Global Epidemiology of Human Infections With Variant Influenza Viruses, 1959-2021: A Descriptive Study.

BACKGROUND: Although human case numbers of variant influenza viruses have increased worldwide, the epidemiology of human cases and human-to-human transmissibility of different variant viruses remain uncertain. METHODS: We used descriptive statistics to summarize the epidemiologic characteristics of variant virus infections. The hospitalization rate, case-fatality, and hospitalization-fatality risks were used to assess disease severity. Transmissibility of variant viruses between humans was determined by the effective reproductive number (Re) and probability of infection following exposure to human cases. RESULTS: We identified 707 naturally infected cases of variant viruses from 1959 to 2021, and their spatiotemporal/demographic characteristics changed across subtypes. The clinical severity of cases of variant viruses was generally mild; patients older than 18 years with underlying conditions were associated with hospitalization. Of 69 clusters of human infections with variant viruses (median cluster size: 2), the upper limit of Re was 0.09 (H1N1v, H1N2v, and H3N2v: 0.20 vs 0.18 vs 0.05), whereas it was not significantly different from the pooled estimates for avian influenza A(H7N9) and A(H5N1) viruses (0.10). Moreover, contacts of H5N1 cases (15.7%) had a significantly higher probability of infection than contacts of individuals with H7N9 (4.2%) and variant virus infections (4.2%-7.2%). CONCLUSIONS: The epidemiology of cases of variant viruses varied across time periods, geographical regions, and subtypes during 1959-2021. The transmissibility of different variant viruses between humans remains limited. However, given the continuous evolution of viruses and the rapidly evolving epidemiology of cases of variant viruses, improving the surveillance systems for human variant virus infections is needed worldwide.

Neutralizing Antibodies Against Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Variants Induced by Natural Infection or Vaccination: A Systematic Review and Pooled Analysis.

Recently emerged severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) variants may pose a threat to immunity. A systematic landscape of neutralizing antibodies against emerging variants is needed. We systematically searched for studies that evaluated neutralizing antibody titers induced by previous infection or vaccination against SARS-CoV-2 variants and collected individual data. We identified 106 studies meeting the eligibility criteria. Lineage B.1.351 (beta), P.1 (gamma) and B.1.617.2 (delta) significantly escaped natural infection-mediated neutralization, with an average of 4.1-fold (95% confidence interval [CI]: 3.6-4.7-fold), 1.8-fold (1.4-2.4-fold), and 3.2-fold (2.4-4.1-fold) reduction in live virus neutralization assay, while neutralizing titers against B.1.1.7 (alpha) decreased slightly (1.4-fold [95% CI: 1.2-1.6-fold]). Serum from vaccinees also led to significant reductions in neutralization of B.1.351 across different platforms, with an average of 7.1-fold (95% CI: 5.5-9.0-fold) for nonreplicating vector platform, 4.1-fold (3.7-4.4-fold) for messenger RNA platform, and 2.5-fold (1.7-2.9-fold) for protein subunit platform. Neutralizing antibody levels induced by messenger RNA vaccines against SARS-CoV-2 variants were similar to, or higher, than that derived from naturally infected individuals.

Prediction of long-term kinetics of vaccine-elicited neutralizing antibody and time-varying vaccine-specific efficacy against the SARS-CoV-2 Delta variant by clinical endpoint.

