Climate Catastrophes as a Sum of Known Risks

An ever-increasing body of research has warned for decades about the impacts of climate change on agriculture, health, flooding, economy, among many others and provided information about when and where these impacts could be larger. Are societies prepared for these expected ‘white-swans’, particularly in the context of a high degree of interconnectedness in Nature and in society? I borrow from the development of the Covid-19 pandemic to illustrate this view. Influenza pandemics have been foreseen decades before, but the characteristics of the virus and the socioeconomic links have made it into the global crisis that it had become in 2020.

Examining the Executioners, Influenza Associated Secondary Bacterial Pneumonia

Influenza infections typically present mild to moderate morbidities in immunocompetent host and are often resolved within 14 days of infection onset. Death from influenza infection alone is uncommon; however, antecedent influenza infection often leads to an increased susceptibility to secondary bacterial pneumonia. Bacterial pneumonia following viral infection exhibits mortality rates greater than 10-fold of those of influenza alone. Furthermore, bacterial pneumonia has been identified as the major contributor to mortality during each of the previous four influenza pandemics. Streptococcus pneumoniae, Staphylococcus aureus, Haemophilus influenzae, and Streptococcus pyogenes are the most prevalent participants in this pathology. Of note, these lung pathogens are frequently found as commensals of the upper respiratory tract. Herein we describe influenza-induced host-changes that lead to increased susceptibility to bacterial pneumonia, review virulence strategies employed by the most prevalent secondary bacterial pneumonia species, and highlight recent findings of bacterial sensing and responding to the influenza infected environment.

Promising Expectations for Pneumococcal Vaccination during COVID-19

The emergence of new viral infections has increased over the decades. The novel virus is one such pathogen liable for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection, popularly known as coronavirus disease 2019 (COVID-19). Most fatalities during the past century’s influenza pandemics have cooperated with bacterial co/secondary infections. Unfortunately, many reports have claimed that bacterial co-infection is also predominant in COVID-19 patients (COVID-19 associated co/secondary infection prevalence is up to 45.0%). In the COVID-19 pandemic, Streptococcus pneumoniae is the most common coinfecting pathogen. Half of the COVID-19 mortality cases showed co-infection, and pneumonia-related COVID-19 mortality in patients >65 years was 23%. The weakening of immune function caused by COVID-19 remains a high-risk factor for pneumococcal disease. Pneumococcal disease and COVID-19 also have similar risk factors. For example, underlying medical conditions on COVID-19 and pneumococcal diseases increase the risk for severe illness at any age; COVID-19 is now considered a primary risk factor for pneumococcal pneumonia and invasive pneumococcal disease. Thus, pneumococcal vaccination during the COVID-19 pandemic has become more critical than ever. This review presents positive studies of pneumococcal vaccination in patients with COVID-19 and other medical conditions and the correlational effects of pneumococcal disease with COVID-19 to prevent morbidity and mortality from co/secondary infections and superinfections. It also reports the importance and role of pneumococcal vaccination during the current COVID-19 pandemic era to strengthen the global health system.

The influenza pandemic in colonial Asante: Lesson drawing for the fight against COVID-19 in the twenty-first century

This paper pays attention to colonial strategies that were deployed to fight against the influenza pandemic among the Asante of Ghana. It does a comparative analysis of the outbreak and mode of spread of COVID-19 and influenza pandemics in Ghana and Asante, in particular. Based on the theory of lesson-drawing, the authors aimed to ascertain whether the strategies adopted to fight the current COVID-19 pandemic reminisce the earlier strategies deployed during the influenza pandemic of 1918. Based on primary and secondary data, the authors have constructed a history which proffers some insights into the fight against COVID-19. Authors conclude that the various health interventions toward the prevention and control of influenza in Asante during the colonial period were skewed in favour of Europeans and natives who worked within the colonial civil service. This did not support relevant strategies and efforts to reduce the spread of the disease at a faster pace. Despite several efforts made to curtail the spread of the disease, the colonial administration together with traditional authorities encountered challenges of inadequate health personnel, culture conflict, financial. The role of security agencies and the collaboration between the colonial administration and traditional authorities offer a very significant lesson for confronting the COVID-19 pandemic in Ghana.

Economics of Implementing Preemptive School Closures to Mitigate Pandemic Influenza Outbreaks of Differing Severity in the United States

The use of nonpharmaceutical interventions (NPIs) to slow disease spread, is a part of national pandemic preparedness as the first line of defense against influenza pandemics. Preemptive school closures (PSCs), an NPI reserved for use in severe pandemics, are highly effective in slowing influenza spread but have unintended consequences. We simulated PSC impacts during a 1957–like pandemic to estimate population impacts and quantify costs of closing schools at the national level. We also simulated 1957–like, 1968–like, and 2009–like pandemics at the Chicago regional level. We estimated economic impacts resulting from loss of income due to illness, providing childcare during closures, and other PSC costs while taking into consideration the number of cases averted with each mitigation strategy. The estimated net PSC costs ranged from $15 billion to $192 billion (2016 USD) (1957–like, national level) where between 2.3 and 47 million US cases may be averted depending on strategy. We found that 2–week school–by–school PSCs (as opposed to county–wide or school district–wide ones) had the lowest cost per discounted life–year gained for both national and Chicago regional–level analyses of all pandemics. While feasibility of such spatiotemporally precise triggering is presently questionable for most locales, this is, theoretically, an attractive option early in an outbreak, while assessing transmissibility and severity of a novel influenza virus. In contrast, we found that county–wide PSCs of longer durations (8 to 12 weeks) would result in the most averted cases (31–47 million) and deaths (105,000–156,000), albeit at considerably more cost ($125–$150 billion net of averted illness costs) for the national–level, 1957–like analysis. The estimated net costs per death averted ($1.0 to $1.2 million) for these scenarios compare favorably to the range of values recommended for regulatory impact analyses ($4.6 to 15.0 million). Hence, economic benefits of such PSCs would exceed the population impacts and economic costs.

