Tulane Outbreak Daily | June 12, 2020

Featured Headlines

Glass vial makers prepare for COVID-19 vaccine – Reuters

Drugmakers are warning of a potential shortage of vials to bottle future COVID-19 vaccines, but their rush to secure supplies risks making matters worse, some major medical equipment manufacturers warn.

COVID-19 and flu, a perfect storm – Science

The world is in uncharted waters for the 2020 respiratory virus season. For the first time in modern history, the Northern Hemisphere faces the prospect of the coronavirus disease 2019 (COVID-19) pandemic and a simultaneous epidemic of seasonal influenza. Each causes life-threatening illness and death, especially in older adults, people with chronic diseases, and other vulnerable populations. How can we prepare for this convergence?

Coronavirus task force fades from view as Trump White House moves on – ABC

The White House coronavirus task force had already faded from public view as the administration pivots from public health to the economy, but as President Donald Trump and Vice President Mike Pence openly shifted into campaign mode this month they have also openly flouted the advice of top administration health officials.

Models show rising US COVID-19 cases, deaths in months ahead – CIDRAP

With more than 2 million cases of COVID-19 detected in the United States, public health experts are revising models meant to guide and inform the public on what the next few months of battling the global pandemic will look like.

It’s not going to magically disappear’: Harvard doctor expects COVID-19 deaths will rise to 200,000 in September – Boston.com

Dr. Ashish Jha, director of the Harvard Global Health Institute, told CNN’s Chris Cuomo on Wednesday that at the moment, the country sees between 800 and 1,000 deaths every day from COVID-19 and the models he’s seen suggest that there will be increases in the coming months.

Disaster looms for indigenous Amazon tribes as COVID-19 cases multiply – National Geographic

Indigenous communities in Brazil suffer from the virus on one hand and “genocidal” interlopers on the other, rights groups say.

Tracking The Pandemic: Are Coronavirus Cases Rising Or Falling In Your State? – NPR

Clinical Considerations

More Calls for Routine VTE Prophylaxis in Severe COVID-19 – MedPageToday

Given the coagulopathy that often complicates severe COVID-19 illness, certain best practices should be followed for venous thromboembolism (VTE) prevention and treatment, even if data to inform these decisions are scarce, experts said.

More Evidence for Remdesivir’s Benefit in Severe COVID-19 – MedPageToday

There was no significant difference in clinical improvement when the antiviral drug remdesivir was administered for 5 days or 10 days in hospitalized patients with severe COVID-19, according to a randomized phase III trial. Note that the evidence of benefit for remdesivir is clearest for patients in the early stages of severe disease. [Related Study]

New-Onset Diabetes in Covid-19 – NEJM

There is a bidirectional relationship between Covid-19 and diabetes. On the one hand, diabetes is associated with an increased risk of severe Covid-19. On the other hand, new-onset diabetes and severe metabolic complications of preexisting diabetes, including diabetic ketoacidosis and hyperosmolarity for which exceptionally high doses of insulin are warranted, have been observed in patients with Covid-19.1-3 These manifestations of diabetes pose challenges in clinical management and suggest a complex pathophysiology of Covid-19–related diabetes.

Emerging Phenotype of SARS-CoV2–Associated Pancreatitis – Practice Update

As the global pandemic of severe acute respiratory syndrome coronavirus 2 (SARS-CoV2) continues, nuances of the disease it precipitates in humans continue to emerge. Following early reports of presentation with gastro-intestinal-type symptoms in China1 and Italy2, a group from Wuhan reported a series of 9 patients with purported pancreatic injury in the context of SARS-CoV2 infection3, but did not provide robust evidence for pancreatitis relying on mild hyperamylasaemia alone. Current international consensus for a diagnosis of acute pancreatitis requires two of the following three features: 1) Abdominal pain consistent with pancreatitis; 2) Serum amylase/lipase greater than 3 times the upper limit of normal and 3) Characteristic findings on cross sectional imaging4. Simply put, there are too many causes for hyperamylasaemia in the context of systemic illness, with or without SARS-CoV2, for its use in isolation as a marker of pancreatic injury. None the less, we report here 5 cases of atypical but proven acute pancreatitis in the context of SARS-CoV2 infection.

