Is the U.S. ready for another pandemic? 

It’s a question members of Congress convened last week to tackle. And one of Northeastern’s own machine learning experts, Mauricio Santillana, a professor of physics and network science, was in Washington D.C. to help shed light on U.S. preparedness from the standpoint of how to leverage big data to create better predictive models. 

Santillana, who leads Northeastern’s Machine Intelligence Group for the Betterment of Health and the Environment, testified last week before the Bipartisan Commission on Biodefense to help, among other things, “explore preparedness needs and efforts, new solutions to improve biosurveillance and data modernization,” the commission said. 

The commission is tasked with making recommendations to Congress to better fortify the federal government’s biodefense infrastructure. Biodefense is concerned with any and all threats to human beings, animals or agriculture. 

Speaking with Northeastern Global News, Santillana painted a concerning portrait of the government’s ability to respond to so-called biological threats—detailing a lax and “reactive” posture when it comes to planning for, and pre-empting, hazards like the kind posed by COVID-19. 

The problem, he says, is partially due to the U.S.’s antiquated data collection and processing methods, and partially because of the influence of politics on government funding. The nature of the U.S. electoral process creates a situation where issues such as climate change and pandemic preparedness take a backseat to more visible, “immediate” problems—a phenomenon researchers have tried to explain through a concept known as temporal discounting. 

“Because we have a cycle of politics, politicians want to invest money in something they show within their tenure,” Santillana says. 

The end result amounts to a kind of collective amnesia—a system that works best when already faced with a crisis, rather than one that is adequately equipped to deal with future ones. 

“When there is a crisis, we see an allocation of funds in a reactive way,” Santillana says. “But we’re not very good at allocating those same funds during ‘peace times,’ when we should be reflecting on whether we are ready for when something bad actually happens.”

When the pandemic was first declared and infections began spreading across the U.S., the situation came as a shock to the general public, Santillana says. That’s because the government was taken aback, too—ill-prepared for a reality many in the scientific community had already anticipated in their models.    

And to those who were watching carefully—Santillana and his collaborators—the writing was on the wall months before it became headline news.  

“It was very clear to us that [the COVID-19 pandemic] was going to be a very big crisis,” says Santillana, who also served as an expert witness to city officials in Boston and made policy recommendations when the pandemic first began. 

Santillana says the federal government needs to invest in upgrading its pandemic surveillance capabilities, including finding better methods to collect data that can be used to predict outbreaks and disease activity.

The way to do that, he says, is simple. Private tech companies routinely collect and aggregate users’ mobile phone and search data to conduct their business. The government should devise “socially responsible data-sharing” solutions in the form of legal agreements, that would facilitate access to relevant anonymized data streams, Santillana says. This data would be collected by these companies and utilized by decision makers, public health officials and academic partners during public health crises.

“We should be leveraging all of the platforms that these big tech companies have built to provide our citizens with better information about potential biological threats,” Santillana says. 

There have been a few examples of how government officials can harness the power of big data to track infectious disease outbreaks. One notable project, Google Flu Trends, sought to use Google search data to “nowcast” outbreaks of influenza based on the number of queries related to the respiratory virus. Launched in 2008—a year before the H1N1 pandemic was declared—the method “failed to reflect the degree to which we would see infections,” Santillana says.

“And then, GFT failed—and failed spectacularly—missing at the peak of the 2013 flu season by 140 percent,” David Lazer, university distinguished professor of political science and computer sciences at Northeastern, wrote for Wired. “When Google quietly euthanized the program … it turned the poster child of big data into the poster child of the foibles of big data.”

Santillana, whose background is in climate science, proposed a better method that leveraged weather forecasting tools to model disease spread—one that he says found traction   

“I became interested in doing something more where I could bring all of my quantitative skills into something that could help people make decisions,” Santillana says.

In October, the White House published a sprawling update to the federal government’s “national biodefense strategy” that, among other things, articulates a set of principles that would steer efforts toward greater pandemic preparedness.

The document is “a call to action for state, local, tribal and territorial entities, practitioners, physicians, scientists, educators, industry, and the international community to work together to elevate biological preparedness and response,” it reads. 

Tanner Stening is a Northeastern Global News reporter. Email him at t.stening@northeastern.edu. Follow him on Twitter @tstening90.

A Northeastern professor says the Centers for Disease Control has significantly overestimated the number of people who have received at least one COVID shot, leading the federal agency to paint a rosier picture of vaccine compliance than actually exists.

One of the authors of the COVID States Project’s recent report on nationwide vaccination rates, David Lazer, says his report shows 75% of adults in the United States received at least one vaccination against the coronavirus, compared to the 92.1% reported by the CDC.

“That’s a very, very big difference,” says Lazer, a Northeastern distinguished professor of political science and computer sciences.

The CDC is “saying 8% of the population has gotten no vaccine, and we’re saying 25%,” he says. “So we’re saying three times as many people have gotten zero vaccines.”

“The reason for that is pretty simple,” Lazer says.

The CDC is relying on information reported by states, which in some cases counts individuals going for booster shots as separate individuals getting the first shots in the series, especially in cases when people forget to bring their vaccination cards for the boosters.

“It’s not like they’re collecting Social Security numbers” to verify the data, Lazer says. 

“We’re basically saying the population is significantly less protected than what the CDC is saying,” he says.

The COVID States Project’s report—its 100th since launching in May of 2020—also shows that vaccination rates have plateaued in the last year and a half.

“It’s barely budged. It’s not like we’re converting all these vaccine resistant people from October 2021. If you weren’t vaccinated in October or November of 2021, you’re not vaccinated now,” Lazer says.

“The CDC data show this very steady increase in people who are getting their first shot. The data are very distorting because the message you get ‘we’re slowly winning the war on vaccine resistance’” and that is not the case, he says.

The report says the regions with the highest vaccination rates are the Northeast, West Coast and Hawaii. The regions with the lowest rates are in the South and in a block of contiguous Western and Midwestern states—North Dakota, South Dakota, Montana, Wyoming and Idaho.

The COVID States Project relied on a survey of 25,000 people for its latest report, which also showed that less than one-third of respondents got the bivalent booster.

The CDC’s reliance on state reporting means it underestimated the number of people getting booster shots, Lazer says. 

In every state, older people were more likely to get vaccinated against COVID-19 than younger people. But the CDC says more 65-year-olds have gotten the shots than there are 65-year-olds in the U.S.

When it comes to reporting the percentage of people who completed the primary series of shots—either two shots of Pfizer or Moderna or one of Johnson & Johnson—the difference between CDC and COVID States Project percentages are less gaping.

The CDC says 79% of Americans completed the first series of shots while the COVID States Project estimates 73%.

Lazer says his survey is more accurate than the CDC’s reporting but adds it is not perfect.

“For example, we’re not getting a good sample of people in nursing homes,” he says. “If they have different rates of vaccination, we’re missing those people.”

The COVID State Project is a multi-university consortium of researchers initially funded by Northeastern University and the National Science Foundation.

As far as COVID-19 reporting is concerned, the project is ongoing but slowing down and may refocus its efforts on broader health policies, Lazer says.

“I don’t think we can say COVID is quite in the rearview mirror, because it’s still killing a lot of people every day, just much more quietly.”

Cynthia McCormick Hibbert is a Northeastern Global News reporter. Email her at c.hibbert@northeastern.edu or contact her on Twitter @HibbertCynthia

The term “pandemic pounds” had already been coined when Lauren Raine and colleagues reopened their lab at Northeastern’s Center for Cognitive and Brain Health to participants in August of 2020.

Even so, they were taken aback by the stark differences a few months of isolation had made in the fitness levels of children and adults they study as part of a federal brain health research project.

“It had only been four to five months (of isolation) and people were drastically different,” Raine says.

She led a team of researchers in quantifying the results for a study published in Frontiers in Public Health that documented increases in the body mass index of participant groups studied before and during COVID shutdowns, as well as decreases in their cardiovascular fitness.

“I don’t think we quite realized the impact” of the shutdowns, when gyms were closed and even parks marked off by caution tape, says Raine, an assistant professor whose co-authors include Northeastern’s Arthur Kramer and Charles Hillman.

Steps taken to reduce people’s exposure to the novel coronavirus may have inadvertently reduced their physical activity levels to the point of unhealthiness, says Raine, who works in the department of physical therapy, movement and rehabilitation sciences and the department of medical science.

“People in the physical therapy department will tell you that if you stop exercising, you see declines very quickly,” she says.

“But people in the general population may say, ‘What’s the big deal if I sat around for two weeks?’” Raine says. “It is a big deal.” 

Cardiovascular fitness measured as participants exercised on a treadmill showed the level for older adults declined by 30%. For children, the decline was even worse—53%.

Her study compared the aerobic capacity and body mass index of 493 adults aged 65-80 before the pandemic with 100 adults in that age range during the pandemic.

The children were all located within one-hour’s drive of Boston, while the adults were located at three sites in Boston, Kansas and Pittsburgh, Raine says.

Body mass index also rose in both age groups, she says.

In older adults it went from 29.5 to 31.3, which “is definitely an increase,” Raine says.

In children, BMI went from 18 to 19.3, but she says it’s tricky to assess the significance of that gain due to children’s rapid growth rates and changing body composition.

What’s concerning is that previous reports indicate children in the heaviest weight categories seem to bear the brunt of the shutdown BMI increases, and “our data falls into line with that,” says Raine

Collaborative ongoing research measures health metrics on the two age groups for National Institutes of Health funded research on exercise and brain health.

Americans—old and young—were suffering high rates of overweight and obesity before the pandemic, she points out, adding that public health strategies should emphasize not just regaining but overtaking lost ground.

“We need to have some public health strategies to help people get back on the right trajectory,” Raine says.

And before the next pandemic appears on the horizon, there should be plans on how to prevent loss of fitness, Raine says.

It won’t be a one-size-fits all, she says.

Some families have access to online exercise classes, others don’t, Raine says. “We just have to be creative and thoughtful.”

Cynthia McCormick Hibbert is a Northeastern Global News reporter. Email her at c.hibbert@northeastern.edu or contact her on Twitter @HibbertCynthia

In these tricky economic times, asking for a raise may seem even more daunting than it would have even a year ago. 

How is inflation influencing these conversations between employer and employee? It’s often conventional wisdom for workers to focus on their performance (merit) when discussing a raise; but many Americans are finding themselves cash-strapped in this economy. Concerns that wages aren’t keeping up with rising prices may be something to consider when talking to your boss.

With the cost-of-living crisis impacting millions of earners, should companies take an interest in how inflation may be impacting employees during these uncertain times? Should employees view higher prices as part of their calculus?

Ravit Heskiau-Ludwig, associate teaching professor of management and organizational development at the D’Amore-McKim School of Business, says there’s no one-size-fits-all approach to these questions. 

“There are multiple and different considerations and circumstances that could guide an employee’s conversation with their manager or employer about salaries and other benefits,” she says. “Like in any relationship, there are different perspectives, in this case the perspective of the employee and that of the employer.” 

In addition to workers, companies have also felt the impact of rising prices, Heskiau-Ludwig says. It is, in some ways, part of the inflationary cycle: businesses raising prices on their customers as a means of coping with supply chain costs. 

“Naturally, the level of raise requested and granted also depends on the financial situation of the organization and whether it is likely that the organization can currently afford certain raises,” Heskiau-Ludwig says. “Employers are also consumers and are affected by inflation.”

Heskiau-Ludwig says there may be other ways for employers and employees to offset costs while finding common ground. As a result of the COVID-19 pandemic, workers have placed more importance on work-life balance, overall well-being and the meaningfulness of work. 

Increased flexibility in terms of remote work, or number of hours worked, may be more attractive to employees and lead to greater savings, she says. Employers can also offer more opportunities for growth, learning or acquiring new and up-to-date skills as a way of keeping their help happy.  

“Employees and employers should reflect on whether there is something more beneficial in the short or long term that can create a ‘win-win’ and satisfy both the employee and the employer,” Heskiau-Ludwig says. 

At the same time, employers should be mindful that inflation really has set many families back.

“On the other hand, for some employees, the rising cost of living is a central concern, and a higher pay is a stronger need,” Heskiau-Ludwig says. 

As the economy heads into a potential recession, companies are most likely getting ready to tighten their belts, which could lead to more layoffs that, in turn, may cause a shift in the worker-boss relationship. That shift may mean workers in some sectors will have less leverage than they did during the pandemic, which might make the business of hiring and firing more transactional than it was in recent months. 

Not all of a company’s employees are on a level playing field in terms of their commitment to the organization and the time in which they plan on staying there, Heskiau-Ludwig says. Company culture and values also differ by organization. Additionally, she says, there could be norms or unwritten rules that shape conversations about salaries, among other things, that employees should consider if they’re thinking about asking for a raise. 

At the end of the day, Heskiau-Ludwig says, organizations and their workers should keep the lines of communication open. 

“Showing empathy and flexibility, by both sides, is a way to invest in this relationship— a relationship that can continue far beyond employment in the specific organization,” Heskiau-Ludwig says.

For media inquiries, please contact media@northeastern.edu. 

The U.S. Food and Drug Administration is considering a major change in the way COVID-19 vaccines and boosters are given. Northeastern experts say it would streamline the process for the public and suppliers.

Rather than tacking on boosters as new variants arise, FDA officials are looking at transitioning to a single vaccine composition for COVID-19 and boosters, selecting for anticipated strains by the summer and administering one annual shot in the fall.

Public health professor Neil Maniar and supply chain expert Nada Sanders say simplifying the COVID-19 vaccination schedule would make the vaccination process less confusing and more accessible. 

“We’re at a point where there’s a lot of COVID fatigue and confusion regarding vaccination recommendations,” says Maniar, director of the master of public health program at Northeastern’s Bouvé College of Health Sciences.

A vaccination schedule that mirrors one already in place for influenza “will be easier to follow and easier to communicate,” he says.

“This is going to ease so much tension,” says Sanders, a distinguished professor at Northeastern’s D’Amore-McKim School of Business.

She says even with her educational credentials and connections to people in the medical profession, “I was confused” about when to get a COVID-19 booster.

“This is going to improve access. It’s going to improve costs,” Sanders says.

Until now the development of COVID-19 vaccines and boosters has been in reaction to disease and variant outbreaks, she says. 

“From a supply chain standpoint, any time you’re in reactive mode it’s costly,” Sanders says.

“There’s no question that moving to a more predictable cycle would dramatically reduce overall costs” by allowing truckers and pharmacies to anticipate transportation and storage issues, she says. 

A story on NPR Monday morning broke the news that the FDA was considering using an approach similar to the flu vaccine with annual updates to match circulating strains.

Also on Monday the FDA made public a briefing document on a Thursday (Jan. 26) meeting of the Vaccines and Related Biological Products Advisory Committee that will “consider questions around simplifying the composition and immunization schedules of the authorized and approved COVID-19 vaccines, the process for determining the need for recommending a period update to COVID-19 vaccines and the timing for implementation of such an update.”

“There’s a solid system in place for how this will work,” Maniar says. “It should be very doable.”

