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Thursday, March 18, 2021

Miami Beach adds extra police ‘under siege’ by spring breakers: mayor

 Miami Beach police are cracking down rowdy spring breakers after days of out-of-control parties in the seaside city that have included violence and drunken debauchery.

Mayor Dan Gelber said tens of thousands of visitors have overrun the Miami Beach Entertainment District — and the city will now step up police enforcement to curtail the behavior, according to WTVJ.

The city is reportedly bringing in officers from nearby Miami to help manage the situation.

“If you have 50 or a 100,000 people coming there and just half of 1 percent are rowdy or drunk or high to the point where they need to be controlled, it becomes a situation which is truly chaotic and unmanageable,” Gelber reportedly said in a virtual city commission meeting Wednesday. 

About 150 partiers were arrested over the weekend, and a man was shot and killed on Monday, according to the South Florida NBC affiliate.

“It has felt at times like this city is under a level of siege simply from the volume of people that are coming,” Gelber said, according to the station.

The mayor ripped the reckless revelers, telling USA Today they “seem to have forgotten that there’s a pandemic.”

Gelber claimed the city is flooded with visitors ignoring safety protocols, and worried that the maskless mayhem could lead to a spike in infections, just after they plateaued.

“We’ve got too many people, too many coming with a desire to go wild, and we have the virus … It really poses a multifaceted peril for us,” he told the paper.

But not everyone wants the party to stop.

Prana Cafe chef and manager Sergio Infantes told WTVJ that the spring breakers have provided a much-needed boost to his pandemic-stunted soul food restaurant.

“So now we are really busy in this season, so all the business, we are hiring more people, because we need more workers for the business,” Infantes said. 

Tourists also told the station they felt safe on South Beach.

“I do personally because I travel a lot, I mean it’s a different atmosphere but I don’t think it’s unsafe,” Rylan Brickhouse, a spring break visitor from Texas, reportedly said.

Some natives of the party town had a different opinion.

Spring breakers walking among the streets of Miami Beach on Wednesday evening which has prompted extra police presence around the area.
“It has felt at times like this city is under a level of siege simply from the volume of people that are coming,” Mayor Dan Gelber told local media.
AFP via Getty Images

“Please immediately block off the residential neighborhoods to protect from what’s happening in the surrounding areas,” Robin Andras reportedly said during the public comment period of the virtual meeting. 

The South Florida revelry is not just confined to South Beach.

One Fort Lauderdale hotspot said last week it would not serve out-of-state college students during spring break after being cited three times in one day in November for flouting pandemic safety measures.

Last weekend, the US saw the highest amount of air travelers since the pandemic began as college students descended on sandy beaches across the South for the celebration.

https://nypost.com/2021/03/17/miami-beach-adding-extra-police-amid-influx-of-spring-breakers/

PHILIPS NV Hiked From Neutral to Buy by JP Morgan

JP Morgan raises rating from Neutral to Buy. The target price has been raised to EUR 50.70 from EUR 44.90.

https://www.marketscreener.com/quote/stock/KONINKLIJKE-PHILIPS-N-V-6289/news/PHILIPS-NV-nbsp-From-Neutral-to-Buy-by-JP-Morgan-32723807/

Acute hepatitis caused by asymptomatic COVID-19 infection

 Marco Bongiovannia, and Tiziano Zagob

doi: 10.1016/j.jinf.2020.09.001

PDF: https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470895/pdf/main.pdf

