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Home News Covid weekly update - Week 34
Covid weekly update - Week 34
Covid-19 disease
Modeling the Onset of Symptoms of COVID-19
Authors: Larson JR et al
Source: Frontiers in Public Health
DOI: 10.3389/fpubh.2020.00473
COVID-19 is a pandemic viral disease with catastrophic global impact. This disease is more contagious than influenza such that cluster outbreaks occur frequently. If patients with symptoms quickly underwent testing and contact tracing, these outbreaks could be contained. Unfortunately, COVID-19 patients have symptoms similar to other common illnesses. Here, we hypothesize the order of symptom occurrence could help patients and medical professionals more quickly distinguish COVID-19 from other respiratory diseases, yet such essential information is largely unavailable. To this end, we apply a Markov Process to a graded partially ordered set based on clinical observations of COVID-19 cases to ascertain the most likely order of discernible symptoms (i.e., fever, cough, nausea/vomiting, and diarrhea) in COVID-19 patients. We then compared the progression of these symptoms in COVID-19 to other respiratory diseases, such as influenza, SARS, and MERS, to observe if the diseases present differently. Our model predicts that influenza initiates with cough, whereas COVID-19 like other coronavirus-related diseases initiates with fever. However, COVID-19 differs from SARS and MERS in the order of gastrointestinal symptoms. Our results support the notion that fever should be used to screen for entry into facilities as regions begin to reopen after the outbreak of Spring 2020. Additionally, our findings suggest that good clinical practice should involve recording the order of symptom occurrence in COVID-19 and other diseases. If such a systemic clinical practice had been standard since ancient diseases, perhaps the transition from local outbreak to pandemic could have been avoided.
Longitudinal SARS-CoV-2 serosurveillance of over ten thousand health care workers in the Providence Oregon cohort
Authors: Leidner R et al
Journal: medRxiv preprint
DOI: 10.1101/2020.08.16.20176107
Frontline healthcare workers (HCW) are a high-risk population for SARS-CoV-2 infection. Here we present results from a large serosurveillance study of 10,019 asymptomatic HCW conducted during April-May 2020, in eight hospital medical centers across the state of Oregon, USA during the initial peak of the pandemic. Free and voluntary testing was performed at 14 +/- 3 day intervals, over a 4-week window at each site, utilizing a lab-developed ELISA based on the Epitope Diagnostics COVID-19 nucleocapsid IgG detection Kit. We identified 253 SARS-CoV-2 IgG seropositive individuals among 10,019 total participants, representing a cross-sectional seroprevalence of 2.53%. Subgroup analysis identified differential seropositivity by job role, ranging from 8.03% among housekeepers, odds ratio 3.17 (95% CI 1.59-5.71), to 0.00% among anesthesiologists, odds ratio 0.00 (95% CI 0-0.26), both of which were significant. Over the course of the study, 17 seroconversions (0.25%) and 101 seroreversions (1.50%) were identified. Self-reported SARS-CoV-2 swab qPCR testing, when compared with subsequent serology on study, showed only modest agreement, κ = 0.47 (95% CI 0.32-0.62). Overall, these findings demonstrate relatively low seroprevalence and very low seroconversion rates among HCW in Oregon, USA, over a period in which aggressive social distancing measures were in place. The high rate of seroreversion observed in this cohort, and the relatively high discordance between SARS-CoV-2 serology and swab qPCR, highlight limitations of current detection methods, and stress the need for development of novel assessment methodologies to more accurately identify exposure (and/or immunity) to SARS-CoV-2 in this population.
Using the COVID-19 to influenza ratio to estimate early pandemic spread in Wuhan, China and Seattle, US
Authors: Du Z et al
Journal: EClinicalMedicine
DOI: 10.1016/j.eclinm.2020.100479
Background: Pandemic SARS-CoV-2 was first reported in Wuhan, China on December 31, 2019. Twenty-one days later, the US identified its first case––a man who had traveled from Wuhan to the state of Washington. Recent studies in the Wuhan and Seattle metropolitan areas retrospectively tested samples taken from patients with COVID-like symptoms. In the Wuhan study, there were 4 SARS-CoV-2 positives and 7 influenza positives out of 26 adults outpatients who sought care for influenza-like-illness at two central hospitals prior to January 12, 2020. The Seattle study reported 25 SARS-CoV-2 positives and 442 influenza positives out of 2353 children and adults who reported acute respiratory illness prior to March 9, 2020. Here, we use these findings to extrapolate the early prevalence of symptomatic COVID-19 in Wuhan and Seattle.
Methods: For each city, we estimate the ratio of COVID-19 to influenza infections from the retrospective testing data and estimate the age-specific prevalence of influenza from surveillance reports during the same time period. Combining these, we approximate the total number of symptomatic COVID-19 infections.
Findings: In Wuhan, there were an estimated 1386 [95% CrI: 420-3793] symptomatic cases over 30 of COVID-19 between December 30, 2019 and January 12, 2020. In Seattle, we estimate that 2268 [95% CrI: 498, 6069] children under 18 and 4367 [95% CrI: 2776, 6526] adults were symptomatically infected between February 24 and March 9, 2020. We also find that the initial pandemic wave in Wuhan likely originated with a single infected case who developed symptoms sometime between October 26 and December 13, 2019; in Seattle, the seeding likely occurred between December 25, 2019 and January 15, 2020.
Interpretation:The spread of COVID-19 in Wuhan and Seattle was far more extensive than initially reported. The virus likely spread for months in Wuhan before the lockdown. Given that COVID-19 appears to be overwhelmingly mild in children, our high estimate for symptomatic pediatric cases in Seattle suggests that there may have been thousands more mild cases at the time.
Contact Settings and Risk for Transmission in 3410 Close Contacts of Patients With COVID-19 in Guangzhou, China
Authors: Luo L PhD et al
Journal: Annals of Internal Medicine
DOI: 10.7326/M20-2671
Background: Risk for transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) to close contacts of infected persons has not been well estimated.
Objective: To evaluate the risk for transmission of SARS-CoV-2 to close contacts in different settings.
Participants:3 410 close contacts of 391 index cases were traced between 13 January and 6 March 2020. Data on the setting of the exposure, reverse transcriptase polymerase chain reaction testing, and clinical characteristics of index and secondary cases were collected.
Results: Among 3410 close contacts, 127 (3.7% [95% CI, 3.1% to 4.4%]) were secondarily infected. Of these 127 persons, 8 (6.3% [CI, 2.1% to 10.5%]) were asymptomatic. Of the 119 symptomatic cases, 20 (16.8%) were defined as mild, 87 (73.1%) as moderate, and 12 (10.1%) as severe or critical. Compared with the household setting (10.3%), the secondary attack rate was lower for exposures in healthcare settings (1.0%; odds ratio [OR], 0.09 [CI, 0.04 to 0.20]) and on public transportation (0.1%; OR, 0.01 [CI, 0.00 to 0.08]). The secondary attack rate increased with the severity of index cases, from 0.3% (CI, 0.0 to 1.0%) for asymptomatic to 3.3% (CI, 1.8% to 4.8%) for mild, 5.6% (CI, 4.4% to 6.8%) for moderate, and 6.2% (CI, 3.2% to 9.1%) for severe or critical cases. Index cases with expectoration were associated with higher risk for secondary infection (13.6% vs. 3.0% for index cases without expectoration; OR, 4.81 [CI, 3.35 to 6.93]).
Conclusion: Household contact was the main setting for transmission of SARS-CoV-2, and the risk for transmission of SARS-CoV-2 among close contacts increased with the severity of index cases.
Explaining the homogeneous diffusion of COVID-19 nonpharmaceutical interventions across heterogeneous countries
Authors: Sebhatu A et al
Journal: PNAS
DOI: 10.1073/pnas.2010625117
We analyze the adoption of nonpharmaceutical interventions in the Organisation for Economic Co-operation and Development (OECD) countries during the early phase of the coronavirus disease 2019 (COVID-19) pandemic. Given the complexity associated with pandemic decisions, governments are faced with the dilemma of how to act quickly when their core decision-making processes are based on deliberations balancing political considerations. Our findings show that, in times of severe crisis, governments follow the lead of others and base their decisions on what other countries do. Governments in countries with a stronger democratic structure are slower to react in the face of the pandemic but are more sensitive to the influence of other countries. We provide insights for research on international policy diffusion and research on the political consequences of the COVID-19 pandemic.
Assessment of COVID-19 Hospitalizations by Race/Ethnicity in 12 States
Authors: Pinar Karaca-Mandic PhD, Archelle Georgiou MD and Soumya Sen PhD
Journal: JAMA Internal Medicine
DOI: 10.1001/jamainternmed.2020.3857
This analysis identified considerable disparities in the prevalence of COVID-19 across racial/ethnic subgroups of the population in 12 US states. These findings are consistent with an earlier Centers for Disease Control and Prevention analysis of 580 hospitalizations between March 1 and March 30, 2020, that found disproportionately high COVID-19 hospitalizations for the Black population.5 Similarly, a study of 1052 confirmed COVID-19 cases between January 1 and April 8, 2020, at a California health system reported higher odds of hospitalization in non-Hispanic Black individuals compared with non-Hispanic White individuals.6 In addition, we observed high hospitalization rates for Hispanic individuals in most of the states analyzed and high hospitalization rates for American Indian and Alaskan Native populations in select states.
These findings highlight the need for increased data reporting and consistency within and across all states. Only 12 of 50 US states have consistently reported hospitalizations by race/ethnicity during our study period. New Jersey and Florida recently started reporting data on COVID-19 hospitalizations by race/ethnicity. The present study is limited in that there was no adjustment for age, sex, comorbidities, and socioeconomic factors within each racial/ethnic group that are likely to be associated with COVID-19 hospitalizations.
