Tulane Outbreak Daily – July 21, 2020

Non COVID Headlines

Germany reports ‘swine flu’ case in child – Outbreak News Today

The WHO was told of one human case of infection with a swine influenza A(H1N1)v virus from Germany on 3 July. Details include the infection was detected in a 2-year old male who developed an influenza-like illness on 9 June 2020. The patient received healthcare on 9 June 2020.

Featured Headlines

Rapid Decay of Anti–SARS-CoV-2 Antibodies in Persons with Mild Covid-19 – NEJM

A recent article suggested the rapid decay of anti–SARS-CoV-2 IgG in early infection,1 but the rate was not described in detail. We evaluated persons who had recovered from Covid-19 and referred themselves to our institution for observational research. Written informed consent was obtained from all the participants, with approval by the institutional review board. Blood samples were analyzed by enzyme-linked immunosorbent assay (ELISA) to detect anti–SARS-CoV-2 spike receptor-binding domain IgG.2 The ELISA was further modified to precisely quantify serum anti–receptor-binding domain activity in terms of equivalence to the concentration of a control anti–receptor-binding domain monoclonal IgG (CR3022, Creative Biolabs).

Texas Doctor Says Wave Of COVID-19 Cases Hit ‘Like A Tsunami’ – NPR

4 Min Audio at the Link – The U.S. Navy on Sunday deployed five medical teams to support health workers in South Texas, an area particularly hard hit by COVID-19. The state has had 10,000 new cases a day on average over the last week, up 55% since the beginning of July. And just over 4,000 people in Texas have died since the start of the pandemic.

An Infectious Disease Doctor Explains Why The U.S. Is Failing To Control The Coronavirus Pandemic – And How That Can Be Fixed – Forbes

Much has been said this past week about Dr. Anthony Fauci, an advisor to the coronavirus task force, and whether he is to blame for the current trajectory of the Covid-19 pandemic now surging with record numbers and hospitalizations across multiple states in the US. This is just a distraction from the real problem: the U.S. has failed to control the virus because we have not followed the basics of outbreak investigation and response.

Promising early findings for 2 more COVID-19 vaccines – CIDRAP

In a pair of promising developments today, researchers from Oxford University and another group from China reported in The Lancet that two different adenovirus-vectored COVID-19 vaccines prompted an immune response and appeared to be safe, paving the way for efficacy trials.

Asymptomatic Spread Could Make the Covid-19 Pandemic Longer and Worse – Georgia Tech

A new statistical study may help dispel lingering doubts about whether to be concerned that people without Covid-19 symptoms are spreading the disease. The asymptomatic spread of the coronavirus is likely both common and significant, authors of a new study said.

Coronavirus Infections Much Higher Than Reported Cases in Parts of U.S., Study Shows – New York Times

Data from antibody tests in 10 different cities and states indicate that many people with no symptoms may be spreading the virus. The number of people infected with the coronavirus in different parts of the United States is anywhere from two to 13 times higher than the reported rates for those regions, according to data released Tuesday by the Centers for Disease Control and Prevention.

How tiny Uruguay, wedged between Brazil and Argentina, has avoided the worst of the coronavirus – Washington Post

The date wasn’t lost on Uruguayans. After watching the novel coronavirus emerge in China and spread to Europe, the country confirmed its first four cases on Friday the 13th — an apparently ominous opening for a disease that would soon burn a wide path through Latin America.

HHS Announces National COVID-19 Testing Implementation Forum – HHS

Today, the U.S. Department of Health and Human Services (HHS) announced a new program to capture feedback between federal officials and the private sector. The National Testing Implementation Forum will bring together representatives from key stakeholder groups to share information and provide input to federal leaders about SARS-CoV-2, the virus that causes COVID-19, testing and diagnostics.

Fauci: ‘No End in Sight’ for COVID-19 – Med Page Today

As the COVID-19 pandemic rages on with “essentially no end in sight,” the clinical and epidemiologic toll has provided a grim reminder of how unpredictable and potentially dangerous coronavirus infections can be, according to Anthony Fauci, MD, director of the National Institute of Allergy and Infectious Diseases.

