Shutdown orders prevented about 60 million novel coronavirus infections in the United States and 285 million in China, according to a research study published Monday that examined how stay-at-home orders and other restrictions limited the spread of the contagion. [Related Nature Study] [Imperial College London Study] [If Wash Post link does not work, try this]
The US government’s current supply of remdesivir, the only drug known to work against Covid-19, will run out at the end of the month, Dr. Robert Kadlec, a US Department of Health and Human Services official, told CNN. The government’s last shipment of the drug will go out the week of June 29. Gilead Sciences, the company that makes the drug, is ramping up to make more, but it’s unclear how much will be available this summer.
British cancer doctor Prof Karol Sikora recently claimed that the current COVID-19 pandemic would “burn itself out”. His thinking is that if there are more infections than we realize, and that those milder, unrecorded infections result in robust immunity, then this would quickly lead to “herd immunity”, leaving the virus nowhere to go but extinct. Extend this to the world’s population and the virus eradicates itself. But the idea that letting the virus run wild would protect us is unlikely to be valid. The antibody results coming in suggest that only a small proportion of people have been infected by SARS-CoV-2. In the UK, only an estimated 6.8% of people have had the virus; for France, the figure is just 4.4%.
See the criteria each used to get their economies back on track, and how that differs from federal guidance
Dramatic spikes in auto traffic around major hospitals in Wuhan last fall suggest the novel coronavirus may have been present and spreading through central China long before the outbreak was first reported to the world, according to a new Harvard Medical School study. [Related Harvard Study]
Asia was the first place to experience the coronavirus, impose lockdowns and then emerge from them. It was also the first to experience new groups of infections, with clusters from nightclubs in Seoul, the Russia-China border, and elsewhere. Although it is early for conclusions, can lessons be learned?
Test used to look for hypocoagulability accurate for hypercoagulation events in study. Hypercoagulability on thromboelastography (TEG) was a good predictor of thrombotic events among COVID-19 patients entering the ICU. [Related Study JAMA]
Kidney injury in COVID-19 patients may be caused not only directly by the virus, but also indirectly and APOL1 gene variants may increase the risk. [Related Italian Study]
More than half of COVID-19 patients admitted to two hospitals in Spain developed some form of neurologic symptoms. [Related Neurology Study]
A major study of coronavirus infection in human airways adds to evidence that wearing a mask is an important protective step toward limiting transmission of COVID-19. [Related Study]
After five days on a ventilator because of covid-19, Susham “Rita” Singh seemed to have turned a corner. Around midnight on April 8, doctors at Houston Methodist Hospital turned off the sedative drip that had kept the previously healthy 65-year-old in a medically induced coma. “The expectation is that you should start waking up after six hours, 12 hours or a day,” said her daughter, Silky Singh Pahlajani, a neurologist in New York City. “But it was six-and-a-half days before she started … opening her eyes. I thought she had suffered a massive stroke. [If Wash Post link above does not work, try this one]
Researchers from Yale School of Medicine have discovered that a low blood level of an enzyme called renalase is associated with severe coronavirus disease 2019 (COVID-19). The team says the findings suggest that renalase, which has potent anti-inflammatory effects, could serve as a useful biomarker for identifying patients with more severe disease. They also point towards a potential mechanism underlying the pathology involved in COVID-19. [Related pre-print]
Different or Shared Etiology and Pathophysiology as Kawasaki Disease? The pediatric inflammatory multisystem syndrome (PIMS) now described in association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has generated considerable interest, both for its severity and delayed emergence in an age group largely spared the complications of primary infection, but also for its overlapping clinical features with Kawasaki disease (KD), the leading cause of acquired heart disease in children in high-income countries.1 This has prompted considerable discussion that the 2 conditions could have different or shared etiologic and pathophysiologic pathways.
The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends. Hours after British Prime Minister Boris Johnson instated stringent social-distancing measures to halt the SARS-CoV-2 coronavirus, LeClerc, a Glasgow-based journalist, arrived home feeling shivery and flushed. Over the next few days, she developed a cough, chest pain, aching joints, and a prickling sensation on her skin. After a week of bed rest, she started improving. But on day 12, every old symptom returned, amplified and with reinforcements: She spiked an intermittent fever, lost her sense of taste and smell, and struggled to breathe.
