.6% of Singaporean adults.
Further, over 56% of participants opposed vaccination of older adults (above 80 years). Social media, family/friends, and physicians were the top sources of misconceptions regarding priority groups.
Mistrust in health authorities, low vaccine confidence, and misconceptions mediated 72.5% of the association between political views and vaccine refusal. As such, the direct association between political views and vaccine refusal was no longer significant.
Political views, mistrust in health authorities, vaccine misconceptions, and low vaccine confidence jointly accounted for about 82% of vaccine refusal in adults aged 18-59 and 69.3% in older populations ( 60 years).
The study showed that political views may have short- and long-term associations with refusal to vaccinate against COVID-19.
This association was primarily mediated by modifiable factors, such as vaccine misconceptions, low vaccine confidence, and mistrust of health authorities.
Building trust in health authorities is vital to offset vaccine refusal. Moreover, governments should prioritize the credibility of health agencies, which would help them improve vaccination coverage.
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Research led by Weill Cornell Graduate School of Medical Sciences shows that certain species of gut fungi, notably Candida albicans, increase in numbers during serious COVID-19 infection and appear to contribute to the excessive and damaging inflammation seen in these patients.
High levels of immunoglobulin G (IgG) antibodies against fungi such as C. albicans and reprogramming of granulocyte myeloid progenitor cells were seen in patients with severe COVID-19 for as long as a year after the initial infection with SARS-CoV-2.
When model mice were colonized with samples of these fungi from patients with COVID-19, they also had an excessive immune reaction during SARS-CoV-2 infection showing high neutrophil levels and associated lung damage.
Studies have reported substantial involvement of the GI tract in the pathophysiology of several inflammatory diseases, including severe COVID-19, write Iliyan Iliev, an associate professor at Weill Cornell Medicine, and colleagues in Nature Immunology.
Patients with COVID-19 present with altered gut microbial composition and gut barrier dysfunction, which could increase the translocation of bacterial products and toxins into the circulation and exacerbate the inflammatory response systemically and at distal sites.
Much research has been and is being carried out on the gut microbiome and its effect on different diseases. Much of the attention has focused on gut bacteria, but fungal species also play an important role.
In this study, Iliev and colleagues analyzed stool samples from patients with serious COVID-19 to assess microbial composition and found abnormally high levels of C. albicans and other gastrointestinal-related fungal species (not common inhaled airborne species), as well as an associated high level of immune reactivity to these fungi.
Treatment with the drug tocilizumab, which targets the interleukin-6 (IL-6) pathway, reduced levels of C. albicans immune reactivity in both humans and mice.
IL-6 is a pleiotropic cytokine with a variety of roles in the immune system that has been linked to tissue damage and immune cell activation in severe COVID-19, explain the authors. Specifically, we found that systemic and lung neutrophilia prompted by intestinal C. albicans expansion was dependent on the IL-6 receptor.
Although it is not the only cause of inflammation in these patients, targeting any excess inflammation can be helpful for COVID-19 patients. Testing for antifungal antibodies could help tailor therapy and highlight who may benefit from antifungal or specific anti-inflammatory therapies such as those targeting the IL-6 pathway.
