Pharmaceutical Technology lists the top five terms tweeted on infectious diseases in Q2 2021, based on data from GlobalData’s Influencer Platform.

1. Vaccine – 8,501 mentions

The Centers for Disease Control and Prevention’s (CDC) announcement to lift restrictions without the requirement of proof of vaccination, thrombotic events associated with AstraZeneca and Johnson & Johnson Covid-19 vaccines, and phase three clinical trial data on Pfizer-BioNTech Covid-19 vaccine were some of the popular discussions on vaccines in Q2.

Carlos del Rio, executive associate dean at Emory University School of Medicine, shared an article on why the CDC should not have removed Covid-19 related restrictions without requiring proof of vaccination. The announcement can remove incentive for people to get vaccinated and create hurdles for achieving herd immunity, which is essential for life to return to normal, according to the article.

People who have not been vaccinated can potentially spread the virus in public spaces if there is no requirement to check vaccination status. The CDC’s announcement should have been revised to state that no restrictions are required for vaccinated people as long as their vaccination status can be checked, the article highlighted.

In another tweet, Helen Branswell, senior writer at Stat News, a news website focused on health and life sciences, shared an article on blood clotting events reported among people who received AstraZeneca Covid-19 vaccine in Europe and Johnson & Johnson Covid-19 vaccine in the US. The European Medicines Agency (EMA) stated that the benefits of AstraZeneca vaccine outweigh its risks of side effects. The side effects of these vaccines, therefore, should be examined by analysing the biology behind the blood clotting disorder, according to the article.

Some theories on the blood clotting events suggest that they may be the result of low platelet count and the structure of the spike protein being similar to platelet factor 4 molecule. The genetic sequence of a portion of the adenovirus vector being similar to tissue plasminogen activator or tPA, which plays a role in regulating normal blood-clotting processes, has also been suggested as one of the reasons behind the blood clots.

Another discussion around vaccine was shared by Francis S. Collins, director of National Institute of Health (NIH), on pharmaceutical company Pfizer’s press release about positive results from a phase three clinical trial on its Covid-19 vaccine BNT162b2 developed in collaboration with BioNTech. The trial conducted in 2,260 adolescents aged between 12 and 15 years demonstrated 100% efficacy and strong antibody response. Pfizer and BioNTech plan to submit the data from the trial to the US Food and Drug Administration (FDA) and EMA for expansion of the Emergency Use Authorisation (EUA) and European Union (EU) Conditional Marketing Authorisation for the BNT162b2 vaccine.

2. Covid-19 and Coronavirus – 5,793 mentions

Surging Covid-19 cases in India, Covid-19 deaths in the US being higher than those recorded during the 1918-’19 Influenza, and how good ventilation and air quality help to protect from Covid-19 were some of the trending discussions in Q2.

India reported more than 310,000 new cases of Covid-19 infection in a single day, according to an article shared by Gregg Gonsalves, associate professor at Yale School of Public Health. The total infections in the country exceeded 15.6 million, the second-highest after the US. The rapid rise in cases was a result of complacency and lack of preparation by the government, the article highlighted. The government imposed a strict lockdown during the initial stages of the pandemic, but was ill-prepared to handle the second wave of the pandemic, according to the article.

Laurie Garrett, a science journalist and author, further shared an article on Covid-19 deaths in the US. The death toll from Covid-19 reached more than 600,000 in the US despite new infection cases and deaths having reduced as more people have got vaccinated. The CDC reported that the number of new cases and deaths declined to the lowest levels in a year but deaths continue to be on the rise. Garrett stated that the death toll from Covid-19 is equal to the estimated deaths from the 1918-’19 Influenza.

Covid-19 also trended in a discussion shared by Ian M. Mackay, adjunct associate professor at the University of Queensland, on the role of good ventilation and air quality in protecting from Covid-19. The disease can be spread through aerosols suspended in the air produced by an infected person. Wearing proper masks, physical distancing, and reducing indoor occupancy can help in avoiding the inhalation of such aerosols. Improved air quality through a good ventilation system can help in reducing suspended particles that can remain airborne for hours and thus protect against infection, highlighted the article.

3. HIV – 1,472 mentions

The role of US leadership in fighting against HIV/AIDS, the analogy between the Covid-19 pandemic and the HIV/AIDS epidemic, and how the lessons learned from fighting HIV can be used to combat Covid-19 were some of the popular discussions on HIV in Q2 2021.

Carlos del Rio shared an article on how US leadership in the global fight against HIV/AIDS has been key to dealing with the epidemic. The US has supported the fight against HIV/AIDS through the US President’s Emergency Plan for AIDS Relief (PEPFAR). PEPFAR is supported by both the US President and Congress and has been functioning as the largest single-nation effort to tackle a disease for the past 20 years. It has helped more than 18 million lives by providing antiretroviral treatment and HIV testing for 50 million people. PEPFAR, however, has been functioning without a new administrator for the first time in its history. The article stated that the US President needs to appoint a strong leader to head PEPFAR and continue its efforts in fighting against the HIV/AIDS epidemic.