BACKGROUND: Evidence on vaccine-specific protection over time, in particular against the Delta variant, and protection afforded by a homologous third dose is urgently needed. METHODS: We used a previously published model and neutralization data for five vaccines-mRNA-1273, BNT162b2, NVX-CoV2373, V01, and CoronaVac- to evaluate long-term neutralizing antibody dynamics and predict time-varying efficacy against the Delta variant by specific vaccine, age group, and clinical severity. RESULTS: We found that homologous third-dose vaccination produces higher neutralization titers compared with titers observed following primary-series vaccination for all vaccines studied. We estimate the efficacy of mRNA-1273 and BNT162b2 against Delta variant infection to be 63.5% (95% CI: 51.4-67.3%) and 78.4% (95% CI: 72.2-83.5%), respectively, 14-30 days after the second dose, and that efficacy decreases to 36.0% (95% CI: 24.1-58.0%) and 38.5% (95% CI: 28.7-49.1%) 6-8 months later. Fourteen to 30 days after administration of homologous third doses, efficacy against the Delta variant would be 97.0% (95% CI: 96.4-98.5%) and 97.2% (95.7-98.1%). All five vaccines are predicted to provide good protection against severe illness from the Delta variant after both primary and homologous third dose vaccination. CONCLUSIONS: Timely administration of third doses of SARS-CoV-2-prototype-based vaccines can provide protection against the Delta variant, with better performance from mRNA vaccines than from protein and inactivated vaccines. Irrespective of vaccine technology, a homologous third dose for all types of vaccines included in the study will effectively prevent symptomatic and severe COVID-19 caused by the Delta variant. Long-term monitoring and surveillance of antibody dynamics and vaccine protection, as well as further validation of neutralizing antibody levels or other markers that can serve as correlates of protection against SARS-CoV-2 and its variants, are needed to inform COVID-19 pandemic responses.

Investigating vaccine-induced immunity and its effect in mitigating SARS-CoV-2 epidemics in China.

BACKGROUND: To allow a return to a pre-COVID-19 lifestyle, virtually every country has initiated a vaccination program to mitigate severe disease burden and control transmission. However, it remains to be seen whether herd immunity will be within reach of these programs. METHODS: We developed a compartmental model of SARS-CoV-2 transmission for China, a population with low prior immunity from natural infection. Two vaccination programs were tested and model-based estimates of the immunity level in the population were provided. RESULTS: We found that it is unlikely to reach herd immunity for the Delta variant given the relatively low efficacy of the vaccines used in China throughout 2021 and the lack of prior natural immunity. We estimated that, assuming a vaccine efficacy of 90% against the infection, vaccine-induced herd immunity would require a coverage of 93% or higher of the Chinese population. However, even when vaccine-induced herd immunity is not reached, we estimated that vaccination programs can reduce SARS-CoV-2 infections by 50-62% in case of an all-or-nothing vaccine model and an epidemic starts to unfold on December 1, 2021. CONCLUSIONS: Efforts should be taken to increase population's confidence and willingness to be vaccinated and to develop highly efficacious vaccines for a wide age range.

Global diversity of policy, coverage, and demand of COVID-19 vaccines: a descriptive study.

BACKGROUND: Hundreds of millions of doses of coronavirus disease 2019 (COVID-19) vaccines have been administered globally, but progress on vaccination varies considerably between countries. We aimed to provide an overall picture of COVID-19 vaccination campaigns, including policy, coverage, and demand of COVID-19 vaccines. METHODS: We conducted a descriptive study of vaccination policy and doses administered data obtained from multiple public sources as of 8 February 2022. We used these data to develop coverage indicators and explore associations of vaccine coverage with socioeconomic and healthcare-related factors. We estimated vaccine demand as numbers of doses required to complete vaccination of countries' target populations according to their national immunization program policies. RESULTS: Messenger RNA and adenovirus vectored vaccines were the most commonly used COVID-19 vaccines in high-income countries, while adenovirus vectored vaccines were the most widely used vaccines worldwide (180 countries). One hundred ninety-two countries have authorized vaccines for the general public, with 40.1% (77/192) targeting individuals over 12 years and 32.3% (62/192) targeting those ≥ 5 years. Forty-eight and 151 countries have started additional-dose and booster-dose vaccination programs, respectively. Globally, there have been 162.1 doses administered per 100 individuals in target populations, with marked inter-region and inter-country heterogeneity. Completed vaccination series coverage ranged from 0.1% to more than 95.0% of country target populations, and numbers of doses administered per 100 individuals in target populations ranged from 0.2 to 308.6. Doses administered per 100 individuals in whole populations correlated with healthcare access and quality index (R2 = 0.59), socio-demographic index (R2 = 0.52), and gross domestic product per capita (R2 = 0.61). At least 6.4 billion doses will be required to complete interim vaccination programs-3.3 billion for primary immunization and 3.1 billion for additional/booster programs. Globally, 0.53 and 0.74 doses per individual in target populations are needed for primary immunization and additional/booster dose programs, respectively. CONCLUSIONS: There is wide country-level disparity and inequity in COVID-19 vaccines rollout, suggesting large gaps in immunity, especially in low-income countries.

