New Coronavirus News from 16 Nov 2022

Ireland faces 'cancer epidemic' after 1m cases missed across Europe during Covid [BreakingNews.ie, 16 Nov 2022]

By NINA MASSEY

An estimated one million cancer diagnoses were missed across Europe in the last two years, and a new report suggests the impact of Covid-19 could set back cancer results by almost a decade.

Researchers say the pandemic has exposed weaknesses in cancer health systems and in the research landscape across the continent.

They argue the issues need to be addressed as a matter of urgency.

In the report, researchers emphasise that prioritising cancer research is crucial for the delivery of more affordable, better, and equal care.

The report sets a target of achieving 70 per cent 10-year survival for all European cancer patients by 2035.

Patients treated in research hospitals have better outcomes than those who are not, a new commission from The Lancet Oncology, “European Groundshot—addressing Europe’s cancer research challenges”, reports.

The study also finds Brexit will continue to negatively impact European cancer research unless European funders/research community and the UK government/research community find a way for continued collaboration.

Additionally, it calls for a doubling of the European cancer research budget, as well as prioritisation of underserved cancer research areas, including prevention and early diagnosis, radiotherapy and surgery, action on gender equality, and a deeper focus on survivorship.

Report co-lead, Professor Richard Sullivan at King’s College London, said: “UK cancer research in the post-Brexit world stands at a crossroads where strategic decisions will determine whether we continue to thrive and partner internationally or whether isolationism will reduce our world standing.

“If the UK is not involved in EU collaborative cancer research and not part of Horizon Europe’s research community, this will have an extremely detrimental effect on European cancer research activity.

“Ultimately, patients with cancer will pay the price for this decision in terms of healthcare outcomes.”

'Race against time'
Professor Mark Lawler, Queen’s University Belfast, and chairman and lead author of the commission, said: “With the backdrop of the Covid-19 pandemic, Brexit, and the Russian invasion of Ukraine, it is more important than ever that Europe develops a resilient cancer research landscape to play a transformative role in improving prevention, diagnosis, treatment, and quality-of-life for current and future patients and those living beyond cancer.

He added: “We estimate that approximately one million cancer diagnoses were missed across Europe during the Covid-19 pandemic.

“We are in a race against time to find those missing cancers.

“Additionally, we saw a chilling effect on cancer research with laboratories shut down and clinical trials delayed or cancelled in the first pandemic wave.

“We are concerned that Europe is heading towards a cancer epidemic in the next decade if cancer health systems and cancer research are not urgently prioritised.

“Our European Groundshot Commission provides crucial findings on the current landscape of cancer research, exposes the key gaps, and demands the prioritisation of European cancer research agendas over the next decade.”

Dr Lynn Turner, director of research, Worldwide Cancer Research, said: “We are concerned to see that the Lancet Oncology Commission predicts Europe is heading towards a cancer epidemic in the next decade, but we welcome the call for the European cancer research budget to double in order to address this.

“The report sets an ambitious target of achieving 70 per cent 10-year survival for all European cancer patients by 2035.

“As the only UK charity funding discovery cancer research anywhere in the world, into any cancer type, Worldwide Cancer Research is proud to support innovative new ideas and ensure that the pipeline of future cancer cures doesn’t run dry.”

The commission analysed data on the impact of coronavirus across Europe and found that clinicians saw 1.5 million fewer patients with cancer in the first year of the pandemic.

While one in two patients with cancer did not receive surgery or chemotherapy in a timely manner.

Additionally, 100 million cancer screening tests were missed, and it is estimated that up to one million European citizens might have an undiagnosed cancer due to the backlog, the report published in Lancet Oncology found.

