The 2 positive samples showed detection of E and RdRp. Sanger sequencing revealed 100% identity with the SARS-CoV-2 E gene. Only 1 pool showed a positive E signal that was not reproducible with testing of the individual samples of that pool.Discussion | Results from this screening strategy support that the burden of disease in the San Francisco Bay Area early in the pandemic was low; less than 1% of all symptomatic individuals with negative routine testing had SARS-CoV-2 infection. The timing of the positive pools overlapped with the first 3 individuals with positive results reported from Santa Clara County, tested using criteria established by the Centers for Disease Control and Prevention. 4,5 Thus, public health counts of individuals with SARS-CoV-2 infection indicated a reasonable estimate of overall disease burden among symptomatic individuals in this area. 6 Nevertheless, the individuals identified with positive results via this screening strategy would not have met the existing testing criteria.A pooled screening strategy was pursued to increase testing throughput, limit use of reagents, and increase overall testing efficiency at an expected slight loss of sensitivity. With only 1 false-positive reading, the strategy was specific. Due to the challenges of restricted access to diagnostic tests and kit supplies across the United States, early testing has largely been limited to symptomatic individuals fulfilling testing criteria. 4 Although this approach facilitates rational use of resources, it may miss individuals in whom COVID-19 risk has not been identified. 4 This study is limited in that it was performed in a single laboratory in a restricted geographical area; additional data are thus required to validate this approach on a larger scale. Furthermore, this screening strategy does not obviate the need for individual diagnostic testing, particularly as community transmission intensifies.Strategies such as pooled screening may facilitate detection of early community transmission of SARS-CoV-2 and enable timely implementation of appropriate infection control measures to reduce spread.
Key Points
Question
Have suicide rates in Japan increased during the coronavirus disease 2019 (COVID-19) pandemic?
Findings
In this cross-sectional study using national data on suicide mortality in Japan, including 90 048 individuals who died of suicide, suicide rates in 2020 compared with 2016 to 2019 were increased in October and November for men and in July through November for women, and the relative increases were particularly pronounced among men aged younger than 30 years and women aged younger than 30 years and 30 to 49 years.
Meaning
These findings suggest that the COVID-19 pandemic was associated with increases in suicide rates in Japan.
Highlights
CCL17, IFN- l 3, IL-6, IP-10, and CXCL9 were predictor for COVID-19 prognosis.
CCL17 were showed strong association with the development of severe pneumonia.
A flare-up of IFN- l 3, IL-6, IP-10, and CXCL9 were a trigger for severe symptom.
The downregulation of CCL17 could be unique in COVID-19.
Recently, reports of syphilis have increased rapidly in Japan, with most cases being men who have sex with women and young women who have sex with men.
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