Evaluation of the safety profile of COVID-19 vaccines: a rapid review.

BACKGROUND: The rapid process of research and development and lack of follow-up time post-vaccination aroused great public concern about the safety profile of COVID-19 vaccine candidates. To provide comprehensive overview of the safety profile of COVID-19 vaccines by using meta-analysis technique. METHODS: English-language articles and results posted on PubMed, Embase, Web of Science, PMC, official regulatory websites, and post-authorization safety surveillance data were searched through June 12, 2021. Publications disclosing safety data of COVID-19 candidate vaccines in humans were included. A meta-analysis of proportions was performed to estimate the pooled incidence and the pooled rate ratio (RR) of safety outcomes of COVID-19 vaccines using different platforms. RESULTS: A total of 87 publications with safety data from clinical trials and post-authorization studies of 19 COVID-19 vaccines on 6 different platforms were included. The pooled rates of local and systemic reactions were significantly lower among inactivated vaccines (23.7%, 21.0%), protein subunit vaccines (33.0%, 22.3%), and DNA vaccines (39.5%, 29.3%), compared to RNA vaccines (89.4%, 83.3%), non-replicating vector vaccines (55.9%, 66.3%), and virus-like particle vaccines (100.0%, 78.9%). Solicited injection-site pain was the most common local reactions, and fatigue and headache were the most common systemic reactions. The frequency of vaccine-related serious adverse events was low (< 0.1%) and balanced between treatment groups. Vaccine platforms and age groups of vaccine recipients accounted for much of the heterogeneity in safety profiles between COVID-19 vaccines. Reporting rates of adverse events from post-authorization observational studies were similar to results from clinical trials. Crude reporting rates of adverse events from post-authorization safety monitoring (passive surveillance) were lower than in clinical trials and varied between countries. CONCLUSIONS: Available evidence indicates that eligible COVID-19 vaccines have an acceptable short-term safety profile. Additional studies and long-term population-level surveillance are strongly encouraged to further define the safety profile of COVID-19 vaccines.

Zoonotic Vectorborne Pathogens and Ectoparasites of Dogs and Cats in Eastern and Southeast Asia.

To provide data that can be used to inform treatment and prevention strategies for zoonotic pathogens in animal and human populations, we assessed the occurrence of zoonotic pathogens and their vectors on 2,381 client-owned dogs and cats living in metropolitan areas of 8 countries in eastern and Southeast Asia during 2017-2018. Overall exposure to ectoparasites was 42.4% in dogs and 31.3% in cats. Our data cover a wide geographic distribution of several pathogens, including Leishmania infantum and zoonotic species of filariae, and of animals infested with arthropods known to be vectors of zoonotic pathogens. Because dogs and cats share a common environment with humans, they are likely to be key reservoirs of pathogens that infect persons in the same environment. These results will help epidemiologists and policy makers provide tailored recommendations for future surveillance and prevention strategies.

Determination Method and Size Dependence of Interfacial Tension between Nanoparticles and a Solution.

