Tulane Outbreak Daily | April 2, 2020

Woman with COVID-19 developed a rare brain condition. Doctors suspect a link. – LiveScience A woman who tested positive for COVID-19 developed a rare brain disease known as acute necrotizing encephalopathy. The woman, a 58-year-old airline worker, checked into the Henry Ford Health System in Detroit, after having a fever, cough (known coronavirus symptoms), and “altered mental status” for three days, the report noted. At the hospital, the woman appeared confused, lethargic, and disoriented. She tested negative for influenza, herpes, Varicella zoster virus, and West Nile virus; and her cerebrospinal fluid contained no trace of bacterial infection. [Related Study]
Rapid COVID-19 escalation pushes world past 900,000 cases – CIDRAP As virus activity enters its fourth month, WHO Director said today at a telebriefing that the world is witnessing nearly exponential growth, and deaths have more than doubled in the past week. He added that, over the next few days, global totals will hit 1 million cases, 50,000 of them fatal.
People with coronavirus may be most infectious in the first week of symptoms – MIT Technology Review That could lend more weight to the argument in favor of wearing a mask while in public. People with coronavirus appear to be most infectious within their first week of experiencing symptoms The study: Researchers analyzed data from nine patients with “relatively mild” coronavirus symptoms in Munich, Germany, to see how infectious they were across a 14-day period. Specifically, they checked the viral load in samples from throat and lung swabs, sputum (coughed-up saliva and mucus), stool, blood, and urine. [Related Study in Nature]
Chinese wet markets still in operation despite COVID-19 – Australian News Thousands of people have started to flood back into Chinese wet markets, with bats, rabbits and dogs still on offer despite the coronavirus outbreak. [Related study from 2007]
Is the coronavirus airborne? Experts can’t agree – Nature The World Health Organization says the evidence is not compelling, but scientists warn that gathering sufficient data could take years and cost lives.
Why is coronavirus killing more men than women? – Wired Coronavirus not only seems to discriminate by age but sex. The likelihood of death may come down to biology, lifestyle and behavior.
The Science Behind A 14-Day Quarantine After Possible COVID-19 Exposure – NPR To stop the spread of the coronavirus, health officials have a favorite refrain: After being in a city or region where there have been a lot of COVID-19 cases, spend 14 days in quarantine even if you feel perfectly fine — don’t leave your house. Coming from New York? 14-day quarantine. Arriving in Hawaii? 14-day quarantine. Been in Italy or China or Iran recently? 14-day quarantine.
The Coronavirus Patients Betrayed by Their Own Immune Systems A “cytokine storm” becomes an all-too-frequent phenomenon, particularly among the young. But treatments are being tested.
Researchers Eye Ocular Abnormalities in COVID-19 – MedPageToday About one-third of a small sample of COVID-19 patients in China had ocular abnormalities, and the virus was present in tears in two patients, researchers found. Twelve of 38 patients with COVID-19 had abnormalities involving the eye, such as conjunctivitis, chemosis, or swelling of the conjunctiva, or epiphora, an overflow of tears onto the face, reported Liang Liang, MD, of China Three Gorges University in Yichang, China, and colleagues. [Related Study]
Organized to fight the pandemic – Harvard Gazette To stem the coronavirus crisis, Harvard Medical School scientists forge ahead on six key fronts
Solving a medical mystery and changing CDC screenings for COVID-19 – Science Daily UC Davis Health physicians and medical staff detail the diagnosis and treatment for first known case of community transmission of COVID-19 in the US. The case reveals how the patient’s symptoms matched — and sometimes varied from — published studies of COVID-19 infection at the time.


Editor’s note: Regarding the case counts below, please consider due to limited testing capabilities in some locations, the real number of cases could be considerably higher.

Official Reporting for April 2, 2020

WHO SITREP #72 ECDC | Country Data Johns Hopkins
Confirmed Cases 823,626 853,200 941,949
Deaths 40,598 41,887 47,522


Total cases: 186,101
Total deaths: 3,603
Jurisdictions reporting cases: 54 (50 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands)

Travel Related: 1,110
Close Contact: 3,128
Under Investigation: 181,863
Total Cases: 186,101

Surveillance Headlines


California: COVID-19 patients in ICUs have quadrupled, hospitalizations have tripled in last six days – Mercury News

Illinois: Highest Single-Day Totals of Cases, Deaths – Local News

New York: A Month of Coronavirus in New York City: See the Hardest-Hit Areas – NYT

Texas and Florida: May be the next hot spots for COVID-19 – ABC News

Fort Lauderdale, Florida: Holland America cruise ships Zaandam and the Rotterdam with 200 sick passengers to dock – Sun Sentinal


Spain: Reports 6,256 new cases and 667 new deaths. – CIDRAP

Italy: Reported 4,782 more cases, total of 110,574. Also reported were 727 new deaths, lifting its world-highest fatality number to 13,115. CIDRAP