A large body of research has identified racial/ethnic health disparities in the risk of infection associated with a higher prevalence of comorbidities, less access to health care, adverse economic conditions, and service-related occupations.2 The unique clinical, financial, and social implications of COVID-19 for racial/ethnic populations that are often systematically marginalized in society must be well understood to design and establish effective and equitable infrastructure solutions.
Assessing the age specificity of infection fatality rates for covie-19: systematic review, meta-analysis and public policy implications
Authors: Levin AT et al
This paper assesses the age specificity of the infection fatality rate (IFR) for COVID-19 using seroprevalence results from eight national studies (Belgium, England, Hungary, Italy, Netherlands, Portugal, Spain, and Sweden), fifteen seroprevalence studies of specific locations in Europe and the United States, and three countries (Iceland, New Zealand, and Republic of Korea) that have engaged in comprehensive tracking and tracing of COVID-19 infections. The estimated IFR is close to zero for younger adults but rises exponentially with age, reaching about 0.3% for ages 50-59, 1.3% for ages 60-69, 4% for ages 70-79, 10% for ages 80-89. Our findings indicate that COVID-19 is not just dangerous for the elderly and infirm but also for healthy middle-aged adults. Consequently, the overall IFR for a given location is intrinsically linked to the age-specific pattern of infections, and hence protecting vulnerable age groups could substantially reduce the incidence of mortality.
Association Between Youth Smoking, Electronic Cigarette Use, and Coronavirus Disease 2019
Authors: Shivani Mathur Gaiha PhD, Jing Cheng PhD and Bonnie Halpern-Felsher PhD
Journal: Journal of Adolescent Health
Purpose: This study aimed to assess whether youth cigarette and electronic cigarette (e-cigarette) use are associated with coronavirus disease 2019 (COVID-19) symptoms, testing, and diagnosis.
Methods: An online national survey of adolescents and young adults (n = 4,351) aged 13–24 years was conducted in May 2020. Multivariable logistic regression assessed relationships among COVID-19–related symptoms, testing, and diagnosis and cigarettes only, e-cigarettes only and dual use, sociodemographic factors, obesity, and complying with shelter-in-place.
COVID-19 diagnosis was five times more likely among ever-users of e-cigarettes only (95% confidence interval [CI]: 1.82–13.96), seven times more likely among ever-dual-users (95% CI: 1.98–24.55), and 6.8 times more likely among past 30-day dual-users (95% CI: 2.40–19.55). Testing was nine times more likely among past 30-day dual-users (95% CI: 5.43–15.47) and 2.6 times more likely among past 30-day e-cigarette only users (95% CI: 1.33–4.87). Symptoms were 4.7 times more likely among past 30-day dual-users (95% CI: 3.07–7.16).
Conclusions: COVID-19 is associated with youth use of e-cigarettes only and dual use of e-cigarettes and cigarettes, suggesting the need for screening and education.
Vitamin D Supplementation in COVID-19 Patients
Authors: Ohaegbulam KC et al
Journal: American Journal of Therapeutics
DOI: 10.1097/MJT.0000000000001222
Background: Coronavirus disease 2019 (COVID-19) has infected more than 4.4 million people and caused more than 300,000 deaths partly through acute respiratory distress syndrome with propensity to affect African American and Hispanic communities disproportionately. Patients with worse outcomes have exhibited higher blood plasma levels of proinflammatory cytokines. Activation of the vitamin D receptor expressed on immune cells has been shown to directly reduce the secretion of inflammatory cytokines, such as interleukin-6, and indirectly affect C-reactive protein.
Areas of Uncertainty: The significance of the vitamin D pathway in patients diagnosed with COVID-19.
Therapeutic Innovation: Vitamin D supplementation in patients after diagnosis of COVID-19.
Patients and Pharmacological Interventions: We report 4 vitamin D deficient patients diagnosed with COVID-19 in April 2020 who were provided with either cholecalciferol of 1000 IU daily (standard dose) or ergocalciferol 50,000 IU daily for 5 days (high dose) as part of supplementation.
Clinical Outcomes: Patients that received a high dose of vitamin D supplementation achieved normalization of vitamin D levels and improved clinical recovery evidenced by shorter lengths of stay, lower oxygen requirements, and a reduction in inflammatory marker status.
Conclusions: Vitamin D supplementation may serve as a viable alternative for curtailing acute respiratory distress syndrome in patients in underserved communities where resources to expensive and sought-after medications may be scarce. Randomized clinical trials will serve as an appropriate vessel to validate the efficacy of the therapeutic regimen and dissection of the pathway.
Reply to Jakovac and to Rocha et al.: Can vitamin D prevent or manage COVID-19 illness?
Authors: Slominski AT
Journal: American Journal of Physiology Endocrinology and Metabolism
DOI: 10.1152/ajpendo.00348.2020
To the editor: The outstanding articles by Jakovac (4) and Rocha et al. (8) emphasize an association between vitamin D deficiency/insufficiency and enhanced coronavirus disease (COVID-19) severity, which is also presented in recent reports (1, 3), and led to unofficial recommendations for taking vitamin D supplements (https://doi.org/10.1016/S2213-8587(20)30183-2). Therefore, we want to further discuss this issue on different levels.
As the COVID-19 pandemic accelerates, it is important to explore different therapeutic options that are effective, economical, and without significant side effects. The clinical spectrum of COVID-19 presentation is wide, ranging from asymptomatic infection to severe viral pneumonia associated with respiratory failure from acute respiratory distress syndrome (ARDS) and multi-organ failure. Older people, racial minorities, and patients with a variety of comorbidities are at higher risk of being vitamin D deficient. The same populations are affected disproportionally by severe symptoms and increased mortality from the COVID-19.
Covid-19 and children
COVID-19 in children: analysis of the first pandemic peak in England
Authors: Ladhani SN et al
Journal: Archives of Disease in Childhood
DOI: 10.1136/archdischild-2020-320042
Objectives :To assess disease trends, testing practices, community surveillance, case-fatality and excess deaths in children as compared with adults during the first pandemic peak in England.
Participants: Children with COVID-19 between January and May 2020.
Main outcome measures: Trends in confirmed COVID-19 cases, severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) positivity rates in children compared with adults; community prevalence of SARS-CoV-2 in children with acute respiratory infection (ARI) compared with adults, case-fatality rate in children with confirmed COVID-19 and excess childhood deaths compared with the previous 5 years.
Results: Children represented 1.1% (1,408/129,704) of SARS-CoV-2 positive cases between 16 January 2020 and 3 May 2020. In total, 540 305 people were tested for SARS-COV-2 and 129,704 (24.0%) were positive. In children aged <16 years, 35,200 tests were performed and 1408 (4.0%) were positive for SARS-CoV-2, compared to 19.1%–34.9% adults. Childhood cases increased from mid-March and peaked on 11 April before declining. Among 2,961 individuals presenting with ARI in primary care, 351 were children and 10 (2.8%) were positive compared with 9.3%–45.5% in adults. Eight children died and four (case-fatality rate, 0.3%; 95% CI 0.07% to 0.7%) were due to COVID-19. We found no evidence of excess mortality in children.
Conclusions: Children accounted for a very small proportion of confirmed cases despite the large numbers of children tested. SARS-CoV-2 positivity was low even in children with ARI. Our findings provide further evidence against the role of children in infection and transmission of SARS-CoV-2.
Heterogeneous antibodies against SARS-CoV-2 spike receptor binding domain and nucleocapsid with implications on COVID-19 immunity
Authors: McAndrews KM et al
Journal: JCI Insight
DOI: 10.1172/jci.insight.142386
Evaluation of potential immunity against the novel severe acute respiratory syndrome (SARS) coronavirus that emerged in 2019 (SARS-CoV-2) is essential for health, as well as social and economic recovery. Generation of antibody response to SARS-CoV-2 (seroconversion) may inform on acquired immunity from prior exposure, and antibodies to the SARS-CoV-2 spike protein receptor binding domain (S-RBD) are speculated to neutralize virus infection. Some serology assays rely solely on SARS-CoV-2 nucleocapsid protein (N-protein) as the antibody detection antigen; however, whether such immune responses correlate with S-RBD response and COVID-19 immunity remains unknown. Here, we generated a quantitative serological enzyme-linked immunosorbent assay (ELISA) using recombinant S-RBD and N-protein for the detection of circulating antibodies in 138 serial serum samples from 30 RT-PCR confirmed SARS-CoV-2 hospitalized patients, as well as 464 healthy and non-COVID-19 serum samples that were collected between June 2017 and June 2020. Quantitative detection of IgG antibodies to the two different viral proteins showed a moderate correlation. Antibodies to N-protein were detected at a rate of 3.6% in healthy and non-COVID-19 sera collected during the pandemic in 2020, whereas 1.6% of these sera were positive for S-RBD. Approximately 86% of individuals positive for S-RBD binding antibodies exhibited neutralizing capacity, but only 74% of N-protein positive individuals exhibited neutralizing capacity. Collectively, our studies show that detection of N-protein binding antibodies does not always correlate with presence of S-RBD neutralizing antibodies, and cautions against the extensive use of N-protein based serology testing for determination of potential COVID-19 immunity.
