Raportuldegardă.ro presents the series “Essential in public health” – the synthesis of news that really matters for controlling and limiting the impact of the Covid-19 pandemic, but also of other emerging infectious diseases that threaten health at the local and international level. Access the page Essential in public health.
Week of October 30 – November 5, 2023
GPMB (Global Preparedness Monitoring Committee) criticizes preparedness in the face of the COVID-19 pandemic
The report GPMB 2023 “A fragile state of preparation” shows that global preparedness for pandemics and other infectious diseases that threaten public health remains inadequate globally. Despite progress driven by COVID-19 in some areas, improvement is modest and in others preparedness has declined, highlighting an urgent need for political commitment and resources. GPMB is the collaboration between the World Health Organization and the World Bank.
Weaknesses identified are related to global coordination of research and development (R&D), combating disinformation, community involvement, participation of low- and middle-income countries in decision-making, funding of training at both national and international levels, independent monitoring and involvement of all actors relevant. Trust issues between countries and communities are a significant obstacle to strengthening preparedness.
Recommendation 1: Strengthen surveillance and hold actors accountable at all levels by improving national monitoring of pandemic prevention, preparedness and response, investing in improved data collection and analysis, and strengthening a global, multisectoral and independent monitoring system. Recommendation 2: Reform the global financing system for pandemic prevention, preparedness and response (PPPR) by ensuring full funding of the Pandemic Fund while identifying new ways to finance these measures. Recommendation 3: “Product-agnostic” – Establish a regional reference network to promote equitable access to research, development and supply of necessary resources, including vaccines, diagnostic tools and medicines. Recommendation 4: Develop a new multi-sectoral and interdisciplinary approach to engaging different stakeholders in pandemic prevention, preparedness and response, including civil society and the private sector.
The report also emphasizes that the Intergovernmental Negotiating Body (INB) needs to complete negotiations on the WHO Pandemic Agreement for adoption by the World Health Assembly in May 2024.
Impact of SARS-CoV-2 at the mitochondrial level causes organ failure and could explain long-COVID symptoms
O international research team dedicated to the study of COVID-19 discovered that SARS-CoV-2 can induce genetic changes at the mitochondrial level, significantly disrupting energy production in organs; altering energy metabolism thus contributing to the range of symptoms associated with long-COVID. The findings could provide new avenues for therapeutic interventions. The study was published in Science Translational Medicine.
During the peak of infection, substantial changes in brain function were observed, particularly a notable decrease in mitochondrial gene expression in the cerebellum. This finding links mitochondrial dysfunction to broader systemic effects seen in patients, including problems with muscle control, balance, cognition and emotions. Although the lungs are the initial site of infection, the effects of the virus are systemic, affecting other organs such as the heart, kidneys and liver, which could explain the prolonged symptoms that many patients experience even after recovery from the acute phase of infection.
Every cell in the body is equipped with mitochondria, which are especially important for maintaining the function of energy-demanding organs such as the heart, brain and lungs. Mitochondria require genes from their own genome (mitochondrial DNA) and nuclear DNA (nDNA) to create energy. These instruct the mitochondria to convert oxygen molecules into cellular energy called adenosine triphosphate (ATP).
The virus blocks the specific genes that use oxygen to create ATP, forcing the body to deplete the body’s energy reserves. Without a source of energy, cells throughout the body begin to die, and the cells that power the brain and heart suffer the most. To keep the body running, heart and neuronal cells can resort to depleting mitochondria. Eventually, the cells are deprived of their vital elements and initiate a form of programmed cell death called necroptosis.
This mechanism causes a cascade of effects, including a powerful inflammatory response that releases pro-inflammatory cells called cytokines throughout the body. Uncontrolled necroptosis further increases sepsis and organ failure.
New insights into how SARS-CoV-2 affects cellular energy generation underscore the need for a broader approach to the treatment and management of long-COVID. The research suggests that addressing mitochondrial dysfunction could be key to reducing persistent post-acute symptoms of COVID-19.
Image by Freepik
A new study explains the immune-induced thrombocytopenia and thrombosis syndrome associated with certain COVID-19 vaccines
A major new study, led by the University of Birmingham and funded by the National Institute for Health Care and Research and the British Heart Foundation, explains the mechanism behind rare but severe cases of thrombosis (formation of blood clots) triggered by some COVID-19 vaccines – Vaccine-Induced Thrombocytopenia and Thrombosis (VIT). The study was publicat în Blood, parte a American Society of Hematology (ASH) Publications and determined how the antibodies of VITT patients react with a protein called Platelet Factor 4 (PF4), resulting in the formation of immune complexes. These then trigger a cascade of platelet activation, leading to the formation of blood clots; the exact role of PF4 in this process was previously unknown.
The team conducted the study using blood from healthy donors and samples from VITT patients, finding that PF4 binds to the platelet receptor c-Mpl, initiating the release of cells involved in thrombosis.
The lead author of the study emphasized the importance of this finding in increasing safety and public confidence in vaccine technology. In addition, the research suggests new potential therapeutic avenues, as the use of ruxolitinib – a drug for certain types of blood cancer – has shown that blocking the receptor that interacts with PF4 can slow clot formation.
Antimicrobial resistance genes boosted by plastics in rivers
Microbial communities that thrive on plastic waste in rivers could harbor potentially pathogenic microbes and act as reservoirs for antimicrobial resistance genes, according to a study published in the journal Microbiome. Researchers submerged films of low-density polyethylene (LDPE – used in the manufacture of most commercial packaging) in the UK’s River Sowe, comparing new and artificially aged plastics to study microbial differences.
Pathogens such as Pseudomonas aeruginosa, Acinetobacter and Aeromonas were identified on both plastic and wooden surfaces, distinct from those in the river water samples. Degraded plastics showed a higher presence of P. aeruginosa and antimicrobial resistance genes compared to new plastics, possibly due to the release of more organic compounds that promote microbial growth.
The study shows the unique microbial communities that form on plastics and the variation between microbes found on new versus degraded plastics, which has implications for human health and the environment. The authors emphasize the need for further research on the risks posed by plastic pollution.
The 5-second rule to prevent the transmission of SARS-CoV-2
A new transmission modeling study conducted at a university in Japan, suggests that to prevent SARS-CoV-2 infection during face-to-face meetings, stopping breathing for a short time, maintaining a physical distance of min. 1 meter and facing upwind, applied within the first 5 seconds of contact, are most effective, significantly reducing the risk of viral infection.
Transmission modeling was made possible by using a full-scale mobile manikin and an advanced particle tracking system to visualize and measure the flow of exhaled aerosol particles during direct interactions. It was observed that the number of aerosols increases sharply in the first 5 seconds after direct interaction and then decreases rapidly, regardless of ventilation or the type of physical activity (walking, jogging, running, sprinting). However, ventilation greatly reduced the presence of airborne particles, suggesting that it is an important factor in reducing the risk of exposure to the virus.
2023-11-06 08:38:09
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