Tulane Outbreak Daily | June 25 2020

Featured Headlines

The Pandemic’s Worst-Case Scenario Is Unfolding in Brazil – Bloomberg

Overflowing hospitals. Widespread corruption. And a chloroquine-obsessed populist in charge. On a recent afternoon in São Luís, the capital of Maranhão state in northeastern Brazil, Hosana Lima Castro sat on a flimsy plastic chair in front of her house as stray dogs sniffed potholes in the narrow street and a few neighborhood kids launched kites. The bar across the way, where a few months ago an acquaintance of Castro’s had been shot, was closed because of the pandemic.

Dr. Fauci Discusses Recent COVID-19 Spikes In Several States – NPR

11 Min Audio at link – NPR’s Rachel Martin talks to Dr. Anthony Fauci, head of infectious diseases at the National Institutes of Health. Fauci told Congress yesterday he’s worried about the recent coronavirus surge.

Pandemic Rages in the U.S., Spurring Quarantines and Mask Orders – Bloomberg

The Covid-19 pandemic is tearing through the U.S. heartland, setting records for hospitalizations and forcing businesses to rethink their plans to reopen as new modeling predicts the virus will kill 180,000 Americans by October.

COVID-19: ‘Nowhere Near the End of the Mitigation Phase’ – MedPageToday

This is not “the pandemic of a century” but “a harbinger of things to come.” The warning from Julie Gerberding, MD, MPH, now executive vice president and chief patient officer for Merck, underscored the need for a “health security agenda,” comprising both sustained leadership and funding, as well as clear communication and coordination, she said.

COVID-19 demands intensify efforts to ease oxygen shortages – CIDRAP

A steady, steep rise in COVID-19 activity has left many nations, especially lower-income countries, with shortages of medical oxygen, which plays a vital role in treating patients, and efforts are under way to boost supplies, the head of the World Health Organization (WHO) said today.

Joint Statement from USDA and FDA on Food Export Restrictions Pertaining to COVID-19 – FDA.gov

“The United States understands the concerns of consumers here domestically and around the world who want to know that producers, processors and regulators are taking every necessary precaution to prioritize food safety especially during these challenging times. However, efforts by some countries to restrict global food exports related to COVID-19 transmission are not consistent with the known science of transmission.”

“Smart Lockdowns” Are the Future in Europe – Bloomberg

Germany, Italy and Portugal are betting on smaller, local shutdowns to prevent a new surge of coronavirus infections. European Union countries are experimenting with new ways of dealing with the coronavirus. Germany, Portugal and Italy have all enforced selective or “smart” lockdowns, shutting down smaller regions in response to new outbreaks as opposed to bringing their entire countries to a halt.

Clinical Considerations

Study Raises Concerns for Pregnant Women With the Coronavirus – New York Times

Pregnant women who are infected wind up in hospitals and I.C.U.’s at higher rates, a federal analysis suggests. But the data is far from conclusive. [Related Study]

Study confirms ‘classic’ symptoms of COVID-19 – Science Daily

A persistent cough and fever have been confirmed as the most prevalent symptoms associated with COVID-19, according to a major review of the scientific literature.

Cytokines May Be An Indication Of Susceptibility To SARS-CoV-2 – Fisher Scientific

Adverse events from SARS-CoV-2 infection may be due to an overactive immune response from your own body and not from the actual virus itself. Studies indicate that severe infections may arise due to an abnormal response from your immune system, resulting in greater susceptibility to complications such as lower respiratory tract infections and other possible side effects.

Distinct Phenotype of Pancreatitis Observed in Patients with SARS-CoV-2 Infection – Infectious Disease Advisor

Sever acute respiratory syndrome coronavirus 2 (SARS-CoV-2)-associated pancreatitis may represent a distinct phenotype of pancreatitis characterized by metabolic stress, abdominal pain, and specific patterns of inflammation, according to results from a case series study published in Gastroenterology.

