Tulane Outbreak Daily | June 30, 2020

Featured Headlines

WHO Director-General’s opening remarks at the media briefing on COVID-19 – 29 June 2020 – WHO

Although a vaccine will be an important long-term tool for controlling COVID-19, there are five priorities that every single country must focus on now, to save lives now. First, empower communities. Every individual must understand that they are not helpless – there are things everyone should do to protect themselves and others. Your health is in your hands. That includes physical distancing, hand hygiene, covering coughs, staying home if you feel sick, wearing masks when appropriate, and only sharing information from reliable sources. You may be in a low-risk category, but the choices you make could be the difference between life and death for someone else. Second, suppress transmission. Whether countries have no cases, clusters of cases or community transmission, there are steps all countries can take to suppress the spread of the virus. Ensure that health workers have access to training and personal protective equipment.

Dr. Anthony Fauci says U.S. coronavirus outbreak is ‘going to be very disturbing,’ could top 100,000 new cases a day – NBC

The U.S. is “not in total control” of the coronavirus pandemic and daily new cases could surpass 100,000 new infections per day if the outbreak continues on its current trend, White House health adviser Dr. Anthony Fauci said Tuesday.

Worst could be yet to come, WHO warns – BBC

WHO head Tedros Adhanom Ghebreyesus said the virus would infect many more people if governments did not start to implement the right policies. His message remained “Test, Trace, Isolate and Quarantine”, he said. More than 10m cases have been recorded worldwide since coronavirus emerged in China late last year. The number of patients who died is now above 500,000. Half the world’s cases have been in the US and Europe but Covid-19 is rapidly growing in the Americas.

How the World Missed COVID-19’s Silent Spread – NYT

Symptomless transmission makes the coronavirus far harder to fight. But health officials dismissed the risk for months, pushing misleading and contradictory claims in the face of mounting evidence. [If link above does not work, try this]

‘Throwing a match at kindling’: Why a few people infect so many. – New York Times

Most infected people don’t pass on the coronavirus to someone else. But a small number pass it on to many others in so-called superspreading events. Transmission seems to happen in a narrow window of time starting a couple days after infection, even before symptoms emerge. Certain places seem to lend themselves to superspreading. A busy bar, for example, is full of people talking loudly. Any one of them could spew out viruses without ever coughing. And without good ventilation, the viruses can linger in the air for hours.

COVID Trials Threatened by Shifting Surges – MedPageToday

While COVID-19 has delayed and disrupted clinical trials across specialties, the trials aimed at disrupting the pandemic have struggled to keep up with the wild swings in epidemiology.

Studying SARS-CoV-2 spread in poultry and domestic animals – The Poultry Site

Many new human pathogens, including SARS-CoV-2, are known to originate in other species before entering human hosts, and so one frequently arising question about SARS-CoV-2 is whether the virus can infect non-human animals and, if so, what we should think or do about it. There have been a handful of reports on SARS-CoV-2 infection in domestic and zoo animals, so this question is not idle speculation. A recent report in Science sheds some light on how SARS-CoV-2 may affect non-human animals and provides a path for future research to benefit humans and animals alike.

Clinical Considerations

Do COVID-19 Symptoms Run Skin-Deep? – MedPageToday

Jury still out, as conflicting evidence for ‘COVID toes’ continues to emerge. Two small studies called into question early research suggesting that so-called “COVID toes” may be tied to coronavirus infection. [Related JAMA Study] [Another JAMA Study] [JAMA paper]

Does COVID Mess With the Menstrual Cycle? – MedPageToday

Women with COVID-19 report changes to their periods; estrogen’s potential protective effects being investigated

Researchers report nearly 300 cases of inflammatory syndrome tied to Covid-19 in kids – STAT

Two U.S. research groups have reported finding nearly 300 cases of an alarming apparent side effect of Covid-19 in children, a condition called multisystem inflammation syndrome, or MIS-C. While researchers have previously reported on the condition, the papers mark the first attempt to measure how frequently the side effect occurs and how it affects children who develop it. [Related NEJM Study]

Early Neonatal SARS-CoV-2 Infection Manifesting With Hypoxemia Requiring Respiratory Support – American Academy of Pediatrics

We describe a case of neonatal SARS-CoV-2 infection, in an infant diagnosed abstract 3 days after birth, and manifesting with silent hypoxemia, requiring respiratory support.

Cardiac Arrest and COVID-19 – FLARE

Early reports from China indicated very poor outcomes with cardiac arrest in COVID-19. These reports likely reflected a high prevalence of factors such as primary respiratory (as opposed to cardiac) arrest and out-of-ICU arrest, which were known to worsen prognosis in the pre-COVID-19 era. Cardiac arrest in COVID-19 does present unique infection control challenges which are addressed by national guidelines. Post-arrest care does not meaningfully differ from post-arrest care in the pre-COVID-19 era.

CDC Adds 3 New Symptoms to Coronavirus List – NBC

Congestion or runny nose, nausea or vomiting and diarrhea are now considered symptoms of COVID-19, according to the nation’s top health agency.