Dear Editor,

Coronavirus disease (COVID-19) is a novel enveloped RNA beta-coronavirus that emerged from Wuhan, China, in December 2019 and rapidly spread across Europe, USA and South America, becoming a worldwide pandemic affecting more than 25 million people. The most common clinical presentation included mainly respiratory symptoms such as shortness of breath, dyspnea, fever and cough, associated with radiological findings consistent with interstitial pneumonia. At the moment, there are no antiviral drugs of proven efficacy against COVID-19 and supportive therapy is the only method for the management of symptomatic subjects, many of whom require mechanical ventilation and other intensive care services. Acute liver injury at admission is a quite common finding in subjects affected by COVID-19 pneumonia; although the elevation of aminotransferases is usually mild, it seems associated with disease severity. In particular, it has been demonstrated that SARS-CoV-2 infection in the liver directly contributes to hepatic impairment in patients with COVID-19 pneumonia. A meta-analysis recently published into your Journal by Kunutsor and Laukkanen assessed that liver enzyme abnormalities, acute hepatic injuries and hypoproteinaemia are frequent hepatic complication among patients hospitalized for COVID-19 pneumonia. Further, patients with pre-existing hepatic diseases appear to have worse outcome of COVID-19 pneumonia. Nevertheless, no data are available on liver enzyme abnormalities in asymptomatic subjects with COVID-19 infection. We report here the case of a young woman diagnosed with COVID-19 infection in absence of respiratory symptoms, presenting at the admission with significant elevation of liver function tests compatible with acute hepatitis.

A 30-years old woman was admitted at the emergency department for mild fever, anosmia and dysgeusia from 10 days. She denied cough, sore throat, shortness of breath, diarrhea, nausea, vomiting, or abdominal pain. Her parents and an uncle were diagnosed positive for COVID-19 infection in the previous three days. She did not have any chronic disease and she was not taking any drug at the time of admission. A nasopharyngeal swab was promptly done and RT-PCR resulted positive for COVID-19 infection. Chest X-ray did not show findings compatible with interstitial pneumonia; arterial oxygen saturation was 99% on room air. On presentation, her temperature was 36 °C. There were no cutaneous manifestations, her lung examination was normal, and there was no jaundice, right upper quadrant tenderness, hepatomegaly, or splenomegaly. Laboratory results were as follows: AST 1531 IU/L (normal value < 35), ALT 893 IU/L (normal < 36), serum bilirubin 1.02 mg/dL (normal < 1.2), alkaline phosphatase 106 IU/L (normal 33–98), INR 1, gammaglutamiltransferase 1276 IU/L (normal < 40), white blood cells 4070 cells/mm3 (normal 4000–10,000), platelets 152,000 cells/mm3 (normal 150,000–450,000). She denied recent intake of reliever drugs as paracetamol or antibiotics in the previous weeks. The abdominal ultrasound did not show significant abnormalities of liver, gallbladder, kidneys, spleen, pancreas and abdominal vessels. The following serological tests were performed and all were negative: hepatitis A, B, C, E, Cytomegalovirus, Epstein-Barr and respiratory viral panel. Blood cultures for bacteria and fungi, and the screening for autoimmune diseases were also negative. She was then treated with infusion of saline solution 0.9% (1500 cc/daily) with progressive reduction of liver abnormalities. In particular, after 3 days laboratory results were: AST 111 IU/L, ALT 89 IU/L, alkaline phosphatase 97 IU/L and gammaglutamiltransferase 246 IU/L. No respiratory symptom occurred during follow-up and the patient was discharged after 5 days of hospitalization, in good clinical condition and asymptomatic from both hepatic and respiratory point of view.

At our knowledge, this is the first report of COVID-19 infection presenting as acute hepatitis in absence of respiratory symptoms. Our patient had very mild symptoms related to COVID-19 infection and was only tested due to her familiar cluster. Other possible causes of liver abnormalities were ruled out, therefore it seems likely that acute hepatitis was directly caused by COVID-19. Recently, Wander et al. described a non-icteric, acute hepatitis in an HIV-infected woman, but their patient developed overt respiratory symptoms in the hours immediately following diagnosis and also had other possible causes of liver tests abnormalities such as the use of concomitant drugs and a fair number of co-morbidities.

Mild-to moderate liver test abnormalities are becoming a frequent finding in subjects admitted to hospital for COVID-19 infection. Patients with known risk factors for COVID-19 infection presenting with acute hepatitis should be rapidly isolated and tested. In our patient, the abnormalities in liver function tests quickly normalized, in absence of specific therapy. The real meaning of liver tests transient alterations has yet to be determined in COVID-19 infected subjects. With the future evolution of the pandemic, prospective observations could provide further information on this specific clinical issue.

https://www.ncbi.nlm.nih.gov/pmc/articles/PMC7470895/

Wednesday, March 17, 2021

Biden administration eyes 'sending some AstraZeneca vaccine to Canada, Mexico'

 The Biden administration is considering sending some AstraZeneca Covid-19 vaccine doses stockpiled and waiting for official usage approval in the US over the border to Mexico and Canada, according to a senior administration official.