Interfacial tension plays an important role in the processes of preparation, research, and application of nanomaterials. Because the interfacial tension is fairly difficult to be determined by experiments, it is still unclear about the effect of particle size on interfacial tension. In this paper, we proposed a method to determine the interfacial tensions and its temperature coefficients by determining the electrode potential of the nanoparticle electrode. Nano-Au with different radii (from 0.9 to 37.4 nm) in an aqueous solution was taken as a research system; we determined the interfacial tension and its temperature coefficient of the interface and discussed the size dependence. At the same time, we found surprisingly that this method can also be applied to determine the Tolman length and the atomic radius. The results show that the particle size of nano-Au has remarkable influences on the interfacial tension and its temperature coefficient. As the particle size decreases, the interfacial tension and the absolute value of its temperature coefficient increase. With the decrease of radius, the influences of the particle size on the interfacial tension and its temperature coefficient become more significant, whereas the influences can be neglected when the radius exceeds 10 nm. In addition, the results also show that the Tolman length is a negative value, and temperature has little effect on the Tolman length. This research can provide a new method to conveniently and reliably determine the interfacial tension on interfaces between nanoparticles and solutions, the temperature coefficients, the Tolman lengths, and the atomic radii; and the size dependences can provide important references for preparation, research, and application of nanomaterials.

UV-stimulated riboflavin exerts immunosuppressive effects in BALB/c mice and human PBMCs.

Riboflavin (RF) as a photosensitizer has been used in corneal surgery and the inactivation of blood products. However, the effect of RF on immune cells after ultraviolet (UV) light stimulation has not been investigated. This study pioneered a novel application method of RF. Firstly, UV-stimulated RF was co-cultured with human peripheral blood mononuclear cells in vitro, and the apoptosis rate of lymphocyte subsets, cell proliferation inhibition rate and concentrations of IL-1ß, IL-6, IL-10, TNF-α were assessed. UV-stimulated RF was then administered intravenously to mice via the tail vein for a consecutive period of 5 days. The levels of immunoglobulin (IgG, IgM, IgA), complement (C3, C4) and cytokines (IFN-γ, IL-4, IL17, TGF-ß) were detected by ELISA. Flow cytometry was employed to analyze the populations of CD3+T, CD4+T, CD8+T and CD4+T/CD8+T cells in spleen lymphocytes of mice. The data showed that UV-stimulated RF can effectively induce apoptosis in lymphocytes, and different lymphocyte subtypes exhibited varying degrees of treatment tolerance. Additionally, the proliferative capacity of lymphocytes was suppressed, while their cytokine secretion capability was augmented. The animal experiments demonstrated that UV-stimulated RF led to a significant reduction observed in serum immunoglobulin and complement levels, accompanied by an elevation in IFN-γ, IL-17 and TGF-ß levels, as well as a decline in IL-4 level. In summary, the results of both in vitro and in vivo experiments have demonstrated that UV-stimulated RF, exhibits the ability to partially inhibit immune function. This novel approach utilizing RF may offer innovative perspectives for diseases requiring immunosuppressive treatment.

Optimization model for bus priority control considering carbon emissions.

To study the impact of bus priority control (BPC) on traffic carbon emissions under the strategies of speed guidance, green extension (GE), and red truncation (RT), with consideration of the main influencing factors such as delay, stopping times, and speed, a combination optimization method was used to develop a bi-level optimization model for BPC. The optimal carbon-emission reductions of buses and social vehicles with different fuel types in the upstream section of the intersection and the intersection control area was the upper-level objective, and the optimal total passenger-delay reduction was the lower-level objective. The Gauss - Seidel iterative algorithm was used to solve the model. Finally, the model was applied to the analysis of calculation cases. The results indicated that after BPC was adopted under the guidance acceleration strategy, the reductions in the carbon emissions and total delay of passenger were optimal when the guidance speed was 38 km/h, i.e. 12.67% and 21.05%, respectively. Under the guidance acceleration and GE strategy, the reductions in the carbon emissions and total delay of passenger were optimal when the guidance speed was 39 km/h and the GE was 6 s, i.e. 27.49% and 38.62%, respectively. Under the guidance deceleration and RT strategy, the reductions in the carbon emissions and total delay of passenger were optimal when the guidance speed was 29 km/h and the RT was 6 s, i.e. 22.18% and 33.52%, respectively. The model reduced the carbon emissions and total delay of passenger in the upstream section of the intersection and the intersection control area to achieve the optimal overall traffic benefit for the intersection.