Functional SARS-CoV-2-specific immune memory persists after mild COVID-19
Authors: Rodda LB et al
The recently emerged SARS-CoV-2 virus is currently causing a global pandemic and cases continue to rise. The majority of infected individuals experience mildly symptomatic coronavirus disease 2019 (COVID-19), but it is unknown whether this can induce persistent immune memory that might contribute to herd immunity. Thus, we performed a longitudinal assessment of individuals recovered from mildly symptomatic COVID-19 to determine if they develop and sustain immunological memory against the virus. We found that recovered individuals developed SARS-CoV-2-specific IgG antibody and neutralizing plasma, as well as virus-specific memory B and T cells that not only persisted, but in some cases increased numerically over three months following symptom onset. Furthermore, the SARS-CoV-2-specific memory lymphocytes exhibited characteristics associated with potent antiviral immunity: memory T cells secreted IFN-γ and expanded upon antigen re-encounter, while memory B cells expressed receptors capable of neutralizing virus when expressed as antibodies. These findings demonstrate that mild COVID-19 elicits memory lymphocytes that persist and display functional hallmarks associated with antiviral protective immunity.
Neutralizing antibodies correlate with protection from SARS-CoV-2 in humans during a fishery vessel outbreak with high attack rate
Authors: Addetia A et al
The development of vaccines against SARS-CoV-2 would be greatly facilitated by the identification of immunological correlates of protection in humans. However, to date, studies on protective immunity have only been performed in animal models and correlates of protection have not been established in humans. Here, we describe an outbreak of SARS-CoV-2 on a fishing vessel associated with a high attack rate. Predeparture serological and viral RT-PCR testing along with repeat testing after return to shore was available for 120 of the 122 persons on board over a median follow-up of 32.5 days (range 18.8 to 50.5 days). A total of 104 individuals had an RT-PCR positive viral test with Ct <35 or seroconverted during the follow-up period, yielding an attack rate on board of 85.2% (104/122 individuals). Metagenomic sequencing of 39 viral genomes suggested the outbreak originated largely from a single viral clade. Only three crewmembers tested seropositive prior to the boat's departure in initial serological and also had neutralizing and spike-reactive antibodies in follow-up assays. None of these crewmembers with neutralizing antibody titers showed evidence of bona fide viral infection or experienced any symptoms during the viral outbreak. Therefore, the presence of neutralizing antibodies from prior infection was significantly associated with protection against re-infection (Fisher's exact test, p=0.002).
Antibody prevalence for SARS-CoV-2 following the peak of the pandemic in England: REACT2 study in 100,000 adults
Authors: Ward H et al
Background: England, UK has experienced a large outbreak of SARS-CoV-2 infection. As in USA and elsewhere, disadvantaged communities have been disproportionately affected.
Methods: National REal-time Assessment of Community Transmission-2 (REACT-2) seroprevalence study using self-administered lateral flow immunoassay (LFIA) test for IgG among a random population sample of 100,000 adults over 18 years in England, 20 June to 13 July 2020.
Results: Completed questionnaires were available for 109,076 participants, yielding 5,544 IgG positive results and adjusted (for test performance), re-weighted (for sampling) prevalence of 6.0% (95% CI: 5.8, 6.1). Highest prevalence was in London (13.0% [12.3, 13.6]), among people of Black or Asian (mainly South Asian) ethnicity (17.3% [15.8, 19.1] and 11.9% [11.0, 12.8] respectively) and those aged 18-24 years (7.9% [7.3, 8.5]). Care home workers with client-facing roles had adjusted odds ratio of 3.1 (2.5, 3.8) compared with non-essential workers. One third (32.2%, [31.0-33.4]) of antibody positive individuals reported no symptoms. Among symptomatic cases, the majority (78.8%) reported symptoms during the peak of the epidemic in England in March (31.3%) and April (47.5%) 2020. We estimate that 3.36 million (3.21, 3.51) people have been infected with SARS-CoV-2 in England to end June 2020, with an overall infection fatality ratio of 0.90% (0.86, 0.94).
Conclusion: The pandemic of SARS-CoV-2 infection in England disproportionately affected ethnic minority groups and health and care home workers. The higher risk of infection in these groups may explain, at least in part, their increased risk of hospitalisation and mortality from COVID-19.
Selective and cross-reactive SARS-CoV-2 T cell epitopes in unexposed humans
Authors: Mateus J et al
Journal: Science
DOI: 10.1126/science.abd3871
Many unknowns exist about human immune responses to the SARS-CoV-2 virus. SARS-CoV-2 reactive CD4+ T cells have been reported in unexposed individuals, suggesting pre-existing cross-reactive T cell memory in 20-50% of people. However, the source of those T cells has been speculative. Using human blood samples derived before the SARS-CoV-2 virus was discovered in 2019, we mapped 142 T cell epitopes across the SARS-CoV-2 genome to facilitate precise interrogation of the SARS-CoV-2-specific CD4+ T cell repertoire. We demonstrate a range of pre-existing memory CD4+ T cells that are cross-reactive with comparable affinity to SARS-CoV-2 and the common cold coronaviruses HCoV-OC43, HCoV-229E, HCoV-NL63, or HCoV-HKU1. Thus, variegated T cell memory to coronaviruses that cause the common cold may underlie at least some of the extensive heterogeneity observed in COVID-19 disease.
Effect of an Inactivated Vaccine Against SARS-CoV-2 on Safety and Immunogenicity Outcomes: Interim Analysis of 2 Randomized Clinical Trials
Authors: Xia S et al
Journal: JAMA
DOI: 10.1001/jama.2020.15543
Objective: To evaluate the safety and immunogenicity of an investigational inactivated whole-virus COVID-19 vaccine in China.
Interventions: In the phase 1 trial, 96 participants were assigned to 1 of the 3 dose groups (2.5, 5, and 10 μg/dose) and an aluminum hydroxide (alum) adjuvant–only group (n = 24 in each group), and received 3 intramuscular injections at days 0, 28, and 56. In the phase 2 trial, 224 adults were randomized to 5 μg/dose in 2 schedule groups (injections on days 0 and 14 [n = 84] vs alum only [n = 28], and days 0 and 21 [n = 84] vs alum only [n = 28]).
Design, Setting, and Participants: Interim analysis of ongoing randomized, double-blind, placebo-controlled, phase 1 and 2 clinical trials to assess an inactivated COVID-19 vaccine. The trials were conducted in Henan Province, China, among 96 (phase 1) and 224 (phase 2) healthy adults aged between 18 and 59 years. Study enrollment began on April 12, 2020. The interim analysis was conducted on June 16, 2020, and updated on July 27, 2020.
Main Outcomes and Measures: The primary safety outcome was the combined adverse reactions 7 days after each injection, and the primary immunogenicity outcome was neutralizing antibody response 14 days after the whole-course vaccination, which was measured by a 50% plaque reduction neutralization test against live severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2).
Results: Among 320 patients who were randomized (mean age, 42.8 years; 200 women [62.5%]), all completed the trial up to 28 days after the whole-course vaccination. The 7-day adverse reactions occurred in 3 (12.5%), 5 (20.8%), 4 (16.7%), and 6 (25.0%) patients in the alum only, low-dose, medium-dose, and high-dose groups, respectively, in the phase 1 trial; and in 5 (6.0%) and 4 (14.3%) patients who received injections on days 0 and 14 for vaccine and alum only, and 16 (19.0%) and 5 (17.9%) patients who received injections on days 0 and 21 for vaccine and alum only, respectively, in the phase 2 trial. The most common adverse reaction was injection site pain, followed by fever, which were mild and self-limiting; no serious adverse reactions were noted. The geometric mean titers of neutralizing antibodies in the low-, medium-, and high-dose groups at day 14 after 3 injections were 316 (95% CI, 218-457), 206 (95% CI, 123-343), and 297 (95% CI, 208-424), respectively, in the phase 1 trial, and were 121 (95% CI, 95-154) and 247 (95% CI, 176-345) at day 14 after 2 injections in participants receiving vaccine on days 0 and 14 and on days 0 and 21, respectively, in the phase 2 trial. There were no detectable antibody responses in all alum-only groups.
Conclusions and Relevance: In this interim report of the phase 1 and phase 2 trials of an inactivated COVID-19 vaccine, patients had a low rate of adverse reactions and demonstrated immunogenicity; the study is ongoing. Efficacy and longer-term adverse event assessment will require phase 3 trials.
Phase 1/2 study of COVID-19 RNA vaccine BNT162b1 in adults
Authors: Mulligan MJ et al
Journal: Nature
In March 2020, the World Health Organization (WHO) declared a pandemic of coronavirus disease 2019 (COVID-19), due to severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)1. With rapidly accumulating cases and deaths reported globally2, a vaccine is urgently needed. We report the available safety, tolerability, and immunogenicity data from an ongoing placebo-controlled, observer-blinded dose escalation study among 45 healthy adults, 18 to 55 years of age, randomized to receive 2 doses, separated by 21 days, of 10 µg, 30 µg, or 100 µg of BNT162b1, a lipid nanoparticle-formulated, nucleoside-modified mRNA vaccine that encodes trimerized SARS-CoV-2 spike glycoprotein receptor-binding domain (RBD). Local reactions and systemic events were dose-dependent, generally mild to moderate, and transient. A second vaccination with 100 µg was not administered due to increased reactogenicity and a lack of meaningfully increased immunogenicity after a single dose compared to the 30 μg dose. RBD-binding IgG concentrations and SARS-CoV-2 neutralizing titers in sera increased with dose level and after a second dose. Geometric mean neutralizing titers reached 1.9- to 4.6-fold that of a panel of COVID-19 convalescent human sera at least 14 days after a positive SARS-CoV-2 PCR.
Government and Health Authorities
Immune cells for common cold may recognize SARS-CoV-2
Source: National Institutes of Health
The virus responsible for the COVID-19 pandemic, SARS-CoV-2, is part of a large family of coronaviruses. Coronaviruses usually cause mild to moderate upper-respiratory tract illnesses, like the common cold. However, SARS-CoV-2 can cause serious illness and even death. Why people's COVID-19 symptoms vary so greatly isn't fully understood.
