Dam-Infant Rhesus Macaque Pairs to Dissect Age-Dependent Responses to SARS-CoV-2 Infection.

The global spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and its associated coronavirus disease (COVID-19) has led to a pandemic of unprecedented scale. An intriguing feature of the infection is the minimal disease in most children, a demographic at higher risk for other respiratory viral diseases. To investigate age-dependent effects of SARS-CoV-2 pathogenesis, we inoculated two rhesus macaque monkey dam-infant pairs with SARS-CoV-2 and conducted virological and transcriptomic analyses of the respiratory tract and evaluated systemic cytokine and Ab responses. Viral RNA levels in all sampled mucosal secretions were comparable across dam-infant pairs in the respiratory tract. Despite comparable viral loads, adult macaques showed higher IL-6 in serum at day 1 postinfection whereas CXCL10 was induced in all animals. Both groups mounted neutralizing Ab responses, with infants showing a more rapid induction at day 7. Transcriptome analysis of tracheal airway cells isolated at day 14 postinfection revealed significant upregulation of multiple IFN-stimulated genes in infants compared with adults. In contrast, a profibrotic transcriptomic signature with genes associated with cilia structure and function, extracellular matrix composition and metabolism, coagulation, angiogenesis, and hypoxia was induced in adults compared with infants. Our study in rhesus macaque monkey dam-infant pairs suggests age-dependent differential airway responses to SARS-CoV-2 infection and describes a model that can be used to investigate SARS-CoV-2 pathogenesis between infants and adults.

The SARS-CoV-2 Pandemic: Real-Time Training and Service for Preventive Medicine Residents.

The 2020 SARS-CoV-2 pandemic created a unique opportunity for Public Health/General Preventive Medicine (PH/GPM) and Occupational and Environmental Medicine (OM) residents to contribute to pandemic public health response activities. We surveyed all 18 Health Resources and Services Administration (HRSA)-funded PH/GPM and OM residency program directors to evaluate program and resident involvement in pandemic response activities from January 1 through June 30, 2020. Of 116 residents, 110 (95%) participated at some level in the response activities including screening/testing, contact tracing, surveillance, data analysis, incident command, provider support, reopening, direct patient care, education, and risk communication. Residents' response activities were in multiple settings, such as state, local, and federal health agencies; hospital systems; long-term care facilities; academic centers; local businesses and labor unions; Federally Qualified Health Centers; homeless shelters; and clinics. Residents' participation was facilitated by their training in public health, epidemiology, the care of patients and populations, and emergency preparedness. Programs should continue to promote these experiences and key roles that PH/GPM and OM residents can play, as this leadership is a necessity for the successful navigation of future major public health events. As the pandemic continues, evaluation of residents' experiences will help guide longer-term changes to program curriculum and partnerships. Many trainees' contributions and expertise met both educational and service goals and therefore should be integrated into ongoing pandemic response work in PH/GPM and OM programs.