Tulane Outbreak Daily – July 8, 2020

Featured Headlines

As Coronavirus Cases Top 3 Million, Fauci Warns Against Misreading a Falling Death Rate – New York Times

Dr. Fauci cautioned on Tuesday that it was a “false narrative to take comfort in a lower rate of death,” as the U.S. surpassed three million cases on Tuesday, and some states that had hoped to be getting back to normal by now have instead been forced to reinstate restrictions and issue mandatory mask orders.

Protective gear for medical workers begins to run low again – AP

The personal protective gear that was in dangerously short supply during the early weeks of the coronavirus crisis in the U.S. is running low again as the virus resumes its rapid spread and the number of hospitalized patients climbs.

WHO acknowledges ’emerging evidence’ of airborne spread of COVID-19 – NBC

The agency said it will release a scientific brief on all modes of transmission in the coming days. Speaking at a briefing in Geneva, Dr. Benedetta Allegranzi, a WHO expert, said the organization believed it had “been open to the evidence on modes of transmission” of the new virus.

HHS Announces ‘Surge Testing’ Sites in Florida, Louisiana, and Texas – MedPageToday

HHS hopes to perform 5,000 tests per day for 5-12 days in: Jacksonville, Florida; Baton Rouge, Louisiana; and Edinburg, Texas, a suburb of McAllen in the Rio Grande valley — to try to find asymptomatic people with COVID-19 and help to dampen the spread of the illness.

Churches Were Eager to Reopen. Now They Are a Major Source of Coronavirus Cases – New York Times

The virus has infiltrated Sunday services, church meetings and youth camps. More than 650 cases have been linked to reopened religious facilities. Pastors and their families have tested positive, as have church ushers, front-door greeters and hundreds of churchgoers. In Texas, about 50 people contracted the virus after a pastor told congregants they could once again hug one another. In Florida, a teenage girl died last month after attending a youth party at her church.

Clinical Considerations

COVID-19 Lungs May Be More Likely to Leak – MedPageToday

Pneumothorax and other barotrauma was more common in COVID-19 patients on invasive mechanical ventilation than seen for other patients on ventilators, a retrospective study showed. [Related study in Radiology]

My Covid-19 symptoms have lasted more than 100 days, and I’m not alone. Will they ever end? – STAT

In the early days, as my symptoms fluctuated, I was determined not to go to the emergency department or urgent care because it seemed like there were too many people who needed the help more than I did. Maybe I was especially sensitive to overcrowding in emergency departments because I’m a physician. But it turns out that this strategy was a common one.

Increase in delirium, rare brain inflammation and stroke linked to COVID-19 – Medical Express

Neurological complications of Covid-19 can include delirium, brain inflammation, stroke and nerve damage, finds a new UCL and UCLH-led study. [Related Study in Brain Journal]

Could Hospitalized COVID-19 Patients Benefit From a Gout Drug? – MedPageToday

-Improved time to clinical deterioration seen with colchicine merits further study. In the absence of vaccines or other game-changers to stem the climbing global COVID-19 death toll, researchers are now looking towards multidimensional treatment approaches aimed at interrupting COVID-19’s chain reaction toward acute respiratory distress syndrome (ARDS).

U.K. Study Provides ‘Snapshot’ of COVID Brain Complications -MedPageToday

49% of patients with altered mental status were under the age of 60. The multiple organs on which COVID-19 wreaks havoc in the body includes the brain. While this does not mean that every COVID-19 patient will suffer from brain complications, there have been reports of neurologic symptoms in a small case series of patients in Wuhan, China, as well as from a small study in France, which reported neurologic and psychiatric manifestations associated with the disease. [Related Study Lancet Psychiatry]

Rare neurological disorder, Guillain-Barre Syndrome, linked to COVID-19 – The Conversation

The patient in the case report (let’s call him Tom) was 54 and in good health. For two days in May, he felt unwell and was too weak to get out of bed. When his family finally brought him to the hospital, doctors found that he had a fever and signs of a severe infection, or sepsis. He tested positive for SARS-CoV-2, the virus that causes COVID-19 infection. In addition to symptoms of COVID-19, he was also too weak to move his legs.