Two bus signal priority control strategies ­ green extension and red truncation ­ were studied.Carbon emission and delay calculation methods under the bus priority control were developed.Considering carbon-emission reductions of buses and social vehicles with different fuel types under different working conditions.Three control methods were studied: guidance acceleration, guidance acceleration and green extension, and guidance deceleration and red truncation.

Long-Term and Stable Dental Therapies via an In Situ Spontaneous Medicine Delivery System.

Chronic oral diseases are boring, long-term, and discomfort intense diseases, which endanger the physical and mental health of patients constantly. Traditional therapeutic methods based on medicines (including swallowing drugs, applying ointment, or injection in situ) bring much inconvenience and discomfort. A new method possessing accurate, long-term, stable, convenient, and comfortable features is in great need. In this study, we demonstrated a development of one spontaneous administration for the prevention and therapy on a series of oral diseases. By uniting dental resin and medicine-loaded mesoporous molecular sieve, nanoporous medical composite resin (NMCR) was synthesized by a simple physical mixing and light curing method. Physicochemical investigations of XRD, SEM, TEM, UV-vis, N2 adsorption, and biochemical experiments of antibacterial and pharmacodynamic evaluation on periodontitis treatment of SD rats were carried on to characterize an NMCR spontaneous medicine delivery system. Compared to existing pharmacotherapy and in situ treatments, NMCR can keep a quite long time of stable in situ medicine release during the whole therapeutic period. Taking the periodontitis treatment as an instance, the probing pocket depth value in a half-treatment time of 0.69 from NMCR@MINO was much lower than that of 1.34 from the present commercial Periocline ointment, showing an over two times effect.

Modeling the Prediction on the Efficacy of a Homologous Third Dose of CoronaVac Against SARS-CoV-2 Omicron BA.1, BA.2, BA.2.12.1, and BA.4/5 - China, 2020-2021.

What is already known about this topic?: Previous studies have reported vaccine efficacy or effectiveness against severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) Omicron subvariants for several vaccine platforms. However, there are currently few data on estimates of inactivated platform coronavirus disease 2019 (COVID-19) vaccines, especially against the globally dominant subvariant - Omicron BA.5. What is added by this report?: The study predicts vaccine efficacy against four Omicron subvariants - Omicron BA.1, BA.2, BA.2.12.1, and BA.4/5 - after vaccination with a homologous third dose of CoronaVac across clinical endpoints and age groups. What are the implications for public health practice?: The results suggest that CoronaVac-elicited immunity may not provide adequate protection against Omicron subvariants after the homologous third dose, and a heterologous booster and Omicron-specific vaccination may be alternative strategies.

Impact of lane-changing behavior on traffic emissions of road sections in multi-dimensional mixed traffic flow environment.

This study analyzed the effect of lane-changing behavior on traffic flow emissions and energy consumption of road sections in fuel vehicle-battery electric vehicle (FV-BEV) and human-driven vehicle-cooperative adaptive cruise control (HDV-CACC) multi-dimensional mixed traffic flow environments. Based on the traditional energy consumption model, a multi-dimensional mixed traffic flow energy consumption model was established by considering the BEV and CACC penetration rates. The microscopic traffic flow theory approach was used to analyze lane-changing behavior and the influencing mechanism of lane-changing behavior on the energy consumption of multi-dimensional mixed traffic flow, and MATLAB was used for the experimental simulation. The lane-changing behavior of the leading vehicle had a negative impact on the energy consumption of road segment traffic flow. Within the 95% effective impact range, the average energy consumption of traffic flow with respect to lane-changing behavior was 7.8% higher than that of the following traffic flow. The BEV penetration rate was beneficial for reducing the energy consumption of mixed traffic flow. At an economic velocity, the energy consumption of homogeneous BEV traffic flow was only 58.3% of that of homogeneous FV traffic flow. The CACC penetration rate could increase the traffic flow toughness. When the BEV penetration rate was constant, the higher the CACC penetration rate, the smaller the impact of lane-changing behavior on emissions. When traffic flow was completely transformed to homogeneous CACC traffic flow, lane-changing behavior only increased the overall energy consumption of the traffic flow by 4.99%, which was lower than the average level. Consequently, the promotion of BEV and CACC can improve the impact of traffic emissions on air pollution. When CACC penetration is low, reducing unnecessary lane-changing behavior to ensure the stability of traffic flow is also an effective way to reduce emissions.Implications: Multi-dimensional mixed traffic flow energy consumption model is proposed.CACC penetration rate, BEV penetration rate and lane-changing behavior will change traffic energy consumption. In this paper, different influencing factors are analyzed one by one.It provides a theoretical basis for relevant departments of traffic management to optimize vehicle emissions and traffic organization.

