Weekly Review: What’s new in the COVID-19 clinical world? – October 26, 2020

What Healthcare Professionals Need to Know about COVID-19 Vaccination Plans

The CDC released this publication, which discusses “Operation Warp Speed”, the global race to produce a successful COVID-19 vaccination. With the likelihood of a vaccine being produced by the end of the year, the CDC aims to educate healthcare professionals on where plans currently stand in the race for a vaccine. The article gives a list of ten key topics that should be known to healthcare workers. To summarize, it is not known exactly which vaccine will be approved for use, however, safety is a top priority. Healthcare professionals will play a crucial role in building public confidence in the vaccine when it is released. When the vaccine is initially released, it will be under an Emergency Use Authorization from the FDA. Once approved, there will be limited quantities available, however, the CDC is planning capacity for large scale delivery once the vaccine is available and the supply is projected to increase substantially in 2021. Some groups will be urged to receive the vaccine first following the guidance from the National Academies of Sciences, Engineering, and Medicine, as well as the Advisory Committee on Immunization Practices. There will likely be an application and training process for those who will be among the first to vaccinate high risk groups. Specific logistical requirements including storage and handling, tracking, administration, and reporting will be implemented. At this time, only non-pregnant adults have participated in early clinical trials so children may not be approved or recommended for children when first distributed. This article reviews what is expected at the time of publication, however, new information is being released frequently and these plans are subject to change.

The COVID-19 Vaccination Program Interim Playbook for Jurisdiction Operations

The CDC has released a Vaccination Program Interim Playbook, which discusses how to plan and operationalize a vaccination response to COVID-19. This publication is significant information for any professionals who will be administering the vaccine once it is approved for distribution. Again, the authors reiterate there may be a limited supply of vaccine, and it is likely that initial vaccinations will be focused on those who are critical to the response, who provide direct care and maintain societal function, and those who are at highest risk for developing severe illness from the COVID-19 virus. Public health preparedness planning and a phased approach to vaccinating is discussed.

The Importance of Understanding the Immune Response to COVID-19

In this article, the authors review the importance of understanding immune responses to COVID-19 when considering treatments and vaccine development. The article discusses what is currently known about human humoral and cellular responses to severe SARS-CoV-2 and relate this information to the current vaccines in phase 3 of clinical trials. The authors discuss the mechanism of short-duration immunity as seen in patients who were infected with other coronavirus syndromes such as SARS and MERS. In one study of 67 patients, research indicates a strong antibody response with severe disease, and a low antibody response association with higher rates of viral clearance. Another report is discussed in which an immune signature is researched to guide clinical care and treatment. The data shows that CD4 T-cell and CD8 T-cell responses occur in most patients within 1-2 weeks after symptom onset and produce increased levels of Th1 cytokines. A vaccine is predicted to be available this year. Current evidence suggests that a balanced humoral and Th1-directed cellular immune response may be crucial for protection from COVID-19 and to avoid vaccine-enhanced disease. The article reviews multiple studies and discusses vaccine clinical trials in depth.

Preparing for a COVID-19 Vaccine

In this article, the author discusses “Operation Warp Speed” and global vaccine research efforts to produce a successful vaccine to protect against SARS-CoV-2. At the time of the publication, three vaccines are candidates for a vaccine and in stage 3 of clinical trials. In a recent letter from the CDC Director, it is possible there may be a vaccine released as early as November 1, 2020. Many Americans are skeptical of the safety and efficacy of a potential COVID-19 vaccine. This article discusses the need for targeted marketing and public education to improve public support and optimism of the future COVID vaccine.

The Role of the Thymus in COVID-19 severity, antibody treatment, and immunization

In this article, authors discuss the role of the thymus in regulation of adaptive immunity and link the aging thymus to increased risk for disease severity when infected with the COVID-19 virus. Inflammation related to atherosclerosis, hypertension, and type 2 diabetes and aging are associated with a predisposition to a severe infection. Thymic regeneration is discussed to encourage a more positive response to treatment and vaccination therapies.

SARS-CoV-2 and Potential for Airborne Transmission

On October 5, 2020, the CDC updated a previously released scientific brief regarding the potential for airborne transmission of COVID-19. In this article, the primary route of infection is through exposure to respiratory droplets carrying the virus that are released during exhalation, coughing, singing, sneezing, etc. and span a spectrum of large and small particles. Airborne transmission can be used to describe any sized particle capable of travel through air. In this publication, the possibility of transmission via airborne routes is discussed. Although uncommon, the ability of the COVID-19 virus to be transmitted through air is possible when in enclosed spaces, during prolonged exposure to respiratory particles, and when inadequate ventilation or air handling is present. Again, hand hygiene, masking, adequate cleaning of surfaces, and ventilation are highly important in prevention of COVID-19 spread.

Mitigation Strategies to Prevent COVID-19 Transmission During the Election

In this CDC early release, interim guidance for the prevention of COVID-19 transmission during a statewide primary election is discussed. Among 522 eligible poll workers, 93% correctly answered all COVID-19 self-administered survey questions regarding safety and prevention. Strategies to strengthen to minimize risk to poll workers include additional training, personal protective equipment, and support for alternative voting options for those who are ill. The report goes on to describe the physical strategies implemented during the Delaware primary election.

|2020-10-26T08:53:25-04:00October 26th, 2020|COVID-19 Literature|Comments Off on Weekly Review: What’s new in the COVID-19 clinical world? – October 26, 2020

About the Author: Casey Cummins

Casey Cummins
Casey Cummins, MSN, APRN, NP-C is a board-certified Family Nurse Practitioner who currently serves as the Chief Nurse Consultant for the Immunizations Division at the Indiana Department of Health. She is part of the ISDH COVID-19 Outbreak Response Team, and has assisted with coordinating testing efforts state-wide during the pandemic. She enjoys spending time with her husband and their children, being outdoors, gardening, and traveling whenever possible.

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