Your body's disease defense system, the immune system, makes B and T cells when exposed to pathogens like viruses and bacteria. B cells make antibodies, which neutralize the microbes, rendering them harmless. T cells have a variety of functions, including killing infected cells and activating or recruiting other immune cells.
Once your body fends off a microbe, it retains some disease fighting cells as memory cells. The next time you're exposed to it, a memory cell is ready to fight the disease again. This gives your immune system a head start in combating the disease.
Coronavirus and depression in adults, Great Britain: June 2020
Source: Office for National Statistics (UK)
Almost one in five adults (19.2%) were likely to be experiencing some form of depression during the coronavirus (COVID-19) pandemic in June 2020; this had almost doubled from around 1 in 10 (9.7%) before the pandemic (July 2019 to March 2020).
One in eight adults (12.9%) developed moderate to severe depressive symptoms during the pandemic, while a further 6.2% of the population continued to experience this level of depressive symptoms; around 1 in 25 adults (3.5%) saw an improvement over this period.
Adults who were aged 16 to 39 years old, female, unable to afford an unexpected expense, or disabled were the most likely to experience some form of depression during the pandemic.
Feeling stressed or anxious was the most common way adults experiencing some form of depression felt their well-being was being affected, with 84.9% stating this.
Over two in five (42.2%) adults experiencing some form of depression during the pandemic said their relationships were being affected, compared with one in five (20.7%) adults with no or mild depressive symptoms.
Media – Science related
Andrew Kimbrell on the Origins of COVID-19
Source: Corporate Crime Reporter
Did it come from nature?
Or did it leak from a lab in Wuhan, China?
The International Center for Technology Assessment is placing its bets on a leak from a lab in Wuhan.
"After considerable research, including a thorough review of the selected research materials and discussions with experts in the field, we have come to agree with the view that the virus causing COVID-19 did not evolve naturally but rather is the product of one of the high-security bio-medical laboratories in Wuhan, China," the group said in a statement issued last month. "We believe that there is a preponderance of circumstantial and scientific evidence demonstrating that the 'laboratory virus' hypothesis is not only possible but probable. By contrast, recent refutation of the hypothesis that the virus originated at a Wuhan wet market and new findings that the virus has not been found in nature despite significant effort to do so, makes the view that the virus evolved naturally unlikely."
Studies of Surgical Masks Efficacy
Author: Chris of the family Masters
Source: 12160.info
As a person who went to medical school, I was shocked when I read Neil Orr's study, published in 1981 in the Annals of the Royal College of Surgeons of England. Dr. Orr was a surgeon in the Severalls Surgical Unit in Colchester. And for six months, from March through August 1980, the surgeons and staff in that unit decided to see what would happen if they did not wear masks during surgeries. They wore no masks for six months, and compared the rate of surgical wound infections from March through August 1980 with the rate of wound infections from March through August of the previous four years. And they discovered, to their amazement, that when nobody wore masks during surgeries, the rate of wound infections was less than half what it was when everyone wore masks. Their conclusion: "It would appear that minimum contamination can best be achieved by not wearing a mask at all" and that wearing a mask during surgery "is a standard procedure that could be abandoned."
I was so amazed that I scoured the medical literature, sure that this was a fluke and that newer studies must show the utility of masks in preventing the spread of disease. But to my surprise the medical literature for the past forty-five years has been consistent: masks are useless in preventing the spread of disease and, if anything, are unsanitary objects that themselves spread bacteria and viruses.
Public Health England has changed its definition of deaths: here's what it means
Authors: Carl Heneghan and Jason Oke
Source: The Centre for Evidence-Based Medicine
Public Health England has changed its definition of deaths. The new definition is now death in a person with a laboratory-confirmed positive COVID-19 test and died within (equal to or less than) 28 days of the first positive specimen date will now be reported
The new data can be accessed here.
What this means is that England has had 36,695 deaths using this definition as opposed to the previous reported 42,072 – a difference of 5,377.
When you observe this difference you can see it is more marked in June, July and August.
For example, under the old PHE system, 2,086 deaths were reported in England in July by date of death, with the 28 days cut off this number is 574 – nearly a quarter of what was previously reported.
The last two days illustrate the difference this change makes to the deaths by reporting date. As opposed to 100 deaths on the 11th of August, 11 would now be reported; today, whereas 72 were reported, only 15 will be reported under the new system.
Source: Lockdown Sceptics
The data continues to unfold exactly in line with a 0.17% false positive rate for the PCR test. Here's the chart.
The definition of "false positive" is important to clarify. One type of false positive would involve detection of not only SARS-CoV-2 but other coronaviruses as well. Perhaps someone who has carefully studied the PCR primers and range of extant human coronavirus sequences could judge how likely this is to occur. A second type of false positive would be the detection of non-infectious viral fragments that can remain in one's respiratory passages for two-three months after the infection has been eliminated by the immune system.
However, the class of false positives most people talk about entails contamination of PCR reactions with trace amounts of viral material – which in PCR labs almost always comes from previous reaction products. The PCR assay works by amplifying a few copies of virus molecules by millions or billions of fold, so it is pretty much impossible to completely avoid having some reaction products escape and contaminate the laboratory or some of the utilised reagents. These then get into, and become amplified in, subsequent test samples, causing false positive results. So let us call these "contamination positives". Since the PCR assays are performed in different laboratories in many places, contamination positives would cause clusters of false positives to pop up in different locations at different times. Sound familiar?
Largest study on home coronavirus antibody testing publishes first findings
Author: Justine Alford
Source: Imperial College London
More than 100,000 people across England have tested themselves for SARS-CoV-2 antibodies at home as part of a major research programme.
Led by Imperial College London, the REACT (REal Time Assessment of Community Transmission) study is using antibody finger-prick tests to track past infections and monitor the progress of the pandemic. It's the first nation-wide antibody surveillance study to be rolled out across England using self-testing at home.
The findings, available in a non-peer-reviewed report submitted to medRxiv, show that slightly under 6% of the population had antibodies to the virus and had likely previously had COVID-19 by the end of June, an estimated 3.4 million people. London had the highest numbers at over twice the national average (13%), while the South West had the lowest (3%).
Key workers in care homes and health care were among those most likely to have already been infected with the coronavirus. And Black, Asian and minority ethnic (BAME) individuals were between two and three times as likely to have had COVID-19 compared to white people.
Preliminary Report of Chinese High Dose Vitamin C for Covid-19 Treatment Studies
Author: Richard Z Cheng MD PhD
Source: Orthomolecular Medicine News Service
(OMNS August 16, 2020) Covid-19 has caused more than 700,000 deaths and USD$86 trillion economic losses worldwide in just over half a year! And yet, there are still no specific drugs or treatments that the top medical advisors (medical agencies) in US are willing to recommend. Really? No specific treatments for Covid-19? Effective, safe and inexpensive treatments for viral infections including Covid-19 do exist. But these medical advisors (medical agencies) either have turned a blind eye or are suppressing these treatments intentionally or not.
Since my early reports of high dose IV vitamin C (HDIVC) for Covid-19 treatment, by Dr. Zhiyong Peng's group in Wuhan and Dr. Enqian Mao's group in Shanghai [1,2], I have been receiving regular inquiries about the results. The studies have been analyzed and papers have been written up. These studies show very promising results including statistically significant reduction in mortality and inflammation of Covid-19 patients treated with HDIVC, with no significant side effect. But no major medical journals have agreed to publish the papers.
While we are waiting for journals to publish these important studies, I'd like to share some of the key results of these studies, as they may help the world in combating Covid-19.
A randomized, controlled clinical trial was carried out in 3 different hospitals in Hubei Province, China, with (Dr. ZY Peng et al). A total of 54 confirmed critical Covid-19 patients were enrolled. Patients with severe acute respiratory syndrome were randomly assigned to either HDIVC or placebo in a 1:1 ratio. HDIVC group received 12 grams of vitamin C in 50 ml IV infusion every 12 hours for 7 days at a rate of 12 ml per hour. The placebo group received sterile water in the same manner. The primary outcome is invasive mechanical ventilation days in 28 days (IMVFD28), the secondary outcome is 28-day mortality, organ failure and inflammation progression.
Hydroxychloroquine: A Morality Tale
Author: Norman Doidge
Publication date: 14 July 2020
Source: Tablet
Early in the coronavirus pandemic, a survey of the world's frontline physicians showed hydroxychloroquine to be the drug they considered the most effective at treating COVID-19 patients. That was in early April, shortly after a French study showed it was safe and effective in lowering the virus count, at times in combination with azithromycin. Next we were told hydroxychloroquine was likely ineffective, and also dangerous, and that that French study was flawed and the scientist behind it worthy of mockery. More studies followed, with contradictory results, and then out came what was hailed by some as a definitive study of 96,000 patients showing the drug was most certainly dangerous and ineffective, and indeed that it killed 30% more people than those who didn't take it. Within days, that study was retracted, with the editor of one of the two most respected medical journals in the Western world conceding it was "a monumental fraud." And on it went.
This revolutionary new coronavirus cure is already saving lives
Author: Chris Smith
Source: BGR
The novel coronavirus is an incredibly scary illness given the complex way it operates. It's incredibly infectious and it can cause severe complications that can lead to death. It even kills younger patients and people who have no other underlying conditions. And some of the people who manage to recover after what could be a months-long battle with COVID-19 will have to deal with secondary health problems that could last a lifetime. That's why you should avoid other people as much as possible, wash your hands often, and wear face masks until treatments and vaccines become available — and even after that. The good news is that doctors and researchers have not run out of ideas in their quest to beat the novel virus. Plenty of promising therapies are in clinical trials right alongside vaccines, as the world will need therapeutics that can cure the infection as well as drugs that can prevent it. Not all of them are "miracle drugs," and remdesivir and dexamethasone are the best examples of that. They're drugs that work and can save lives, but they won't save everyone. And we've often told you that we don't even need a single miracle drug. Instead, combinations of effective medicines could reduce complications and the risk of death. But it turns out there may be a drug that does qualify as a "miracle COVID-19 cure," one that might save plenty of severe COVID-19 patients.