In the spring, health experts will look at strains emerging around the world and use those findings to make recommendations for what the vaccine should be in the fall, he says.

Maniar says he doesn’t know if an annual COVID-19 shot would be a better match for the coronavirus than the flu shots are for circulating strains of influenza, but says technology has developed to the point “we’re able to address new variants in a pretty timely way.”

People could get vaccinated against both COVID-19 and influenza at the same time, although the shots would be separate. 

While most people would likely get just one COVID-19 shot under the new vaccination schedule, the FDA says elderly people and the very young would likely get two shots.

The goal is to increase the number of people vaccinated to keep disease from spreading and to prevent COVID-19 illnesses from becoming serious, Maniar says.

Simplifying the message to the public about when to get a COVID-19 shot will make people more likely to sign up for a shot, Sanders says.

It will also allow pharmacies to make plans for when they should expect to stock up and create refrigerated storage space, she says. “Every bit of handling is critical especially when dealing with a biologic like this. It’s not a pair of sneakers you can leave in the hall.”

“COVID has been very disruptive for both individuals and communities,” Maniar says. “This schedule will provide another opportunity to help us navigate and co-exist with COVID in a way that buffers the disruption and keeps people healthy.”

Cynthia McCormick Hibbert is a Northeastern Global News reporter. Email her at c.hibbert@northeastern.edu or contact her on Twitter @HibbertCynthia

Your Google searches and Twitter accounts alert marketers about what items you might like to  purchase—could they also serve as an early warning system when COVID-19 levels are about to take off? 

A team of scientists including Northeastern University machine learning expert Mauricio Santillana says internet users’ “digital traces” can be adopted to alert public health officials to sharp increases in COVID-19 at the county level one to six weeks ahead of a major outbreak.

In a paper published Wednesday, Jan. 18, in Science Advances, Santillana and other authors say digital data will help close information gaps left by existing surveillance methods.

Analysis of the data streams will allow policymakers to get a jump on decisions such as whether to reissue masking recommendations or bump up vaccination and boosting campaigns, says Santillana, director of the Machine Intelligence Group for the Betterment of Health and the Environment at the Network Science Institute at Northeastern.

“What we aspire to do is to use the same information that Google or Amazon or any of these big firms use to send ads to you” to inform public health decisions early on in an outbreak, Santillana says. 

COVID-19-related digital streams include internet searches for fever, clinician searches for COVID-19 treatments and Twitter users’ comments about being too sick to work, among other things.

The researchers also used machine learning methods that took historic information from outbreaks in 97 U.S. counties from Jan. 1, 2020, and 2022 and combined them to create a single predictive indicator.

“The goal is not necessarily to quantify how many infections there are but to quantify when sharp increases in infections will happen,” says Santillana, who participated in the research with scientists from Boston Children’s Hospital, Harvard Medical School, Oklahoma State University and other organizations.

Researchers found that the predictive capacity at the state and county levels was roughly similar—the early warning system deployed at one to six weeks in advance at the county level and four to six weeks at the state level.

The study says the digital data will help fill in vital missing information for the Centers for Disease Control and Prevention, which it says has failed to reliably forecast “rapid changes in the trends of reported cases and hospitalizations.”

“When CDC COVID-19 forecasts were shared with the public, they very frequently missed the timing of when outbreaks were starting,” Santillana says. He says by the time actual case numbers were tallied, surges were already well under way.

“The next chapter would be for the CDC to say, ‘We know that this is an alternative and complementary way to anticipate outbreaks. We will implement it inhouse, and we will have it as an additional tool in our toolbox,” Santillana says.

“He says the study is part of a new CDC initiative started by President Biden called the Center for Forecasting and Outbreak Analytics within the CDC.”

“It is within that effort that we did the work in this paper,” published in an open access journal of the American Association of the Advancement of Science, Santillana says.

He says he and his team already had been working with the CDC for three to four years on predicting flu incidence and flu hospitalizations, but he wasn’t satisfied with what he considered the CDC’s inability to incorporate novel Internet-based sources of information into their prediction systems.”

“When COVID hit, they called and said, ‘We need all hands on deck. So please do what you can.’”

“I asked if they could be flexible, because my team and I were interested in innovating rather than just continuing to implement the exact same models,” Santillana says.

“The model is not perfect,” he says.

The counties studied were only a fraction of the 3,006 counties in the United States, according to the paper on using digital traces to build prospective and real-time county-level early warning systems.

“Our internet search-based methods may struggle to perform well in areas with poor literacy rates and limited access to internet resources,” the paper says.

The researchers say a possible solution for counties with poor internet access or literacy challenges may be to use state-level early warning systems to guide county-level decisions around outbreaks.

“When we navigate the internet on our computer or phone it leaves traces,” Santillana says.

“Whether we like it or not, the reality is that most companies use this information to increase their profit or their margins,” he says.

“Instead, we want to use that information to inform public officials when the next outbreak will happen.”

Cynthia McCormick Hibbert is a Northeastern Global News reporter. Email her at c.hibbert@northeastern.edu or contact her on Twitter @HibbertCynthia

The COVID-19 subvariant XXB.1.5 is spreading so fast that the World Health Organization last week advised people to wear masks in certain situations, including in crowded, enclosed and poorly ventilated spaces, regardless of local infection rates.

The announcement came three days after the WHO recommended that people mask up on long-haul flights, according to Reuters. 

Two experts at Northeastern University say the new Omicron subvariant is so transmissible it will cause a wave of illness, but they do not anticipate it will overwhelm hospitals and emergency rooms.

“It follows a trend of more infectious, less deadly,” says Jared Auclair, director of bioinnnovation at Northeastern’s Office of the Provost.

“We’ll definitely, definitely have another wave,” says Mauricio Santillana, a Northeastern University physics professor and expert in machine learning who is part of a team that monitors COVID-19 cases in the U.S. “I’m cautiously optimistic that even if we see an explosion of cases, it will not be as bad as previous waves.”

Protection from vaccination and previous COVID-19 infections likely offers some hedge against the new subvariant causing severe illness, Santillana says.

“Our bodies have seen at least one version already,” he adds.

COVID-19 infections are currently raging through China, which until recently had a zero tolerance policy for infections and has a poorer track record than other developed countries of vaccinating elderly people more susceptible to severe illness from COVID-19.

In the U.S., the percentage of COVID-19 cases attributable to XXB.1.5 is skyrocketing.

For the week ending Jan. 14, 43% of all U.S. cases stemmed from the new subvariant, compared to just 2.3% for the week ending Dec. 3, 2022.

The lion’s share of XXB.1.5 cases are in the Northeast, accounting for nearly all COVID-19 cases in New England and New York, 81.7% and 82.7%, according to the CDC.

The new Omicron subvariant is responsible for fewer COVID-19 cases in the West—15.8% in California, Nevada and Arizona and 8.1% in Washington, Oregon and Idaho—but Western states will soon catch up, scientists say.

Preliminary assessments indicate XXB.1.5 is more infectious than other Omicron subvariants because it binds more tightly to cells, increasing the chance of uptake, Auclair says.

It’s hard to tease out how much of the bump in cases is due to holiday travel and gatherings and how much is due to the increased infectiousness of XXB.1.5, Auclair says.

Far fewer people are getting PCR tests from which positive results are reported to public health officials, Auclair says.

Many individuals with symptoms are relying on at-home rapid antigen tests, and some people have such mild symptoms they consider their infection the common cold and do not bother to test at all, he says.

January of 2022 his lab in Burlington was processing 8,000 COVID-19 tests from the university and public schools and partners in a 24-hour period; now the lab does 100 tests a week, Auclair says.

“Last January, the original Omicron spike was very intense. I don’t expect to see that with this variant for a whole host of reasons,” including improved therapeutics, he says.

Even so, people who are elderly and immunocompromised remain at highest risk of severe illness and death, Santillana says.

He says it’s important that people who have symptoms or who are ill wear facial masks to reduce the spread of illness and to take a rapid test if they experience symptoms.

“I would like people to be more responsible,” Santillana says.

Since February the federal government has required people working or visiting federal buildings to wear masks when the community COVID-19 infection rate is high.

WHO factored local infection rates into mask guidelines until Friday, when it updated guidance to advise mask wearing in certain situations “irrespective of the local epidemiological situation, given the current spread of the COVID-19 globally.”

It says masks are recommended “following a recent exposure to COVID-19, when someone has or suspects they have COVID-19, when someone is at high-risk of severe COVID-19, and for anyone in a crowded, enclosed, or poorly ventilated space.” Previously, WHO recommendations were based on the epidemiological situation.

Auclair says, “It’s a good time to remind people to do all those things that we were doing a year ago, and that we might have slacked off on. Make sure you have your booster shots, make sure that you wash your hands, make sure that you’re vaccinated and have your booster shots.”

“And if you’re sick, wear a mask,” he says.

Cynthia McCormick Hibbert is a Northeastern Global News reporter. Email her at c.hibbert@northeastern.edu or contact her on Twitter @HibbertCynthia

The director of Northeastern’s Network Science Institute says it’s possible that 50% of China’s 1.4 billion people will become infected with COVID-19 in the near future, a scenario that threatens to overwhelm the country’s health care systems and further aggravate world-wide supply chain problems.

“That means 700 million people in the next few months,” says Alessandro Vespignani, whose research models possible scenarios for how a disease might spread.

“We are talking about a large number of people in a very short window of time,” he says.

“This is going to be a serious risk for the health care system. This will affect the economy of China. It will also affect the supply chain for Western countries, and we already are not in a good place because of problems in the supply chain.”

China is easing away from its “zero COVID” policy of locking down entire cities at a time it faces a surge of COVID-19 cases stemming from Omicron sub-variants.

The strict containment policies kept COVID-19 from spreading in the past, Vespignani says.

But the Omicron strains currently in circulation are so contagious they would likely spread among the population even if the old policies were still in place, he says. 

The changes came after protestors took to the streets of Beijing and other major cities against the strict mandates China has had in place for the past three years.

No longer will people with mild or no symptoms be shipped to government quarantine facilities, and officials will no longer be able to label entire residential zones as high risk areas, according to Voice of America.

“It’s more and more difficult to contain these outbreaks. If they start to reopen, the virus will spread very quickly,” he says, adding that Chinese health officials “are trying their best to let it spread but in a way that is not disruptive.”

While China “crushed the curve” in the past, it is now trying to flatten it, Vespignani says.

While the U.S. and other countries emphasized vaccination campaigns and lifted restrictions as massive numbers of citizens got vaccinated, in China, only 40% of the most fragile population (people over 60) have received a booster shot, he says.

“The population is not very well vaccinated and they didn’t use the most effective vaccines available,” the mRNA vaccines, Vespignani says.

“At the moment, it’s likely that (COVID-19) is spreading more in the younger and adult population more than the elderly because they are more active, they are going to work, etc.,” he says. “But sooner or later the virus will spread across the at-risk population.”

Omicron is not as deadly as the original virus or Delta variant, but it can still take a toll on hospital facilities in China as it strikes a “COVID naive” population that has not been exposed to the virus, Vespignani says.

Some projections have estimated that 1 million people in China could die as a result of the surge, he says, adding that deaths could include individuals suffering heart attacks and other health emergencies who are not able to get treated in time.

Vespignani says it is hard to assess the likelihood of mutations emerging from the wave of infections.

There is little evolutionary pressure on the virus to change as it encounters a population that was not exposed to previous infections, he says.

“But we’re talking about millions of infections, so there is some concern that something new could emerge.”

“No one has a crystal ball for what the virus can do,” Vespignani says.

“I hope they will have a strategy to try and slow down this wave as much as possible.”

“I would say that before, in a way, they were dealing very well with the virus,” Vespignani says. “But their exit strategy was really badly orchestrated.”

For media inquiries, please contact media@northeastern.edu. 

With pediatric pain and fever medications in short supply, many parents are eyeing their bottles of adult acetaminophen with an eye on cutting down the dosage for their children.

Brandon Dionne, associate clinical professor in Northeastern’s School of Pharmacy, urges caution.

Acetaminophen in tablets for adults is the same active ingredient in acetaminophen liquid drops and chewable tablets for children, he says. But unlike dosages for adults, pediatric dosages are based on age and weight, Dionne says.

“For adults, you have fixed dosages,” Dionne says. The minimum adult dose of acetaminophen is a 325-milligram regular strength tablet every three to four hours, he says. The maximum dose for that time period is 500 milligrams.

Compare that to the dosage scale for children published by the company that makes Tylenol, a name brand for acetaminophen.

Tylenol says on its website that the dose for a child between the ages of 9 and 10 who weighs between 60 to 71 pounds is 400 milligrams.

For a 4- to 5-year-old child weighing between 36 to 47 pounds, the maximum single dose drops to 240 milligrams.

“It would be hard to make some of those doses with adult formulations,” Dionne says, adding that getting the exact measurement is important.

Tylenol warns on its website against cutting adult doses for children.

But so many parents are doing exactly that that a poison control organization in Canada, which started experiencing the shortage of pediatric acetaminophen before the United States, has published a conversion dosing guide for parents.

The Ontario Poison Centre guide to alternatives to infant and children’s liquid pain medication lists dosage conversions for both acetaminophen, based on a 325-milligram tablet, and for ibuprofen based on a 200-milligram tablet.

Ibuprofen is a pain and fever reducer that is also anti-inflammatory, Dionne says.

For a child weighing 12.1 to 17.6 pounds, which according to Tylenol correlates to a child between the ages of 4 to 11 months, would get one-quarter of a 325-milligram acetaminophen tablet, according to the poison center guide.

A child weighing 16.5 to 23.8 pounds would get a third and a youngster between 23.9 to 35.7 pounds would get a half.

The Ontario Poison Control Centre, which also established maximum doses per day, says children weighing between 11 and 22 pounds should only take a quarter of a 200-milligram ibuprofen tablet.

A pill cutter can help parents cut the tablet down correctly.

But Dionne says that is especially challenging with ibuprofen since the pills are so small.

There is also the issue of getting children to take the medication, he says. 

“You’re going to have to try to crush it up and hide it in some food. It’s not as easy as giving them the liquid formulation or a chewable tablet,” Dionne says.

The Ontario Poison Control Centre advises parents to call their pharmacist for advice on crushing and serving the acetaminophen or ibuprofen, but in the meantime parent social media sites are full of advice—and admonitions.

Acute shortage of oral amoxicillin

There is also an acute shortage of oral amoxicillin, according to the FDA. Parents of children with ear and respiratory infections report being prescribed half the amount of the liquid medication due to limited supplies.

Parents are being advised to “check back later” and grab generic alternatives if they are available, according to ABC News.

The news service says that instead of using automated E-scripts that send prescriptions directly from physician offices to specific drugstores, parents should consider asking for written prescriptions in case they have to check out several different pharmacies.

“You could ask for a paper prescription,” Dionne says.

Another possible alternative is using a compounding pharmacy, Dionne says. 

Compounding pharmacies combine ingredients in house to meet patients’ specific needs and might be available to make pediatric versions of amoxicillin, for instance, he says.

Dionne says people can search for compounding pharmacies in their area at Find A Compounder  and Find a Provider. 