Popular Heartburn Drugs Linked to Heightened COVID-19 Risk – Time Magazine

In the study, published Tuesday in pre-print form in the American Journal of Gastroenterology, scientists led by Cedars-Sinai Medical Center’s Dr. Brennan Spiegel conducted an online survey involving more than 86,000 people. Among them, more than 53,000 reported abdominal pain or discomfort, acid reflux, heartburn or regurgitation, and answered questions about the medications they took to relieve those symptoms. Of those, more than 3,300 tested positive for COVID-19. [Related pre-print from American Journal of Gastroenterology]

Intact Brain Network Function in an Unresponsive Patient with COVID ‐19 – Annals of Neurology

Despite prolonged unresponsiveness and structural brain injury, a 47-year-old patient with severe COVID-19 showed intact brain network function and eventually was able to follow commands.

 

Official Reporting for July 8, 2020

World Health Organization

SITREP #170

Confirmed Cases: 11,669,259

Deaths: 539,906

ECDC

Confirmed Cases: 11,801,805

Deaths: 543,902

Johns Hopkins

Confirmed Cases: 11,896,251

Deaths: 545,618

Centers for Disease Control and Prevention (CDC)

Total cases: 2,982,900
Total deaths: 131,065

Surveillance Headlines

UNITED STATES

Texas: Reports more COVID-19 cases in single day than any EU country as cases rise by 10,000 – Reuters

Mississippi: At least 8 Mississippi lawmakers test positive for COVID-19 – ABC News

California: Breaks record with more than 9,000 new coronavirus cases in a day – SF Chronicle

Florida: Invited the nation to its reopening — then it became a new coronavirus epicenter – Washington Post

Alabama: Dr. Anthony Fauci: ‘Risky behavior’ in Alabama amid coronavirus pandemic – 15NBC

Oregon: COVID-19 cases steadily rise among Oregonians in their 20s – Oregonlive

North Carolina: COVID-19 hospitalizations set another record in NC – News Observer

Utah: Gov. Herbert considering statewide mask mandate after hospital officials say they are ‘alarmed’ by growing COVID-19 caseload – DeseretNews

Washington State: Washington state coronavirus hospitalizations on the rise, but still far below peak – Seattle Times

Atlanta, Georgia: Atlanta Mayor To Order Masks To Be Worn In Public Spaces – NPR

EUROPE

Italy: Has Italy Beaten COVID-19? – MedPageToday

LATIN AMERICA

Brazil: Sick With Covid, Brazil’s Bolsonaro Defends His Virus Approach – Bloomberg

ASIA

Hong Kong: Reports 19 Local Virus Cases as Resurgence Fears Grow – Bloomberg

Science and Tech

Experts say COVID’s airborne transmission may deserve more attention – Popular Science

Researchers who study tiny aerosols are concerned that the role of these particles is being downplayed in public health communication. Virologists and other scientific experts still know relatively little about SARS-CoV-2, the virus that causes COVID-19. But the ever-growing body of evidence about how the virus is transmitted suggests that tiny airborne particles, commonly known as aerosols, play a big role in spreading the microbe around. Researchers who study this area are concerned that the role of these aerosols is being downplayed in public health communication. This affects the recommendations public health officials are giving out in regards to how individuals and larger systems should be changing their behaviors as the pandemic continues to spread. [Related Letter in Clinical Infectious Diseases]

Researchers Create Air Filter that Can Kill the Coronavirus – University of Houston

The researchers reported that virus tests at the Galveston National Laboratory found 99.8% of the novel SARS-CoV-2, the virus that causes COVID-19, was killed in a single pass through a filter made from commercially available nickel foam heated to 200 degrees Centigrade, or about 392 degrees Fahrenheit. It also killed 99.9% of the anthrax spores in testing at the national lab, which is run by the University of Texas Medical Branch.