Intense discussions are taking place following a request for doses from both countries and, for Mexico at least, an agreement could be announced as soon as Friday, according to the Mexican Foreign Minister.
"I'd say we've made good progress, but the details, figures, provisions, won't be known until Friday," Mexican Foreign Minister Marcelo Ebrard told reporters on Tuesday morning, according to Reuters. "We requested as many (AstraZeneca doses) as possible."
    The Biden administration has committed to having enough vaccines for all Americans before sharing doses, and if this agreement comes together it would be the first time the US has shared vaccines directly with another country. It would also likely give a major boost to vaccination efforts in Canada and Mexico who are struggling with their vaccine roll-out in comparison to the US.
    On Wednesday, White House press secretary Jen Psaki confirmed that requests have been received from both Mexico and Canada and said that they are being considered carefully. She provided no details on when a decision would be reached.
      The administration official told CNN that one option under consideration is a swap agreement with the two countries: an agreement to share the AstraZeneca doses now with the condition that Mexico and Canada will share excess vaccines with the US in the future.
      There are tens of millions of AstraZeneca doses stockpiled in the US and the company believes it will have roughly 50 million Covid-19 vaccine doses available to the US government by the end of April. None of those doses are available to Americans now because AstraZeneca has not applied to the Food and Drug Administration for an emergency use authorization, and the vaccine is still going through clinical trials in the US.
        AstraZeneca has been approved for use in both Canada and Mexico, and the company itself has asked the Biden administration to consider requests to donate inventory to other nations.
        Mexican President Andres Manuel Lopez Obrador announced Monday that he was close to reaching two agreements on vaccines, but he didn't specify which countries would be sending them. Another top official in Mexico publicly asked the US to share AstraZeneca vaccines earlier this week.
        A Canadian Embassy spokesperson said that there have been "great engagements" with the Biden administration about Covid-19 and added that "conversations are ongoing" when it comes to getting more Canadians vaccinated. The spokesperson did not comment on the possible swap agreement.

        Tensions over vaccine diplomacy

        These conversations come as political leaders in both Mexico and Canada are under increasing pressure to secure vaccines amid a wider global scramble for doses.
        The US is now ahead of almost every other country in the world when it comes to vaccinating its population and having secured contracts with vaccine producers. Biden said last week that by May 1 all adults will be able to receive vaccines.
        The US has contributed $2 billion in total to a global coronavirus vaccine initiative called COVAX, and has pledged to release an additional $2 billion "as we work with other donors to elevate pledge commitments." It has established bilateral agreements with certain countries for vaccine storage efforts, and is working alongside the allies in the Asia-Pacific region to increase production in India.
        The Biden administration will eventually share excess vaccines -- beyond the AstraZeneca doses -- and does not see joint efforts alongside US allies as precluding them from unilaterally donating vaccines to other countries down the road, according to the senior administration official.
        "We are giving $4 billion to COVAX. But we also know once we get our own country vaccinated, since we have suffered worse than virtually any country besides Brazil -- we are both way up there with over 530,000 deaths -- then we will make any surplus vaccine available to the countries who have not the resources to be able to make it themselves," Dr Anthony Fauci, director of the National Institute of Allergy and Infectious Diseases, told a hearing of the House Energy and Commerce Committee on Wednesday.
        Biden made the same commitment last week.
        "If we have a surplus, we're going to share it with the rest of the world," Biden said. "We're going to start off making sure Americans are taken care of first."
        Secretary of State Antony Blinken also said last week that "until everyone in the world is vaccinated, then no one is really fully safe."
        The Biden administration's decision to focus inward on vaccines, particularly given the dire need globally and the administration's top priority to re-assert US global leadership, is putting the Biden administration in a somewhat awkward position in comparison to a global rivals.
        China has taken a different approach to the US and is exporting vaccines widely before making vaccines widely available at home. Russia and India are also sharing vaccines but not on the same scale as Beijing. The Chinese Foreign Ministry announced March 3 that it is providing free vaccines to 69 countries and commercially exporting them to 28 more.
        Some US allies and partners are worried that China's global effort to ramp up vaccine exports and vaccine production agreements so quickly will make it hard for the US to catch up, diplomats told CNN.
        Mexico has received AstraZeneca shots from India and is also the focus of China's vaccine diplomacy. Mexican media reported March 9 that the country will receive 22 million doses of China's Sinovac and Sinopharm vaccines.
        Beijing's push to aggressively export vaccines has been characterized by US officials as an attempt to spread China's influence and soft power.
          When asked on Wednesday if the US will be able to surpass China's efforts on vaccine diplomacy after fulfilling the commitment of vaccinating Americans, Deputy State Department Spokesperson Jalina Porter did not answer the question.
          A State Department spokesperson said that while Biden has made the priority to vaccinate Americans clear he is also "deeply focused on the issue of expanding global vaccination, manufacturing, and delivery, which will all be critical to end the pandemic."