Further, Paul Sax, clinical director at Brigham and Women’s Hospital, shared an article on how the current Covid-19 situation can be compared with the HIV/AIDS epidemic in the past. HIV became an epidemic despite a triple combination drug being approved in 1995. Countries that could not afford the drug witnessed high death rates until various campaigns were undertaken to expand access to the drug. The rise in Covid-19 cases in developing countries due to new variants represents a similar trend as lack of access to effective vaccines is hindering the ability of these countries to combat the virus. The article called for global cooperation to ramp up the production of vaccines and distribute them globally to prevent the further spread of the pandemic.

Another discussion around HIV was on an article shared by Ani Shakarishvili, MD, special advisor to Joint United Nations Programme on HIV/AIDS (UNAIDS), an innovative partnership aimed at ensuring universal access to HIV services. The article detailed how the lessons learned from reducing the transmission of the HIV virus can be applied to the Covid-19 pandemic. Understanding the pandemic and expanding the knowledge regarding disease is key to dealing with the pandemic, noted the article.

Furthermore, the pandemic is causing an increase in racism and inequality as it is disproportionately impacting people of colour in the US. The article stated that to fight the pandemic there is an urgent need to eliminate racial inequalities in research and development, medical treatment, and disease prevention. There should be a consensus that disease propagation and dissemination of pathogens are based on human behaviour and a single region or country should not be held responsible for the spread of the disease, added the article.

4. Antibiotic Resistance – 356 mentions

The detection of oseltamivir-resistant influenza A (H1N1) cases and a new antibiotic to treat gram-negative ‘superbug’ infections entering clinical trials were some of the trending discussions on antibiotic resistance in the last quarter.

Judy Stone, a journalist, shared an article on the discovery of four cases of oseltamivir-resistant influenza A (H1N1) in Texas at a border detention centre. Oseltamivir is prescribed as an antiviral drug to treat influenza, but oseltamivir-resistant influenza A (H1N1) viruses became widespread between 2007 and 2009. Analysis of the four cases revealed that they had NA-H275Y mutation, which is known to be resistant to oseltamivir. The article noted that the cluster of cases is concerning and requires constant monitoring as it could lead to the spread of oseltamivir-resistant viruses during the flu season.

Antibiotic resistance was also discussed in an article shared by Steffanie Strathdee, co-director at University of California, on the discovery of a new antibiotic named QPX9003 to treat Gram-negative infections. The Gram-negative bacteria can infect a person with pneumonia, bloodstream infections, urinary tract infections, peritonitis and meningitis.

The drug was discovered by researchers at Monash Institute of Pharmaceutical Sciences (MIPS), and the Monash Biomedicine Discovery Institute (BDI) in collaboration with US-based biopharmaceutical company Qpex Biopharma (Qpex). QPX9003 has displayed better safety and efficacy in pre-clinical trials over antibiotics such as polymyxin B and colistin that are used to treat Gram-negative infections. Qpex is currently evaluating the drug in phase one clinical trials in the US.

5. Sepsis – 200 mentions

New techniques for the diagnosis of bacterial infections and sepsis, and the connection between sepsis and Covid-19 were some of the popular discussions on sepsis in the second quarter of the year.

Patrick Harris, staff specialist at UQ Centre for Clinical Research at the University of Queensland, shared an article on new microbiological techniques that can quickly diagnose bacterial infections and sepsis in patients admitted to intensive care units (ICU).

Some of the new methods listed in the article include multiplex polymerase chain reaction (PCR) tests that can detect pathogens with more than 90% accuracy, nucleic acid detections tests, and metagenomics-based assays. The innovative tests can help in removing the limitations of the traditional bacterial identification methods in terms of turn-around time, accuracy, and reduced costs, highlighted the article.

Sepsis also trended in a discussion shared by Dr. Ron Daniels, CEO of The UK Sepsis Trust, a charity focused on raising awareness and funding to deal with sepsis. The article stated that critically ill Covid-19 patients exhibit conditions and symptoms such as multi-organ dysfunction, respiratory distress syndrome, and gastrointestinal dysfunction, which are characteristic of sepsis.

Supportive therapies are currently being used to treat non-Covid sepsis in the absence of specific therapies. The global research efforts and ongoing clinical trials on Covid-19, however, provide evidence for the use-specific therapies to treat sepsis. Daniels stated that the research and approach towards treating Covid-19-related sepsis should be used to treat sepsis in the post-pandemic period.