Global disparities in SARS-CoV-2 genomic surveillance [Nature, 16 Nov 2022]

Authored by Anderson F. Brito, Elizaveta Semenova, Gytis Dudas, Gabriel W. Hassler, Chaney C. Kalinich, Moritz U. G. Kraemer, Joses Ho, Houriiyah Tegally, George Githinji, Charles N. Agoti, Lucy E. Matkin, Charles Whittaker, Bulgarian SARS-CoV-2 sequencing group, Communicable Diseases Genomics Network (Australia and New Zealand), COVID-19 Impact Project, Danish Covid-19 Genome Consortium, Fiocruz COVID-19 Genomic Surveillance Network, GISAID core curation team, Network for Genomic Surveillance in South Africa (NGS-SA), Swiss SARS-CoV-2 Sequencing Consortium, Benjamin P. Howden, Vitali Sintchenko, Neta S. Zuckerman, Orna Mor, Heather M. Blankenship, Tulio de Oliveira, Raymond T. P. Lin, Marilda Mendonça Siqueira, Paola Cristina Resende, Ana Tereza R. Vasconcelos, Fernando R. Spilki, Renato Santana Aguiar, Ivailo Alexiev, Ivan N. Ivanov, Ivva Philipova, Christine V. F. Carrington, Nikita S. D. Sahadeo, Ben Branda, Céline Gurry, Sebastian Maurer-Stroh, Dhamari Naidoo, Karin J. von Eije, Mark D. Perkins, Maria van Kerkhove, Sarah C. Hill, Ester C. Sabino, Oliver G. Pybus, Christopher Dye, Samir Bhatt, Seth Flaxman, Marc A. Suchard, Nathan D. Grubaugh, Guy Baele & Nuno R. Faria

Abstract
Genomic sequencing is essential to track the evolution and spread of SARS-CoV-2, optimize molecular tests, treatments, vaccines, and guide public health responses. To investigate the global SARS-CoV-2 genomic surveillance, we used sequences shared via GISAID to estimate the impact of sequencing intensity and turnaround times on variant detection in 189 countries. In the first two years of the pandemic, 78% of high-income countries sequenced >0.5% of their COVID-19 cases, while 42% of low- and middle-income countries reached that mark. Around 25% of the genomes from high income countries were submitted within 21 days, a pattern observed in 5% of the genomes from low- and middle-income countries. We found that sequencing around 0.5% of the cases, with a turnaround time <21 days, could provide a benchmark for SARS-CoV-2 genomic surveillance. Socioeconomic inequalities undermine the global pandemic preparedness, and efforts must be made to support low- and middle-income countries improve their local sequencing capacity.

Nature Communications volume 13, Article number: 7003 (2022)

COVID depression is real. Here's what you need to know. [The Japan Times, 16 Nov 2022]

BY KNVUL SHEIKH

The World Health Organization noted this year that anxiety and depression increased by 25% across the globe in just the first year of the COVID-19 pandemic. And researchers have continued to find more evidence that the coronavirus wreaked havoc on our mental health.

In a 2021 study, more than half of American adults reported symptoms of a major depressive disorder after a coronavirus infection. The risk of developing these symptoms — as well as other mental healthdisorders — remains high up to a year after you’ve recovered.

It’s not surprising that the pandemic has had such a huge impact. “It’s a seismic event,” said Dr. Ziyad Al-Aly, a clinical epidemiologist at Washington University in St. Louis and the chief of research and development at the Veterans Affairs St. Louis Health Care System.

Health concerns, grief from losing loved ones, social isolation and the disruption of everyday activities were a recipe for distress, especially early on in the pandemic. But compared with those who managed to avoid infection (while also dealing with the difficult impacts of living through a pandemic), people who got sick with COVID-19 seem to be much more vulnerable to a variety of mental health problems.

“There’s something about the coronavirus that really affects the brain,” Al-Aly said. “Some people get depression, while other people can have strokes, anxiety, memory disorders and sensory disorders.” Still others have no neurological or psychiatric conditions at all, he said.

Why do some people get depressed when they have COVID-19?
Scientists are still learning exactly how the coronavirus alters the brain, but research is beginning to highlight some possible explanations. A few studies, for example, have shown that the immune system goes into overdrive when some people get sick. They can end up with inflammation throughout the body and even in the brain.

There is also some evidence that the endothelial cells lining blood vessels in the brain become disrupted during a bout of COVID-19, which may inadvertently allow harmful substances through, affecting mental function.

