CEBM BLOGS & MEDIA ARTICLES

Tom Jefferson: Covid-19—supermarket wisdom

We obviously got Coronaviridae habits wrong.

COVID-19. Can Historical Antivirals Be of Use?

We hope that the availability of this historical record will aid the search for possible treatments against COVID-19 based on molecules that have shown promise in the past and test them in larger population trials.

COVID-19 – The Tipping Point

A quick look at the distribution of SARS 2 cases around southern Europe shows that viral circulation is widespread. Higher incidence may be explained (at least in part) by the old adage “seek and thou shall find”. 

COVID-19: What proportion are asymptomatic?

 we thought we would try to answer an important question: what is the proportion of people with  SARS-COV-2 who are asymptomatic?

Problems in identifying the origins of an outbreak

The most famous attempt at pinpointing the origin of an outbreak from the distribution of cases is John Snow’s iconic map of the 1854 Cholera outbreak with an epicentre in Soho.

Covid 19 - Modelling the models

All models, be they prospective or retrospective, if they are based on scientific principles have substantial uncertainty as to their starting point and are incompatible with oracle-like statements of certainty.

SARS-CoV-2 viral load and the severity of COVID-19

We discuss evidence in SARs, SARs-CoV-2 and Influenza and the relationship of viral load and severity of the disease. We then present a summary of the sources that verify current healthcare workers who have died across different countries.

Are COVID-19 patients in hospital or admitted to hospital?

It has become common for the UK government daily briefings to include one slide that shows data relating to COVID-19 patients in hospital.  

COVID-19 – The great plague of Lombardy – A Not so Distant Resonance Chamber

What happened in Lombardy (the richest and most densely populated region of Italy) in the late winter of 2019/20 will be the topic of future commentary.

Is Lombardy the widow of Hampstead?

We now require a series of hypotheses that can be tested to shed light on the transmission dynamics. We should use this unique opportunity to use the extraordinary to shed light on the ecology of COVID-19

What does RCGP surveillance tell us about COVID-19 in the community

The RCGP surveillance data reports trends for Influenza-Like Illness (ILI), upper respiratory tract infections (URTIs) and lower respiratory tract infections (LRTI), along with weekly data on COVID-19 case investigations.

COVID-19 – Tracking European Mortality

Comparing the excess death curve with that of previous seasons we see the trend is consistent with previous outbreaks. 

COVID 19 – The Widow of Hampstead Revisited

The events of February 2020 in two epicentres, Codogno in the province of Lodi in Lombardy and Vò Euganeo in Padova in Veneto region may shed some light on the dynamics of viral transmission.

Effect of Latitude on COVID-19

We recently conducted a rapid review of evidence to explore if climate conditions may influence the spread of SARS-CoV-2.

Six Countries: Three-quarters of the COVID Deaths

As of the 26th April, six countries accounted for 155,457 out of 206,008 (75.5%)  COVID-19 deaths.

Covid 19 Epidemic “Waves”

One recurring theme of the COVID coverage is the fear (or the firm prediction) of second or third waves of the disease. 

COVID 19 – Nova et Vetera: Lazaretts of Venice

The contrast between the new and the old is valuable for understanding the current outbreak

COVID-19: Unravelling the Uncertainties

Our so-called ‘plans’ for dealing with the outbreak have not survived contact with COVID-19.

COVID-19: Re-establishing ‘Fever Hospitals’

Given the current problems with the COVID-19 outbreak, in countries such as the UK and Italy (which have far too few hospital beds – see the table), we need to re-establish ‘fever hospitals’. 

COVID 19 - Understanding the Unknown in Acute Respiratory Infections

Several different sources show that a large proportion of pathogens implicated in respiratory infections are unknown. This could be because the ILI has no recognised agent, or…

COVID-19: Have we forgotten our children in all this?

Most governments around the world have temporarily closed educational institutions in an attempt to contain the spread of the COVID-19 pandemic.’

Let’s bring back Britain’s fever hospitals

A century ago, there were hundreds of so-called ‘fever hospitals’ dotted across Britain. These small institutions were built for diseases of a bygone age – smallpox, scarlet fever and typhus – but were designed for precisely the same problems we face today. 

Don’t place too much faith in models predicting another coronavirus wave

There is much concern about a second, third or even fourth wave of Covid-19, implying an inevitable increase in the numbers infected.

Could mass testing for Covid-19 do more harm than good?

Detection of viruses using Polymerase Chain Reaction (PCR) is helpful so long as its accuracy can be understood: it offers the capacity to detect RNA in minute quantities, but whether that RNA represents infectious virus is another matter. 

TRANSMISSION OF SARS-COV-2

(work ongoing for complete synopsis, see https://www.cebm.ox.ac.uk/research/transmission-of-sars-cov-2)

TOM JEFFERSON, ELIZABETH SPENCER, JON BRASSEY, CARL HENEGHAN.

Viral cultures for COVID-19 infectivity assessment. Systematic review.

medRxiv 2020.08.04.20167932; doi: https://doi.org/10.1101/2020.08.04.20167932

https://www.medrxiv.org/content/10.1101/2020.08.04.20167932v2

T JEFFERSON, E A SPENCER, J BRASSEY, C HENEGHAN, Viral cultures for COVID-19 infectious potential assessment – a systematic review, Clinical Infectious Diseases, Dec 3, 2020. https://doi.org/10.1093/cid/ciaa1764

JEFFERSON, T.; HENEGHAN, C.; SPENCER, E.; BRASSEY, J.; PLUDDEMAN, A.; ONAKPOYA, I.; EVANS, D.; CONLY, J. A Hierarchical Framework for Assessing Transmission Causality of Respiratory Viruses . Preprints 2021, 2021040633 (doi: 10.20944/preprints202104.0633.v1).

ELENA CECILIA ROSCA, CARL HENEGHAN, ELIZABETH A SPENCER, JON BRASSEY, ANNETTEPLUDDEMANN, IGHO ONAKPOYA, DAVID H EVANS, JOHN M CONLY, TOM JEFFERSON.

Transmission of SARS-CoV-2 associated with cruise ship travel: protocol for a systematic review (Version 1)

medRxiv 2021.10.11.21264724; doi:https://doi.org/10.1101/2021.10.11.21264724

TOM JEFFERSON, ELIZABETH SPENCER, JON BRASSEY, ANNETTE PLUDDEMANN, IGHO ONAKPOYA, DAVID H EVANS, JOHN M CONLY, CARL HENEGHAN. Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from pre and asymptomatic infected individuals. A systematic review

Transmission of Severe Acute Respiratory Syndrome Coronavirus-2 (SARS-CoV-2) from pre and asymptomatic infected individuals: a systematic review update https://www.sciencedirect.com/science/article/pii/S1198743X22003299

Clinical Microbiology and Infection 2021 (e pub ahead of print).

https://www.clinicalmicrobiologyandinfection.com/article/S1198-743X(21)00616-9/fulltext

Viral Cultures for Assessing Fomite Transmission of SARS-CoV-2: a Systematic Review and Meta-Analysis https://www.journalofhospitalinfection.com/article/S0195-6701(22)00283-3/fulltext