The Edinburgh University-led research will identify why the disease affects some more than others.

A new study by University of Alberta paleontologists shows that one type of ancient reptiles evolved a special type of tooth enamel, similar to that of mammals, with high resistance to wear and tear. The study is the first to report this kind of enamel in a fossil reptile.

Ants use their numbers to overcome navigational challenges that are too large and disorienting to be tackled by any single individual, reports a new study in the open-access journal eLife.

The rainforest fjords of Southeastern Alaska harbour one of the highest concentrations of lichen diversity found anywhere on Earth, according to a new study spearheaded by University of Alberta scientists.

The general goal is to try and distance yourself as much as possible from the novel coronavirus. However, a controversial approach called 1 Day Sooner is aiming to purposely infect a large number of volunteers with the virus to speed up clinical trials. 

When Health24 reported on this approach in late April 2020, 2 300 volunteers had already signed up for this grassroots effort. But that number has now grown to more than 16 000, according to the latest reports.

What is the goal of this approach?

Co-founder Josh Morrison wants to use this campaign to demonstrate that many people are keen to participate in helping to speed up clinical trials and the possible success of a vaccine.

Without a successful vaccine or treatment, the only reality is to live with the virus and practice measures of physical distancing. A vaccine is the only way to return to a normal world as we know it. Unfortunately, developing a vaccine takes a long time and comprises several stages – the four phases of clinical trials being crucial to establish safety and efficacy in a large, diverse group of people.

Morrison stated that the goal of 1 Day Sooner is to recruit as many people as possible to pre-qualify them as suitable to participate in human trials as they occur.

Controversial or selfless?

But what about the ethics and risks involved in voluntarily being infected with a virus? Dr Nir Eyal, director of the Center for Population-Level Bioethics at Rutgers University agrees that it’s not a standard approach, but that it may help.

“It’s not every day we give a healthy individual an exposure to a pathogen – the very same thing doctors are trying to protect people from, but it becomes increasingly clear that the only sustainable exit from the current health and societal crisis is a vaccine, and there are ways to conduct such a trial that are perfectly ethical,” he said in a statement.

What does the human challenge entail?

Initially, people who sign up for this challenge should be relatively young and healthy.

According to an article published in Nature, the risk of harm in volunteers is reduced significantly when they are between the ages of 20 and 45 and generally healthy.

The goal is not to make anyone significantly ill.

Volunteers are also kept safe by daily monitoring and access to medical care once they are infected, Morrison said.

Would authorities allow this?

While there are currently no plans for a public study in the US, several politicians and volunteers are pushing for this, and the World Health Organization (WHO) has released a document to set out criteria for an ethically acceptable plan.

The Food and Drug Administration (FDA) has never allowed a trial of this type for a disease this new, especially without a specific cure, but hasn’t ruled out the possibility completely. Right now, they are open to the idea, but advise caution.

“Human challenge studies are a way to expedite the development of a vaccine to prevent Covid-19,” the FDA stated in an article. “Because these studies involve exposing volunteers to the virus, the studies raise a variety of potential scientific, feasibility, and ethical issues. The FDA will work with those who are interested in conducting human challenge trials to help them evaluate these issues.”

Dr Matthew Memoli, director of clinical studies at the Laboratory of Infectious Diseases at the National Institutes of Health, also stated that a human challenge trial of this type might be pursued as the pandemic is rapidly changing our society.

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Compiled by Marelize Wilke

The number of organ transplants in the UK last month was the lowest for 36 years, figures show.

Care home deaths fall 12% in past week with ministers expressing “relief” cases may have peaked.

Fear of exposure to Covid-19 appears to be exacting an unexpected toll on public health: Childhood vaccination rates have plummeted, leaving millions at risk for other life-threatening illnesses.

“We’re seeing a general drop in paediatrician visits of 70% to 80% – and that’s very concerning,” said Dr Sara Goza, president of the American Academy of Pediatrics (AAP). She added that the pandemic has prompted many parents to skip “well visits” for their little ones.

Babies under age two traditionally get check-ups this time of year, and older kids get vaccinated for summer camp. But not this spring, she said.

Dr Sean O’Leary, an associate professor of paediatrics-infectious diseases at the University of Colorado, in Aurora, agreed. “Most practices are seeing a huge drop,” he said.

Public health disaster

The US Centers for Disease Control and Prevention is trying to get a handle on the pandemic’s effect on childhood vaccine rates.

“We are currently examining the impact on a national level,” said Dr Melinda Wharton of the CDC’s National Center for Immunization and Respiratory Diseases. The agency’s findings and additional guidance will be published in the next several weeks, she added.

Evidence of a potential public health disaster is already more than anecdotal. The New York Times reported last week on a paediatric vaccine survey by the Physician’s Computer Company (PCC), a paediatric electronic health records firm.

PCC contacted 1 000 independent paediatricians to collect pre-Covid vaccine numbers as well as current vaccination rates. Vaccine figures from the week ending on 16 February were compared to those from the week ending on 5 April.