UK: Reported 4,323 more cases, up sharply from 3,009 reported yesterday. Also reported 563 more deaths. – CIDRAP

France: Reported 4,861 new cases. CIDRAP

Germany: Reported 5,971 new cases, up from nearly 5,000 reported yesterday. CIDRAP

Brussles: Brussels hospital network nearing maximum ICU capacity – Brussels Times


China: Jia county goes into coronavirus lockdown as country tries to get back to work amid fear of second wave – South China Morning Post


Science and Tech

Updates on NIAID Funding for SARS-CoV-2 and COVID-2019 Research – NIH Six weeks ago, we highlighted NIAID’s Urgent Notice of Special Interest (NOSI) inviting competitive revision supplement applications on severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) and coronavirus disease 2019 (COVID-2019) through NIH’s Urgent funding opportunity announcement (FOA). Refer to our February 19, 2020 article “NIAID’s Multi-Pronged Response to the COVID-2019 Outbreak.”

NASA issues agency-wide crowdsourcing call for ideas around COVID-19 response – Tech Crunch There’s crowdsourcing a problem, and then there’s crowdsourcing a problem within NASA, where some of the smartest, most creative and resourceful problem-solvers in the world solve real-world challenges daily as part of their job. That’s why it’s uplifting to hear that NASA has issued a call to its entire workforce to come up with potential ways the agency and its resources can contribute to the ongoing effort to fight the current coronavirus pandemic.

The long game: UVa researchers shift focus to COVID-19 – Daily Progress UVa laboratory leaders, building upon studies by researchers across the world, are working on possible vaccines, screening existing drugs for efficacy and studying the use of antibodies in fighting SARS-CoV-2, the novel coronavirus that causes the COVID-19 disease that has swept the globe.

Patients with SARS-CoV-2 Coronavirus Often Have Other Respiratory Viruses, Study Finds – Sci News About 1 in 5 patients infected with SARS-CoV-2, a new coronavirus that causes the COVID-19 disease, are also infected with other respiratory viruses, according to a preliminary analysis by the Stanford School of Medicine. In addition, the analysis found that about 1 in 10 people who exhibit symptoms of respiratory illness at an emergency department, and who are subsequently diagnosed with a common respiratory virus, are co-infected with SARS-CoV-2. The findings challenge the assumption that people are unlikely to have COVID-19 if they have another type of viral respiratory disease.


Australian scientists begin tests of potential vaccines – BBC The vaccines, made by Oxford University and US company Inovio Pharmaceutical, have been cleared for animal testing by the World Health Organization. Australia’s national science agency will assess if the vaccines work, and if they would be safe for humans.


Remdesivir Has Therapeutic Potential against SARS-CoV-2 Coronavirus – SciNews SARS-CoV-2 is easily transmissible because spike proteins on the virus’ surface bind exceptionally efficiently to angiotensin-converting enzyme 2 (ACE2) on the surfaces of human cells. A pilot clinical trial is underway in patients with severe COVID-19, investigating use of recombinant human ACE2 to act as decoys that would attach to spike proteins, disabling SARS-CoV-2’s mechanism for entry into human cells.


Detroit to be first to deploy Abbott Labs’ 5-minute COVID-19 test – Tech Crunch Detroit is on track to be the first city to deploy Abbott Labs’ five-minute COVID-19 test. The test would be available for first responders who are self-isolating but have yet to test positive for the virus.

Published Research

No Evidence of Rapid Antiviral Clearance or Clinical Benefit with the Combination of Hydroxychloroquine and Azithromycin in Patients with Severe COVID-19 Infection -Médecine et Maladies Infectieuses

COVID-19–associated Acute Hemorrhagic Necrotizing Encephalopathy: CT and MRI Features – Radiology

SARS-CoV-2 Readily Shed Early in Infection, Transmissible Before Symptoms Emerge – NEJM Journal Watch

Characteristics of Ocular Findings of Patients With Coronavirus Disease 2019 (COVID-19) in Hubei Province, China – JAMA Opthamology

Virological assessment of hospitalized patients with COVID-2019 – Nature

Pre-Pub (not yet peer reviewed, should not be regarded as conclusive)

SARS-CoV-2 infection in health care workers: a retrospective analysis and a model study – MedRXiv

Opinions & Editorials

These Coronavirus Exposures Might Be the Most Dangerous – NYT Li Wenliang, the doctor in China who raised early awareness of the new coronavirus, died of the virus in February at 34. His death was shocking not only because of his role in publicizing the developing epidemic but also — given that young people do not have a high risk of dying from Covid-19 — because of his age. Is it possible that Dr. Li died because as a doctor who spent a lot of time around severely ill Covid-19 patients, he was infected with such a high dose? After all, though he was one of the first young health care workers to die after being exposed up close and frequently to the virus, he was unfortunately not the last. [If you hit a paywall at the link, try here]


Coping in Quarantine

How To Safely Get Takeout In The Coronavirus Era – NPR

Dealing With Quarantine, Family-Style – Wired

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