And cells called microglia, which normally act as the brain’s housekeepers, may go rogue in some patients, attacking neurons and damaging synapses, Al-Aly said.

It’s possible that COVID-19 may even compromise the diversity of bacteria and microbes in the gut. Since microbes in the gut have been shown to produce neurotransmitters like serotonin and dopamine, which regulate mood, this change could be at the root of some
neuropsychiatric issues.

Who is most at risk?
One of the biggest risk factors for developing depression after COVID-19 — or after any major illness — is having a diagnosed mental health disorder before you get sick. People who had severe COVID-19 symptoms and had to stay at a hospital during their illness also have increased chances of depression, said Megan Hosey, a rehabilitation psychologist who works with ICU patients at the Johns Hopkins Hospital.

According to WHO estimates, young people are disproportionately at risk of suicidal and self-harming behaviors after COVID-19. Women are more likely than men to report mental health effects after COVID-19.

And people with pre-existing physical health conditions, such as asthma, cancer and heart disease, are more likely to develop symptoms of mental disorders after COVID-19.

Additionally, people who experience extensive sleep disruption, social isolation or a significant change in other behaviors, like the amount of alcohol they consume or the type of prescription medications they take, may be more likely to face depression after the physical symptoms of COVID-19 fade away.

“We know that having additional stressors on your plate can predict depressive symptoms later on,” Hosey said. Some studies suggest that people who experience these stressors may be more vulnerable to developing long COVID-19 in general.

When do COVID-19 blues become clinical depression? What are some early signs?
While you are in the thick of things, fighting off viral infection, it is normal to feel tired and headachy.

“When you feel physiologically terrible, it can interfere with your mood,” Hosey said. “I would never diagnose somebody with a clinical depression in the acute phases of a COVID infection.”

But if your exhaustion and feeling of being overwhelmed persist for two to six weeks after your COVID-19 infection and start to interfere with day-to-day activities or negatively affect your relationships with others, it could be a sign of depression, Hosey said.

Some people with depression may also experience persistent sadness, tearfulness, irritability, changes in appetite or weight, trouble thinking or concentrating, or feelings of immense guilt, worthlessness or hopelessness. Those with severe depression may think frequently of death and develop suicidal ideation, Hosey said.

What can you do to treat depression after COVID-19?
If you are concerned that you or a loved one may be experiencing symptoms of depression after a COVID-19 infection, it’s important to talk to a medical or mental health professional.

“Not everyone will need to see a psychiatrist to be evaluated for depression,” Al-Aly said.

People can share what they are going through with their primary care doctor to get help as well, he said. “The most important thing is to seek help. And seek help sooner rather than later.”

Depression is not something you can typically shake off on your own, Hosey said. It can be tempting to use online resources and self-diagnostic screening tools and to order supplements that promise to calm COVID-related inflammation or repair your gut health. But many of these interventions are not reliable or backed by evidence.

It is a good idea to take stock of your diet, sleep and drug and alcohol use. Consuming more nutritious foods and setting up a good sleep routine, for example, may have a small positive impact on your mental health. Research suggests that exercise and meditation may also help heal the mind in some cases.

But if behavioral changes don’t work, a professional can recommend therapy or medication, depending on your needs.

During the pandemic, access to telehealth and mental health services expanded, Hosey said.

Several states now allow licensed psychologists to provide care to patients in other states that are part of the Psychology Interjurisdictional Compact, or PSYPACT. That means you can more easily search for an in-person or online mental health provider even if there is a shortage of specialty care in your area, Hosey said.

It’s not yet clear how long it takes to move beyond depression symptoms after COVID-19.

“Recovery from depression is a very individualized process,” Hosey said. Many people recover after a brief course of treatment. Some people experience relapses, where their symptoms get better and worse and they may need to try a different treatment, she said. Sometimes depression resolves without treatment, though that may be more likely to happen for people with mild cases.

“In the wake of a COVID infection, you should give yourself a little bit of a break and be patient,” Hosey said. “An infection can be hard to cope with.”