The shortage of pediatric medications is being spurred by a “tripledemic” of pediatric RSV, flu and COVID-19, health experts say.

Really a supply chain problem

But there’s really no excuse for the problem, which is a supply chain issue, says Nada Sanders, a distinguished professor at Northeastern’s D’Amore-McKim School of Business.

As winter approaches with more possibility of illness, “I would like to see more reassurances from a supply chain standpoint in terms of what does the supply chain look like,” Sanders says.

“The fact that we’re seeing shortages is definitely alarming,” says Neil Maniar, director of Northeastern’s master of public health program.

Acetaminophen and amoxicillin “are really important medications,” Maniar says. “They’re really important tools to help manage illness and to treat the illness.”

Dionne says that while amoxicillin plays a vital role in combating bacterial infections, he adds, “It is too often overprescribed for viral infections, which can have unintended consequences. Parents can ask their child’s pediatrician whether an antibiotic is absolutely necessary.”

He says that whatever parents do, they should not hoard pediatric medications. That will only make it harder for children who are ill to get them, Dionne says.

“Try to only buy what you think you’ll need for a short time in the future,” he says.

For media inquiries, please contact media@northeastern.edu.

Half of U.S. adults report being sickened with COVID-19 at some point during the pandemic, with only a fraction saying they received an official medical diagnosis of the respiratory infection, according to a new survey by the COVID States Project, led by Northeastern researchers.  

Among the key findings, the survey found that self-diagnosing via at-home, or rapid, testing has far eclipsed medical testing for the virus, meaning official reporting is missing “a significant number of positive cases” at this late stage of the pandemic, researchers found. 

Researchers with the COVID States Project, a multi-university team focusing on issues of “computational social science, network science, public opinion polling, epidemiology, public health, communication and political science,” surveyed 26,161 people over the age of 18 between Oct. 6 and Nov. 9 to gather information on the health of Americans. 

Researchers aimed to give an update on the state of the pandemic by attempting to provide an updated snapshot of “COVID-19 cases, vaccination and booster shot rates, antiviral treatment usage, mask-wearing habits and flu shot rates,” they wrote.

Among those who reported testing positive for COVID-19 in the last six months, four in 10 American adults said they were never diagnosed by a medical professional, the survey shows. Seven in 10 reported using an at-home rapid test to test for the infection. 

Among those who reported testing positive for COVID-19 in the last three months, 76.3% said they did so at least once using an at-home or rapid test. Only 36.4% of those who tested positive for COVID-19 with an at-home test in the last three months followed up to get tested again at their doctor’s office or another testing facility. Among those who did follow up, 92.3% tested positive again—this time, by PCR—compared to 63.4% who did not, researchers wrote.

Vaccinations continue to be slow-going, the research found. A substantial majority of American adults have not gotten the bivalent booster shot, which protects against the present strain in circulation—the BA.5 omicron variant—and the original virus, the survey shows; but a majority of those who have not said they “plan[ned] to or are open to getting the shot.” Additionally, roughly 28% of respondents said they have received their flu shot. 

The survey’s findings come amid concerns that the U.S. is headed into a “tripledemic” this winter characterized by elevated rates of COVID-19, flu and RSV, or respiratory syncytial virus.  

The survey also found that antiviral medications are not being heavily utilized, even among those most at-risk—a finding that echoes the results from a prior COVID States Project survey. Among respondents who reported contracting COVID-19 in 2022, just 9.2% said they were treated with leading antiviral medications Paxlovid or Molnupiravir.

Among those who were sick over the last six months, roughly 16.3% said they took the antivirals; but among those 65 and over, that figure rises to roughly 35%. 

Mask-wearing to combat viral spread appears to have largely fallen off compared to earlier phases of the pandemic. Roughly 47% of respondents say they’re still wearing masks, but only 27% say they are “very closely following” the suggestion to mask up outside of the home. That’s compared to the 53.1% who said they are “not closely following” the mask-wearing recommendation, and the 32.6% who said they are “not at all closely following” the guidance. 

David Lazer, university distinguished professor of political science and computer science at Northeastern, and co-author of the research, says the findings show that “as a society, we are underutilizing our tools to defend against COVID.”

“Only a small minority of even high risk people have gotten the bivalent vaccine; and antivirals are not being used that frequently, even for higher risk patients,” Lazer says. “Many people are still dying every day from COVID; those numbers should be much smaller.”

Lazer adds that “our picture of the continued state of the pandemic is deteriorating, where official data are likely missing about half of known COVID cases.”

For media inquiries, please contact media@northeastern.edu.

Age-old mysteries of the common cold have long blocked scientists from developing a cure. Has a Northeastern researcher discovered a way past the congestion?

A new study focuses on the crucial question of why people are more vulnerable to catching colds during the months of winter. The answer hinges on an evolved defense system, innate to the human nose, that is numbed by frigid temperatures. 

The findings, to be published in The Journal of Allergy and Clinical Immunology, could lead to treatments drawn from the body’s own defense mechanism, says Mansoor Amiji, university distinguished professor of pharmaceutical sciences and chemical engineering at Northeastern.

“Can we ultimately create a defense mechanism in the nasal cavity?” says Amiji, who led the research with Dr. Benjamin Bleier of Harvard Medical School and Massachusetts Eye and Ear. “Can you create an anti-infective environment there?” 

Sick days lost to common colds reportedly cost the U.S. economy more than $40 billion annually. Among the many groups seeking a cure is Amazon, which has reportedly devoted more than 100 employees to researching and developing a vaccine.

Alternatively, Amiji’s team focused on an innate response while building on 2018 research that first identified an immune mechanism in the nose and its release of extracellular vesicles—a spray of tiny sacs released from cells—that swarm, bind and kill bacteria at the point of inhalation.

“It’s akin to if you kick a hornets’ nest, and all the hornets come out and attack,” Bleier says. “The nose detects these pathogens and releases a swarm of extracellular vesicles.”

With their latest study, the researchers set out to answer two questions:

• Does the innate response in the nose also provide defense against viruses? (Turns out it does.) 
• Does the temperature of the air diminish the antiviral immune response—thereby helping explain why people become especially susceptible to colds in winter?

“There’s never been a convincing reason why you have this very clear increase in viral infectivity in the cold months,” Bleier says. “This is the first quantitative and biologically plausible explanation that has been developed.”

Nasal samples from volunteers were divided and cultured in Amiji’s Northeastern lab at the normal body temperature of 37 degrees Celsius as well as at 32 degrees Celsius, which is the plummeting temperature of the nasal pathway when people are outdoors in cold weather. 

Under normal body-heat conditions, the researchers found that nasal extracellular vesicles were deployed with success by acting as decoys that directly bind and block viral entry. 

“Those extracellular vesicles actually bind to the viruses, which are suspended in the nasal mucus,” says lead author Di Huang of Harvard Medical School and Massachusetts Eye and Ear. (The other authors of the paper are Maie Taha, a former postdoctoral associate; Angela Nocera, a former Ph.D. student in the Amiji lab; and Alan Workman, a medical fellow at Massachusetts Eye and Ear.)

In colder temperatures, a sparser net of fewer extracellular vesicles was deployed in tests involving two rhinoviruses and a coronavirus that are typical of the winter flu season.

“This paper uncovers a very robust mechanism that explains a lot about how we typically fight off viruses,” says Bleier, who describes the innate response in warmer temperatures as both instantaneous and broad.

Amiji anticipates that the body’s evolved response to pathogens could be tested against a wide variety of viruses, including SARS-CoV-2, the virus that causes COVID-19.

“So now you have this therapeutic potential,” Amiji says. “Can you create artificial virus sponges—a decoy cell—that the virus can bind to? And now you have an antiviral compound that destroys it before it infects the actual cell.”

“The intriguing piece is that we are exploiting a natural phenomena in the nose to inhibit viral transmission,” adds Amiji, looking ahead to potential outcomes.

For media inquiries, please contact Marirose Sartoretto at m.sartoretto@northeastern.edu or 617-373-5718.

The COVID-19 pandemic has been defined not only by its outsized impact on the lives of people all over the world. In the U.S. the global pandemic has become a polarizing political issue, with misinformation flying far and wide on social media.

Now, new research suggests that politics played a significant role in who was dying early in the pandemic.

Mauricio Santillana, a professor of physics at Northeastern who specializes in epidemiology, and a team of researchers tracked trends in COVID-19 death rates during the first year of the pandemic. What they found was that deaths spiked in well-connected, Democrat-heavy cities early in 2020, but that by the first pandemic winter, deaths were about three times higher in Republican-leaning—and specifically Trump-leaning—areas of the country.

“In epidemiology, when you see 10% or 20% higher, you worry, but when you see threefold differences, then you panic,” Santillana says.

Strikingly, the researchers found that the median death rate for counties with the strongest Republican leaning was between 40% and 300% higher than the counties that leaned Democrat. Santillana says the stark differences are symptomatic of a public health crisis that has been heavily politicized.

“Something that became clear very early on in the pandemic was that people were listening to different voices,” Santillana says. “As a consequence, what started as a public health crisis started becoming a crisis that was determined more by the political affiliation that people had.”

In that way, the COVID-19 pandemic is different from past pandemics, he says. Typically, epidemiological models don’t even take into account the political leaning of communities. In this case, Santillana and the rest of the research team set out to document the vital role that political affiliation played in the devastation of the pandemic.

As part of their research, the team created models based on death counts from the country’s 2,000 counties that looked at factors ranging from socioeconomic status to obesity. Even when controlling for every other variable, the team found that political affiliation factored heavily in the death rate. 

“We started monitoring how the different communities that aligned better with certain political affiliations started showing big differences in the way they were behaving, and we were concerned that would lead to different outcomes, some outcomes that would be regrettable, namely higher rates of mortality,” Santillana says. “We started realizing that political affiliation was an important factor in an epidemic outbreak, something that in prior outbreaks hadn’t been as explicit as it was during COVID-19.”

Between February 2020 and February 2021, the focus of this research, 462,475 people died from COVID-19 nationwide. Regionally, the story looks different in that time period. 

In the Northeast, the majority of deaths, 51%, were in the first four months, when COVID-19 first arrived in the states and spread rapidly. Deaths decreased during summer 2020 as the CDC recommended mask wearing and states adopted mask mandates and social distancing policies were put in place. Meanwhile in the South, in the same period, deaths rose in the summer and peaked in the winter, with 57% of deaths occurring between October 2020 and February 2021. Deaths in the Northeast also rose slightly in winter 2020, but not to the same degree as the South. Santillana says this is when the link between behavior, inspired by information and misinformation, and its impact on COVID-19 outcomes can be most clearly seen. (The research draws on Johns Hopkins University’s COVID-19 data portal.)

“We realized that people who were listening to the stronger voices coming from the Republican party, specifically from Donald Trump, were dismissing the gravity of contracting COVID-19 and were dismissing the usefulness of masks and social distancing,” Santillana says. “Sadly, that led to much worse outcomes in those communities.”

Justin Kaashoek, the lead author on the research, says that based on the discourse around vaccines and boosters, the pandemic is still heavily politicized. However, he hopes this research can help avoid a similar story in the future.

There are still people who are dying from this disease, and there’s going to potentially, hopefully not in our lifetimes, be another pandemic,” Kaashoek says. “How do we make sure our political differences don’t get in the way of something that is strictly not political and shouldn’t be?”

During a panel organized by the University of Cambridge’s philosophy panel, Santillana admits his usual optimism was shaken when a member of the audience suggested that “what happened during COVID is intrinsic to societies working as political systems.”

“I have this optimistic perspective … that if we were only able to share the consequences in a transparent way, everyone should be able to digest the information and conclude that we should behave differently,” Santillana says. “But in our current system, when vaccines were rolled out, even though we were presenting the studies showing their advantages … still people were choosing to believe or not believe. Can we really hope for a better outcome in the next [pandemic], which will occur at some point?”

For media inquiries, please contact Sara Awaleh at s.awaleh@northeastern.edu or 617-373-5718.

Pfizer-BioNTech and Moderna are currently developing and testing various “combined” vaccines to guard against diseases such as COVID-19, influenza and RSV (respiratory syncytial virus) in one single injection.

The combination shots are possible thanks to advances in mRNA technology, which allow the drugmakers to encode flu antigens into a vaccine cocktail that also carries coronavirus antigens, such as the one proposed by Pfizer, says Mansoor Amiji, Northeastern distinguished professor in the departments of pharmaceutical sciences and chemistry.

Separate from the two pandemic companies, a team of scientists from the University of Pennsylvania published research last week in Science Magazine detailing a “universal” mRNA flu vaccine that in theory would inoculate against all 20 known strains and subtypes of flu. Experimentally, the researchers say the shot produced “high levels of antibodies” for all 20 variants in mice and ferrets—a step that could soon lead to protection in humans.  

“They’re developing specifically an mRNA flu vaccine, which would be one vaccine that wouldn’t necessarily need to change year-to-year,” Amiji says of the experimental universal flu shot. “That gives us this opportunity to say, if you could create a universal flu vaccine, why not create that together with the COVID booster? Both of them would be using mRNA technology.”

These innovations have been long-anticipated. By reducing the frequency of injections, manufacturers could spur vaccination rates, leading to greater immunity across populations, Amiji says. That would translate to less severe disease and hospitalization—a concern that’s only increased since the COVID-19 pandemic showed how easily and quickly hospitals get overwhelmed during disease outbreaks.

Interest in creating effective combinatory vaccines couldn’t be higher as the U.S. heads into a “tripledemic,” a winter season with higher rates of flu, RSV and COVID-19. Such vaccines could be a panacea for low booster rates amid so much COVID fatigue and persistent vaccine hesitancy in the face of a potentially deadly winter, Amiji says.

“This way both flu and COVID vaccines will be widely disseminated because now you’re only getting one injection instead of two,” Amiji says. 

From a business standpoint, Amiji says there may be some downsides to a single vaccine thwarting multiple diseases. One product instead of two or several could mean less revenue. But companies such as Pfizer and Moderna valuing vaccine compliance may make good business sense in the end, Amiji says. 

Both Moderna and Pfizer have tailored their production timelines such that their combination vaccines, if approved, would be ready by the fall of 2023, Amiji says. Which raises the question: Will the Omicron lineage of COVID-19—of which there have been numerous mutations—still be the prevailing variant, or will the virus continue to evolve at such a rate as to outpace these vaccines? 

“That’s the one big question with COVID,” Amiji says. “But with the flu, again relying on this universal flu mRNA vaccine, then it suddenly makes sense to have one type of flu mRNA, or a single mRNA molecule coding for these specific strains.” 

While a universal vaccine with full type coverage would be entirely new, the idea of giving multiple vaccines at once is, of course, not. And nor are combined vaccines. Some childhood vaccines are administered together on the same day; and there are even examples of combined vaccines already in use, says Eric Rubin, editor-in-chief of the New England Journal of Medicine, 

“The flu vaccine contains three or four different antigens; the pneumococcal vaccine contains as many as 23 different targets. And we even have vaccines that combine antigens from very different viruses, like the MMR vaccine—measles, mumps and rubella—that’s given to all children,” Rubin says. 