Clinical Considerations

None Today

Official Reporting for July 21, 2020

World Health Organization


Confirmed Cases: 14,562,550

Deaths: 607,781


Confirmed Cases: 14,684,741

Deaths: 610,110

Johns Hopkins

Confirmed Cases: 14,774,887

Deaths: 611,599

Centers for Disease Control and Prevention (CDC)

Total cases: 3,819,139
Total deaths: 140,630

Surveillance Headlines


Minneapolis, Minnesota: Minnesota reports infant COVID-19 death, more than 900 new cases – Star Tribune
JULY 21, 2020 — 6:51AM

Colorado: 10 charts that show why the coronavirus pandemic may be about to get a lot worse in Colorado – Colorado Sun

Washington State: Nearly 800 new coronavirus cases reported Monday in Washington state – King5

South Carolina: South Carolina Hospitals Face Down COVID Surge – Med Page Today

Hawaii: Hawaii sees increased COVID-19 hospitalizations – KHON


Netherlands: Nearly 1k test positive for COVID-19, big increase over last week – NL Times

Sweden: Sweden says people infected with COVID-19 should do contact tracing themselves – Reuters

Israel: Doctor in Israel reinfected with COVID-19 three months after recovering – Medical News.net


Brazil: Brazil Tops 80,000 COVID-19 Deaths As 2 Government Ministers Test Positive For Virus – NPR

Science and Tech

Freeze-framing the shape-shifting SARS-CoV-2 spike protein – Eureka Alert

The rod-like spike proteins on the surface of SARS CoV-2 are the tip of the spear of the COVID-19 pandemic. The spikes bind to human cells via the ACE2 receptor and then dramatically change shape, jack-knifing to fuse the cell membrane with the coronavirus’s outer membrane and opening the door to coronavirus infection. A study led by Boston Children’s Hospital for the first time freeze-frames the spike protein in its “before” and “after” shapes.

Genes May Influence COVID-19 Risk, New Studies Hint – Scientific American

As COVID-19 continues its fateful march around the globe, researchers have seen patterns of characteristics tied to bad cases of the disease. Increased age, diabetes, heart disease and lifelong experiences of systemic racism have come into focus as risk factors. Now some connections to certain genes are also emerging, although the links are fuzzier.

A Wearable for Early COVID-19 Diagnosis? – Med Page Today

The Skeptical Cardiologist previously reviewed the Oura ring as a sleep tracker and found it fairly useless as a sleep or “readiness” tracker, although I really enjoyed its design, wearability, and user interface.


Trial Shows ‘Robust Immune Response’ From Oxford Coronavirus Vaccine – New York Magazine

“We are seeing good immune response in almost everybody,” Dr. Adrian Hill, director of Oxford’s Jenner Institute, told the AP. Trials showed that the vaccine, which was developed using the virus that causes the common cold in chimpanzees, triggers both the production of antibodies, which can block infection, and a T-cell response, which helps the body beat the virus. “What this vaccine does particularly well is trigger both arms of the immune system,” Hill said.


Synairgen announces positive results from trial of SNG001 in hospitalised COVID-19 patients – Synairgen

The odds of developing severe disease (e.g. requiring ventilation or resulting in death) during the treatment period (day 1 to day 16) were significantly reduced by 79% for patients receiving SNG001 compared to patients who received placebo (OR 0.21 [95% CI 0.04-0.97]; p=0.046).

Published Research

Immunogenicity and safety of a recombinant adenovirus type-5-vectored COVID-19 vaccine in healthy adults aged 18 years or older: a randomised, double-blind, placebo-controlled, phase 2 trial – The Lancet

Rapid Decay of Anti–SARS-CoV-2 Antibodies in Persons with Mild Covid-19 – NEJM

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

The Infectious Nature of Patient-Generated SARS-CoV-2 Aerosol – RXiv

Coping in Quarantine

From Psychoanalysis to Short Stories. Coping with the Pandemic Through Creative Writing – Psych Central

Since the beginning of the lockdown in March, it was obvious to me how many people turned to their creative selves to cope and navigate through the challenges of the pandemic. Left to our own devices within the confinement of our homes, we’ve had to adapt and adjust the way we live to match the reality of our public health circumstances. From a psychoanalytic perspective, quarantine presents a particular challenge for the human by eliminating distractions from the outside and tuning people in with their inner selves and their unconscious. Fears tend to intensify, emotions and difficulties from prior to the pandemic are magnified. If you were already working in analysis or therapy, maybe you noticed some of the work deepening and allowing you access to places within yourself you didn’t know existed. Many people have made their first phone call to search for help in these challenging times and many of the therapists and analysts I know find themselves busier than ever.

Old Spice embraces shaggy quarantine hair – Marketing Drive

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