BOD1 regulates the cerebellar IV/V lobe-fastigial nucleus circuit associated with motor coordination.

Cerebellar ataxias are characterized by a progressive decline in motor coordination, but the specific output circuits and underlying pathological mechanism remain poorly understood. Through cell-type-specific manipulations, we discovered a novel GABAergic Purkinje cell (PC) circuit in the cerebellar IV/V lobe that projected to CaMKIIα+ neurons in the fastigial nucleus (FN), which regulated sensorimotor coordination. Furthermore, transcriptomics profiling analysis revealed various cerebellar neuronal identities, and we validated that biorientation defective 1 (BOD1) played an important role in the circuit of IV/V lobe to FN. BOD1 deficit in PCs of IV/V lobe attenuated the excitability and spine density of PCs, accompany with ataxia behaviors. Instead, BOD1 enrichment in PCs of IV/V lobe reversed the hyperexcitability of CaMKIIα+ neurons in the FN and ameliorated ataxia behaviors in L7-Cre; BOD1f/f mice. Together, these findings further suggest that specific regulation of the cerebellar IV/V lobePCs → FNCaMKIIα+ circuit might provide neuromodulatory targets for the treatment of ataxia behaviors.

Batesian mimicry in the nonrewarding saprophytic orchid Danxiaorchis yangii.

Batesian mimicry, a type of deceptive pollination, is a complicated strategy used by nonrewarding plants to attract pollinators, but some hypotheses concerning this have not been systematically verified. In order to show in detail a case of Batesian mimicry on saprophytic orchid Danxiaorchis yangii, the ecological relationship between Danxiaorchis yangii, Lysimachia alfredi and Dufourea spp. was explored. Lysimachia alfredi could provide a reward to Dufourea sp., whereas Danxiaorchis yangii not. The floral morphology and geographical distribution of these two plants were highly overlapping, and the fruit set rate of Danxiaorchis yangii was significantly positively correlated with the number of nearby L. alfredi individuals. In a glass cylinder experiment, Danxiaorchis yangii and L. alfredi attracted Dufourea spp. through visual signals, but the insect could not distinguish between flowers of the two plants before landing on flowers. The ultraviolet reflection spectra of flowers between the two plant species were highly similar. In the hexagonal color models constructed according to the visual characteristics of bees, the flower color signals of these two plant species highly overlap, indicating that the visual signals of the flowers of the two plants to the pollinator were greatly similar. All of these results provided evidence that Danxiaorchis yangii simulated the visual signals of L. alfredi through Batesian mimicry, thereby deceptively attracting Dufourea spp.

The pollination of Habenaria rhodocheila (Orchidaceae) in South China: When butterflies take sides.