          Purifying the air to prevent COVID-19 transmission

           The onset of the COVID-19 pandemic had people sharing an array of strategies for disinfection and disease prevention. The ensuing months showed that the SARS-CoV-2 virus is primarily spread through the air via contaminated droplets, prompting a new wave of air purifying technology. A feature article in Chemical & Engineering News, the weekly newsmagazine of the American Chemical Society, details the various air purifier technologies and their efficacy against the coronavirus.

          Although official guidance from the U.S. Centers for Disease Control and Prevention (CDC) suggests that social distancing and mask wearing are the most effective ways to prevent the spread of COVID-19 indoors, they also state that air purifiers can help reduce airborne contaminants, including viruses. These gadgets rely on various technologies, writes special correspondent Mark Peplow, and whereas some are proven to work, others require more data. Filtration with high-efficiency particulate air (HEPA) filters made from glass or polymer fibers is the most popular choice in hospitals and other clinical settings.

          Another air purification method involves using ultraviolet C (UVC) light to deactivate viruses, including SARS-CoV-2, by making them unable to replicate. However, direct exposure to UVC can be harmful to people, which has led experts to suggest placing the lights in HVAC ducts, or lowering the intensity of the UVC light so that it can't penetrate living cells but can still kill airborne viruses. Another type of purification is known as bipolar ionization, which uses high voltage electrodes to create positive and negative ions from the air that can then attach to viral particles and prevent them from spreading. Although makers of ionization purifiers tout their ability to combat SARS-CoV-2, experts argue that the research has not been as convincing as that of other methods. Scientists agree that even with air purifiers, masks and social distancing should still be the first line of defense against the spread of SARS-CoV-2.

          ###

          The article, "Which air purification technologies can tackle COVID-19?," is freely available here.

          https://www.eurekalert.org/pub_releases/2021-03/acs-pta031721.php

          Sturdier spike protein explains faster spread of coronavirus variants

           The fast-spreading UK, South Africa, and Brazil coronavirus variants are raising both concerns and questions about whether COVID-19 vaccines will protect against them. New work led by Bing Chen, PhD, at Boston Children's Hospital analyzed how the structure of the coronavirus spike proteins changes with the D614G mutation -- carried by all three variants -- and showed why these variants are able to spread more quickly. The team reports its findings in Science (March 16, 2020).

          Chen's team imaged the spikes with cryo-electron microscopy (cryo-EM), which has resolution down to the atomic level. They found that the D614G mutation (substitution of in a single amino acid "letter" in the genetic code for the spike protein) makes the spike more stable as compared with the original SARS-CoV-2 virus. As a result, more functional spikes are available to bind to our cells' ACE2 receptors, making the virus more infectious.

