Upcoming Virtual Events
Fauci to speak at UVa Medical Center Hour virtual event open to all
Held by UVa’s School of Medicine, the weekly forums on medicine and society regularly feature speakers of note. The Medical Center Hour event is free and can be accessed via us02web.zoom.us/j/86828545236. The passcode is 439854 and advanced registration is required.
Featured Headlines
Moderna says its covid-19 vaccine is nearly 95% effective – MIT Technology Review
The news comes hot on the heels of an announcement last week from Pfizer, which reported that its own covid-19 vaccine was more than 90% effective. [Related article and 3 min audio on Moderna’s vaccine NPR]
First interim analysis included 95 participants with confirmed cases of COVID-19. Phase 3 study met statistical criteria with a vaccine efficacy of 94.5% (p <0.0001). Moderna intends to submit for an Emergency Use Authorization (EUA) with U.S. FDA in the coming weeks and expects the EUA to be based on the final analysis of 151 cases and a median follow-up of more than 2 months
Winter will make the pandemic worse. Here’s what you need to know. – MIT Tech Review
(Article from October, but relevant now) As the weather gets colder and people spend more time inside, improving air circulation and filters in buildings will be key to controlling covid-19.
Coronavirus emerged in Italy earlier than thought, Italian study shows – Reuters
The new coronavirus was circulating in Italy since September 2019, a study by the National Cancer Institute (INT) of the Italian city of Milan shows, signaling that COVID-19 might have spread beyond China earlier than previously thought.
Tourists are buying fake covid-19 test results on the black market to travel – Washington Post
So it may have been only a matter of time before a black-market option emerged: counterfeit test results. The practice of forging or purchasing fake results has surfaced in destinations around the world, with instances of manipulated negatives in Brazil, France and the United Kingdom.
Promising Interim Results from Clinical Trial of NIH-Moderna COVID-19 Vaccine – NIH Director’s Blog
An independent data and safety monitoring board (DSMB) overseeing the Phase 3 trial of the investigational COVID-19 vaccine known as mRNA-1273 reviewed trial data and shared its interim analysis with the trial oversight group on Nov. 15, 2020. This interim review of the data suggests that the vaccine is safe and effective at preventing symptomatic COVID-19 in adults. The interim analysis comprised 95 cases of symptomatic COVID-19 among volunteers. The DSMB reported that the candidate was safe and well-tolerated and noted a vaccine efficacy rate of 94.5%. The findings are statistically significant, meaning they are likely not due to chance. 90 of the cases occurred in the placebo group and 5 occurred in the vaccinated group. There were 11 cases of severe COVID-19 out of the 95 total, all of which occurred in the placebo group.
Clinical Considerations
Out-of-hospital cardiac arrest survival fell 17% amid COVID-19 – CIDRAP
The outcomes of out-of-hospital cardiac arrest (OHCA) were poorer in the United States during the beginning of the COVID-19 pandemic than before—even in counties with low case-fatality rates. [Related Study JAMA Cardiology]
Renal Injury by SARS-CoV-2 Infection: A Systematic Review – Karger
For patients with SARS-CoV-2 infection, renal injury mainly manifests as increased serum creatinine, variable degrees of proteinuria and hematuria, and radiographic abnormalities of the kidneys. In this review, we summarize the pathogenesis of renal injury deriving from SARS-CoV-2 infection by focusing on its etiology, pathology, and clinical manifestations. The virus causes kidney injury by either direct infection or systemic effects, including host immune clearance and immune tolerance disorders, endothelium-mediated vasculitis, thrombus formation, glucose and lipid metabolism disorder, and hypoxia
Venous Thromboembolism Rates in Patients With SARS-CoV-2 Infection – Hematology Advisor
A total of 3405 patients were treated only in the emergency department, and 2748 other patients were admitted to the hospital. In a new study, researchers reported on the frequency of venous thromboembolism (VTE) among more than 6000 patients who tested positive for infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2). [Related study]
Comparing the immune response in children and adults – Medical News Today
A recent study from researchers at Columbia University Irving Medical Center in New York demonstrated distinct differences between the antibody responses of children and adults with COVID-19. In particular, the differences were seen in the type, amount, and neutralizing activity of antibodies.