Higher SARS-CoV-2 Viral Load, Less Severe Disease Reported in Symptomatic Infants – Infectious Disease Advisor

Infants were found to have higher SARS-CoV-2 nasopharyngeal viral loads at presentation but developed less severe disease compared with older children and adolescents, according to the results from a report published as a letter to the editor in Clinical Infectious Diseases.

WHO has published a rapid advice guidance on the Use of chest imaging in COVID-19 – WHO

The guide examines available evidence and makes recommendations for the use of radiography, computed tomography and ultrasound for acute care of adult patients with suspected, probable or confirmed COVID-19 at different levels of disease severity.

Official Reporting for June 12, 2020

WHO SITREP #144 ECDC Johns Hopkins
Confirmed Cases 7,410,510 7,481,063 7,570,801
Deaths 418,294 421,190 422,981


Total cases: 2,016,027
Total deaths: 113,914
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines


Rhode Island: RI sees uptick in new COVID-19 cases, hospital admissions, positivity rate – Rhode Island News

Orange County, California: Drops mandatory face-covering policy – New York Times

Arizona: Spike In Coronavirus Cases As Top Health System Runs Low On ICU Beds – NPR

Florida: Florida migrant towns become coronavirus hot spots in US – ABC News

Oregon: Oregon Health Authority reports largest single-day increase in COVID-19 cases – Local News

Alabama: Alabama reports record single-day increase in COVID-19 cases, total hospitalizations – ABC News


Why South Africa’s coronavirus outbreak could be a ‘catalyst for transformation’ – National Geographic

The three-point line and bleachers are the first signs that Khayelitsha Field Hospital is atypical. Once a community sports hall, there are now roughly 60 hospital beds lining center court. Jerseys have been swapped for face masks, visors, and green scrubs, which the medical staff wear to tend to COVID-19 patients.



Yemen: Coronavirus death rates in Yemen’s Aden could exceed its wartime fatalities – CNN


The Coronavirus Is Spreading Through Indigenous Amazon Communities – NPR


Science and Tech







Coronavirus Can Set Off a ‘Cytokine Storm.’ These Drugs May Calm It. – New York Times

At least a dozen treatments are being evaluated for virus patients whose immune systems go on the attack. Many coronavirus patients seem to get better at first, then rapidly decline and are overtaken by an overwhelming immune response that causes the body to turn on itself. [If the link above does not work, try this]

Infection Prevention

How The Widespread Mask Use Could Slow The Coronavirus Pandemic – NPR

NPR’s Mary Louise Kelly talks with Dr. Atul Gawande, a staff writer for the New Yorker, about the efficacy of different face masks and why masks remain essential in dealing with the coronavirus.


Published Research

Natural History of Asymptomatic SARS-CoV-2 Infection – NEJM

Remdesivir for 5 or 10 Days in Patients with Severe Covid-19 – NEJM

Transmission and clinical characteristics of asymptomatic patients with SARS-CoV-2 infection – future virology

Symptomatic Infants have Higher Nasopharyngeal SARS-CoV-2 Viral Loads but Less Severe Disease than Older Children – Clinical Infectious Diseases

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

Coping in Quarantine

He was a Covid-19 patient. She cleaned his hospital room. Their unexpected bond saved his life – CNN

The first thing Rosaura Quinteros noticed was his fear. The man lay alone in his pressurized room at Dr. P. Phillips Hospital in Orlando. He had a severe case of Covid-19, and it looked like he was losing the battle.

Quarantined cruise ship employee creates incredible outfits out of paper bags – CNN

Australian dancer Ashleigh Perrie was thrilled to start working on board the MS Zaandam. The cruise ship was due to travel through Antarctica — past penguins and sea lions — and onward to South America, while Perrie spent her days doing what she loved: performing.

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