Official Reporting for June 25, 2020

WHO SITREP #156 ECDC Johns Hopkins
Confirmed Cases 9,129,146 9,400,295 9,295,365
Deaths 469,587 482,468 473,797


Total cases: 2,336,615
Total deaths: 121,117
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines


USA: U.S. hits highest single day of new coronavirus cases with more than 45,500, breaking April record – NBC

California: California breaks coronavirus records. Gatherings in homes may fuel spread as more young people get sick – CNN

Minnesota: Cluster of COVID-19 cases in southern Minnesota tied to reopened bars – Star Tribune

Georgia: Nurses Say Georgia Hospital Tried to Cover Up COVID Cases – MedPageToday

Wisconsin: Biggest Number of New COVID-19 Cases in Three Weeks – Urban Milwaukee

Arkansas: OVID-19 deaths are accelerating in Arkansas – Local News

Texas: Gov Says Texas Facing ‘Massive’ COVID-19 Outbreak – Dallas News

Ohio: COVID-19 cases surge to highest levels in Greater Cincinnati; leaders urge everyone to wear masks – Cincinnati.com

North Carolina: State sees second-highest increase of daily confirmed cases – WLOS News


Sweden: Swedish Expert Who Doubted Face Masks Reconsiders Their Use – Bloomberg


India: As Delhi becomes India’s coronavirus capital, its hospitals are struggling to cope – CNN



South Africa: Rolls out continent’s first trials for COVID-19 vaccine – Reuters


Brazil: Begins testing Oxford coronavirus vaccine – Medical Express

Mexico: Important Facts About The Spread Of Coronavirus In Mexico City – Forbes

Science and Tech

MIT Researchers Design Experimental Peptide That Targets and Destroys COVID-19 – Sci Tech Daily

Using computational models of protein interactions, researchers at the MIT Media Lab and Center for Bits and Atoms have designed a peptide that can bind to coronavirus proteins and shuttle them into a cellular pathway that breaks them down.

A Virus Study You’ve Never Heard of Helped Us Understand COVID-19 – Smithsonian

What Columbia University researchers learned when they tried to get a complete picture of how respiratory viruses spread across Manhattan. Virus studies tend to be passive, not proactive. People get tested when they show up for treatment. But that paints only a partial picture of infections, one that misses those who are infected and spreading the disease but don’t go to the doctor.


CDC and drugmakers boost flu vaccine doses amid fears of an unprecedented respiratory illness season – Washington Post

Worried about a simultaneous assault of the novel coronavirus and seasonal influenza this winter, public health officials and vaccine manufacturers are making millions of extra flu vaccine doses to protect those most vulnerable to the pandemic and influenza, according to government and company officials.

Human trial of new vaccine begins in UK – BBC

About 300 people will have the vaccine over the coming weeks, as part of a trial led by Prof Robin Shattock and his colleagues, at Imperial College London.


Colchicine Shows Promise in COVID-19 Patients, With Caveats – MedPageToday

Hospitalized patients with COVID-19 who received colchicine, an anti-inflammatory drug traditionally used to treat gout and rheumatic disease, had improved time to clinical deterioration versus standard of care, a randomized open-label trial from Greece found.

Tocilizumab in patients with severe COVID-19: a retrospective cohort study – The Lancet

Of 1351 patients admitted, 544 (40%) had severe COVID-19 pneumonia and were included in the study. 57 (16%) of 365 patients in the standard care group needed mechanical ventilation, compared with 33 (18%) of 179 patients treated with tocilizumab (p=0·41; 16 [18%] of 88 patients treated intravenously and 17 [19%] of 91 patients treated subcutaneously). 73 (20%) patients in the standard care group died, compared with 13 (7%; p<0·0001) patients treated with tocilizumab (six [7%] treated intravenously and seven [8%] treated subcutaneously). After adjustment for sex, age, recruiting centre, duration of symptoms, and SOFA score, tocilizumab treatment was associated with a reduced risk of invasive mechanical ventilation or death (adjusted hazard ratio 0·61, 95% CI 0·40–0·92; p=0·020). 24 (13%) of 179 patients treated with tocilizumab were diagnosed with new infections, versus 14 (4%) of 365 patients treated with standard of care alone (p<0·0001).