Engineered COVID-19-Infected Mouse Bites Researcher Amid 'Explosion' Of Risky Coronavirus Research
Author: Jonathan Latham PhD
Source: Independent Science News
University researchers genetically engineer a human pandemic virus. They inject the new virus into a laboratory mouse. The infected mouse then bites a researcher…..It is a plot worthy of a Hollywood blockbuster about risky coronavirus research.
But according to newly obtained minutes of the Institutional Biosafety Committee (IBC) of the University of North Carolina (UNC), Chapel Hill, these exact events need not be imagined. They occurred for real between April 1st and May 6th this year.
The identity of the bitten coronavirus researcher has not been revealed except that they were working in a high security BSL-3 virus lab when the accident happened.
According to Richard Ebright, an epidemiologist from Rutgers University, the UNC incident underscores an important development in virus research since the pandemic began:
"There has been an explosion of research involving fully infectious SARS-CoV-2 over the last six months. Research with infectious SARS-CoV-2 now is occurring in every, or almost every, BSL-3 facility in the US and overseas."
Imperial College of London Vaccine to be Tested in Uganda by December 2020
Source: Trial Site News
The Uganda Virus Research Institute (UVRI) aligned with Imperial College of London to launch the country's first COVID-19 vaccine clinical trial by December 2020. With the final internal processes and procedures underway, Professor Pontiano Kaleebu reports the team is authoring the protocol directing the trial associated with the vaccine under development by Imperial College London of the United Kingdom. The first phase trial will center on safety and immunogenicity.
COVID-19 in Uganda
With over 42 million people, Uganda has a good-sized population, but the cases of COVID-19 have not spread very far or wide. There are various hypotheses for this, which TrialSite won't delve into here. According to public records, the entire nation has 1,313 cases and nine deaths. However, the fear is that the virus could spread, and the nation's health authorities don't want to take any chances.
Legacy of Mistrust
In a recent article in the Monitor, the local news reminded all about some of the ethical violations involving clinical trials in past years. Africans have resented any effort to unethically test subjects with foreign vaccines.
Russia Approves World's First Coronavirus Vaccine
Author: Jef Akst
Source: The Scientist
Russian President Vladimir Putin announced today (August 11) that his country had won the global race to approve a vaccine against COVID-19, several news outlets have reported. Despite having only been in clinical trials for less than two months, the vaccine developed by the Gamaleya Institute in Moscow is safe, Putin said at a televised cabinet meeting, noting that it has already been given to one of his daughters, according to Reuters and The Washington Post. The government plans to first vaccinate high-risk groups such as healthcare workers and teachers, with mass vaccination starting in October after large-scale production begins, according to the Associated Press.
"It works effectively enough, forms a stable immunity and, I repeat, it has gone through all necessary tests," Putin said at the meeting, according to The New York Times.
Researchers around the world, including in Russia, expressed worries that Gamaleya and its collaborators may be cutting corners of vaccine development, with no safety or immunity data yet released from ongoing early stage trials, and no Phase 3 trial yet underway. "Fast-tracked approval will not make Russia the leader in the (vaccine) race, it will just expose consumers of the vaccine to unnecessary danger," Russia's Association of Clinical Trials Organizations said Monday as it cautioned against the vaccine's premature approval, according to the AP.
Media – Reporting
Herd immunity must be why Covid-19 is on the wane in Cape Town – doctor
Author: Jarryd Neves
Source: BizNews
I read the article in Biznews of 30 July 2020 entitled "Cape Town puzzled over easing of its coronavirus crisis". In the article it states that authorities do not know why the Cape Town coronavirus crisis is easing. The article notes that numbers are declining despite most businesses having re-opened. The article states that the trajectory of the disease has got many people puzzled. A theory put forward for the decline is that people are adhering to social distancing and wearing of masks.
I would like to suggest a more plausible explanation for the trajectory of the epidemic in Cape Town. Social distancing measures are unlikely to be the correct explanation at this phase of the epidemic since far more social contact and intermixing are occurring now than was the case during level 4 and 5 of the lockdown and yet the numbers are still declining. So we are seeing declining numbers in the face of less stringent social distancing now compared to a few months ago.
I believe that there is only one plausible explanation for the decline in coronavirus numbers in Cape Town, and that is that the herd immunity threshold (HIT) has been reached in the Cape Town region.
Optimism on Covid-19 immunity climbs as studies show antibodies protect and T-cells last longer
Authors: Georgina Hayes and Paul Nuki
Source: The Telegraph
Scientists are growing increasingly confident about the human immune response to SARS-CoV-2 after studies showed antibodies provide "real-world" protection against the virus and cellular immunity may be long-lasting, even in mild cases.
A study of a Covid-19 outbreak on a Seattle fishing boat involving more than 100 sailors has all but proven that antibodies provide protection against re-infection. Meanwhile, an encouraging body of evidence has found that T and B cells remain in the blood even once antibodies fade.
"This is exactly what you would hope for," Marion Pepper, an immunologist at the University of Washington and an author on one of the new studies, told The New York Times. "All the pieces are there to have a totally protective immune response."
"This is very promising," echoed Smita Iyer, an immunologist at the University of California, Davis "This calls for some optimism about herd immunity, and potentially a vaccine."
What if 'Herd Immunity' Is Closer Than Scientists Thought?
Author: Apoorva Madavilli
Source: The New York Times
We've known from the beginning how the end will arrive. Eventually, the coronavirus will be unable to find enough susceptible hosts to survive, fading out wherever it briefly emerges.
To achieve so-called herd immunity — the point at which the virus can no longer spread because there are not enough vulnerable humans — scientists have suggested that perhaps 70 percent of a given population must be immune, through vaccination or because they survived the infection.
Now some researchers are wrestling with a hopeful possibility. In interviews with The New York Times, more than a dozen scientists said that the threshold is likely to be much lower: just 50 percent, perhaps even less. If that's true, then it may be possible to turn back the coronavirus more quickly than once thought.
We are massively overreacting to new Covid 'outbreaks'
Author: Ross Clark
The Imperial College study published this morning claiming that 3.4 million people (six per cent of the UK population) have antibodies indicating that they have been exposed to Covid-19 provides no great revelation. The Office of National Statistics (ONS) has already published similar figures suggesting that 6.5 per cent of the population has been infected. Nevertheless, it is yet more confirmation of how irrelevant are the official statistics for Covid 19 cases – and what a nonsense it is to rely on them for policymaking.
According to the Government's Covid "dashboard", updated at 4pm on Wednesday, 313,798 people in Britain have had the disease. This is less than one tenth of the number suggested by the Imperial study. In other words, for all Matt Hancock's efforts to ramp up testing, the vast majority of cases have not been detected.
This should come as no surprise. Back in March, the Government ordered people with mild symptoms not to bother the NHS; just to stay at home and wait to get better. Moreover, a significant proportion of people infected with Covid-19 show no symptoms whatsoever (the Imperial study claims 30 per cent fall into this category, but evidence from Italy and China suggests it could be as high as 70 to 80 per cent). This group will have seen no reason to get tested.
The Sneaky Trick a Public Health Official Used to Make Mask Mandates Look Super Effective
Author: Jon Miltimore
Source: Foundation for Economic Education
As of early August, 34 US states mandate the use of masks in public to limit the spread of COVID-19.
The efficacy of face masks has been a subject of debate in the health community during the pandemic. Because health experts disagree on their effectiveness, countries and health agencies around the world, including the World Health Organization and the CDC, have done a reversal on their mask recommendations during the pandemic.
Reasonable and persuasive cases can be made both for and against the use of masks in the general population. Unfortunately, the science of masks and viruses is becoming less clear because of the politicized nature of the debate.
A case in point is the Kansas public health official who made news last week after he was accused of using a deceptive chart to make it appear counties with mask mandates had lower COVID-19 case rates than they actually did.
Coronavirus: All New Zealand's confirmed COVID-19 cases to be put in quarantine facilities from now on
Author: Matt Burrows
Source: Newshub
Director-General of Health Dr Ashley Bloomfield announced the change at a press conference on Thursday, moments after revealing there are 13 new cases of coronavirus linked to an outbreak in south Auckland.
The use of quarantine facilities marks a major departure from how positive cases were managed by health officials when New Zealand was last at level 3, as cases earlier in the year were told to simply self-isolate in their homes.
Dr Bloomfield says the mandatory quarantine will apply to both new cases and, if necessary, close family members who might be at risk.
"[It] shows how serious we are about limiting any risk of ongoing transmission - even in self-isolation and including to others in the household," he added.
"A reminder, these facilities have been set up specifically and have excellent processes and resources in place to look after people with COVID-19, including health staff on site at all times.
"It will help us avoid any further inadvertent spread into the community as part of our overall response."
'History will judge the hysteria'
Source: Arutz Sheva
Prof. Udi Qimron will soon head the Department of Clinical Microbiology and Immunology at Tel Aviv University.
In an interview with Yediot Ahronot, Qimron shed further light on the coronavirus. "There is a very great interest for anyone who has supported the draconian measures taken around the world to say that Sweden's policy has failed. Because if it succeeded, and trillions went down the drain for no reason, someone will have to answer for it."
"That is why all over the world they prefer to claim that [Sweden] was wrong. But in the end, the truth came to the surface. In a world where decision makers, their advisers and the media were able to admit their mistake and the initial panic that gripped them, we would have long since returned to routine. The ongoing destruction due to the inability to admit this mistake, despite the epidemic's small mortality numbers, is outrageous. History will judge the hysteria."