Infection Prevention

EPA approves two Lysol products as the first to effectively kill novel coronavirus on surfaces – CNN

Lysol Disinfectant Spray and Lysol Disinfectant Max Cover Mist meet the EPA’s criteria for use against the SARS-CoV-2, the virus responsible for the ongoing pandemic, based on laboratory testing that found both products kill the virus two minutes after contact, the agency announced in a statement Monday.

Can Salad Bars Be Saved? – Bloomberg

They’ve been crucial for supermarkets, but germ fears might make them a pre-pandemic memory. In a frantic push to ease skittish consumers and shore up sales, some chains are tossing prepackaged salads into the bar’s now-empty bins, a stopgap measure that’s easy to do, but eliminates the customization—extra onions, less croutons, etc.—that shoppers crave. Publix Super Markets Inc. placed an employee next to the bar to take orders during peak hours, but that full-service option slows things down and adds labor.

Social/Psychological Impact

Lost On The Frontline – Kaiser Health Network

America’s health care workers are dying. In some states, medical personnel account for as many as 20% of known coronavirus cases. They tend to patients in hospitals, treating them, serving them food and cleaning their rooms. Others at risk work in nursing homes or are employed as home health aides.

The Fight Over a Coronavirus Vaccine Will Get Ugly – Bloomberg

Once Covid-19 shots become available, there will be arguments about who gets them, and an even bigger battle with anti-vaxxers who refuse them. For most people a vaccine against the coronavirus can’t come soon enough, as it will be the only tolerable way to achieve herd immunity. So it’s encouraging that more than 100 drug candidates in 12 countries are in development, and eight are already entering clinical trials. To accelerate the process, some people are heroically volunteering to expose themselves to infection. With luck, some of us can get our shots next year.

The World’s Cruise Ships Can’t Sail. Now, What to Do With Them? – Bloomberg

Hurricanes, humidity, expired permits—they’re all costly threats to empty ships. Hundreds of people lined the banks of Glasgow’s River Clyde a few weeks ago for the rare sight of a small, high-end cruise ship sailing upriver—practically into the heart of the city. The Azamara Journey thrilled socially distanced onlookers by blasting its horn, typically a heralding of lively celebration. But this time nobody was there to wave on the deck of the 700-passenger ship, aside from the couple dozen members of its skeleton crew. This was no celebratory arrival, after all: it was a vessel on life support, just like every other ship dealing with the pandemic’s brutal wake.

Published Research

High Incidence of Barotrauma in Patients with COVID-19 Infection on Invasive Mechanical Ventilation – Radiology

SARS-CoV-2 in fruit bats, ferrets, pigs, and chickens: an experimental transmission study – The Lancet

The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings – Brain

Increased Risk of COVID-19 Among Users of Proton Pump Inhibitors – American Journal of Gastroenterology

Direct evidence of active SARS-CoV-2 replication in the intestine – Clinical Infectious Diseases

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

None Today

Coping in Quarantine

The pandemic didn’t create working moms’ struggle. But it made it impossible to ignore. – Washington Post

An old cartoon from 1976 has been circulating on social media recently, titled “My Wife Doesn’t Work.” In 20 panels, it follows the daily routine of a stay-at-home mom: At 7 a.m., she’s packing lunches; at 11 a.m., she’s running errands; at 2 and 3 and 5 p.m., she’s sweeping, ironing and dishwashing while a toddler tugs on her skirt. The titular panel comes at 1 p.m. when we drop in on her husband chatting with a colleague. “My wife doesn’t work,” he explains. The joke has one of two interpretations: either he has no idea how much work it takes to run a house because he’s not around to see this labor, or he’s aware of it but doesn’t count it as “work.” Maybe both. [If the link above does not work, try this]

Ideas For Reopening Schools; Evidence Of Airborne Spread – NPR

Audio File at the link – Education and public health experts agree it’s important that kids get back to school in the fall. The question is how to do it safely. NPR’s Anya Kamenetz reports on some radical ideas for reopening.

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