Taking into account theory and practice, Rubin says he doesn’t have any particular concerns with the development of a combined COVID-flu vaccine. “There is a question, though; the flu vaccine is seasonal and we don’t know how often we’ll have to vaccinate against COVID,” he adds. “So making one vaccine might be more trouble than it’s worth.”

For media inquiries, please contact media@northeastern.edu.

The winter forecast for COVID-19 looks to be the mildest yet, say experts from Northeastern University.

Promising results from the bivalent booster combined with greater immunity to Sars CoV-2 in the general population means the coronavirus may pack less of a seasonal wallop this year.

“We are in a much better place in this pandemic than we’ve been in prior years. We have the tools to keep ourselves safe,” says Neil Maniar, associate chair, professor of practice, and director of the master’s in public and urban health program at Northeastern.

“I think it will be relatively milder than last year, unless we see a new variant,” says Mansoor Amiji, distinguished professor and chairman of the department of pharmaceutical sciences at Northeastern’s School of Pharmacy and Pharmaceutical Sciences.

“With Omicron BA.5 or BA.6, we will have a mild season,” he says.

That is due at least in part to what appears to be a good match between the bivalent booster and the circulating variants of COVID-19.

The bivalent boosters produced by Moderna and Pfizer target both the original COVID-19 strain and the Omicron BA.5 and BA.4 variants.

Stat News says that both pharmaceutical companies reported this month that the new bivalent booster is more protective against recent Omicron variants than the original vaccine.

“The new data involves lab measurements of antibodies and their ability to neutralize the SARS-CoV-2 virus, not data on how well the vaccines prevent cases of symptomatic illness or severe disease,” according to Stat.

“The higher antibody titers that they showed in the studies is evidence the bivalent is working,” Amiji says. “There’s no doubt in my mind it’s working.”

Earlier studies showed mixed results, according to Stat, with researchers from Beth Israel Deaconess Medical Center and Columbia University indicating the new boosters might not be as effective, while studies at the University of Texas and Emory University showed the bivalent shots may provide better protection.

The latest reports supporting better antibody protection don’t surprise Brandon Dionne, associate clinical professor at Northeastern’s School of Pharmacy and Pharmaceutical Sciences.

He says it makes sense an updated bivalent shot has a higher antibody response since it includes spike proteins from more recently circulating variants.

“The new booster shot is targeting two specific Omicrons,” says Jared Auclair, director of bioinnovation at Northeastern’s Office of the Provost.

“The new variants are all flavors of Omicron,” Auclair says. He says the bivalent vaccine is more closely related to XBB and other new variants that are likely to circulate than the original vaccine.

“We are continuing to see mutations. But we are not seeing Omicron (change) to another completely different variant,” Amiji says.

That said, time will tell how effective the bivalent shot is in preventing severe disease and hospitalization this winter, Amiji says.

The FDA did not require efficacy studies for the bivalent vaccine because the chemistry is so similar to the original vaccine, he says.

“There’s really nothing different about the chemistry of the MRNA or the chemistry of the delivery system that is being used to bring the MRNA to the body. That is why the FDA approved it.”

Plus, with so many people already having been infected with COVID-19, it’s hard to tease out the impact of the boosters versus natural antibodies, Dionne says.

Between vaccinations and infections, “circulating immunity right now is pretty good,” he says.

“It’s totally possible there is a variant that becomes more severe,” Auclair says. But “the virus wants to stay alive so it wants to be more transmissible and less severe so it doesn’t kill its host.”

“I think we’re going to transition to what I consider normal COVID seasons now. We’ll adjust like the flu,” Auclair says.

“Get vaccinated. Wash your hands. All those normal things one is a proponent of during the winter.”

There are already plenty of sick people this autumn, but much of their illnesses stem from delayed exposure to flu and other respiratory viruses.

“People have a little better immunity to COVD” than those other illnesses at this time, Dionne says.

For Amiji, that translates into plans for winter travel. “A lot of us are looking forward to the activities we missed for a long time,” he says.

But predictions for a milder COVID winter don’t mean letting down one’s guard, Amiji says.

“At the same time we have to continue to be vigilant,” he says. “Watch the news and make sure you are informed. Real news.”
For media inquiries, please contact media@northeastern.edu.

Don’t worry if you’ve waited until all the Halloween candy has been gobbled up to get your annual flu shot.

Experts from Northeastern say the weeks leading up to Thanksgiving get-togethers are a great time to get vaccinated against seasonal influenza.

“Now is exactly the right time,” if you haven’t gotten it already, says Samuel Scarpino, director of life sciences at the Institute for Experiential AI at Northeastern University.

“The flu vaccine is a good match, which isn’t the case every year,” he says.

With an early start to the flu season in 2022, “maybe the best time to get the vaccine was two weeks ago. But the second best time is right now.”

It takes about two weeks for vaccines to build up enough antibodies to reach peak efficacy, says Brandon Dionne, associate clinical professor at Northeastern’s School of Pharmacy.

That means people who get vaccinated against the flu in the next few days should have some protection against influenza at Thanksgiving gatherings.

“I’d say it’s never too late,” says Dionne, who advises getting vaccinated in mid- to late-October, “when you start seeing Halloween candy for sale.”

He does not advise that people get the flu vaccine as soon as it rolls out in August and early September. 

The immunizations work for six months, but their effectiveness diminishes, Dionne says. 

“It wanes over time. You have a lower level of circulating antibodies at six months,” he says.

That means people might not be at peak protection if the flu surges in January, February or March, as it sometimes does.

“Your biggest bang for your buck is before flu season picks up,” Dionne says.

This year, of course, flu season started early, combined with RSV and COVID-19 cases to form a “tripledemic” that filled hospital beds.

Dionne says it’s possible that the 2022-23 influenza season will be “biphasic,” meaning it has two peaks. Or maybe it just had one early peak, he says.

“I’ve learned not to predict the future when it comes to respiratory viruses.”

With flu season in the Northern Hemisphere still in its early stages, there is little data on how effective the quadrivalent vaccines have been in preventing the spread of flu.

But Scarpino says comparisons of genetic sequences of circulating viruses to the strains covered by the vaccines seem to  indicate a good match.

“My guess is it’s going to be in the 50 to 75% range,” he says.

And despite its early start, influenza season is still on the upswing, Scarpino says. So if you are considering whether to get an annual flu shot, “Now is a great time to do that.”

For media inquiries, please contact media@northeastern.edu.

A team of medical professionals, clinicians, epidemiologists and political scientists recently published the results of a study that revealed new information about the prevalence of post-acute sequelae of SARS CoV-2 infection, otherwise known as “long COVID.”

Mauricio Santillana, professor physics and network science at Northeastern and director of the Machine Intelligence Group for the betterment of Health and the Environment, helped author the research that was published in the American Medical Association’s JAMA Network Open. The study includes data from eight waves of the COVID States Project, an online survey that spans all 50 states and was administered to more than 16,000 people every six weeks between Feb. 5, 2021, and July 6, 2022.

Santillana says the team is going to continue collecting data to refine its understanding of long COVID, defined in this study as “the persistence of COVID-19 symptoms beyond two months.” However, the study has already produced surprising insights into the prevalence of long COVID.

“What was interesting was we identified the degree to which women showed higher risk of developing long COVID,” Santillana says. “You’re almost twice as likely to get long COVID just being a woman, controlling for everything else.”

Santillana doesn’t currently have an explanation for why long COVID might be more prevalent among women, but he hopes the results of this study will provide new avenues for further research.

“It’s puzzling, and it’s an invitation for clinicians to start looking at whether there’s some mechanism that COVID may stay longer in the body for women,” Santillana says.

The study also found that older adults were more at risk, with the risk increasing every decade above age 40.

Santillana says his team’s data also indicates that each subsequent COVID-19 variant has led to less long COVID, although he acknowledges there is still not enough data to confirm definitively whether that will continue.

“I’m going to say that with caution because we are still monitoring the population, so we’ll see if that persists over time,” Santillana says.

Notably, the researchers found that the prevalence of long COVID among survey respondents, about 15% in U.S. adults, lined up well with similar studies in other countries.

“We’re seeing similar numbers, and it is substantial,” Santillana says. “If one in 10 or one in nine are getting long COVID, then it deserves attention.”

Researchers and medical professionals are still working to gain a better understanding of long COVID, and Santillana says every piece of information about post-COVID conditions is valuable. Symptoms can vary widely, from consistent, long-term fatigue to respiratory and heart issues, and can even be critical in some cases.

Santillana says the results of the study indicated vaccines also helped mitigate the risk of long COVID. Those who had received the first two doses of their COVID-19 vaccine had a 30% decrease in risk, and the scope of the published study did not yet include data with booster shots.

Santillana hopes to continue the study until next summer to continue learning more about long COVID and inform clinicians and public health officials about the impacts of COVID-19 beyond the initial infection.

“COVID will stay with us for years to come, so it will still be a thing,” Santillana says. “It will be great to characterize the risks associated with it and move forward so we can better document how to treat people and how we can learn to live with it in our societies.”

For media inquiries, please contact Marirose Sartoretto at m.sartoretto@northeastern.edu or 617-373-5718.

Get ready for a bumpy ride, virus-wise, as autumn turns into winter this year. 

COVID-19 infections have run into an early flu season and an usual surge of respiratory infections in young children to create what some experts are calling a “tripledemic.”

Northeastern University experts explain what is behind the triple whammy, why it’s hitting now— and why next year might not be as bad.

“I think it’s going to be a rough winter,” says Brandon Dionne, associate clinical professor at Northeastern University’s School of Pharmacy. “There’s lots of factors at play.”

But chief among them is what experts are calling the “immunity gap,” the lack of regular exposure to viruses that helps rebuild the body’s immune response to individual viruses.

“People were taking all these precautions in the past few years that were really mitigating the spread of all respiratory viruses,” Dionne says.

“It meant immune systems didn’t have a way to train themselves in the way they typically would,” says Neil Maniar, who directs Northeastern’s master of public health program.

The Centers for Disease Control and Prevention is reporting an early spike in flu hospitalizations, especially for children and older adults, while CNN reports an unprecedented rise of respiratory syncytial virus (RSV) in children that is putting a strain on pediatric hospital beds.

The viruses are surging just as new COVD-19 variants such as BQ.1.1 and XBB show some signs of being able to evade immunity, according to the New Scientist.

“We were expecting flu and COVID to go together, but we were not expecting RSV to be this high,” says Mansoor Amiji, Northeastern distinguished professor in the departments of pharmaceutical sciences and chemistry.

“Our immune systems are not primed,” says Jared Auclair, the director of bioinnovation in the office of the provost at Northeastern.

“It’s like when your parents told you it’s good to eat mud pies because it builds your immune system. There’s some truth to that.”

“You’ve got to expose your immune system to things. I would expect a more intense cold season and flu season, perhaps,” Auclair says. 

“As people wear fewer and fewer masks and have sort of gone back to life as normal pre-COVID, more or less, I would expect more common viruses and infections that circulate in our population to present clinically different and sometimes worse.”

“There are new things we need to be vigilant about,” Maniar says. 

Children and adults entered the pandemic in 2020 with antibodies from previous exposures to routine viruses.

But during the masking and social isolation of the COVID-19 pandemic, those exposures grew less frequent.

“The immunity waned over time and didn’t have an opportunity to strengthen again,” Maniar says. 

“For a lot of us, that first cold we got after emerging from isolation was a whopper,” he says. “Our immune system hadn’t been trained in a while to fight off infection.”

Masking and isolating was the right thing to do when COVID-19 first emerged and no vaccines or treatments were available, Auclair says. But he says trying to avoid every virus is not the goal.

“I’m not a proponent of everyone wearing masks for the rest of their lives,” Auclair says.

“What we’re seeing now is another step in the process of emerging from the pandemic and into a new normal,” Maniar says. “This winter may be particularly tough.”

He says parents should be vigilant about reporting symptoms of respiratory infection in their children to their pediatric healthcare providers.

“There really is a surge of illness among children. RSV is something that’s highly contagious” and can be contracted through coming into contact with surfaces with the virus on it, or someone sneezing or coughing, Maniar says.

The CDC says RSV is a common respiratory infection, and most children get it by the age of two. However, about 58,000 children under 5 years old are hospitalized every year in the U.S. for RSV, which is particularly dangerous for premature infants, babies younger than 6 months and children with health issues.

The bodies of young children are so small it makes it easier for a respiratory infection such as RSV to get into the lungs, Amiji says.

Some children are at risk of developing such severe coughing episodes they can’t keep food in their stomach and have shortness of breath, he says. “That’s where we find these kids going to the hospital.”

Amiji says he does not believe the spike in RSV is connected to cases of COVID and flu. “I think it’s just coincidence.”

The good news is that exposure to normal viruses will build antibodies and rebuild the immune system, Maniar says.

“It needs exposure to pathogens to get stronger,” Maniar says, comparing the process to retraining muscles after a period of inactivity.

“I do think it’s going to happen naturally,” he says. 

Does that mean next winter people might catch a break as far as flu and RSV are concerned? Maniar says he thinks levels will go back to what they were in the past.

For media inquiries, please contact media@northeastern.edu.

Experts say individuals recently vaccinated against or infected with COVID-19 should hold off for a few weeks before getting the newly approved, updated booster shot that targets the Omicron variant.  

Millions of Americans are eligible for the boosters approved Aug. 31 by the U.S. Food and Drug Administration. 

On Sept. 1, the Centers for Disease Control and Prevention recommended the use of the updated Pfizer shot for people ages 12 and up and Moderna shot for people ages 18 and older. 

CDC Director Dr. Rochelle P. Walensky urged individuals who are eligible to get the booster and said in a press release, “There is no bad time to get your COVID-19 booster.”

Massachusetts state public officials say the boosters will be available in the Bay State Monday.

But they also told COVID-19 vaccine providers in a Sept. 1 email to give recently vaccinated and boosted individuals at least two months between their last shots and injection with the new booster.

In addition, individuals recently infected with COVID-19 should consider waiting at least a few weeks before getting the updated jabs, according to two professors at Northeastern University.

“It’s not going to hurt anyone” to get the booster too soon, says Brandon Dionne, associate clinical professor at Northeastern’s School of Pharmacy.

“It may be less beneficial to anyone who has had a recent COVID infection,” he says. The limited data that’s available suggests the booster may not prompt as strong an antibody response to the virus in a recently infected person. 

Naturally occurring infections bring about their own antibody response, and Mansoor Amiji, distinguished professor in Northeastern’s departments of pharmaceutical sciences and chemical engineering, says recently infected people should delay getting the updated booster until that response wanes.  

“You are already protected,” for a while, he says.

While Amiji says he advises people to wait at least four months after a COVID infection to get the booster, Dionne says his research indicates the wait time should be more like two to three months.

“The spacing is important,” Amiji says. 

After the vaccine first came out in late 2020, he says he heard stories of people going from place to place to get six to seven shots. “Look, it doesn’t help.”