The upshot: Diphtheria and whooping cough shots were down 42%, human papillomavirus (HPV) shots fell 73%, and vaccination for measles, mumps and rubella (MMR) dropped 50%, according to the Times.

The recent drop-off is worrisome, because it follows a wave of vaccine resistance dating to the late 20th century. The refusal of some parents to vaccinate their kids on health and religious grounds has led to a return of infectious diseases that had been eradicated or nearly so.

High vaccination rates

“This really is an impending crisis,” O’Leary said.

The MMR shot is a must-have paediatric vaccine, experts say. It’s a two-dose immunisation, with the first shot given between 12 and 15 months of age, followed by a second round between four and six years of age. The idea that thousands of kids are missing their shots is very troubling, O’Leary said.

“For decades, the US has maintained very high vaccination rates overall, despite the impression you might get from recent coverage about certain pockets of the country refusing to get their children vaccinated,” he said.

To prevent disease outbreaks, vaccine coverage must be high. Typically, more than 90% of people must get their shots for so-called “herd immunity” to kick in. For the most part, O’Leary said, “that’s what we’ve been able to do”.

Now, Goza said, that society-wide protection is at risk.

“The fear is that our whole vaccine structure can crumble if parents don’t bring their children in,” she explained.

Patient visits down

Goza and O’Leary said several forces are keeping recent vaccine rates down: Parents are worried about going out during the pandemic; like other businesses, some paediatric offices have had the financial rug pulled out from under them; and some now offer only emergency care.

O’Leary noted that the CDC and AAP have advised paediatricians not to stop vaccinating.

But with patient visits down, some practices are struggling to pay their staff and might not even be able to afford vaccines, he pointed out. “A lot of practices are struggling or simply shutting their doors,” O’Leary said.

So what’s the prescription?

Some point to a renewed interest in physician house calls, or even drive-by vaccinations. But both Goza and O’Leary said the imperative must be to restore parental confidence in the safety of child-treatment facilities.

“Paediatricians are going above and beyond to make our spaces safe,” Goza said. “We’re constantly cleaning between patients, and using personal protective devices as needed. We’re triaging with sick patients via telehelp, to keep them outside of the office, or even seeing them in the parking lot.”

Afraid for ‘little ones’

Staggering sick-patient appointments and well-visits is another tactic, she said, as is maintaining separate care spaces or entrances.

Like hospital emergency departments, paediatric offices also operate under the assumption that anyone can be a Covid-19 spreader, O’Leary said.

“Nobody wants their staff or patients to get sick, and everyone has quickly ramped up to do what needs to be done to provide safe care – all of which means the likelihood of Covid transmission in a paediatrician’s office is actually very low,” he said.

Goza said she’s afraid for the little ones whose shots are getting skipped.

“We have to get the message out, because I worry about the young children, the babies,” she said, recalling the days before vaccination was available for the brutal and sometimes deadly disease meningitis. “I remember those days. And I don’t want to go back,” Goza said.

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Heart failure raises the risk of complications and death from Covid-19, and requires extra vigilance during the pandemic, the American Heart Association (AHA) says.

More than six million people in the United States have heart failure. It occurs when the heart no longer pumps blood as well as it should.

“When the cardiac system is weakened by heart failure and unable to maintain normal efficiency, it can be susceptible to the inflammatory stress induced by a viral infection like Covid-19,” Dr Jacob Chemmalakuzhy said in an association news release. He’s medical director of advanced heart failure and transplant cardiology at Medical City Heart Hospital in Plano, Texas.

Another concern is that people with heart failure may have a weakened immune system.

Do these things every day

If you have heart failure, the AHA says you must manage your symptoms and report significant changes to your health care provider team. This enables the team to monitor your symptoms – which can be done via telemedicine – before deciding if you should go to a hospital.

According to the association, people with heart failure should do these things every day:

• Weigh yourself and report increases of 2–3 pounds to your health care team
• Monitor any swelling in the legs
• Monitor shortness of breath
• Watch for chest pain
• Assess whether you can do the same level of physical activity as the previous day
• Make sure you get enough restful sleep

As much as possible, people with heart failure should avoid exposure to others due to the risk of Covid-19.

Because of this, the heart association also offered suggestions for people who can’t make in-person visits to loved ones with heart failure.

You can keep in touch virtually or by phone to see how your loved one is doing. Mention the need to do daily self-checks and to take prescribed medications.

Virtual appointments

Make a plan in case your loved one develops Covid-19 symptoms: Have him or her call their health care team to find out the next steps for care and testing.

People with heart failure also need to know to call 911 if they have life-threatening symptoms, such as shortness of breath that comes on suddenly and does not resolve with rest, or is paired with chest pain, dizziness or lightheadedness.

Help your loved one with virtual appointments if in-person appointments aren’t an option. Set up a conference call so you can listen in and ask questions, and ask the healthcare provider for guidance if there is an immediate need for tests and visits.

Offer to get groceries and do other outside errands for your loved one, or offer to arrange grocery deliveries.

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