Habenaria is one of the largest terrestrial genera in the family Orchidaceae. Most field studies on Habenaria species with greenish-white and nocturnal scented flowers are pollinated by nocturnal hawkmoths and settling moths. However, H. rhodocheila presents reddish flowers lacking a detectable scent and fails to fit the moth pollination syndrome. We investigated the pollinators, breeding system, and functional traits of H. rhodocheila in South China and found that two diurnal swallowtail butterflies Papilio helenus and Papilio nephelus (Papilionidae) were the effective pollinators. When butterflies foraged for nectar in the spur, the pollinia became attached between the palpi. A triangular projected median rostellar lobe was found at the entrance (sinus) of the spur of H. rhodocheila. This lobe divided the spur opening into two entrances forcing butterflies to enter their proboscides through the left or right side. When the projection of median rostellar lobe was removed, the site of pollinium attachment changed to the eyes of the butterflies, leading to a higher rate of pollinium removal but lower rate of pollinium deposition. Our quartz glass cylinder choice experiment suggested that visual rather than olfactory cues provided the major stimuli for butterflies to locate these flowers. Hand pollination experiments suggested this species was self-compatible but pollinator-dependent. However, the proportion of seeds with large embryos produced in self-pollinated fruits was significantly lower than in cross-pollinated fruits, indicating a significant inbreeding depression. Unlike many other orchid species, fruit set was higher than rates of pollinium removal, indicating a high level of pollination efficiency in a species with friable pollinia. Shifts from moth to butterfly pollination in the genus Habenaria parallel other orchid lineages providing insights into the potential for pollinator-mediated floral trait selection.

Herd immunity induced by COVID-19 vaccination programs and suppression of epidemics caused by the SARS-CoV-2 Delta variant in China.

BACKGROUND: To allow a return to a pre-COVID-19 lifestyle, virtually every country has initiated a vaccination program to mitigate severe disease burden and control transmission. However, it remains to be seen whether herd immunity will be within reach of these programs. METHODS: We developed a data-driven model of SARS-CoV-2 transmission for China, a population with low prior immunity from natural infection. The model is calibrated considering COVID-19 natural history and the estimated transmissibility of the Delta variant. Three vaccination programs are tested, including the one currently enacted in China and model-based estimates of the herd immunity level are provided. RESULTS: We found that it is unlike to reach herd immunity for the Delta variant given the relatively low efficacy of the vaccines used in China throughout 2021, the exclusion of underage individuals from the targeted population, and the lack of prior natural immunity. We estimate that, assuming a vaccine efficacy of 90% against the infection, vaccine-induced herd immunity would require a coverage of 93% or higher of the Chinese population. However, even when vaccine-induced herd immunity is not reached, we estimated that vaccination programs can reduce SARS-CoV-2 infections by 53-58% in case of an epidemic starts to unfold in the fall of 2021. CONCLUSIONS: Efforts should be taken to increase population's confidence and willingness to be vaccinated and to guarantee highly efficacious vaccines for a wider age range.

Comprehensive mapping of neutralizing antibodies against SARS-CoV-2 variants induced by natural infection or vaccination.

Background: Immunity after SARS-CoV-2 infection or vaccination has been threatened by recently emerged SARS-CoV-2 variants. A systematic summary of the landscape of neutralizing antibodies against emerging variants is needed. Methods: We systematically searched PubMed, Embase, Web of Science, and 3 pre-print servers for studies that evaluated neutralizing antibodies titers induced by previous infection or vaccination against SARS-CoV-2 variants and comprehensively collected individual data. We calculated lineage-specific GMTs across different study participants and types of neutralization assays. Findings: We identified 56 studies, including 2,483 individuals and 8,590 neutralization tests, meeting the eligibility criteria. Compared with lineage B, we estimate a 1.5-fold (95% CI: 1.0-2.2) reduction in neutralization against the B.1.1.7, 8.7-fold (95% CI: 6.5-11.7) reduction against B.1.351 and 5.0-fold (95% CI: 4.0-6.2) reduction against P.1. The estimated neutralization reductions for B.1.351 compared to lineage B were 240.2-fold (95% CI: 124.0-465.6) reduction for non-replicating vector platform, 4.6-fold (95% CI: 4.0-5.2) reduction for RNA platform, and 1.6-fold (95% CI: 1.2-2.1) reduction for protein subunit platform. The neutralizing antibodies induced by administration of inactivated vaccines and mRNA vaccines against lineage P.1 were also remarkably reduced by an average of 5.9-fold (95% CI: 3.7-9.3) and 1.5-fold (95% CI: 1.2-1.9). Interpretation: Our findings indicate that the antibody response established by natural infection or vaccination might be able to effectively neutralize B.1.1.7, but neutralizing titers against B.1.351 and P.1 suffered large reductions. Standardized protocols for neutralization assays, as well as updating immune-based prevention and treatment, are needed. Funding: Chinese National Science Fund for Distinguished Young Scholars.