The updated Pfizer and Moderna boosters received approval as schools open for the fall, leading to a time of year when respiratory infections traditionally go up.

The CDC says COVID-19 cases, hospitalizations and deaths are trending downward, but last week there were more than 117,000 cases and over 800 deaths nationwide.

CDC officials say they expect to recommend updated COVID-19 boosters to an expanded age group of children soon.

The updated boosters provide protection both against original COVID and the highly contagious Omicron subvariants currently prevalent in the United States, which is why they are called bivalent boosters as opposed to the original monovalent vaccine and boosters.

CDC officials say that adding Omicron BA.4 and BA.5 spike protein components to the vaccine composition will help “restore protection that has waned since previous vaccination by targeting variants that are more transmissible and immune evading.”

One question on everyone’s mind is how effective the new booster will be in preventing disease.

“It’s a tricky question,” Dionne says. “So far the only data is from mice. It probably will have some impact. It can only be beneficial.”

“I’ve always been skeptical about the effectiveness of variant-oriented vaccines,” Amiji says, noting that by winter another variant may emerge.

“We may be working with a moving target,” he says. 

Dionne says he doesn’t have any concerns about the safety of the updated boosters because they are built on a platform established by the original vaccines, which underwent lengthy testing.

The reformulation involved “tweaking” the technology, Dionne says. 

It’s okay for people to get boosted with Moderna if they’ve been vaccinated and boosted with Pfizer, and vice versa, or to get the updated booster from Moderna or Pfizer if they’ve had the Johnson & Johnson single shot or booster in the past, says Amiji, who noting that the Moderna and Pfizer mRNA shots have proven more effective.

“You want to get the one that’s available in your pharmacy,” he says.

People getting boosted now will not have a choice between the old and updated formulas, because the FDA says the original monovalent booster will no longer be available.

It looks as though people will benefit from being boosted approximately every six months, in the absence of a naturally occurring COVID infection, Amiji says.

Dionne says he doesn’t see the demand for the updated boosters approach anything like the clamor for the COVID vaccines when they first came out.

It’ll probably be more like the demand for the flu vaccine during influenza season—and, like the flu shot—the booster may end up being an annual ritual, Dionne says.

Amiji says he understands people’s questions about the efficacy of the new booster, but he plans on getting the shot.

“Any extra protection is better than none.”

For media inquiries, please contact media@northeastern.edu. 

New research by a Northeastern engineering professor used recent storms and the COVID-19 pandemic to predict human movement during disasters in anticipation of more effective emergency response.

The research team, led by Qi Ryan Wang, associate professor of civil and environmental engineering at Northeastern, and Jianxi Gao, assistant professor of computer science at Rensselaer Polytechnic Institute, also found a disparity in movement among different economic groups that exposed those of little means to greater risk.

Wang and his team used anonymous data from 90 million Americans during six major events to create a mathematical model to predict human mobility during disasters. The results were published earlier in August in the high-profile Proceedings of the National Academy of Sciences (PNAS) journal.

Predictable patterns of movement emerged from Hurricane Dorian, Tropical Storm Imelda, the Saddleridge Wildfire, the Kincade Wildfire—all in 2019—the 2021 Texas winter freeze and the COVID-19 pandemic, Wang says.

“The idea started with the pandemic,” Wang says. 

“We started looking at people’s behavior, but particularly their mobility behavior,” he says. “How long they are spending time outside their home, particularly when social distancing was so important.”

Wang and other team members used anonymous information provided by an outside company to analyze pings from the electronic devices of 90 million people across the U.S.

There were some universal behaviors—such as the tendency of people to leave their homes more frequently as time passed, a phenomenon known in scientific terms as temporal decay.

When the researchers added variables such as information provided by census tracts on income and ethnic diversity, they found large differences between human mobility in less and more wealthy neighborhoods.

They found that people in poorer neighborhoods left home sooner and more frequently than people living in wealthier areas. 

The behavior is not based on lack of commitment to safe practices, Wang says. 

“People from poor neighborhoods took much longer to practice social distancing” during the COVID-19 pandemic, Wang says. “They are essential workers. They still need to go to work to support their families.”

The research team observed similar patterns during weather-related catastrophes, Wang says. 

“The model can describe all of them,” he says.

Wang says the research can help emergency services and other agencies target responses during disasters and also identify those at greatest risk of exposure to danger from large-scale events.

“Some probably want to socially distance more, but they just can’t,” he says.

“Based on the results, we can speculate about the reason,” Wang says. 

People with lower incomes not only need to be physically present at their job; they are also less likely to be able to stock up on food, water and ice and have emergency generators at their disposal.

Wang says the mobility patterns may also help account for different COVID-19 rates in different communities.

“We hailed these essential workers as heroes, but really we are sacrificing their health so they can provide these services,” Wang says.

Governments and emergency responders can use the information provided by the human mobility model to better understand how to allocate their resources during a public crisis, Wang and the other authors say in the PNAS article.

“Our model represents a powerful tool to understand and forecast mobility patterns post emergency, and thus to help produce more effective responses.”

For media inquiries, please contact media@northeastern.edu.

Paxlovid and Molnupiravir, two leading COVID-19 antiviral medications, are life-saving drugs that have been shown to reduce deaths, in Paxlovid’s case, by a factor of 10 in the most severe cases.

However, according to new research published Wednesday by the COVID States Project, the two treatments have been vastly underutilized in the U.S., renewing concerns about the extent to which the federal government’s oft-criticized COVID-19 response contributed to preventable deaths from the disease.

The research is based on a nationwide survey that was conducted between June 8 and July 6 involving 24,414 respondents. Of them, 43% said they had been infected with COVID-19 recently; and of those who were sick between May and early July, only 11% reported having taken the antivirals, the data shows. The antiviral drugs are typically used at the onset of symptoms to blunt the progression of disease, according to the Centers for Disease Control and Prevention.  

“These data suggest a tremendous lost opportunity, where many of the approximately 200,000 deaths from COVID-19 since January 1, 2022 might have been prevented with the timely use of antivirals,” the authors wrote. 

The survey deployed PureSpectrum, a research technology platform, and used nonprobability sampling. Researchers reweighted the data “using demographic characteristics to match the U.S. population with respect to 2020 vote choice and turnout, race/ethnicity, age, gender, education and living.”

Researchers also report significant socioeconomic and gender disparities in who received treatment, with roughly 16% of those surveyed who received treatment for their infections reporting that they earn more than $100,000, compared to just 7% of those who reported earning $25,000 or less, the data shows. Adults over 65—considered high risk for severe COVID-19 illness—had higher treatment rates than other age groups at roughly 20%, which the authors note is still low. 

David Lazer, university distinguished professor of political science and computer science, and co-author of the research, says the data points to “systemic failures” in getting people the treatment. 

“It is plausible that 100,000 to 150,000 lives could be saved this next year by a more aggressive use of antivirals,” Lazer says, acknowledging, also, that new variants could influence projections. 

Asked if he thought that the problem is linked to supply chain disruptions, Lazer said he thinks it may have more to do with failures to effectively distribute existing stockpiles. The drugs were in short supply when they received emergency use authorization in December, leading to concerns that patients wouldn’t have access to them. But, as the Omicron wave dissipated, reports emerged that the medications were sitting unused on pharmacy shelves across the U.S.  

“I don’t think it’s about availability,” Lazer says. “It could be that it’s just not in the right places all the time; that there is enough of it but not enough of it in every place.”

Researchers also note that, although cases, hospitalizations and deaths continue to trend downward across the U.S., there are still on average more than 400 deaths from COVID-19 every day. If “the reasons for the limited use of medication treatment can be better understood,” they write, there’s an opportunity to further save lives.

“News reports have emphasized the ‘Paxlovid rebound’ (a return of a positive test after taking Paxlovid), rather than the high efficacy of the antiviral at preventing death,” the authors wrote. 

Additionally, uneven distribution and murky guidance from the federal government has contributed to “shortages and confusion at the state and local levels among eligible patients and their healthcare providers,” they wrote. 

For media inquiries, please contact media@northeastern.edu. 

Students arriving at Northeastern for the fall semester will see very few outward signs of the COVID-19 pandemic. Testing will be voluntary and the only people who will be masked will be those who choose to be.

Students, faculty and staff—or anyone else—will not be required to socially distance in classrooms, student centers, athletic facilities in Boston or on any of the university’s 13 global campuses. 

Masks will only be required in the health centers, in line with general public health guidance.

The university’s requirement for students, faculty and staff to be fully vaccinated and boosted will remain in place, and campus life will continue as normal, says Ken Henderson, Northeastern’s chancellor and senior vice president for learning.

“We are continuing fully in person, no distancing, with all events as they would normally be pre-COVID,” he said. “Convocation is in person. Orientation is in person.”

Henderson, who is a structural chemist, former dean of the College of Science, and co-chaired the university’s COVID management task force, recently answered questions from News@Northeastern about what to expect in the fall. His comments have been edited for clarity and brevity.

What level of vaccination does Northeastern require?

On its U.S. campuses, the university follows CDC guidelines that recommend people under 50 be fully vaccinated and have one booster shot.

The Toronto and Vancouver campuses follow the Provincial Health Officer’s recommendation that students, faculty and staff be fully vaccinated, however the university does not require proof of vaccination in order to be on campus.

All COVID requirements and restrictions have been lifted in England.

What is the university’s policy regarding masking and social distancing?

Same as the spring semester. We don’t have any indoor mask requirements, or distancing or density requirements. The only exception is the health centers.

The number of people allowed to attend university athletic and cultural events is based on crowd capacity only.

People who choose to wear a face mask are welcome to do so.

Will students, faculty and staff be tested for COVID?

We have no formal testing requirement in place. We dropped that last academic year, in the spring semester. We are clearly now in a very different stage of the pandemic. Our goal has always been to provide the highest quality learning and research environment in balance with the risks associated with the pandemic.  

In the beginning we determined that as an experiential university it was critical to develop both in-person and remote options to best serve our community in a safe manner. At that time a key goal was putting measures in place to minimize the number of infections within our community. We were very successful in these efforts through a combination of distancing, deep cleaning, environmental controls such as increasing airflow in buildings, mask mandates, isolation, and regular comprehensive testing. 

These strategies were important at that time as there was no vaccine yet developed, and very limited medications. We are now in a position where we have very effective clinical measures to reduce the likelihood of serious illness, including vaccinations, antiviral medications and antibody treatments. 

In addition, the new variants of the virus that have appeared over the past year have become much more infectious but demonstrate lower severity than the early variants. In combination these factors lead us to a new normal, where measuring severity and hospitalization rates is more important than infection rates alone.

What happens if my student comes down with COVID? What is the protocol?

We’re continuing with the same policy we put in place in spring semester, which is to isolate for five days and wear a mask in public the next five days. After that, they can go maskless.

How will students with COVID continue their course work?

We moved back to a fully in-person expectation for all classes in the fall of 2021. We will continue with that, but the university will make academic accommodations for anyone with any illness—not just COVID. It’s up to individual professors to decide what accommodation works best for them and their students.

The professor could record the session and give students access. It could be synchronous live classes. It could be assignments. Thanks to COVID, we have the added advantage of new technology. That’s an added layer of flexibility.

Will medical treatment be available for students with COVID?

The key here is about severity. Obviously we have accommodations in place for those who are high-risk. But that is a small population of students. While COVID variants have been growing more contagious, they’ve also been declining in severity, especially among the younger population.

Students who wish to can consult with the university’s health counseling services or their own primary care physician. It’s really up to their comfort level.

How will guidance change as COVID evolves?

We use  guidance from multiple sources in order to make decisions. We don’t follow just one agency or information source. We look at a whole range of guidance in order to make decisions that make the best sense.

When the pandemic broke out, the world was a different place. But with the advent of effective vaccines and clinical treatments the world has changed significantly. We don’t look at the rate of infection alone. We also look at severity.

We’ve pivoted and changed depending on the circumstances of the pandemic. We can ratchet up restrictions as required and ratchet them down. Right now we’re back to no restrictions. Everything’s back to normal.

With U.S. monkeypox cases going from zero to more than 6,000 in less than three months,  Northeastern University professors concerned about the pace of transmission are calling for better tests and more vaccine doses to stop the viral outbreak in its tracks.

“It’s very striking to see this pox” in the U.S., especially with cases declining in parts of the world where monkeypox has a historical presence, says Mansoor Amiji, who chairs the Department of Pharmaceutical Sciences at Northeastern University.

Amiji calls the rise in cases in the U.S. and Europe “fairly rapid and steep.”

So far the U.S. government has secured 1.1 million doses of vaccine for monkeypox, according to Politico. 

“That is still not enough. We have a lot of work to do,” says Neil Maniar, director of Northeastern University’s Master of Public Health Program. 

Since May of this year, monkeypox cases have appeared more than 25,000 times in countries where the disease is not endemic, prompting the World Health Organization to declare a public health emergency of concern July 23.

The Centers for Disease Control and Prevention says that as of Aug. 3, there have been 26,208 cases of monkeypox worldwide, only 344 of which were in seven countries in Africa historically reporting monkeypox.

The majority of the other cases have been clustered in Europe and the United States—which had 6,617 cases as of Aug. 3—with hundreds of cases also being reported in South America and Canada. 

“It’s a little more concerning than it was a few weeks ago,” says Jared Auclair, Northeastern University’s associate dean of professional programs and graduate affairs, whose Burlington laboratory is partnering with a Boston biotech company to explore population surveillance of monkeypox.

“We should be more aggressive with testing and other interventions,” especially for populations at higher risk of developing the monkeypox virus, also known as MPV, Auclair says.

The CDC says that many but not all cases of monkeypox are occurring among gay, bisexual and other men who have sex with men, underscoring the need to reach out to those populations with education, testing and vaccination programs.

The federal health agency says monkeypox is spread through direct contact with bodily fluids, scabs or rashes on the body of someone who has the virus or direct contact with materials such as linens or clothing that have touched the bodily fluids or rash of an infected person.

“It can also be spread by respiratory secretions during prolonged, face-to-face contact, or during intimate physical contact, such as kissing, cuddling or sex. In addition, pregnant people can spread the virus to their fetus through the placenta,” the CDC says.

The rise in cases in New York, California and Illinois—which have 1,666, 826 and 547 cases as of Aug. 3—prompted officials in those states to declare states of emergency in late July and early August to bolster vaccination and other efforts to stem the viral outbreak.

In Massachusetts, which had 134 monkeypox cases as of Aug. 2, a good portion of the vaccine doses supplied to the state by the CDC July 5 went to Outer Cape Health Services, a healthcare organization that serves people in the area of Provincetown, a municipality with a large gay year-round and summer population.

“I don’t know a townie who isn’t vaccinated. We had access to it early,” says Massachusetts state Sen. Julian Cyr, D-Truro.

“We have been fortunate we’ve been able to vaccinate a number of our residents and seasonal workers,” he says. 

One of the historic epicenters of the HIV/AIDS epidemic and last summer’s Delta COVID-19 outbreak, Provincetown is “a place that knows how to pull together public healthcare and political resources to get information out to the community on critical issues” such as monkeypox, Cyr says.