Territorial and Temporary Spread of COVID-19 in the World at the Beginning of the 2020 Pandemic

Relevance. COVID-19 remains a serious problem for all countries of the world, affecting all areas of public life. The brunt of the problem falls on health care. The new coronavirus infection has raised many questions, in particular regarding its epidemiologyAim. Determine the sequence of the global spread of COVID-19 at the beginning of the 2020 pandemic and the possible influence of seasonality on its distribution.Materials and methods. Data on the countries of the Northern and Southern hemispheres of the sites «Our World in Data» from the section «Coronavirus (COVID-19) Cases». Стопкоронавирус.рф, Johns Hopkins University were used. The analysis of the spread of COVID-19 in the world was carried out based on data on the incidence and deaths from COVID-19 by climatogeographic zones.Results and discussion. The sequence of the spatio-temporal spread of COVID-19 across countries and continents at the beginning of the pandemic in 2020 has been determined. The similarity of the global spread of COVID-19 and "seasonal" influenza A(H3N2) epidemics indicates the spread of these infections along the primary migration routes of the population. The global spread of the COVID-19 pandemic virus, as well as influenza A(H1N1), was sufficient for 1–1.5 months. The COVID-19 pandemic began in the Northern Hemisphere in the spring and summer, but atypical seasonality was often observed at the beginning of influenza pandemics. On the other hand, data on the influence of seasonality on the spread of COVID-19 were obtained: the highest incidence in the Northern Hemisphere countries was in the winter, and in the Southern Hemisphere countries, with reverse seasonality, a high incidence was observed already in the summer months. Therefore, it will be possible to make a final conclusion about the seasonality of this infection in the following years.

Common Features of Coronavirus and Influenza Pandemics and Surface Proteins of their Pathogens. Parallels

Relevance. Coronaviruses and influenza viruses induce pandemics taking away many human lives and seeding social-economic chaos. Possibility to prognose pandemic features on characteristics of surface proteins of their pathogens is not investigated.Aim is to characterize the common features of the pandemic coronavirus S-protein and the pandemic virus influenza hemagglutinin in connection with the features of a coronavirus pandemic and influenza pandemics.Materials and method. For the bioinformatic analysis the protein sequences of pandemic coronavirus strains and pandemic influenza virus strains, influenza virus strains of 2017–2018 season and also influenza virus type B strains were used. In proteins an amino acid content, the sums of the charged amino acids and the.Results. It was found out that the increase of amount of the amino acids forming intrinsically disordered regions in the coronavirus S-protein S1 subunit and influenza virus H1 hemagglutinin HA1 subunit is characteristic of the pandemics with high morbidity and the increase of arginine and lysine with comparison with aspartic and glutamic acids in those proteins is peculiar to viruses inducing the pandemics with lower lethality.Conclusion. The features (morbidity and lethality) of the coronavirus pandemic and influenza virus pandemic are associated with the quantitative amino acids content of pandemic virus surface proteins.

1363Just a flu? Comparing COVID-19 and influenza mortality

Background Benchmarks are needed for assessing the severity of the COVID-19 pandemic. However, comparisons can be misleading unless marked differences in age-specific mortality and differences in population age structure are considered. Methods Using COVID-19 death rates for New York City as at 2 June 2020, we used indirect age standardization to estimate standardized mortality ratios (SMR) for the first winter waves of the 1918 and 2009 influenza pandemics and the severe 2017-2018 influenza season in the United States (US). Data were obtained from published statistics. Results After adjusting for age, New York City’s death rate during the 1918 winter influenza pandemic wave was 6.7 times higher overall compared with the first wave of COVID-19 in 2020. New York City's first wave COVID-19 death rate was an estimated 59 times higher than that of the 2009 US influenza pandemic, and 14 times higher than that of the severe 2017-2018 influenza season. In < 45 year-olds, the 1918 influenza death rate was 42 times higher than COVID-19 in 2020. In ≥ 65 year-olds, compared with the 2009 pandemic, the COVID-19 death rate was 320 times higher, while in children it was one half. Conclusions The 1918 pandemic was more deadly than COVID-19, which was, in turn, far more deadly than both the 2009 influenza pandemic and severe seasonal influenza. Age-specific mortality differences should be considered in decisions on COVID-19 vaccination strategies. Key messages Fundamental epidemiological methods remain valuable for modern epidemic risk assessment. COVID-19 is not just a ‘flu’.

Indigenous Groups and Influenza: Protocol For A Systematic Review and Meta-Analysis

Background: Several studies have documented that indigenous groups have been disproportionally hit by previous pandemics, with some exceptions. The objective of this review and meta-analysis is to provide a comprehensive historical overview of pre-COVID impact of influenza on indigenous groups by combining data from the last five influenza pandemics and seasonal influenza up to date. Methods/Principle Findings: The review will include peer-reviewed original studies published in English, Spanish, Portuguese, Swedish, Danish and Norwegian. Records will be identified through systematic literature search in eight databases: Embase, Medline, Cinahl, Web of Science, Academic Search Ultimate, SocIndex, ASSIA and Google Scholar. Results will be summarized narratively and using meta-analytic strategies. Discussion: To our knowledge, there is no systematic review combining historical data on the impact of both seasonal and pandemic influenza on indigenous populations. By summarizing results across indigenous groups in different countries and historical periods, we aim to provide information on how strong the risk for influenza is among indigenous people, and how consistent this risk is across groups, areas and time. Systematic review registration: PROSPERO registration number: CRD42021246391