"If we had not been told that there was an epidemic in the country, you would not have known there was such an epidemic and you would not have done anything about it," he said emphatically. "The fact that this issue runs all day in the media inflates it beyond its natural dimensions. If black death had raged here, as in the 14th century, you would not have had to follow the situation in the news, the bodies would have piled up in the streets. We were not and we are not in this situation today."
Prof. Qimron noted that the total number of coronavirus deaths does not exceed 0.1% of the total population in any country, and the death rate from coronavirus is less than 0.01% of the total world population, meaning that 99.99% of the world's population so far has survived the epidemic and the virus is negligibly lethal.
Doctors Pen Open Letter To Fauci Regarding The Use Of Hydroxychloroquine for Treating COVID-19
Author: Tyler Durden
Source: Zero Hedge
Dear Dr. Fauci:
You were placed into the most high-profile role regarding America's response to the Coronavirus pandemic. Americans have relied on your medical expertise concerning the wearing of masks, resuming employment, returning to school, and of course medical treatment.
You are largely unchallenged in terms of your medical opinions. You are the de facto "COVID-19 Czar". This is unusual in the medical profession in which doctors' opinions are challenged by other physicians in the form of exchanges between doctors at hospitals, medical conferences, as well as debate in medical journals. You render your opinions unchallenged, without formal public opposition from physicians who passionately disagree with you. It is incontestable that the public is best served when opinions and policy are based on the prevailing evidence and science, and able to withstand the scrutiny of medical professionals.
As experience accrued in treating COVID-19 infections, physicians worldwide discovered that high-risk patients can be treated successfully as an outpatient, within the first 5 to 7 days of the onset of symptoms, with a "cocktail" consisting of hydroxychloroquine, zinc, and azithromycin (or doxycycline). Multiple scholarly contributions to the literature detail the efficacy of the hydroxychloroquine-based combination treatment.
No overseas travel, and no welfare payments: The way the government will force people to get a COVID-19 jab - even as the PM insists the vaccine will NOT be compulsory
Author: Charlie Coë
Source: Mail Online
Australians could face being banned from travelling overseas for refusing jab
Federal Health Minister Greg Hunt said he would 'not rule out' strict measures
Echoed prime minister saying he'd make vaccine 'as mandatory as possible'
Scott Morrison said later on Wednesday he had no power to enforce a vaccine
Mr Hunt said government was not considering making inoculation compulsory
But said authorities would have option of enforcing policies like 'no jab, no pay'
AstraZeneca to be exempt from coronavirus vaccine liability claims in most countries
Authors: Ludwig Burger and Pushkala Aripaka
AstraZeneca has been granted protection from future product liability claims related to its COVID-19 vaccine hopeful by most of the countries with which it has struck supply agreements, a senior executive told Reuters.
With 25 companies testing their vaccine candidates on humans and getting ready to immunise hundred millions of people once the products are shown to work, the question of who pays for any claims for damages in case of side effects has been a tricky point in supply negotiations.
"This is a unique situation where we as a company simply cannot take the risk if in ... four years the vaccine is showing side effects," Ruud Dobber, a member of Astra's senior executive team, told Reuters.
"In the contracts we have in place, we are asking for indemnification. For most countries it is acceptable to take that risk on their shoulders because it is in their national interest," he said, adding that Astra and regulators were making safety and tolerability a top priority.
Coronavirus face masks: an environmental disaster that might last generations
Authors: Keiron Philip Roberts, Cressida Bowyer, Simon Kolstoe and Steve Fletcher
Source: The Conversation
Face coverings are now a legal requirement in many public spaces around the world. But even before they became compulsory, masks were causing litter problems on land and at sea.
One February beach clean in Hong Kong found 70 masks along 100 metres of shoreline, with 30 more appearing a week later. In the Mediterranean, masks have reportedly been seen floating like jellyfish.
Despite millions of people being told to use face masks, little guidance has been given on how to dispose of or recycle them safely. And as countries begin to lift lockdown restrictions, billions of masks will be needed each month globally. Without better disposal practices, an environmental disaster is looming.
The majority of masks are manufactured from long-lasting plastic materials, and if discarded can persist in the environment for decades to hundreds of years. This means they can have a number of impacts on the environment and people.
CDC: A Quarter of Young Adults Say They Contemplated Suicide This Summer During Pandemic
In economics, we talk a lot about unintended consequences.
It's easy to forget that societies are complex ecosystems. Legislators often pass sweeping changes hoping to achieve one result, not realizing it will create countless other consequences not intended.
Some of the unintended consequences will be positive, but many of them will not be. A case in point can be found in new government statistics that show a surge in suicidal thoughts among young adults during the COVID-19 pandemic.
Global firms expected to sue UK for coronavirus losses
Author: Jamie Doward
Source: The Guardian
Governments around the world – including the UK – face a wave of lawsuits from foreign companies who complain that their profits have been hit by the pandemic.
Webinars and presentations shared with clients reveal that leading global law firms anticipate governments around the world will soon face claims over their response to the Covid-19 crisis. The actions are being brought under investor state dispute settlement (ISDS) clauses which are embedded in trade and investment agreements and allow foreign investors and firms to sue other countries' governments.
The claims are heard in highly secretive ad hoc tribunals before a panel of three judges. Often it is not apparent that a case is being brought until the panel sits.
NHS bosses warn mental [health] staff facing 'burnout' amid coronavirus pandemic
Author: John Johnston
Source: PoliticsHome
NHS bosses have warned of "unprecedented challenges" facing mental health services in the wake of the coronavirus pandemic.
The NHS Confederation, which represents health services in England, Northern Ireland and Wales, called for "intensive investment" from the Government to prepare mental health teams for a surge in patients.
In a new report, the group said an initial drop in referrals at the start of the crisis had now reversed, with some health providers reporting they were treating more patients than pre-pandemic levels.
And they said some services were seeing a 20% increase in patients, despite being forced to cut their capacity by 10-30% due to infection control and social distancing measures.
It comes after the Centre for Mental Health estimated an additional 500,000 people could require support for mental health over the next two years as a result of the pandemic.
GDP monthly estimate, UK: June 2020
Source: Office for National Statistics
UK GDP fell by 20.4% in Quarter 2 (Apr to June) 2020
Figure 1: GDP saw its second consecutive quarterly decline in Quarter 2 2020
UK GDP growth, Quarter 1 (Jan to Mar) 2005 until Quarter 2 (Apr to June) 2020
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The trauma severity model: An ensemble machine learning approach to risk prediction.
Home » Citations » The trauma severity model: An ensemble machine learning approach to risk prediction.
Summary of "The trauma severity model: An ensemble machine learning approach to risk prediction."
Statistical theory indicates that a flexible model can attain a lower generalization error than an inflexible model, provided that the setting is appropriate. This is highly relevant for mortality risk prediction with trauma patients, as researchers have focused exclusively on the use of generalized linear models for trauma risk prediction, and generalized linear models may be too inflexible to capture the potentially complex relationships in trauma data. To improve trauma risk prediction, we propose a machine learning model, the Trauma Severity Model (TSM). In order to validate TSM's performance, this study compares TSM to three established risk prediction models: the Bayesian Logistic Injury Severity Score, the Harborview Assessment for Risk of Mortality, and the Trauma Mortality Prediction Model. Our results indicate that TSM has superior predictive performance on National Trauma Data Bank data and on Nationwide Readmission Database data.
Efficient corrections for DFT noncovalent interactions based on ensemble learning models.
Ensemble machine learning prediction of posttraumatic stress disorder screening status after emergency room hospitalization.
Dynamic multi-outcome prediction after injury: Applying adaptive machine learning for precision medicine in trauma.
A comparative study on machine learning based algorithms for prediction of motorcycle crash severity.
Predicting residential structures from open source remotely enumerated data using machine learning.


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Co-Working Solutions
Arlington is home to several co-working solutions for startups needing space for collaboration and innovation. For additional information on co-working opportunities in Arlington and connecting with providers, please email [email protected].
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redpajama_set_name: RedPajamaCommonCrawl


Providenciales, 26 May 2015 – A man is in custody following the death of a woman at Dock Yard near Kew Town yesterday.
About 2:56pm (Monday 25 May 2015), emergency services were called to a home in Dock Yard after reports of a woman had been injured at the property.
Officers attached to various units arrived to find the body of a 44-year-old woman who appeared to have suffered severe injuries to her body. Doctors arriving on scene examined the woman and later pronounced her dead.
A crime scene was established at the home, which was examined by forensic specialists and detectives.
Following further inquiries a 25-year-old man was arrested in the down town area of Providenciales shortly before 4pm.


Making pendants is super relaxing, so I've been experimenting with some new designs! You can find them on Etsy, as usual.
Anyway, newsletter and Patreon subscribers can expect coupons, as usual, in time for holiday shopping. Keep an eye on your inboxes!


text:
Thursday November 7, 2013 5:00 am
Jennifer Aniston Was Bored of Her Hair
Posted by Andru Edwards Categories: Celebrities, Hairstyles,
Jennifer Aniston chopped off her long locks because she was "bored."
The We're the Millers actress debuted a chic blonde bob on Monday while running errands in Los Angeles, which came as a surprise after years of wearing her trademark honey-colored hair down past her shoulders.
She told Vogue magazine the radical change was a spur-of-the-moment decision, saying, "I'm always one of those girls who does a big old chop just to get it really healthy, to repair all the [damage from] hair coloring and stuff like that. And I just got bored, honestly. It's fun to change it up once in awhile."
