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Russian vaccine https://www.thelancet.com/action/showPdf?pii=S0140-6736%2820%2931866-3 https://www.telegraph.co.uk/news/2020/09/04/russias-fast-track-vaccine-safe-use-produces-immune-response/ Two early-phase trials 2 doses n = 76 Open-label Non-randomised Healthy adult volunteers (men and women) aged 18–60 Phase 3 needed, randomised, blinded, placebo controlled Sputnik V Two formulations (frozen and lyophilised) 21 days, antibody in all 28 days, T-cell response in all 42 days, good safety profile Mild local and systemic side effects No serious adverse events were detected Two-part vaccine, two attenuated recombinant adenovirus vectors Carrying the gene for SARS-CoV-2 spike protein Approval already granted in Russia Richard Horton, UK government critic Symptomatic and Asymptomatic Viral Shedding in Pediatric Patients Infected With Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2) Under the Surface (JAMA 28 August) https://jamanetwork.com/journals/jamapediatrics/fullarticle/2770149 South Korea Children data 22% asymptomatic for entire course of infection 20% began asymptomatic but later developed symptoms 58% symptomatic Length of time children remained symptomatic, 3 days to 3 weeks Probably contagious for longer times SARS-CoV-2 viral load predicts COVID-19 mortality, (Lancet, August, NY) https://www.thelancet.com/journals/lanres/article/PIIS2213-2600(20)30354-4/fulltext#%20 SARS-CoV-2 viral load at diagnosis, independent predictor of mortality In a large hospitalised prospective cohort n=1,145 adjusted for age, sex, asthma, atrial fibrillation, coronary artery disease, chronic kidney disease, chronic obstructive pulmonary disease, diabetes, heart failure, hypertension, stroke, race Significant independent association between viral load and mortality Hospitalised testing needs to change from qualitative to quantitative Risk stratifying patients

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