          Preventing spikes' shape change

          In the original coronavirus, the spike proteins would bind to the ACE2 receptor and then dramatically change shape, folding in on themselves. This enabled the virus to fuse its membrane with our own cells' membranes and get inside. However, as Chen and colleagues reported in July 2020, the spikes would sometimes prematurely change shape and fall apart before the virus could bind to cells. While this slowed the virus down, the shape change also made it harder for our immune system to contain the virus.

          "Because the original spike protein would dissociate, it was not good enough to induce a strong neutralizing antibody response," says Chen.

          When Chen and colleagues imaged the mutant spike protein, they found that the D614G mutation stabilizes the spike by blocking the premature shape change. Interestingly, the mutation also makes the spikes bind more weakly to the ACE receptor, but the fact that the spikes are less apt to fall apart prematurely renders the virus overall more infectious.

          "Say the original virus has 100 spikes," Chen explains. "Because of the shape instability, you may have just 50 percent of them functional. In the G614 variants, you may have 90 percent that are functional, so even though they don't bind as well, the chances are greater that you will have infection."

          Chen proposes that redesigned vaccines incorporate the code for this mutant spike protein. The more stable spike shape should make any vaccine based on the spike (as are the Moderna, Pfizer, and Johnson & Johnson vaccine) more likely to elicit protective neutralizing antibodies, he says.

          Future direction: A drug to block coronavirus entry

          Chen and his colleagues are further applying structural biology to better understand how SARS-CoV-2 binds to the ACE2 receptor, with an eye toward therapeutics to block the virus from gaining entry to our cells.

          In January, the team showed in Nature Structural & Molecular Biology that a structurally-engineered "decoy" ACE2 protein binds the virus 200 times more strongly than the body's own ACE2. The decoy potently inhibited the virus in cell culture, suggesting it could be an anti-COVID-19 treatment. Chen is now planning to advance this research into animal models.

          ###

          Chen is senior investigator on the paper in Science. Jun Zhang and Yongfei Cai in Boston Children's Division of Molecular Medicine were co-first authors. Coauthors were Tianshu Xiao, Hanqin Peng, Sophia Rits-Volloch, and Piotr Sliz of Boston Children's; Jianming Lu of Codex BioSolutions, Inc., Sarah Sterling and Richard Walsh Jr. of the Harvard Cryo-EM Center for Structural Biology (Harvard Medical School); and Haisun Zhu, Alec Woosley, and Wei Yang of the Institute for Protein Innovation (Harvard Institutes of Medicine). The work was funded by the National Institutes of Health (AI147884, AI147884-01A1S1, AI141002, AI127193), a COVID-19 Award by MassCPR, and Emergent Ventures.

          https://www.eurekalert.org/pub_releases/2021-03/bch-ass031721.php

          Ultrasound has potential to damage coronaviruses: MIT study

           The coronavirus' structure is an all-too-familiar image, with its densely packed surface receptors resembling a thorny crown. These spike-like proteins latch onto healthy cells and trigger the invasion of viral RNA. While the virus' geometry and infection strategy is generally understood, little is known about its physical integrity.

          A new study by researchers in MIT's Department of Mechanical Engineering suggests that coronaviruses may be vulnerable to ultrasound vibrations, within the frequencies used in medical diagnostic imaging.

          Through computer simulations, the team has modeled the virus' mechanical response to vibrations across a range of ultrasound frequencies. They found that vibrations between 25 and 100 megahertz triggered the virus' shell and spikes to collapse and start to rupture within a fraction of a millisecond. This effect was seen in simulations of the virus in air and in water.

          The results are preliminary, and based on limited data regarding the virus' physical properties. Nevertheless, the researchers say their findings are a first hint at a possible ultrasound-based treatment for coronaviruses, including the novel SARS-CoV-2 virus. How exactly ultrasound could be administered, and how effective it would be in damaging the virus within the complexity of the human body, are among the major questions scientists will have to tackle going forward.

          "We've proven that under ultrasound excitation the coronavirus shell and spikes will vibrate, and the amplitude of that vibration will be very large, producing strains that could break certain parts of the virus, doing visible damage to the outer shell and possibly invisible damage to the RNA inside," says Tomasz Wierzbicki, professor of applied mechanics at MIT. "The hope is that our paper will initiate a discussion across various disciplines."