Official Reporting for June 8, 2020
|WHO SITREP #139||ECDC||Johns Hopkins|
- Knowledge and Practices Regarding Safe Household Cleaning and Disinfection for COVID-19 Prevention — United States, May 2020 (MMWR)
- First Reported Cases of SARS-CoV-2 Infection in Companion Animals — New York, March–April 2020 (MMWR)
Total deaths: 110,375
New York City: After Lockdown And Unrest, New York City Begins Reopening During Pandemic – NPR
Arizona: Arizona COVID-19 hospitalization data shows record-high metrics – AZ News
Oregon: Oregon Reports Highest Daily Coronavirus Count Since Start Of Pandemic – Oregon News
Houston, Texas:COVID-19 Hospitalizations, Cases Going Up In Houston Area – Houston Public Media
Washington DC: Hundreds Of Positive COVID-19 Cases At D.C.’s Children’s National Hospital – NPR
California: Coronavirus Jumps the Border, Overwhelming Hospitals in California – NYT
New Zealand: With No Current Cases, New Zealand Lifts Remaining COVID-19 Restrictions – NPR
India: India Reopens Public Places Even As Coronavirus Cases Rise – NPR
Singapore: Half of Singapore’s new COVID-19 cases are symptomless – Reuters
Brazil: In a Coronavirus free fall – NYT
Brazil: Brazil stops releasing Covid-19 death toll and wipes data from official site – Guardian
Brazil: Brazil Surpasses Italy in Coronavirus Deaths; Toll Tops 34,000 – Bloomberg
Science and Tech
OUR SMARTPHONES ARE set to play a significant role in helping navigate our way out of the coronavirus pandemic, with countries and companies around the world preparing their own apps as part of a track-and-trace system to keep infection levels low.
The public has known for months now about two efforts at the University of Pittsburgh to create a vaccine that would help end the worldwide COVID-19 pandemic and get us back to normal.
Patients with severe COVID-19 have a hyperinflammatory immune response suggestive of macrophage activation. Bruton tyrosine kinase (BTK) regulates macrophage signaling and activation. Acalabrutinib, a selective BTK inhibitor, was administered off-label to 19 patients hospitalized with severe COVID-19 (11 on supplemental oxygen; 8 on mechanical ventilation), 18 of whom had increasing oxygen requirements at baseline. Over a 10-14 day treatment course, acalabrutinib improved oxygenation in a majority of patients, often within 1-3 days, and had no discernable toxicity. Measures of inflammation – C-reactive protein and IL-6 – normalized quickly in most patients, as did lymphopenia, in correlation with improved oxygenation. At the end of acalabrutinib treatment, 8/11 (72.7%) patients in the supplemental oxygen cohort had been discharged on room air, and 4/8 (50%) patients in the mechanical ventilation cohort had been successfully extubated, with 2/8 (25%) discharged on room air. Ex vivo analysis revealed significantly elevated BTK activity, as evidenced by autophosphorylation, and increased IL-6 production in blood monocytes from patients with severe COVID-19 compared with blood monocytes from healthy volunteers. These results suggest that targeting excessive host inflammation with a BTK inhibitor is a therapeutic strategy in severe COVID-19 and has led to a confirmatory international prospective randomized controlled clinical trial.
End of the Road for HCQ in COVID-19? – MedPageToday
No indication of survival benefit was found for hydroxychloroquine (HCQ) in hospitalized COVID-19 patients in a large randomized trial
This document provides advice on the use of masks in communities, during home care, and in health care settings in areas that have reported cases of COVID-19. It is intended for individuals in the community, public health and infection prevention and control (IPC) professionals, health care managers, health care workers (HCWs), and community health workers. This updated version includes a section on Advice to decision makers on the use of masks for healthy people in community settings.
Virus DNA left on a hospital bed rail was found in nearly half of all sites sampled across a ward within 10 hours and persisted for at least five days, according to a new study by UCL and Great Ormond Street Hospital (GOSH).
In the early months of 2020, millions of workers worldwide were laid off as the Covid-19 pandemic shuttered entire industries. Yet not all industries suffered contractions: the healthcare sector, for instance, saw demand grow, as did schools, in some parts of the world, and online retail. Under normal conditions, workers constantly shift between different industries, albeit at a slow pace. However, the Covid-19 pandemic created an urgent need to make labor shifts happen much more quickly.
Thromboelastographic Results and Hypercoagulability Syndrome in Patients With Coronavirus Disease 2019 Who Are Critically Ill – JAMA
Indirect effects of severe acute respiratory syndrome coronavirus 2 on the kidney in coronavirus disease patients – Clinical Kidney Journal
Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19) – Infection Control and Hospital Epidemiology
Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry – Neurology
Virus DNA spread across surfaces in hospital ward over 10 hours –
Analysis of hospital traffic and search engine data in Wuhan China indicates early disease activity in the Fall of 2019 – Harvard Univesity
SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart – Heart, Lung, and Circulation
Pre-Pub (not yet peer reviewed, should not be regarded as conclusive)
Coping in Quarantine
An epidemiologist points to new stresses in the U.S. mental health system that may persist from the novel coronavirus pandemic
A few weeks ago, BBC asked for lockdown confessions. It turns out some of you have a lot to get off your chest. We’ve all had to sacrifice a lot while being stuck indoors. Some of you have new guilty secrets you wanted to share. And some of you have engaged in rule-breaking while others were behaving themselves.