Tulane Outbreak Daily – October 7, 2020

Featured Headlines

Even Mild Covid-19 Infections Can Make People Sick for Months – Bloomberg

Two-thirds of patients who had a mild-to-moderate case of Covid-19 reported symptoms 60 days after falling ill, when more than a third still felt sick or in a worse condition than when their coronavirus infection began. Prolonged symptoms were more likely among patients aged 40 to 60 years and those who required hospitalization, according to staff at Tours University Hospital, who followed 150 non-critical patients from March to June.

Covid-19 neurological symptoms emerge in most hospitalized patients, study says – CNN

The study “highlights the high frequency and range of neurologic manifestations, which occurred in more than four fifths of Covid‐19 patients hospitalized in our hospital network system,” the researchers wrote in the study, published in the journal Annals of Clinical and Translational Neurology on Monday. [Related Study]

The CDC has finally acknowledged that the coronavirus can be airborne – MIT Technology Review

The evidence that the virus can be spread by tiny particles lingering in the air has been mounting for months. The news: The US Centers for Disease Control and Prevention has updated its guidelines to acknowledge that the coronavirus can be spread by tiny particles that linger in the air. The agency said it made the decision because of the mounting evidence that people with covid-19 can infect people even if they are more than six feet away, or shortly after the infected person left the area. These cases all occurred in poorly ventilated and enclosed spaces, and often involved activities that cause heavier breathing, like singing or exercise. However, “the CDC continues to believe, based on current science, that people are more likely to become infected the longer and closer they are to a person with COVID-19,” it said in a statement. The long-coming update could help to finally clarify the situation after the CDC published guidance acknowledging airborne transmission and then suddenly retracted it last month.

Hospitals That Don’t Report COVID-19 Data Daily Will Get Warning Letter – NPR

The enforcement timeline starts Wednesday, said Seema Verma, administrator for the Centers for Medicare & Medicaid Services, in a call with reporters Tuesday. CMS issued a rule in early September requiring hospitals to report full, daily COVID-19 data to the federal government, including such information as the number of patients and ventilators they have. On Wednesday, CMS is sending letters to hospitals across America alerting many that they have not been in compliance.

This Overlooked Variable Is the Key to the Pandemic – The Atlantic

Why, for instance, was there such an enormous death toll in northern Italy, but not the rest of the country? Just three contiguous regions in northern Italy have 25,000 of the country’s nearly 36,000 total deaths; just one region, Lombardy, has about 17,000 deaths. Almost all of these were concentrated in the first few months of the outbreak. What happened in Guayaquil, Ecuador, in April, when so many died so quickly that bodies were abandoned in the sidewalks and streets?* Why, in the spring of 2020, did so few cities account for a substantial portion of global deaths, while many others with similar density, weather, age distribution, and travel patterns were spared? What can we really learn from Sweden, hailed as a great success by some because of its low case counts and deaths as the rest of Europe experiences a second wave, and as a big failure by others because it did not lock down and suffered excessive death rates earlier in the pandemic? Why did widespread predictions of catastrophe in Japan not bear out? The baffling examples go on.

Clinical Considerations

Prolonged incubation of SARS-CoV-2 in a Patient on Rituximab Therapy – Infection Control and Hospital Epidemiology

The incubation period of SARS-CoV-2 is rarely greater than 14 days. We report a patient with hypogammaglobulinemia who developed SARS-CoV-2 infection with a confirmed incubation period of at least 21 days. These findings raise concern for a prolonged presymptomatic transmission phase, necessitating a longer quarantine duration in this patient population.

Official Reporting for October 7, 2020

World Health Organization

Weekly Epi Update October 5, 2020 (Last Updated)

Cumulative Cases: 35,659,007
Cumulative Deaths: 1,044,269


Confirmed Cases: 35 848 254
Deaths: 1 048 181

Johns Hopkins

Confirmed Cases: 36,026,644
Deaths: 1,053,357

Centers for Disease Control and Prevention (CDC)

Total cases: 7,475,262
Total deaths: 210,232

Surveillance Headlines


Montana: Hits new daily coronavirus record – Bozeman Daily Chronicle

Pennsylvania: New coronavirus cases and hospitalizations on rise in Pennsylvania, Lancaster County – Lancaster News

Wisconsin: Opening Field Hospital As Covid-19 Cases Surge – Forbes


Brazil: Tops 5 Million Cases – Bloomberg


New Zealand Stamps Out the Virus. For a Second Time – New York Times


UK: London Hit by Rising Coronavirus Infections – Bloomberg

UK: British Dorms on Lockdown After Coronavirus Outbreaks – New York Times

Science and Tech


Emergency Use Authorization for Vaccines to Prevent COVID-19 – FDA

FDA plays a critical role in protecting the United States from threats such as emerging infectious diseases, including the Coronavirus Disease 2019 (COVID-19) pandemic. FDA is committed to providing timely guidance to support response efforts to this pandemic. FDA is issuing this guidance to provide sponsors of requests for Emergency Use Authorization (EUA) for COVID-19 vaccines with recommendations regarding the data and information needed to support the issuance of an EUA under section 564 of the FD&C Act (21 U.S.C. 360bbb-3) for an investigational vaccine to prevent COVID-19 for the duration of the COVID-19 public health emergency.



At-home COVID testing launches in Boston – Harvard Gazette

A large-scale research study that will facilitate at-home testing for both the SARS-CoV-2 virus and antibodies against it, is accepting applications from 10,000 current and former Brigham and Women’s Hospital patients.

Psychological and Sociological Impact

What We Dream When We Dream About Covid-19 – New York Times

Several recent studies shed light on the pandemic preoccupations of sleepers. The swarm of insects — sometimes gnats, sometimes wasps or flying ants — arrived early in this year of nightmares. With summer came equally unsettling dreams: of being caught in a crowd, naked and mask-less; of meeting men in white lab coats who declared, “We dispose of the elders.”

‘Brain fog’ following COVID-19 recovery may indicate PTSD – UCLA

A new report suggests that lingering “brain fog” and other neurological symptoms after COVID -19 recovery may be due to post-traumatic stress disorder (PTSD), an effect observed in past human coronavirus outbreaks such as SARS and MERS. People who have recovered from COVID-19 sometimes experience lingering difficulties in concentration, as well as headaches, anxiety, fatigue or sleep disruptions. Patients may fear that the infection has permanently damaged their brains, but researchers say that’s not necessarily the case.

Published Research

Seroprevalence of SARS-CoV-2 immunoglobulin antibodies in Wuhan, China: part of the city-wide massive testing campaign – Clinical Microbiology and Infection

The Novel SARS-CoV-2 Pandemic: Possible Environmental Transmission, Detection, Persistence and Fate during Wastewater and Water Treatment – Science of the Total Environment

Misinformation, Disinformation, and Conspiracy Theories

From Instagram

Coping in 2020 (formerly known as Coping in Quarantine)

That Airport Spa? It’s a Coronavirus Testing Clinic – New York Times

XpresSpa used to offer pedicures and chair massages at airports. Now it’s in the coronavirus testing business.

Alone – Modern Love Podcast by the New York Times

Weeks or months into worldwide stay-at-home orders, the Modern Love team wanted to know how people who live alone were faring in isolation. What were they doing to keep themselves occupied? What did they most long for? What did they feel liberated to live without? More than 2,000 people shared their experiences. On this week’s Modern Love podcast, you can listen to some of the stories from “Alone,” recorded by the people who wrote them.

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