But there’s not enough vaccine available on a state or national level, Cyr says. “The demand for the vaccine is huge.”

The fact that monkeypox is transmitted mainly by bodily fluids means it is less of a contagion threat to the general population than the novel coronavirus, Amiji says. “We don’t have airborne transmission in this case. It’s contact transmission.”

Monkeypox is also a recognized virus with established testing and treatment protocols in place, he says. “It’s a little bit of a mixed blessing, where we are with monkeypox.”

“It’s not like COVID where we had to develop a new test,” Maniar says.

But there are limits to the monkeypox testing that is available, he says.

“Right now we can only test when someone has active lesions. We’re only able to test when someone has developed the symptoms of monkeypox,” Maniar says, calling the issue “a key roadblock for us in getting this outbreak under control.”

Auclair says his lab and other organizations are trying to come up with sample mediums that could aid in detecting monkeypox earlier, either through nasal swabs or saliva, for example, or, on a broader population approach, through wastewater.

The earlier people can be isolated and treated, the better, Auclair says, adding that he doesn’t see a need for the pop-up testing sites that took place during the COVID pandemic.

Unlike COVID, a single-stranded RNA virus, monkeypox is a stable, double-stranded DNA virus, which makes it much less likely to mutate, Auclair says. “We’re not going to have different variants of monkeypox floating around any time soon.”

There are two vaccines available for monkeypox, with the two-shot JYNNEOS, which is manufactured in Denmark, being preferred by U.S. health officials over ACAM2000, which can cause side effects in people with weakened immune systems, according to Medpage Today.

The CDC recommends the vaccine for those who have been exposed to monkeypox or those who are likely to get the virus. The federal health agency recommends the vaccine be given within four days of exposure but says the severity of the disease can be reduced if the vaccine is  administered up to 14 days of exposure to monkeypox.

There have been few deaths associated with the current monkeypox outbreak, but some sufferers are hospitalized due to severe pain from the pustules.

“These blisters go deep into the skin,” penetrating into the dermal area where nerve endings are located, Amiji says. 

Other symptoms of monkeypox include fever, swollen lymph nodes and muscle aches and chills.

Some people think the isolation that people experience during the COVID-19 pandemic may have contributed to the unexpectedly robust spread of monkeypox, Maniar says.

“We’re in this day and age right now where our immune systems are not trained as much to fight off things as they were prior to the pandemic,” he says.

It’s important for public health officials to get the word out about monkeypox, in different languages and literacy levels, so people know symptoms, risk factors and what precautions they can take, Maniar says.

Pre-existing health disparities put some communities at greater risk, he says. “We really have to close those gaps as quickly and sustainably as possible.”

“We know that there are going to be infectious disease outbreaks. It’s the nature of this world,” Maniar says.

“What’s different here is that we understand monkeypox,” he says. “We should be able to respond to this much more rapidly, much more broadly and much more effectively.”

President Joe Biden has plenty of company as he experiences a case of rebound COVID-19 after completing a course of the antiviral medication Paxlovid.

Mansoor Amiji, who chairs the Department of Pharmaceutical Sciences at Northeastern University, says that approximately 10% of people who complete the five-day Paxlovid course test positive again—although, like Biden, they tend to have few or no symptoms.

“It’s a relatively rare event. But we’re seeing it more often,” says Neil Maniar, who directs the Master of Public Health Program at Northeastern University.

Rebound cases have led some scientists to question whether a longer course of Paxlovid is needed as variants behave differently in the body.. 

“There’s some question as to whether the five-day rule is a hard and fast rule,” Maniar says. He says a rebound case means there’s enough of a remaining viral load to cause a person to remain infectious—and contagious—for COVID-19 even after the standard course of Paxlovid treatment.

Biden tested positive for COVID-19 on an antigen test Saturday, after four days in a row of negative results following the completion of  Paxlovid treatment, according to NPR.

The 79-year-old president, who is vaccinated and has had two booster shots, said on Twitter that he had no symptoms but was going to isolate himself “for the safety of everyone around me.”

Manufactured by Pfizer, Paxlovid is recommended in mild to moderate cases of COVID-19 to prevent hospitalization and death in individuals considered to be at higher risk of more severe disease, including people age 65 and older, according to the Centers for Disease Control and Prevention (CDC).

With the U.S. Department of Health and Human Services saying that more than 3 million courses of Paxlovid have been administered in this country, the math indicates that there have been thousands and thousands of cases of rebound COVID.

That doesn’t mean Paxlovid is not working, Maniar says.

“It’s doing its job” of preventing more severe illness, he says. “The fact that we’re seeing rebound cases in no way undermines the effectiveness of Paxlovid.”

“It does put into question the five-day” treatment protocol, Maniar says. “We shouldn’t assume that just because five days have passed you’re not infectious.”

Amiji says Paxlovid works by stopping replication of the virus in the body.

In cases of the Omicron variant, the virus seems to be restricting itself more to the upper respiratory tract, such as the nose and throat, he says.

That’s good news because the viral particles are less likely to go deep into the lungs, but it does mean there could be a more intense viral load in the nose, Amiji says.

“People are speculating that the drug masks the viral particles in the nose,” he says. Some think that once the Paxlovid course of three pills twice a day—for a total of 30 doses—ends, the virus starts replicating in the nose again, Amiji says.

“These are interesting theories, but until you get data you don’t have evidence to prove it,” he says.

Amiji says Biden may have been tested too soon after completing his Paxlovid course.

“It takes about seven to eight days to get a clear negative test,” Amiji says. “I feel there may have been a false negative test.”

Amiji says when he himself got COVID he was symptom free after five days and tested negative on an antigen test after eight days.

“I’ve had worse common colds,” he says, which he credits to being vaccinated and boosted.

Amjiji says he didn’t elect to take Paxlovid and does not recommend it for young and healthy people, since it comes with a set of possible side effects including muscle aches, diarrhea and altered sense of taste, according to the U.S. Food and Drug Administration.

The CDC recommends that people at risk of severe illness start Paxlovid no later than five days after the onset of symptoms. The Biden administration has encouraged the use of the antiviral, and states such as Massachusetts have made ordering it relatively easy via telehealth appointments. 

In cases of rebound COVID, the CDC recommends that people once again quarantine for five days and wear masks for 10 days. The federal health agency does not recommend a second course of Paxlovid for rebound cases.

Biden’s isolating himself—he announced the news about the killing of al-Qaeda leader Ayman al-Zawahri from a White House balcony—is following good public health protocol, Amiji says.

“We all wish him a speedy recovery,” he says. “I think health wise, he’s doing fine.”

If Jared Auclair has his way, his lab at Northeastern University will help ensure that the U.S. is never again caught off guard by an emerging pathogen like COVID-19.

Auclair, technical supervisor of the university’s Life Sciences Testing Center, and his team are working with the Boston biotech company Ginkgo Bioworks to develop a system to test samples collected at airports and other places of entry to the country for monkeypox.

The process is serving as a test case for a partnership that could result in Northeastern University playing an important role in national biosurveillance and biosecurity programs, Auclair says.

“We’re thinking about a national infrastructure of response to future pathogens. We’re really thinking of what is entering the country and how we can monitor it,” he says.

“One of the most important parts of surveillance is response time,” Auclair says.

“If we see a report of a pathogen starting to come through the country like we saw with COVID in Seattle or monkeypox overseas, how quickly can we respond?”

In the case of monkeypox, the answer is two weeks.

That’s how long it took the Life Sciences Testing Center to validate a test for monkeypox, says Auclair, who is also associate dean of professional programs and graduate affairs in Northeastern’s College of Science and director of Northeastern’s Biopharmaceutical Analysis Training Laboratory. 

He says if Ginkgo goes ahead with a monkeypox surveillance program, the biotech company would be in charge of collecting samples for testing “where you would see places of entry to the country,” such as airports. The Life Sciences Testing Center in Burlington would run the tests on the pooled samples.

The idea is to develop an early warning system for pathogens entering the country, Auclair says. “It is population level surveillance.”

So far, the World Health Organization says, monkeypox outbreak has infected more than 18,000 people in 78 countries, but has resulted in only a handful of deaths. About 10% of people infected are hospitalized to deal with pain caused by the illness.

All five deaths were in Africa, Reuters reported July 20, although the majority of the cases are clustered in Europe, according to the WHO, which July 23 declared the monkeypox outbreak a global emergency.

The Centers for Disease Control says that as of July 26, there were 3,591 cases in the United States, including 96 in Massachusetts and 900 in New York state.

Symptoms include fever, headache, muscle aches and backaches, chills, exhaustion, swollen lymph nodes and a rash that can look like blisters or pimples.

Unlike what happened with COVID-19, also known as SARS-CoV2, a quickly activated monkeypox surveillance and testing program could slow the progression of the virus early in the outbreak by putting public health measures in place, Auclair says.

He says his lab first partnered with Ginkgo during the COVID-19 pandemic, when the Life Sciences Testing Center became a member of the Ginkgo Clinical Lab Network.

Through Ginkgo and other partners outside the university, Auclair’s lab tested pooled samples from Maine public school districts and, at one time, the Chicago school district, for COVID-19.

The relationship with Ginkgo has evolved since then into a joint project to conduct biosurveillance on monkeypox and whatever emerging pathogen might pose the next serious health threat in the U.S., Auclair says.

Ginkgo “responds to outbreaks in real time by preparing for surge capacity—so that additional testing is available if needed if an outbreak grows quickly,” says Karen Hogan, senior director at Concentric by Ginkgo, the biosecurity and public health arm of the company. 

She says Ginkgo works with lab partners like Northeastern “to make sure that capacity is ready to go.”

“Our lab network is a mix of academic and industry labs. This is a great model, as we get to work with leading researchers and laboratories to develop new methods and launch them at scale for public health,” Hogan says.

“From day one, Jared and his team have been invaluable partners as we worked to grow our capacity to help our communities fight COVID locally and nationally,” she says.

“(Auclair) is smart and hard working and the team he has built is that and much more. They turned on COVID testing services almost overnight and have maintained a high level of quality and performance. We enjoy working with them and plan to expand our work to fight COVID and more in service of public health,” Hogan says.

Auclair says monkeypox is different from COVID-19 in that it is a DNA rather than an RNA virus, making it more difficult to mutate into variants.

“Monkeypox is not contagious through the air. You have to come in contact with bodily fluid,” he says.

Even so, monkeypox joins COVID-19 as a viral illness that meets WHO’s definition of a health emergency. The Washington Post says WHO named the coronavirus pandemic a global crisis in early 2020.

The Post says that officials hope the emergency designation will help stop the outbreak, which so far has been centered in men who have sex with men.

The Washington Post says the Biden Administration is considering declaring the monkeypox outbreak a national emergency. The administration also is planning to announce a White House coordinator to respond to the surge in cases.

It is inevitable that monkeypox will be followed by some other global health concern, Auclair says.

“It’s really important to monitor the pathogens that are coming in and out of the country so we can respond appropriately, which could include treatments and therapies or vaccines. It could include the ability to activate our healthcare system as opposed to having to be so reactive during COVID,” he says. “We can be more proactive.”

Summer is here, meaning it’s time to break out the tick protection along with the sunscreen.

Although the deer ticks that transmit Lyme disease are active whenever it’s above freezing, they are not only out now, they are so tiny—the size of a pencil tip or poppy seed—they are practically invisible.

Why is tick exposure so dangerous at this time of year?

That lack of visibility gives them stealth disease-transmitting powers. 

“This is when a lot of people get infected,” says Northeastern University professor Kim Lewis, director of the university’s Antimicrobial Discovery Center.

People are outdoors, enjoying backyards, parks and hiking trails. But if they can’t see the tick that bit them to remove it with a pair of tweezers, they give the tiny ticks more time to feed on them and transmit pathogens with their saliva.

No wonder then that Massachusetts state public health officials say the majority of cases of tick-borne disease, including Lyme disease, occur from June to August.

At this stage of development, deer ticks are known as nymphs. They will hang around until August, when if they are lucky enough to get a blood meal they will turn into adults, says Larry Dapsis, entomologist with the Cape Cod Cooperative Extension.

Adult deer ticks actually are more likely to carry the bacterium, Borrelia burgdorferi, that causes Lyme disease, Dapsis says. But being more visible—they are sesame seed-sized—the adults are more likely to be spotted and pulled off before they can do any damage.

“The infection rate for nymphal ticks is 20% compared to the adult stage, which is 50%. But the nymphs are responsible for 85% of all tick-borne diseases,” Dapsis says.

The nymphs emerge in mid- to late-May and tend to lurk in the leaf litter, unlike the adults that perch on grasses and shrubs that are knee high.

What can people do to protect themselves from Lyme and other tick-borne diseases?

Dapsis says there are a number of things people can do to protect themselves from becoming a meal for the tiny arthropods, the terrorists of the forest floor, and he has enumerated them in a  series of short videos on fighting tick-borne disease.

The first line of defense is to spray clothing–especially footgear—with permethrin, a medication and insecticide that Dapsis says The Food and Drug Administration deems safe for attire used by adults and clothing.

“Spray shoes until they are visibly wet” and spray again after four weeks, Dapsis says.

Dose pants to mid-thigh on the exterior and from the knee down inside, he says.

Spray clothes while they are off your body and don’t apply permethrin to skin.

A tick on a surface treated with permethrin will start lifting its eight legs like it’s got a hot foot, Dapsis says. “After 60 seconds of exposure, it’s a goner.”

People who aren’t interested in the do-it-yourself approach to permethrin treatment can purchase pre-treated clothing or pay for a service to treat their clothes, such as Insect Shield.

Dapsis also advises people coming in from outdoors to throw their clothes in the dryer for 20 minutes. The heat will kill moisture-loving ticks.

Tick checks are also important, but when the tiny nymphs are out the best approach is to use fingertips to feel ticks that may be too small to see, Dapsis says.

Sticking to the center of trails and avoiding bushy vegetation can help people avoid contact with ticks, Lewis says.

In the summer “they’ll be essentially pretty much everywhere, crawling around, looking for prey. If you are on a path in the woods, you are considerably better off than veering off the path,” he says.

What are the symptoms of Lyme disease?

Some people—but not all—develop a tell-tale bull’s eye rash or series of rashes in the early stage of Lyme disease.

“The disease presents like a typical infection with some muscle aches and pains, flu-like symptoms,” Lewis says.

These days it’s hard to tell early Lyme from COVID-19, he says.

“The first thing that used to happen during COVID was coughing. These later variants do not induce cough.”

What should people do if they have been bitten by a tick?

Carefully remove the tick with a set of tweezers and consider mailing it to TickReport to test for possible pathogens, Dapsis says.

People who have been bitten should consult their physician, who is likely to give them a prescription for prophylactic doxycycline to prevent Lyme disease, Lewis says.

Those diagnosed with the disease typically are given a 10- to 21-day course of antibiotics.

Lyme disease that isn’t treated—or isn’t treated successfully—could end up causing cardiac, neurological and joint problems, Lewis says.

“Approximately 10% of people who got Lyme disease will end up having some sort of chronic Lyme condition, and this includes people who have been treated with antibiotics in a timely manner,” he says.

