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Immunity to the SARS-CoV-2 virus ensures protection against reinfection by this virus thanks to the combined action of neutralizing antibodies and T lymphocytes specific to viral proteins, in particular the Spike protein. It must be distinguished from the immune response that ensures healing of the infection following contamination that involves innate immunity, particularly type 1 interferons, and which is followed by adaptive cellular and humoral immunity. The importance of the effect of interferons is highlighted by the occurrence of severe forms of the disease in genetically deficient subjects or in patients with antibodies neutralizing type 1 interferon. Herd immunity is not an individual biological property. It is a mathematical property that qualifies the fact that when the proportion of subjects with individual immunity is high enough, there is little chance that an epidemic can occur. The level of that proportion—the herd immunity of the population can be computed under theoretical, often unrealistic, hypotheses, and is difficult to assess in natural conditions.

Although syndromic surveillance systems using nonclinical data have been implemented in the United States, the approach has yet to be tested in France. We present the results of the first [...]

We propose a Bayesian statistical framework for estimating the reproduction number R early in an epidemic. This method allows for the yet-unrecorded secondary cases if the estimate is obtained before [...]

Influenza epidemics occur once a year during the winter in temperate areas. Little is known about the similarities between epidemics at different locations. We have analyzed pneumonia and influenza deaths [...]

AIDS patients should probably be admitted to medical intensive care units (MICUs) on the same basis as any other gravely ill patient. Among 120 AIDS patients consecutively admitted to a Paris MICU, 86 were discharged alive. Of those discharged, 86% survived one week, 82% one month, 53% six months, and 39% one year. Survival to discharge from the MICU was related to severity of illness at time of admission whereas long-term survival was related to severity of AIDS. The survival to discharge rate was similar to that of non-AIDS patients., Objective.--To help physicians decide whether to admit patients with acquired immunodeficiency syndrome (AIDS) to the medical intensive care unit (MICU). Design.---Case series study of AIDS patients admitted to the MICU between October 1990 and October 1992 and followed up until April 1993 (median followup, 1 year). Setting.--The MICU in a 970-bed teaching hospital in Paris, France. Patients.--A total of 120 consecutive AIDS patients with acute respiratory failure (50%), central nervous system dysfunction (22.5%), pneumothorax (12.5%), shock (10.8%), or miscellaneous conditions (4.2%). A total of 86 patients were discharged alive from the MICU. Main Outcome Measures.--Predictive factors for mortality during and after MICU stay. Results.--Multivariate analysis identified 3 factors predicting poor MICU outcome: Simplified Acute Physiology Score I (SAPS I) above 10 (relative risk [RR], 6.1; 95% confidence interval [CI], 1.5-26.6), time between AIDS diagnosis and MICU admission more than 1 year (RR, 6.0; 95% CI, 2.1-17.5), serum albumin level less than 30 g/L (RR, 4.9; 95% CI, 1.3-18.2). The CD4 cell count, [Beta.sub.2]microglobulinemia, and previous opportunistic infections had no influence on MICU mortality. After MICU discharge, survival rates were 86% at 1 week, 82% at 1 month, 53% at 6 months, and 39% at 1 year. The Karnofsky scale score and the number of previous opportunistic infections were simultaneously associated with post-MICU outcome. Predictive factors for MICU survival did not influence post-MICU survival. Conclusion.--The MICU mortality was related to immediate severity (assessed within 48 hours of admission) and the time between AIDS diagnosis and MICU admission. Long-term survival after MICU discharge depended only on the severity of AIDS. We conclude that AIDS patients should be admitted to the MICU on the same basis as other patients. JAMA. 1996;276:1240-1245

BACKGROUND: The temperature-mortality relationship has repeatedly been found, mostly in large cities, to be U/J-shaped, with higher minimum mortality temperature (MMT) at low latitudes being interpreted as indicating human adaptation to climate. OBJECTIVES: Our aim was to partition space with a high-resolution grid to assess the temperature-mortality relationship in a territory with wide climate diversity, over a period with notable climate warming. METHODS: The 16,487,668 death certificates of persons > 65 years of age who died of natural causes in continental France (1968-2009) were analyzed. A 30-km x 30-km grid was placed over the map of France. Generalized additive model regression was used to assess the temperature-mortality relationship for each grid square, and extract the MMT and the RM25 and RM25/18 (respectively, the ratios of mortality at 25°C/MMT and 25°C/18°C). Three periods were considered: 1968-1981 (P1), 1982-1995 (P2), and 1996-2009 (P3). RESULTS: All temperature-mortality curves computed over the 42-year period were U/J-shaped. MMT and mean summer temperature were strongly correlated. Mean MMT increased from 17.5°C for P1 to 17.8°C for P2 and to 18.2°C for P3 and paralleled the summer temperature increase observed between P1 and P3. The temporal MMT rise was below that expected from the geographic analysis. The RM25/18 ratio of mortality at 25°C versus that at 18°C declined significantly (p = 5 x [10.sup.-5]) as warming increased: 18% for P1, 16% for P2, and 15% for P3. CONCLUSIONS: Results of this spatiotemporal analysis indicated some human adaptation to climate change, even in rural areas. http://dx.doi.org/10.1289/ehp.1307771, Introduction The variation of daily mortality with the temperature at the time of death has repeatedly been found to be U/J-shaped, with increased mortality at both low and high temperatures [...]