The We're The Millers actress also revealed her transformation was the result of her addiction to Brazilian blow dries, which use a combination of formaldehyde and keratin to keep locks straight for up to three months. Before stepping out in public with her shorter cut, Jennifer explained to Elle magazine, "It wasn't for a role. My hair went through a phase - this thing called a Brazilian and my hair did not react really well to it."
The star - who is engaged to Justin Theroux - has no regrets about getting six inches taken off her hair length: "I did it! I feel great. I feel lighter. It's simple, it's really simple, that's for sure."
Jennifer is famed for her sleek and shiny hair, which caused a worldwide craze in the 90s when fans of popular sitcom Friends copied her iconic layered bob, which became known as The Rachel after her character in the show. The brunette is also a spokesperson and part-owner of haircare company Living Proof.
Gallery: Jennifer Aniston Was Bored of Her Hair
actresses, celebrities, hair cuts, hair styles, haircuts, hairstyles, jennifer aniston


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Memorial service for Wopashitwe Mondo Eyen we Langa held in Omaha
It was a place of joy and a place of sorrow. An event both somber and heartwarming. A time of tributes and a time for reflection. It was a memorial service for Wopashitwe Mondo Eyen we Langa, formerly David Lewis Andrew Rice. Buddy Hogan gave opening remarks at the Malcolm X Memorial Center in Omaha on March 26 to honor Mondo, who died two weeks earlier at the Nebraska State Penitentiary.
Mondo served forty-five years of a life sentence for the murder of an Omaha policeman, but you could not convince any of the one hundred persons attending the memorial service of his guilt. Mondo went to his death proclaiming his innocence and once wrote, "I'm paying on a debt I do not owe."
Condolences from Black Panther in-exile Pete O'Neal were read. O'Neal, formerly from Kansas City, now lives in Tanzania. Mondo was attending a rally in August 1970 in Kansas City for O'Neal who had been arrested by the Alcohol, Tobacco and Firearms Division when Mondo's house in Omaha was searched by police and ATF agents who claim they found dynamite in the basement. Mondo's house was unlocked and wide open when police arrived for the search.
Tekla Agbala Johnson conducted an African Spirituality and Initiation into the Ancestor Realm ceremony, which she conducted in Kiswahili. Mondo would likely have approved, as he chose words from four African languages to compose his name. Sondra McSwain, a local Omaha dancer, performed an African Welcoming Dance which included a call and response with the audience.
Black Panther Party archivist and activist, Billy X, also known as Bill Jennings, brought messages from Panther members scattered in Australia, Great Britain, New Zealand, and other parts of the world and around the United States. Billy X never forgot about Mondo, owns several pieces of Mondo's art, and corresponded with him over the long years in prison.
National Jericho Movement Chair, Jihad Abdulmumit, spoke about the need to continue the work, to free all political prisoners. Mondo had been on Jericho's list of political prisoners for years and the organization has repeatedly called for Mondo's release.
Writer Linda Kennedy gave the history of the Harambee African Cultural Organization at the Nebraska State Penitentiary. The organization flourished under Mondo's leadership. She also spoke about Mondo's affect on others—that he could have been a bitter body builder— instead he was a mentor and friend. "No one knows," Kennedy said, "how many lives he touched, how many young men he may have saved."
Part of the ceremony included African drumming. The drummer said, "They can take your body, they can take your mind, they can even break your heart—but don't let them take your soul."
A message of farewell from Ed Poindexter to his old friend was read. Poindexter was Mondo's co-defendant and has also done forty-five years of his life sentence. The pair became known as the Omaha Two and both men were targets of the clandestine COINTELPRO operation by the Federal Bureau of Investigation. Poindexter remains imprisoned at the Nebraska maximum-security prison and could not attend the memorial service.
Activist and author, Angela Davis, read Mondo's poem, "When It Comes To This Point" about recent police shootings of unarmed young black men. Davis was kind and gracious and a captivating speaker. Davis said despite the conditions under which Mondo lived, he was funny and maintained a sense of humor and in spite of the inhumane conditions, Mondo retained his humanity. Davis, at one time on the FBI's Ten Most Wanted list, has made a number of trips to Nebraska over the years to show her support for the Omaha Two.
In prison, Mondo conducted himself as an innocent man would and consequently held his head high, not in arrogance but with pride. Mondo did not let a wrongful conviction influence his approach to people. Mondo remained both a gentle man and a gentleman, gaining the respect of many.
Nebraskans For Justice President Tariq Al-Amin spoke of police violence/brutality. Al-Amin, a former Omaha policeman himself, was praised by Buddy Hogan as being, "what a police officer should be." Hogan said, "He was there to protect and serve. And he continues to serve his community."
Mondo's nieces Shanita Rice and Melissa Rice Stratford and nephew Michael Rice spoke of Mondo, not as a political figure, but as their beloved uncle who kept track of their schools, birthdays, grades, and hobbies. Mondo encouraged their education and told them how important it is to read. He sent them books and encouraging letters.
One woman attending the memorial event said it was a lovely service with beautiful music and eloquent speakers, yet she sat teary-eyed throughout. The celebration of Mondo's life was made more poignant by the tragedy of forty-five years behind bars.
Supporters of Mondo reaffirmed their dedication to work to free Ed Poindexter so the next event can be a homecoming celebration and a real testament to Mondo's life. The event ended with everyone raising their hands in a Black Power salute and chanting five times, "Power to the People."
Linda Kennedy and Bonnie Cosentino-Welsch contributed to this report
Wopashitwe Mondo Eyen we Langa explains David Rice is not his name
Amnesty International investigator on Wopashitwe Mondo Eyen we Langa's death
Political prisoner Wopashitwe Mondo Eyen we Langa has joined the ancestors
Prison interviews with Wopashitwe Mondo Eyen we Langa
The last poem of Wopashitwe Mondo Eyen we Langa


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Humamities
History of the Americas
An Inquiry into the Law of Negro Slavery in the United States of America Hardback
by Thomas Read Rootes Cobb
Part of the Studies in the Legal History of the South series
First published in 1858 and unavailable since the 1970s, An Inquiry into the Law of Negro Slavery in the United States of America was the first and only treatise published by a southern author on slavery law.
Thomas R. R. Cobb, often referred to as "the James Madison of the Confederacy," was an ardent secessionist and a prominent lawyer in antebellum Georgia.
The work, based on extensive scholarship on the Roman law of slavery and racist to the core, fully explicates the southern defense of slavery.
An important practical manual for legal practitioners and judges at the time of its publication and an essential tool for scholars and students of slavery and legal history ever since, the work is also the most significant summary of proslavery legal theory.
Format:Hardback
Pages:600 pages
Publisher:University of Georgia Press
Modern history to 20th century: c 1700 to c 1900
Slavery & abolition of slavery
Constitutional & administrative law
Paperback / softback from £38.69
Paperback / softback | Published 18/01/2015 | £38.69 | View now
Also by Thomas Read Rootes Cobb | View all
An Historical Sketch of Slavery, from...
General Digested Index to Georgia...
An Inquiry Into the Law of Negro...
Also in the Studies in the Legal History of the South series | View all
Federal Law and Southern Order
The Legal Ideology of Removal
Defending Constitutional Rights


text:
A Dictionary of Archit...
A Dictionary of Architecture and Landscape Architecture
James Stevens Curl
Published online January 2006 | e-ISBN: 9780191726484 | DOI: https://dx.doi.org/10.1093/acref/9780198606789.001.0001
'Splendid...much more perceptive than its recent predecessors...you can't have a more concise, entertaining and informative guide to the words of architecture', Architectural Review
The first edition of the Dictionary of Architecture received excellent reviews. Now it has been fully revised, and expanded, bringing it completely up-to-date. There are entries on architects, terms, periods, and styles, covering all periods of Western architectural history. Biographies range from Brunelleschi and Imhotep to Le Corbusier and Richard Rogers. New entries include definitions of landscape terms, and...
The first edition of the Dictionary of Architecture received excellent reviews. Now it has been fully revised, and expanded, bringing it completely up-to-date. There are entries on architects, terms, periods, and styles, covering all periods of Western architectural history. Biographies range from Brunelleschi and Imhotep to Le Corbusier and Richard Rogers. New entries include definitions of landscape terms, and biographies of modern architects. Each entry is followed by a mini-bibliography, with suggestions for further reading.
Book. 6162 pages. 608057 words. Illustrated.
Subjects: Architecture
Aalto, Hugo Alvar Henrik (1898–1976) in A Dictionary of Architecture and Landscape Architecture
Aaron's rod in A Dictionary of Architecture and Landscape Architecture
abaciscus in A Dictionary of Architecture and Landscape Architecture
abaculus in A Dictionary of Architecture and Landscape Architecture
abacus in A Dictionary of Architecture and Landscape Architecture
Abadie, Paul (1783–1868) in A Dictionary of Architecture and Landscape Architecture
abamurus in A Dictionary of Architecture and Landscape Architecture
abated in A Dictionary of Architecture and Landscape Architecture
abat-jour in A Dictionary of Architecture and Landscape Architecture
abaton in A Dictionary of Architecture and Landscape Architecture
See all items in Oxford Index »


text:
Saudis Bristle at Obama's Outreach to Iran
by Daniel Pipes
http://www.danielpipes.org/13720/saudis-iran-obama
Translations of this item:
The "Joint Plan of Action" signed with Iran by the so-called P5+1 (China, France, Germany, Russia, the U.K., and the U.S.) on Nov. 24 in Geneva caused Shiite Arabs to celebrate, Sunni Arabs to worry, and Saudis to panic. The Saudi response will have far-reaching and unpredictable consequences.
Jubilant crowds welcomed the Iranian negotiator home from Geneva.