“Symptoms of chronic Lyme, which some people are calling long Lyme, are the same as long COVID.”

“Fatigue. Muscle pain. Anxiety. Depression. Brain fog. Sleep disorders,” Lewis says. “ It’s most likely derived from similar damage, probably, to the immune system. That’s the educated guess at the moment.”

Are newer, more effective treatments on the horizon?

Lewis’ team has developed a possible treatment that uses a targeted antibiotic to eradicate the spiral-shaped bacterium causing Lyme disease that doesn’t appear to harm the gut microbiome the way broad spectrum antibiotics such as doxycycline appear to do.

It’s possible that damage to the microbiome is associated with the cardiac, neurological and immune system problems associated with chronic Lyme, Lewis says.

Treatment with the antibiotic known as Hygromycin A has cleared Lyme disease in lab mice, Lewis says.

His team has licensed the compound to a biotech company called Flightpath for further development and a clinical investigation.

If all goes well with Flightpath’s plans, it will still be a couple of years before Hygromycin A is tested in FDA-approved trials, Lewis says.

“This just shows you the importance of preventing a tick bite in the first place,” says Dapsis, who calls himself an anti-Lyme “evangelist.”

He says Lyme disease isn’t just a New England problem. “It’s in 49 states—every state but Hawaii.”

The COVID-19 pandemic upended daily life for everyone, changing the way we went about our lives in every conceivable way. Sudden disruptions to society were immediately apparent: School closures, business shutdowns, new—and in some cases, unprecedented—public health policies. But other pandemic impacts remain hidden, locked away in datasets and public records not yet meaningfully analyzed.

The determination to uncover that data—and make it widely available—led a group of Northeastern researchers to construct a “data-support system” from multiple information sources in and around the city of Boston that, when combined, paint a portrait of how communities and neighborhoods were impacted by the pandemic, especially those of color. 

The comprehensive database includes data from a variety of local sources, including Boston 911 and 311 (the city’s non-emergency line) dispatches, building permits, internet sources such as Yelp and Craigslist, among many other sources. 

The data-cleanse-and-aggregation project aims to “captur[e] aspects of housing and land use, crime and disorder, and commercial activity and institutions” to understand how “social, [behavioral], and economic disruptions” varied across Boston neighborhoods, according to a description of the database published in Nature Scientific Data this week. 

“We identified every data source that we could get our hands on—from administrative data to social media posts,” says Northeastern professor Dan O’Brien, who leads the Boston Area Research Initiative that oversaw the data project. 

O’Brien says the team of researchers combed through the different information sources, cleansing them of any errors or extraneous data, then “scraping” them into a user-friendly system that’s easy to use and publicly available. Throughout the pandemic, the database has served as a public resource for researchers, policymakers, public health officials and practitioners, and educators.  

“It’s a great resource for answering questions on the fly,” O’Brien says. “And now that we’re approaching the other side of the pandemic, we can use this database to look at inequitable outcomes, to think about which communities had more or less impact from infections … and also to look at how business activity was impacted, through Yelp reviews, inspections, et cetera.” 

O’Brien says public health researchers are just starting to understand the ways the pandemic has exacerbated long-standing health inequities in communities of color. Researchers with the Boston Area Research Initiative organized the data so that they correspond to and describe distinct geographical places and regions—making it easier to identify pandemic shifts in low-income communities. 

The end result of the data project, he says, should help provide researchers with a “comprehensive multidimensional view of how different communities experience the pandemic.”

Early on in the pandemic, the public was clamoring for information about the highly infectious and deadly novel coronavirus. Governments all around the U.S. initiated virtually unprecedented infection tracking protocols that resulted in a deluge of information about viral case counts, hospitalizations, and deaths that’s still a feature of daily life in this late phase of the pandemic. 

Beyond mere “dashboarding” of COVID-19 information, O’Brien says their database offers a picture of the pandemic on multiple levels of society. 

“This [database] goes a step further than that and says, ‘The pandemic was more than just one variable,’” he says. “It was more than just COVID infections; it disrupted everything. We literally shut everything down, which then alters anything that contributes to the operation of a community.”

For media inquiries, please contact media@northeastern.edu

A group of Northeastern researchers is tapping into the power of machine learning to develop new models for identifying patients who may have post-acute sequelae of SARS-CoV-2 infection, or so-called “long COVID.”

Using electronic health records from the National COVID Cohort Collaborative, a federal database that compiles medical information about COVID-19 patients, researchers were able to develop models that helped identify COVID long haulers across a range of features—from past COVID diagnosis, to the types of medications they’ve been prescribed, according to new research published in Lancet Digital Health.

The data harmonization effort drew from a variety of information sources to construct a picture of what long COVID looks like in the U.S.—and who is most likely to have it. Those sources include demographic data, healthcare visit details, diagnoses and medications for 97,995 adults with COVID-19, the study says. 

Patients most likely suffering from the post-infection illness, which is estimated to plague between 10-30% of people who contract COVID-19, are often characterized as having new or lingering symptoms that are present 90 days after being diagnosed with the viral infection—a criteria researchers also used to determine their base population in their analysis. 

Kristin Kostka, director of the Observational Health Data Sciences and Informatics Center at the Roux Institute. Photo by Nicole Wolf

“The real question at the heart of this is: Who gets long COVID, and what do they present with?” says Kristin Kostka, director of the Observational Health Data Sciences and Informatics Center at the Roux Institute and co-author of the study. “There’s really a lack of understanding by the clinical community of these fatigue-based illnesses that follow viral infection. It’s not just COVID.”

In analyzing the glut of patient data, which also included 597 patients from long COVID clinics, researchers trained three machine learning models to spot potential long COVID among all patients with COVID-19, patients hospitalized with COVID-19, and patients who had COVID-19 but were not hospitalized. The result is that specific features emerged that Kostka says could help clinicians better identify existing and future long-haulers. 

“The success rate of identification was above 90% using a specific model created for the research,” Kostka says. “The key markers of those most at risk of long COVID are: age, pulmonary symptoms and metabolic identifiers.”

The post-infection illness is still not well understood. Patients can have a wide range of symptoms, but those most commonly reported include fatigue—particularly after and during exertion or exercise—fever, difficulty breathing or shortness of breath, and a range of neurological problems, such as difficulty thinking or concentrating (or “brain fog”), headaches, difficulty sleeping, dizziness, depression and anxiety, according to the Centers for Disease Control and Prevention. 

Kostka says there’s still a tremendous need for more clinical awareness about long COVID as even physicians often overlook the symptoms that are consistent with a diagnosis.  

“This is really just the tip of the iceberg in acknowledging this burden,” Kostka says. “COVID isn’t just something you get through and you’re over it. For a subset of people, you’re never the same.” 

Kostka says her team is in the process of elaborating on these machine learning models of long COVID patients in research they hope to publish in the future. 

For media inquiries, please contact media@northeastern.edu.

Parents of children between the ages of 5-18 weighed in on where they obtained important information about their children’s health and the decision to vaccinate them against SARS-CoV-2, the coronavirus that causes COVID-19, in a new survey conducted by researchers at Northeastern.   

Researchers at the Covid States Project—a collaborative reporting effort by Northeastern, Harvard, Northwestern, and Rutgers—sought to tease out where parents of both vaccinated and unvaccinated children get their information about the COVID-19 vaccine and broader health matters. The data was collected over the course of several months from a national pool of parents. 

In seeking information about vaccination for their children, parents by and large consulted official sources, such as news websites and government and medical websites, with 49% and 51% stating they “often” or “sometimes” got information from these sources, respectively. 

David Lazer, distinguished professor of political science and computer and information science. Photo by Adam Glanzman/Northeastern University

Television and Facebook were next in order of popularity, with 39% and 35% of parents surveyed saying they often or sometimes used those sources to find information, respectively. At the bottom were books and magazines, with only 19% and 18% of parents saying they relied on the print options for information, respectively.

The survey also looked at differences in how parents of vaccinated children seek information about their children’s health and vaccination compared to parents of unvaccinated children. Using one set of questions and answers, the researchers found that there is only slight variation between the two groups in terms of where they sought out information, with parents of vaccinated children tending to consult information sources of all kinds more frequently than their counterparts, says Krissy Lunz Trujillo, a postdoctoral researcher in Northeastern’s Network Science Institute. 

But, whereas parents of vaccinated children were “much more likely” to cite health care professionals, the government, and schools, parents of unvaccinated children were more likely not to seek information from any sources, the study shows.  

“One takeaway is that parents of unvaccinated kids were less likely to have looked at all,” Trujillo says, adding that those parents, rather than citing information sources, were more likely to state that the decision not to vaccinate their children stemmed from personal values.

When it came to the decision to vaccinate their children, respondents were invited to give their own open-ended responses on where they sought information based on whether they had or had not gotten their children vaccinated. Here researchers found significant disparities, with parents of vaccinated children citing health care professionals at nearly twice the rate (28%) of parents with unvaccinated children (15%). Parents with vaccinated children also cited the government at more than three times the rate (16%) than parents with unvaccinated children (6%).

Parents with unvaccinated children were also more than five times (11%) more likely to cite themselves as the source of information about whether to vaccinate their children than their counterparts (2%). 

The survey confirms what many in public health already knew: That distrust of certain information sources, such as the government and the media, for example, has been a significant predictor of vaccine hesitancy in adults, says David Lazer, university distinguished professor of political science and computer sciences at Northeastern, and co-author of the study. 

“Everyone wants to keep their children healthy,” Lazer says. “But a significant minority of people don’t trust the information the government and the medical profession is providing about vaccinating children.”

For media inquiries, please contact media@northeastern.edu.

On the heels of the COVID-19 pandemic, public health experts are racing to understand the unexpected spread of monkeypox to Massachusetts.

State officials have been collaborating with the Centers for Disease Control and Prevention (CDC) to investigate the first monkeypox case known to reach the United States this year. Its carrier, a man who had recently visited Canada, has been isolated in a Boston hospital since May 12. The CDC on Wednesday confirmed that he was infected with the less-severe West African strain of the virus. 

Cases were being investigated in Canada, Australia, and eight European countries.

More than two years of COVID-19 have conditioned people to brace for the next global health crisis. But Northeastern experts say it is wildly premature to compare this relatively small outbreak to the pandemic that has claimed more than 6 million lives.

“We’ve had outbreaks of monkeypox in the past, most recently in 2003,” says Brandon Dionne, an associate clinical professor in Northeastern’s department of pharmacy and health systems sciences, in reference to a U.S. outbreak of more than 70 cases two decades ago. “Its transmission is much, much lower than it is with COVID. So it’s something that you can be aware of, but it’s not something to panic about at this point.”

If cases of monkeypox escalate to create a greater level of concern, then the experts note that its symptoms will be more noticeable and the virus will be more treatable than SARS-CoV-2, the coronavirus that causes COVID-19—especially in the early stages of the pandemic.

“I would characterize the dispersion of cases as pretty confusing in the sense that the situation is evolving hour by hour,” says Alessandro Vespignani, director of the Network Science Institute and Sternberg Family Distinguished Professor at Northeastern. “The outbreak is quite sizable, and obviously we need to understand what’s going on.”

The CDC describes monkeypox as a “rare but potentially serious viral illness that typically begins with flu-like illness and swelling of the lymph nodes and progresses to a widespread rash on the face and body.”

The virus was discovered in 1958 in research monkeys and was first reported in a human in the Democratic Republic of Congo in 1970. No infections were reported in humans for four decades before monkeypox re-emerged in 2017. Over the past five years, fewer than 500 cases have been reported—the great majority of them contained to Nigeria.

The West African strain that has infected the Boston patient is deadly in approximately 1% of patients. (Alternatively, the Congo Basin strain has a death rate of 10%.) The death rate of COVID-19 in the U.S. is 1.2%, based on confirmed cases, according to Johns Hopkins.

Are we out of the pandemic? What Fauci meant by ‘a transitional phase’

read more

The inital spread of cases to Portugal, the United Kingdom, and Spain triggered concerns that the virus is spreading more easily than before. But Vespignani says that conclusions of increasing transmissions cannot be formed without a clear understanding of the patients’ histories, their communities, travel patterns, and other factors.

It’s important to not overreact at this early stage, says Jared Auclair, director of the Biopharmaceutical Analysis Training Lab at Northeastern.

“We all have a heightened sensitivity to viruses right now because of COVID,” says Auclair, who also serves as technical supervisor for Northeastern’s Life Science Testing Center. “People should monitor symptoms, and if they start having lesions or pox then go to the doctor. But it’s not much to worry about, generally speaking.”

The CDC notes that the virus can be transmitted by respiratory droplets in close settings. It can also spread through contact with body fluids, monkeypox sores, or items (including clothing and bedding) that have been contaminated with fluids or sores. 

Those sores can help identify carriers in the latter stage of the disease, which Vespignani notes could help limit the spread if contact tracing becomes necessary.

Most promising is that the existing vaccine for smallpox is effective against monkeypox. Widespread smallpox vaccinations were responsible for rendering monkeypox dormant for more than 40 years, says Vespignani.

“Luckily enough, we have the vaccine,” Vespignani says, though he notes that stockpiles are currently low.

Common household disinfectants are effective against monkeypox on surfaces, according to the CDC.

Although monkeypox was first discovered in monkeys, the name of the virus is a misnomer, says Dionne.

“It actually comes from rodents, and mostly in parts of Africa,” Dionne says. “What is unique right now is that we’ve seen it in people who have no travel to the endemic areas. And so that’s the question: How are we now seeing these kinds of outbreaks in people that haven’t traveled to a known area where they have cases?

“But overall,” he adds, “the risk of contracting it for each individual is still very low.”

For media inquiries, please contact media@northeastern.edu.

It seems like yet another punchline for anyone joking about the past two years of pandemic life. But to scientists forecasting future disease outbreaks, it’s important data.

Scented candles began receiving an influx of negative reviews online in 2020. Dissatisfied customers proclaimed that some of the most fragrant, most popular products from famous companies like Yankee Candle had “no smell” or even smelled bad. 

This wasn’t just a few bad reviews. The most popular scented candles sold on Amazon were receiving an average of 4 to 4½ stars before 2020, but over the course of that first year of the pandemic, the reviews fell by about a full star. Social media users mused about a link between these negative reviews and the loss of the sense of smell associated with COVID-19 infections.

When COVID-19 cases rose again at the end of 2021 due to the omicron variant, researchers noted another uptick in those negative “no smell” reviews.

Those negative online reviews are what Mauricio Santillana calls “breadcrumbs.” As people navigate the digital world, they leave traces of what is going on in their offline lives, explains the director of the Machine Intelligence Group for the betterment of Health and the Environment (MIGHTE) in the Network Science Institute at Northeastern. Those “breadcrumbs” leave a trail for researchers like Santillana to follow as they project potential future outbreaks of COVID-19 and other diseases.

If there are anomalies in online trends—a spike in Google searches for shops that deliver chicken noodle soup, a sudden flurry of Tweets about navigating a quarantining family member, or bad reviews on scented candles—it could indicate that trouble is brewing. So Santillana is creating machine-learning models to spot the anomalies, make sense of these clues, and create an early warning system for disease outbreaks. 