Official Reporting for June 30, 2020

World Health Organization


Confirmed Cases: 10,185,374

Deaths: 503,862


Confirmed Cases: 10,273,001

Deaths: 505,295

Johns Hopkins

Confirmed Cases: 10,365,963

Deaths: 507,014

Centers for Disease Control and Prevention (CDC)

Total cases: 2,581,229
Total deaths: 126,739

Surveillance Headlines


To Spot Future Coronavirus Flare-Ups, Search the Sewers – Scientific American

U.S.: ‘We are getting clobbered’: Six months into COVID-19, doctors fear what comes next – NBC

U.S.:As Coronavirus Surges, How Much Testing Does Your State Need To Subdue The Virus? – NPR

Arizona: Arizona Issues New Shutdown Order As Coronavirus Cases Spike – NPR

Michigan: More than 100 Covid-19 cases linked to Michigan bar – CNN

Texas: South Texas leaders plead for help to stop COVID-19 from ‘overwhelming’ hospitals – Border Report

Sacramento, California: Sacramento County Orders Bars To Close Again As Coronavirus Cases Spike – 13 News


Mexico: Mexicans offered little coronavirus aid as death and economic tolls climb – Axios

Brazil: Brazil coronavirus death toll reaches 58,314 – Reuters


Americans will remain barred from European travel as the EU gradually reopens its borders – CNBC


South Korea: South Korea Caught in Endless Coronavirus Whack-a-Mole – WSJ


Nigeria: Community leaders help drive COVID-19 testing in Nigeria’s Kano – WHO



Science and Tech

COVID-19 Relies on Cell’s ‘Master Regulators’ for Survival – UCSF

UC San Francisco scientists assembled an international research team that has figured out how SARS-CoV-2, the virus that causes COVID-19, hijacks proteins in host cells that serve as master regulators of key cellular processes. By doing so, the virus is able to rewire the cell’s internal circuitry to promote its own spread and survival. But the reliance of the virus on host-cell proteins may also prove to be its Achilles’ heel, as these same proteins can be easily targeted with existing drugs.

Lab-Grown ‘Mini-Brains’ Suggest COVID-19 Virus Can Infect Human Brain Cells – Johns Hopkins

A Johns Hopkins collaboration has demonstrated that the novel coronavirus, SARS-CoV-2, can infect and replicate within a human mini-brain model. [Related Study]

Even in the worst COVID-19 cases, the body launches immune cells to fight back – Medical Express

A new study from researchers at La Jolla Institute for Immunology (LJI) and Erasmus University Medical Center (Erasmus MC) shows that even the sickest COVID-19 patients produce T cells that help fight the virus. The study offers further evidence that a COVID-19 vaccine will need to elicit T cells to work alongside antibodies.


TED Talk | The Trials, Tribulations, and Timeline of COVID-19 Vaccine

Developing a vaccine usually takes five to 10 years, costs about a billion dollars and has a failure rate of 93 percent. Under the pressure of the coronavirus pandemic, scientists are being asked to speed that timeline up to 12 to 18 months, says Jerome Kim, director general of the International Vaccine Institute. How are things going? Kim updates us on the varied field of vaccine candidates and discusses the challenges of making sure the one that works gets distributed to the whole world. (This virtual conversation, hosted by head of TED David Biello, was recorded June 15, 2020.)

Engineers use “DNA origami” to identify vaccine design rules – MIT News

In lab tests, virus-like DNA structures coated with viral proteins provoke a strong immune response in human B cells.Beijing approves experimental Covid-19 vaccine for use in Chinese military – CNN

The Chinese government has approved the use of an experimental Covid-19 vaccine for the country’s military — the latest step in a global race to stop the deadly disease caused by the novel coronavirus.


Global COVID-19 prevention trial of hydroxychloroquine to resume – Reuters

A global trial designed to test whether the anti-malaria drugs hydroxychloroquine and chloroquine can prevent infection with COVID-19 is to restart after being approved by British regulators.

No clinical benefit from use of lopinavir-ritonavir in hospitalised COVID-19 patients studied in RECOVERY – Recoverytrial.com

In March 2020, the RECOVERY trial was established as a randomised clinical trial to test a range of potential treatments for COVID-19, including lopinavir-ritonavir (an antiviral treatment commonly used to treat HIV). Over 11,800 patients have been enrolled from 176 NHS hospitals in the UK.

Anti Virals

U.S. to Secure Enough Remdesivir for Half a Million COVID Patients – MedPageToday

Supply expected over coming months, priced at $3,120 for privately insured patients. Supplies of remdesivir will be allocated to states and territorial health departments based on data regarding the number of suspected or confirmed COVID-19 hospitalizations. Shipments are slated to begin in 2 weeks, and HHS will oversee allocation until the end of September. A senior health official said the administration has not yet decided which states would receive the first shipment.

Social/Psychological Impact

All the ways the coronavirus will make this school year harder than the last, even if campuses reopen – Washington Post

School communities desperate for normalcy are hoping that the new school year will be more stable than the last, when the coronavirus forced schools to close and launch remote learning overnight. But that seems like wishful thinking, as 2020-2021 is shaping up to be even more problematic.


Infection Prevention

COVID-19 and Air conditioning risks – MIT News

To date, all evidence shows that SARS CoV-2, the virus that causes COVID-19, spreads primarily during close person-to-person contact, transmitted from one individual to another through large respiratory droplets expelled when people cough, sing, breathe, or even talk. But scientists have also been concerned about the possibility of airborne or aerosol transmission. Aerosols are smaller, microscopic particles that can stay aloft and travel for longer distances. [Related Nature Paper]


Published Research

Digital tools against COVID-19: taxonomy, ethical challenges, and navigation aid – The Lancet

Infant Case of Co-infection with SARS-CoV-2 and Citrobacter koseri Urinary Infection – Oxford Academic

SARS-CoV-2 Detection, Viral Load and Infectivity over the Course of an Infection: SARS-CoV-2 Detection, Viral Load and Infectivity – Science Direct

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

Coping in Quarantine

Lessons from the History of Quarantine, from Plague to Influenza A – Emerging Infectious Diseases

A song for self isolation

Some art for Self Isolation

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