          The team's results appear online in the Journal of the Mechanics and Physics of Solids. Wierzbicki's co-authors are Wei Li, Yuming Liu, and Juner Zhu at MIT.

          A spiky shell

          As the Covid-19 pandemic took hold around the world, Wierzbicki looked to contribute to the scientific understanding of the virus. His group's focus is in solid and structural mechanics, and the study of how materials fracture under various stresses and strains. With this perspective, he wondered what could be learned about the virus' fracture potential.

          Wierzbicki's team set out to simulate the novel coronavirus and its mechanical response to vibrations. They used simple concepts of the mechanics and physics of solids to construct a geometrical and computational model of the virus' structure, which they based on limited information in the scientific literature, such as microscopic images of the virus' shell and spikes.

          From previous studies, scientists have mapped out the general structure of the coronavirus -- a family of viruses that s HIV, influenza, and the novel SARS-CoV-2 strain. This structure consists of a smooth shell of lipid proteins, and densely packed, spike-like receptors protruding from the shell.

          With this geometry in mind, the team modeled the virus as a thin elastic shell covered in about 100 elastic spikes. As the virus' exact physical properties are uncertain, the researchers simulated the behavior of this simple structure across a range of elasticities for both the shell and the spikes.

          "We don't know the material properties of the spikes because they are so tiny -- about 10 nanometers high," Wierzbicki says. "Even more unknown is what's inside the virus, which is not empty but filled with RNA, which itself is surrounded by a protein capsid shell. So this modeling requires a lot of assumptions."

          "We feel confident that this elastic model is a good starting point," Wierzbicki says. "The question is, what are the stresses and strains that will cause the virus to rupture?"

          A corona's collapse

          To answer that question, the researchers introduced acoustic vibrations into the simulations and observed how the vibrations rippled through the virus' structure across a range of ultrasound frequencies.

          The team started with vibrations of 100 megahertz, or 100 million cycles per second, which they estimated would be the shell's natural vibrating frequency, based on what's known of the virus' physical properties.

          When they exposed the virus to 100 MHz ultrasound excitations, the virus' natural vibrations were initially undetectable. But within a fraction of a millisecond the external vibrations, resonating with the frequency of the virus' natural oscillations, caused the shell and spikes to buckle inward, similar to a ball that dimples as it bounces off the ground.

          As the researchers increased the amplitude, or intensity, of the vibrations, the shell could fracture -- an acoustic phenomenon known as resonance that also explains how opera singers can crack a wineglass if they sing at just the right pitch and volume. At lower frequencies of 25 MHz and 50 MHz, the virus buckled and fractured even faster, both in simulated environments of air, and of water that is similar in density to fluids in the body.

          "These frequencies and intensities are within the range that is safely used for medical imaging," says Wierzbicki.

          To refine and validate their simulations, the team is working with microbiologists in Spain, who are using atomic force microscopy to observe the effects of ultrasound vibrations on a type of coronavirus found exclusively in pigs. If ultrasound can be experimentally proven to damage coronaviruses, including SARS-CoV-2, and if this damage can be shown to have a therapeutic effect, the team envisions that ultrasound, which is already used to break up kidney stones and to release drugs via liposomes, might be harnessed to treat and possibly prevent coronavirus infection. The researchers also envision that miniature ultrasound transducers, fitted into phones and other portable devices, might be capable of shielding people from the virus.

          Wierzbicki stresses that there is much more research to be done to confirm whether ultrasound can be an effective treatment and prevention strategy against coronaviruses. As his team works to improve the existing simulations with new experimental data, he plans to zero in on the specific mechanics of the novel, rapidly mutating SARS-CoV-2 virus.

          "We looked at the general coronavirus family, and now are looking specifically at the morphology and geometry of Covid-19," Wierzbicki says. "The potential is something that could be great in the current critical situation."

          https://www.eurekalert.org/pub_releases/2021-03/miot-uhp031721.php