By adding human behavior to the mix, “we’re creating an observatory of disease activity using different telescopes,” says Santillana, a professor of physics and of electrical and computer engineering who recently joined Northeastern from Harvard University. 

Santillana is teaming up with Alessandro Vespignani, director of the Network Science Institute and Sternberg Family Distinguished Professor at Northeastern, who leads a team of infectious-disease modelers that have been developing a set of projections about the possible futures of the COVID-19 pandemic since the crisis began. 

Vespignani’s models integrate details such as case counts, hospitalizations, deaths, human mobility patterns, how often humans interact, how the virus transmits and more data focused on the disease spread itself. Santillana says his research adds a different sort of thermometer by looking at digital traces of human behaviors that are a step removed from the epidemiological data. 

“In a way, we’re trying to bring together these two perspectives to provide a more whole picture of outbreaks like COVID-19,” Santillana says.

Santillana and Vespignani have already been collaborating, combining this digital behavioral data with epidemiological data in their modeling work. In a paper published in Science Advances last year, they showed that such a harmonized early warning system could anticipate a surge in COVID-19 cases and deaths by two to three weeks. With Santillana joining the Network Science Institute, the pair will work together to further develop this early-warning system for disease outbreaks—and not just for COVID-19.

No needles? No problem. This COVID-19 vaccine could be inhaled.

read more

The data that Santillana gathers encompasses a vast, diverse collection of information—not just Google search trends, social media posts, and online shopping reviews or orders. He has also used anonymized smart thermometer data to identify when some sort of illness might be ticking up in a region, anonymized mobility data from smartphones that illustrates when more people might be staying home sick, as well as trends in clinician searches for certain kinds of treatments or symptoms. 

Even the Google searches and social media posts encompass a wide range of data. People could be searching for more information about their symptoms or quarantine recommendations, or they could simply be trying to figure out where to buy cough syrup or soup. 

An uptick in just one of these behaviors in a region might indicate that COVID-19 or another infectious disease is sweeping into a community, or it might just be that there was a new sci-fi film that came out and piqued people’s curiosity about pandemics more generally. That’s why Santillana says it’s important for his models to take into account many different data sources. The machine learning models are also designed to figure out whether a rise in certain Google searches, for example, actually correlates with a rise in infections and hospitalizations in order to determine if it is worth considering as a harbinger of a disease outbreak.

This new type of “telescope,” as Santillana termed it, will be a component of the U.S.’s new disease forecasting initiative, the Center for Forecasting and Outbreak Analytics (CFA). Santillana is part of a team of experts advising that effort. 

“In the same way that the weather forecasting systems around the world work,” he explains, “the idea is to contribute different ways to look at information that is being produced in real time and design systems that will recognize when something anomalous happens.” 

Like weather forecasting agencies, the CFA will essentially be an early warning system, identifying when and where disease outbreaks might occur so that public-health officials can take action to prevent them from becoming devastating. 

For media inquiries, please contact Shannon Nargi at s.nargi@northeastern.edu or 617-373-5718.

Perhaps you stocked up when at-home COVID-19 test kits were hard to come by, before the U.S. federal government started a program to mail some to each household. Or maybe you found a bunch of test kits for a good price at your local pharmacy. Or bought a few when insurance companies started reimbursing the cost.

In any case, if you have a pile of COVID-19 test kits at home, be sure to check the expiration date on the box before using them. The tests do expire, and become more likely to report a false negative result after the expiration date, says Jared Auclair, director of the Biopharmaceutical Analysis Training Lab at Northeastern.

Jared Auclair, who is an associate teaching professor of chemistry and chemical biology at Northeastern, leads the Biopharmaceutical Analysis Training Lab, and runs the university’s COVID-19 testing facility, the Life Sciences Testing Center in Burlington, Massachusetts. Photo by Adam Glanzman/Northeastern University

“COVID-19 tests that are past their expiration dates should literally be thrown out,” Auclair says. “They’ll be less potent and more likely to be inaccurate.”

Unlike food labels—which provide a variety of information about when the food will be freshest and taste best but not necessarily when it actually spoils—medical labels indicate crucial information about when the medicine (or test kit) can and can’t be used.

“When you buy milk, oftentimes the expiration date is when you need to buy it,” Auclair says. “COVID tests—and medicines in general—that have expired are all junk. They need to go in the trash.”

According to the federal Food and Drug Administration, at-home COVID-19 tests have expiration dates printed on the boxes that indicate “the end of the test’s shelf life and … the date through which the test is expected to perform as accurately as when manufactured.”

Over-the-counter COVID-19 testing kits contain antibody tests that respond to cells produced by your body’s immune system to fight off SARS-CoV-2, the virus that causes COVID-19. After the test’s shelf life, the chemical and molecular components that indicate the presence of those antibodies may degrade or break down, making the tests less sensitive, Auclair says. 

Which COVID-19 test should I take?

read more

Drugmakers and researchers use a process called stability testing to determine the time period during which medicines (or tests) perform consistently. In other words, the period of time during which their performance is stable.

You may notice that your at-home COVID-19 test kits have a range of expiration windows. Some are good for six months, some for nine, some for 11. According to the FDA, this is due to some variation in stability testing.

Researchers gain the most accurate data from real-time testing, according to the FDA. In this process, “the manufacturer stores the tests for the time period of the proposed shelf-life (plus a little extra time to ensure the expiration date can be relied upon) and then evaluates its ability to perform accurately.”

Other times, researchers will use accelerated testing to get results faster. In this process, the manufacturer will store the test or the drug in more extreme conditions (at a higher temperature, for example) for a shorter amount of time.

The accelerated process doesn’t give researchers and regulators as much information about long-term stability as real-time testing does, but it does give them enough data (“sufficient assurance”) to determine that at-home COVID-19 test kits are effective for at least six months, according to the FDA.

That’s enough to get the tests out the door while researchers collect more real-time data. As the longer-term data rolls in, the FDA may extend the test’s shelf life accordingly. The administration keeps a running database online of authorized over-the-counter COVID-19 tests, and when they expire.

As the stability testing protocols indicate, it’s important to store your COVID-19 test kits properly at home, Auclair says. Keep the tests dry and at room temperature, and don’t let them dry out or expose them to extreme heat or freezing.

Still, Auclair says your best bet is just to follow the date stamped on the box.

“You might get a test that still works after the expiration date, but that’s not a risk I’m willing to take,” he says.

For media inquiries, please contact media@northeastern.edu.

Dr. Anthony Fauci, the nation’s leading infectious disease expert, said last week that the U.S. is transitioning “out of the pandemic phase” of the COVID-19 health crisis. His comments were followed by news that the European Union is moving out of the emergency phase of the pandemic as COVID-19 deaths and hospitalizations across Europe decline significantly, according to the New York Times. 

“We’re really in a transitional phase, from a deceleration of the numbers into hopefully a more controlled phase and endemicity,” Fauci said, according to The Washington Post. 

While Fauci’s comments signal hope that the U.S. and other nations could finally be moving into a post-pandemic world, officials should proceed with caution, says Wendy Parmet, Matthews Distinguished University Professor of Law and co-director of Northeastern’s Center for Health Policy and Law.

Portraits of Wendy E. Parmet, Matthews University Distinguished Professor of Law and professor of public policy and urban affairs and Neil Maniar, director of the Master of Public Health program and a professor of the practice in the Bouvé College of Health Sciences. Photos by Matthew Modoono/Northeastern University

So much of the government’s response to the COVID-19 pandemic relied on so-called emergency powers, Parmet says. If federal officials are confident that a post-pandemic transition is in progress, then pandemic-era flexibilities, such as COVID-related health-care coverage, could soon be dispensed with as well, she says. 

There’s also the problem of the public’s perception of what “transitioning out of the pandemic” really means for public health.  

“To the public I think ‘pandemic’ has often come to mean ‘dangerous,’” Parmet says. “And so the opposite, ‘When it’s not a pandemic it’s not dangerous,’ is itself dangerous thinking.”

Amid a steep decline in COVID-19 cases and hospitalizations over the last several months, state, local, and federal officials began rolling back health protocols, such as masking and testing mandates. 

However, Parmet says officials should continue to take steps to protect against another surge, or the next pandemic. Those steps include ensuring that sufficient testing capacity remains in place at all levels of government; that the healthcare system remains resilient; and that more communities measure COVID-19 levels in wastewater to continue real-time monitoring of potential outbreaks. 

Endemicity, or the idea that an outbreak of disease is such that it can be managed without overwhelming the health-care system, is the goal, Parmet says. But even in an endemic period, disease levels can grow to alarming levels. 

“We want the disease to be endemic—we want it to be, it should be; but it should be endemic at a low rate [of disease]—not a high rate,” Parmet says. Endemic diseases such as “smallpox and diphtheria killed lots of children.” 

For COVID-19, ‘endemic’ does not mean ‘the end’

read more

“Endemics can be really bad,” Parmet continued. “I’m not saying we’re there. I’m saying that when people hear these terms—what they’re hearing and what they have come to mean in popular discussion is not necessarily the same as what the scientists say they mean.”

Fauci’s comments come as cases in the U.S. have been ticking back up as the highly contagious COVID-19 subvariant, known as BA.2, spreads—although some experts have suggested that the rise may not necessarily lead to another surge. Case counts are still at their lowest levels since last summer—and hospitalizations are close to record lows, according to the New York Times. 

“Case counts are lower, hospitalizations and deaths have decreased,” says Neil Maniar, director of the Master of Public Health program, associate chair of the Department of Health Sciences, and professor of public health practice at Northeastern. 

Maniar interprets the White House’s messaging as a sign that we could be “emerging from the pandemic,” and that “for the time being,” disease levels are under control. 

“It means we are in an environment right now where the burden of COVID is much more manageable,” Maniar says. “It does not mean that COVID has gone away, and it does not mean that the pandemic is over, globally.”

Maniar says it’s important to recognize that, even amid such progress, health-care systems vary worldwide in their ability to handle certain caseloads, meaning local outbreaks can continue to threaten communities around the world. 

“Globally we know there’s a lot of variation in terms of health-care infrastructure,” Maniar says. “But I do think that there’s a general framework of using multiple sources of data to really understand what the burden of COVID is in a given place, and how we can effectively manage and control the spread of disease.” 

For media inquiries, please contact media@northeastern.edu. 

People who have been diagnosed with COVID-19 may be at a higher risk of developing the autoimmune disease Type 1 diabetes, according to a study of more than 27 million people across the United States. 

Researchers found that patients who were infected with SARS-CoV-2, the coronavirus that causes COVID-19, were 42% more likely to develop Type 1 diabetes than those who did not contract COVID-19 during the study period. 

The risk is highest among the youngest of pediatric patients (those under the age of 1 were at an increased risk of 584%) and elevated among older adult patients with COVID-19. The researchers also observed differences across race and ethnicity, with risk of Type 1 diabetes associated with a COVID-19 infection being most pronounced among American Indian/Alaskan Native (130% increased risk), Asian/Pacific Islander (101%), and Black patients (59%).

Trenton Honda, clinical professor and associate dean in the Bouvé College of Health Sciences at Northeastern University

“Particularly in pediatric populations, [COVID-19] is not usually a life-threatening, oftentimes not serious, condition. But Type 1 diabetes is usually a lifetime illness that requires dramatic amounts of contact with the medical community, increases your risk of death, increases your risk of long-term comorbidity,” says Trenton Honda, clinical professor and associate dean in Northeastern’s Bouvé College of Health Sciences, and a member of the research team led by Fares Qeadan at Loyola University Chicago.

“Our interest is really looking at the question, ‘Are there going to be hidden costs, even among those who are not at high risk from COVID itself, because of COVID, later on?’” Honda says.

The scientists also probed whether patients who had Type 1 diabetes before contracting COVID-19 were more likely to suffer a serious, life-threatening complication called diabetic ketoacidosis after being infected with the virus. They found that those patients who had Type 1 diabetes and then were infected had a 126% increased risk of developing diabetic ketoacidosis compared to those who did not get infected. Their results were published in the journal PLOS One earlier this month. 

Honda uses the word “association” when referring to the increased risk, careful not to say that a COVID-19 infection causes Type 1 diabetes onset. 

“We are the first study in the U.S. population in a really, really big national dataset to be able to say that people who got COVID appear to be at higher risk of developing Type 1 diabetes, although we’re not able to say that COVID caused that increased risk. It could be any number of things,” he says. To establish that causal connection, Honda says, researchers would need to do a randomized controlled trial. Instead, the team looked at the anonymized data of more than 27 million people who came into contact with hospital medical care across the U.S. from December 2019 through the end of July 2021. 

There’s other evidence that links COVID-19 infection to increased risk of being diagnosed with Type 1 diabetes. SARS-CoV-2 is not the first virus to be associated with an increased risk of Type 1 diabetes onset. It has also been linked to several viral infections such as mumps, rubella, cytomegalovirus, and Epstien-Barr virus.

The official count of COVID-19 shots in older adults is distorted. What’s going on?

read more

It all comes down to the pancreas.

All of the cells in your body rely on sugar (glucose) for fuel, Honda explains. But some cells require prompting by a hormone called insulin in order to absorb glucose from the blood. Insulin is produced by the pancreas in response to changes in blood sugar.

Type 2 diabetes is typically an issue of insulin resistance developing in those cells that require it. But Type 1 diabetes is an autoimmune disease, Honda explains. “Essentially your body produces antibodies and immune cells that go in and destroy the cells that produce insulin. So you end up with this precipitously low insulin level over time. And what that means is that the cells in our body that need insulin to get sugar into them stop using sugar and they start using fats. And by doing so, they change the entire metabolism of the body and institute an acidotic state that ultimately is fatal.”

Before what Honda calls “one of the greatest moments in all of medical history” when insulin was purified from pigs, Type 1 diabetes was a death sentence. Now, it’s a lifelong disease that is survivable with glucose monitoring and insulin injections. 

With other viruses, scientists think that the way the virus invades the cells in the pancreas causes them to spontaneously die, Honda explains. And when they die, the immune system mobilizes to destroy those dead cells. The idea, he says, is that this might foster the development of an autoimmune response to those cells—and it could get out of control and continue attacking those vital insulin-producing cells in the pancreas.

“This is the way that other viruses are presumed to lead to Type 1 diabetes,” Honda says. “So that’s the logic behind this study.”

This study focused on COVID-19 cases in the absence of vaccines. Honda says the next big question is to determine whether immunization against SARS-CoV-2 is linked to any further or minimized risk of Type 1 diabetes. 

The research team also aims to study associations between 40 other autoimmune diseases and COVID-19 infections. 

“If we think about just the burden of disease that COVID causes, it’s quite possible that the immediate disease is going to have a much, much smaller impact, particularly on people who are at low risk from the disease itself,” Honda says. “And we might end up with a huge number of lifelong disorders that develop…from the exposure to COVID.”

For media inquiries, please contact Marirose Sartoretto at m.sartoretto@northeastern.edu or 617-373-5718.