Serological evidence of human infection with SARS-CoV-2: a systematic review and meta-analysis.

BACKGROUND: A rapidly increasing number of serological surveys for antibodies to SARS-CoV-2 have been reported worldwide. We aimed to synthesise, combine, and assess this large corpus of data. METHODS: In this systematic review and meta-analysis, we searched PubMed, Embase, Web of Science, and five preprint servers for articles published in English between Dec 1, 2019, and Dec 22, 2020. Studies evaluating SARS-CoV-2 seroprevalence in humans after the first identified case in the area were included. Studies that only reported serological responses among patients with COVID-19, those using known infection status samples, or any animal experiments were all excluded. All data used for analysis were extracted from included papers. Study quality was assessed using a standardised scale. We estimated age-specific, sex-specific, and race-specific seroprevalence by WHO regions and subpopulations with different levels of exposures, and the ratio of serology-identified infections to virologically confirmed cases. This study is registered with PROSPERO, CRD42020198253. FINDINGS: 16 506 studies were identified in the initial search, 2523 were assessed for eligibility after removal of duplicates and inappropriate titles and abstracts, and 404 serological studies (representing tests in 5 168 360 individuals) were included in the meta-analysis. In the 82 studies of higher quality, close contacts (18·0%, 95% CI 15·7-20·3) and high-risk health-care workers (17·1%, 9·9-24·4) had higher seroprevalence than did low-risk health-care workers (4·2%, 1·5-6·9) and the general population (8·0%, 6·8-9·2). The heterogeneity between included studies was high, with an overall I2 of 99·9% (p<0·0001). Seroprevalence varied greatly across WHO regions, with the lowest seroprevalence of general populations in the Western Pacific region (1·7%, 95% CI 0·0-5·0). The pooled infection-to-case ratio was similar between the region of the Americas (6·9, 95% CI 2·7-17·3) and the European region (8·4, 6·5-10·7), but higher in India (56·5, 28·5-112·0), the only country in the South-East Asia region with data. INTERPRETATION: Antibody-mediated herd immunity is far from being reached in most settings. Estimates of the ratio of serologically detected infections per virologically confirmed cases across WHO regions can help provide insights into the true proportion of the population infected from routine confirmation data. FUNDING: National Science Fund for Distinguished Young Scholars, Key Emergency Project of Shanghai Science and Technology Committee, Program of Shanghai Academic/Technology Research Leader, National Science and Technology Major project of China, the US National Institutes of Health. TRANSLATION: For the Chinese translation of the abstract see Supplementary Materials section.

Transmission heterogeneities, kinetics, and controllability of SARS-CoV-2.

A long-standing question in infectious disease dynamics concerns the role of transmission heterogeneities, which are driven by demography, behavior, and interventions. On the basis of detailed patient and contact-tracing data in Hunan, China, we find that 80% of secondary infections traced back to 15% of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) primary infections, which indicates substantial transmission heterogeneities. Transmission risk scales positively with the duration of exposure and the closeness of social interactions and is modulated by demographic and clinical factors. The lockdown period increases transmission risk in the family and households, whereas isolation and quarantine reduce risks across all types of contacts. The reconstructed infectiousness profile of a typical SARS-CoV-2 patient peaks just before symptom presentation. Modeling indicates that SARS-CoV-2 control requires the synergistic efforts of case isolation, contact quarantine, and population-level interventions because of the specific transmission kinetics of this virus.