Statin use is linked to lower death rate in hospitalized COVID-19 patients – Medical Express

The use of cholesterol-lowering drugs called statins is associated with a lower death rate and a lower incidence of mechanical ventilation in patients hospitalized with Coronavirus disease 2019 (COVID-19), researchers report June 24 in Cell Metabolism. The large-scale retrospective study also showed that mortality risk and other negative outcomes were not increased by combination therapy consisting of statins and blood pressure-lowering drugs called angiotensin-converting enzyme (ACE) inhibitors and angiotensin II receptor blockers (ARBs).

Social/Psychological Impact

COVID’s Drain on Mental Health; Struggle for New Moms – MedPageToday

Mass quarantine and social isolation lead to increased use of social media and other information-based websites, which in turn increases fear, stress, and the risk of fear-related disorders,” researchers said in a JAMA Psychiatry viewpoint this week. [Related Study]

(Opinion) What’s Really Behind the Gender Gap in Covid-19 Deaths? – New York Times

More men than women are dying of Covid-19. The numbers are striking. In Italy, men in their 50s died at four times the rate of women in their 50s. Globally, twice as many men than women may be dying of Covid-19.

Infection Prevention

Asymptomatic Coronavirus Carriers Can Shed Virus on Surfaces: Study – HealthDay

COVID-19 patients with no symptoms are as likely as those with symptoms to contaminate many surfaces in their rooms, researchers report. The investigators sampled the surfaces and air of six negative pressure non-intensive care unit rooms with 13 laboratory-confirmed COVID-19 patients — two of whom had no symptoms — who had returned from overseas and were in an isolation ward in Chengdu, China. In a negative pressure room, a machine pulls air into the room and then filters that air before moving it outside. [Related Study]

Mask wearing in pre-symptomatic patients prevents SARS-CoV-2 transmission: An epidemiological analysis – Travel Medicine and Infectious Disease

Pandemic COVID-19 has become a seriously public health priority worldwide. Comprehensive strategies including travel restrictions and mask-wearing have been implemented to mitigate the virus circulation. However, detail information on community transmission is unavailable yet.

Master List Of U.S. Airline Seating And Mask COVID-19 Policies – Forbes

Flying now doesn’t look like it ever has before. Airports are receiving only a fraction of the travelers compared to the same time last year and some eateries and other businesses are closed. The experience in-flight is different, too. Nearly all airlines require masks onboard and most have announced stringent cleaning protocols as well.

Strategic National Stockpile Needs Overhaul – MedPageToday

The Strategic National Stockpile (SNS) needs a new name and a clear mission, Sen. Ron Johnson (R-Wis.), chairman of the Senate Committee on Homeland Security & Governmental Affairs, said Wednesday. “We absolutely have to change the name of the Strategic National Stockpile — it’s misleading,” Johnson said at a committee hearing on the stockpile’s role in the pandemic response. “We do have to stockpile some things but this is more of a coordinating role. We really rely on local governments to do what they can do first; when they can’t handle it, the state steps in; when they can’t handle it, the national government steps in … We need a new name because otherwise we’ll continue to mislead people and have them believe that literally, there’s all this PPE [personal protective equipment] just sitting there stockpiled and why don’t we have our fair share? Why can’t you supply us with everything we need? We simply don’t have the supplies to meet the enormous demand in this kind of situation.”


Published Research

Tocilizumab in patients with severe COVID-19: a retrospective cohort study – The Lancet

Clinical course of severe and critical COVID-19 in hospitalized pregnancies: a US cohort study – American Journal of Obstetrics & Gynecology

Asymptomatic COVID-19 Patients Can Contaminate Their Surroundings: an Environment Sampling Study – ASM

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

Emerging phenotype of SARS-CoV2 associated pancreatitis – Gastroenterology

Coping in Quarantine

One of the hardest things during this pandemic — for kids and adult children — has been staying away from their parents and grandparents. People 65 years and older are at higher risk for getting a severe case of COVID-19, according to the Centers for Disease Control and Prevention. And about 80% of deaths in the U.S. from COVID-19 have been in people older than 65.

What to Watch in While Isolating

Available for free until July 1, 2020. The Black Death: The World’s Most Devastating Plague

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