Nondrug measures slowed COVID-19 spread without lockdown, analysis finds

Physical distancing, enhanced screening, and quarantining of people with confirmed or suspected COVID-19—without a lockdown—reduced the spread of the novel coronavirus outside of a hard-hit South Korean province by up to 34%, results of a study published yesterday in Emerging Infectious Diseases suggest.

The researchers analyzed data from local public health authorities from before South Korea implemented enhanced community screening and testing on Feb 23 and mandated physical distancing in mid-March and after they began to relax these measures on Apr 19. The outbreak was deemed contained as of Apr 21.

The authors collected data for 2,023 (98%) of the 2,066 reported COVID-19 cases to estimate the instantaneous effective reproduction number (Rt) outside of Daegu-Gyeongsangbuk province, the site of super-spreading events. Rt is a real-time measure of disease transmission intensity. An Rt of less than 1 means that the outbreak is under control.

Mean Rt was 2.23 the week before Feb 23, declining to 1.48 the following week, corresponding to a 33.6% reduction in transmissibility (95% confidence interval [CI], 23.46% to 43.44%). Likewise, implementation of stringent physical distancing measures was associated with a further reduction in Rt of 9.28% (95% CI, 6.80% to 11.75%).

Mean time from symptom onset to laboratory confirmation of COVID-19 was 4.6 days before public health measures were implemented (95% CI, 0.0 to 12.4), declining to 3.4 (95% CI, 0.0 to 9.0) after. Median incubation period was 4.7 days (95% CI, 0.1 to 15.6).

While non-lockdown measures appeared to suppress spread, the authors noted that South Korea remains vulnerable to future outbreaks. “Because social distancing measures will be relaxed while opportunities for importation of infections from abroad continue, ongoing monitoring of the effective reproductive number can provide relevant information to help policymakers control a potential second wave of COVID-19,” they wrote.
Jun 2 Emerg Infect Dis study


India and Taiwan report more high-path avian flu in poultry, other birds

India yesterday reported six more highly pathogenic H5N1 avian influenza outbreaks in poultry and other birds, and earlier this week, Taiwan reported another outbreak involving H5N5, according to separate reports from the World Organization for Animal Health (OIE).

In India, three outbreaks involved poultry, two involved house crows, and one affected birds at a zoo. The poultry outbreaks occurred at farms, in backyards, and at a livestock market in Kerala, Karnataka, and Madhya Pradesh states starting Mar 6 to 15. Taken together, the outbreaks killed 111 of 11,912 birds. The rest were destroyed to curb the spread of the virus. India continues to report sporadic H5N1 outbreaks, and it reported its last event in February, which involved a farm in Odisha state.

Also, the country reported two outbreaks involving wild birds in two different states. One event occurred in Bihar state, with three detections in house crows and one in red-headed trogons. The outbreak occurred between Feb 15 and Mar 19, killing 57 birds, most of them house crows.

In another report, India reported three outbreaks involving house crows at different locations in Madhya Pradesh state, which began between Mar 20 and Mar 22, killing 148 birds. And lastly, an outbreak at a zoo in Jharkhand state that began on Feb 23 killed nine birds, including lesser adjutants, white ibises, and grass owls.

Elsewhere, Taiwan this week reported another H5N5 outbreak in poultry, which occurred at a farm in Yunlin County. The event began on May 21, killing 55 of 24,103 birds. The rest were culled as part of the outbreak response.
Jun 2 OIE report on H5N1 in India (Kerala)
Jun 2 OIE report on H5N1 in India (Karnataka)
Jun 2 OIE report on H5N1 in India (Madhya Pradesh)
Jun 2 OIE report on H5N1 in India (Bihar state wild birds)
Jun 2 OIE report on H5N1 in India (Madhya Pradesh house crows)
Jun 2 OIE report on H5N1 in India (zoo)
Jun 1 OIE report on H5N5 in Taiwan


CEPI announces funding to develop another chikungunya vaccine

The Coalition for Epidemic Preparedness Innovations (CEPI) and its Indian affiliate today announced a new partnership with India-based Bharat Biotech and the International Vaccine Institute (IVI) to advance the development of a chikungunya vaccine.

According to a CEPI statement, the group will give the consortium up to $14.1 million to develop and make a 2-dose live-inactivated vaccine. This part of the award is supported by the European Union’s Horizon 2020 program through an existing partnership with CEPI.

A grant of up to $2 million from the Indian government’s CEPI initiative will go toward setting up manufacturing facilities in India and producing vaccine for a clinical trial. The money will also fund phase 2 and 3 clinical trials in Colombia, Panama, and Thailand. The vaccine has been through preclinical trials and a phase 1 trial of an adjuvanted version of the vaccine in India.

So far, CEPI has announced more than $80 million for the development of three chikungunya vaccines.
Jun 3 CEPI press release

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