As Iran's chief negotiator, Mohammad Javad Zarif, brought home a deal worth about US$23 billion to Iran, Arab Shiites fell into step with Tehran. Prime Minister Nouri al-Maliki of Iraq expressed his "full support for this step." President Bashar al-Assad of Syria welcomed the agreement as "the best path for securing peace and stability." Parliamentary Speaker Nabih Berri of Lebanon called it the "deal of the century." And Hezbollah considered the agreement a "great victory for Iran."
Syria's Assad, here scratched out, praised the Geneva deal.
Among Sunni Arabic-speakers, in contrast, responses ranged from politely supportive to displeased to alarmed. Perhaps most enthusiastic was the Egyptian governmental newspaper Al-Ahram, which called the deal "historic." Most states stayed mum. Saudis expressed the most worry. Yes, the government cabinet officially stated that "If there is goodwill, then this agreement could be an initial step toward reaching a comprehensive solution to Iran's nuclear program," but note the skepticism conveyed in the first four words.
If that was the mildest response, perhaps the most unbuttoned comment came from Alwaleed bin Talal, a Saudi prince who occasionally sends up trial balloons for the royal family: He called Iran "a huge threat" and noted that, historically speaking, "The Persian empire was always against the Muslim Arab empire, especially against the Sunnis. The threat is from Persia, not from Israel," a ground-breaking and memorable public statement.
Saudi prince Alwaleed bin Talal on his airplane throne, sitting under the logo of his company.
Alwaleed then detailed how the Iranians are "in Bahrain, they are in Iraq, they are in Syria, they are with Hezbollah in Lebanon and Hamas, which is Sunni, in Gaza." As this listing suggests, Saudis are fixated on the danger of being surrounded by Iran's agents and are more scared by the non-nuclear implications of the joint plan than the nuclear ones. Gregory Gause of the University of Vermont sees Saudis worrying that the accord opens the way "without any obstacles" for Iran to achieve regional dominance. (This contrasts with the Israeli and Western position, which focuses on the nuclear danger.)
Abdullah al-Askar, foreign affairs committee chairman of the kingdom's appointed Shura Council, elaborates: he worries "about giving Iran more space or a freer hand in the region. The government of Iran, month after month, has proven that it has an ugly agenda in the region, and in this regard no one in the region will sleep and assume things are going smoothly. … The people of the region … know that Iran will interfere in the politics of many countries."
Saudi media reiterated this line of analysis. Al-Watan, a government newspaper, warned that the Iran regime, "which sends its tentacles into other regional countries, or tries to do so by all means necessary," will not be fettered by the accord. Another daily, Al-Sharq, editorialized about the fear that "Iran made concessions in the nuclear dossier in return for more freedom of action in the region."
Some analysts, especially in the smaller Persian Gulf states, went further. Jaber Mohammad, a Bahraini analyst, predicted that "Iran and the West will now reach an accord on how to divide their influence in the Gulf." The Qatari government-owned Al-Quds Al-Arabi worried about "a U.S.-Iran alliance with Russian backing." Rumors of Obama wanting to visit Tehran only confirm these suspicions.
The Saudi ambassador in London, Prince Mohammed bin Nawaf bin Abdulaziz, drew the most overt public conclusion, threatening that "We are not going to sit idly by and receive a threat there and not think seriously how we can best defend our country and our region." To put it mildly, this is not how Saudi diplomats normally speak about fellow Muslims.
What does this unwonted rhetoric amount to? Iranian bellicosity and the Obama administration's pro-Iran policies have combined to end many decades of Saudi strategic reliance on Washington and to begin thinking how to protect themselves. This matters, because as Alwaleed rightly boasts, his country is leader of the Arabs, enjoying the most international, regional, cultural, and religious clout. The results of this new-found assertiveness – fighting against fellow Islamists, allying tacitly with Israel, perhaps acquiring Pakistani-made nuclear weapons, and even reaching out to Tehran – marks yet another consequence of Barack Obama's imploding foreign policy.
Mr. Pipes (DanielPipes.org) is president of the Middle East Forum. © 2013 by Daniel Pipes. All rights reserved.
Related Topics: Iran, Saudi Arabia, US policy
The Geneva Agreement with Iran: A Foreign Policy Disaster
Using Cold War Tactics to Confront Iran
[Iraq and Iran:] The Tarbabies of American Politics
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Reader comments (27) on this item
3 Could This Be One Reason Why Saudis Are Worried? [94 words] yonason Dec 29, 2014 14:13 220002
1 Very interseting Shia hadith [114 words] dhimmi no more Dec 30, 2014 08:44 220002
Thanks For The Deeper Analysis [61 words] yonason Jan 11, 2015 12:46 220002
1 Shia v. Sunni Islam [363 words] dhimmi no more Jan 16, 2015 13:33 220002
Very Interestng [68 words] yonason Jan 21, 2015 23:39 220002
1 Atheists in Saudi Arabia! [282 words] dhimmi no more Jan 23, 2015 13:30 220002
Some Signs Of Hope, Perhaps [171 words] yonason Jan 27, 2015 12:18 220002
1 America's friendly enemies. [90 words] Mike Massey Sep 29, 2014 23:34 218324
3 who cares [25 words] Peter, Scotland Dec 10, 2013 17:17 212104
3 Always look at the Big Picture [96 words] Michael Hanni Morcos Dec 7, 2013 19:23 212046
2 Islamic Power Struggle [190 words] Mike Ramirez Dec 4, 2013 23:41 212011
2013 : A BAD YEAR TO BE A SUNNI [183 words] PAUL JEFFERY Dec 4, 2013 18:08 212006
Different Hymn Sheets [116 words] Amin Riaz Dec 25, 2013 22:21 212006
where do you live? [49 words] Yebiveter Dec 31, 2014 04:45 212006
3 The enemy of my enemy is my friend [101 words] dhimmi no more Dec 4, 2013 08:24 211997
Dear DNM [70 words] Debanjan Banerjee Jan 8, 2014 02:21 211997
3 My enemy and my friend revisited [534 words] dhimmi no more Jan 11, 2014 09:53 211997
Dear DNM [328 words] Debanjan Banerjee Jan 11, 2014 22:19 211997
3 Mullahs and Mobeds and other sordid matters [1193 words] dhimmi no more Jan 15, 2014 10:33 211997
2 Arabian imperialism and its victims and the Qur'an says in Q9:60 that Muslims should bribe non Muslims to get them to convert to Islam! What a disaster [489 words] dhimmi no more Jan 19, 2014 10:14 211997
2 Keep the Arabs upset and their preachers out of the Civilized world. [262 words] Petros Houhoulis Jan 23, 2014 18:29 211997
I'll Give You My Response [39 words] yonason Jan 12, 2015 15:50 211997
3 Saudi prince Alwaleed bin Talal on his airplane throne [38 words] Ray Dec 3, 2013 18:59 211992
2 Israel's new image [169 words] myth Dec 3, 2013 17:29 211991
3 Global View changes game [215 words] Mark Werfel Dec 3, 2013 09:13 211982
P5+1 all outsiders [108 words] myth Dec 3, 2013 08:14 211981


Nearly 40 missionary units, including more than 30 couples and several singles, are directly or indirectly sharing the gospel, discipling new believers, and training new leaders for churches. Around 20 missionary units serve overseas in Latin America, Europe, the Middle East, Africa, and Asia. Others have ministries based in the United States and serve high school and college students, military families, Jewish people, and Hispanics in both this country and Mexico. Some work in vital support positions in North America, and those who live in the area also serve in various ministries right here at Lake Ridge. Below are bios and other information for many of our missionaries.
Bob & Sharla joined Camino Global in 1993. They served in Mexico for almost 15 years in Pachuca and Queretaro in the areas of church planting, children's and youth ministries, and Latin missions mobilization. Currently Bob serves Camino Global's 30+ team leaders as Director of Field Ministries.
Milad is the Director the Christian Alliance Institute of Theology (CAIT) and the senior pastor of the Christian Evangelical Alliance Church in Beirut (known as the Karantina Alliance Church). He has been lecturing at CAIT since 1989 in the fields of Old Testament and Systematic Theology. He and Anna, an elementary English teacher on the outskirts of Beirut, have three grown children.
God has used the ministry of Young Life throughout east Dallas since the 1940s. David accepted Christ through the ministry of Young Life in 1980. He has been the area director in Garland for the last 3 ½ years. The job ahead of us truly is an amazing opportunity that we can only begin to be attempted with the guidance of the Holy Spirit and much hard work. The new area represents 17 high schools and 27 middle schools. That's more than 50,000 kids who need to hear the story of God who created them to be in relationship with their Creator.
Roger retired as Senior Pastor of Lake Ridge Bible Church after 18 years of service in June of 2017 and serves Lake Ridge as part-time pastor of Senior Adults and Missions. Roger & Judy serve with Camino Global as members of their Pastoral Care Team. Roger & Judy have been married 42 years and have three adult children and five grandchildren.
The Shepherds provide counsel, encouragement, and soul care for missionaries and Christian leaders from the more than 20 countries that make up the Eastern European Block. They are currently preparing the Garden House in Budapest as a "soul care center".
Andrew and Lori serve at East Asia School of Theology, a seminary dedicated to training Asian students from China, Mongolia, Myanmar, India, Malaysia, Korea, Japan, Cambodia, and Singapore. Andrew teaches Bible and Greek classes; Lori teaches English.
Church planting, evangelism, mentoring, Camp Ministry, and Bible Institute ministry in Aguascalientes, Mexico.
Jarod is the pastor of Chesterfield Bible Church in Chesterfield, IL, a small village of less than 250 people. The average Sunday morning attendance is 40. The support of RHMA makes it possible for small rural congregations to have a pastor.