Official Reporting for November 16, 2020
World Health Organization
Weekly Epi Update November 13, 2020 (Last Updated)
Confirmed Cases: 54,301,156
Deaths: 1,316,994
ECDC
Confirmed Cases: 54 576 428
Deaths: 1 319 792
Johns Hopkins
Confirmed Cases: 54,831,062
Deaths: 1,323,175
Centers for Disease Control and Prevention (CDC)
Total cases: 10,984,398 (+138,025 New Cases)
Total deaths: 245,470 (+660 New Deaths)
Surveillance Headlines
UNITED STATES
Texas: El Paso Grapples With Surge: ‘We Are Busting at the Seams’ – MedPageToday
ASIA
South Korea: How South Korea Avoided a COVID-19 Lockdown – MedPageToday
Science and Tech
Dr. Fauci’s Lecture from MIT’s Free Course on COVID-19: It’s Now Online – Openculture
What monoclonal antibodies are – and why we need them as well as a vaccine – The Conversation
When President Trump was diagnosed with COVID-19, one of the cutting-edge experimental therapies he received was a mixture of monoclonal antibodies. But now a vaccine may soon be available. So are other therapies necessary or valuable? And what exactly is a monoclonal antibody?
Will the Coronavirus Evolve to Be Less Deadly? – Smithsonian
No lethal pandemic lasts forever. The 1918 flu, for example, crisscrossed the globe and claimed tens of millions of lives, yet by 1920, the virus that caused it had become significantly less deadly, causing only ordinary seasonal flu. Some pandemics have lasted longer, like the Black Death, which swept out of Central Asia in 1346, spread across Europe, and ultimately may have killed as many as a third of the inhabitants of Europe, the Middle East, and parts of Asia. That pandemic, too, came to an end, roughly seven years after it started, probably because so many had perished or developed immunity.
Wildlife professionals continue to work diligently to understand and manage the spread between humans and wildlife of the beta coronavirus SARS-COV-2 that causes COVID-19. Zoonotic disease management often requires the involvement of wildlife, livestock, and human health professionals to address these issues. Recently, news stories have emerged concerning SARS-COV-2 in farmed mink and steps taken to minimize the risk of humans potentially transmitting SARS-COV-2 to bats.
Vaccine
Pfizer’s ultra-cold vaccine could be difficult to distribute – The Conversation
The excitement that greeted the news of a vaccine candidate that may be highly effective against COVID-19 was indeed something to behold. If the final results show anything like the numbers quoted in the press release, then the world can indeed be pleased and the scientists behind the scenes very proud of themselves.
Psychological and Sociological Impact
It’s Time to Hunker Down – The Atlantic
The end may be near for the pestilence that has haunted the world this year. Good news is arriving on almost every front: treatments, vaccines, and our understanding of this coronavirus. Pfizer and BioNTech have announced a stunning success rate in their early Phase 3 vaccine trials—if it holds up, it will be a game changer. Treatments have gotten better too. A monoclonal antibody drug—similar to what President Donald Trump and former Governor Chris Christie received—just earned emergency-use authorization from the FDA. Dexamethasone—a cheap, generic corticosteroid—cut the death rate by a third for severe COVID-19 cases in a clinical trial.
Anxiety disorders, insomnia, and dementia were the most common diagnoses. [Related report in the New York Times and a recent study in the Lancet]
Doctors Are Calling It Quits Under Stress of the Pandemic – New York Times
Thousands of medical practices are closing, as doctors and nurses decide to retire early or shift to less intense jobs.
Published Research
Bidirectional associations between COVID-19 and psychiatric disorder: retrospective cohort studies of 62 354 COVID-19 cases in the USA – The Lancet
Outcomes for Out-of-Hospital Cardiac Arrest in the United States During the Coronavirus Disease 2019 Pandemic – JAMA Cardiology
Frequency of venous thromboembolism in 6513 patients with COVID-19: a retrospective study – Blood Advances
SARS-CoV-2 in Migrant Worker Dormitories: Geospatial Epidemiology Supporting Outbreak Management – International Journal of Infectious Diseases
Misinformation, Disinformation, and Conspiracy Theories
How Pediatricians Are Fending Off Coronavirus Myths – New York Times
Doctors report misinformation at both extremes, with some parents worrying about taking impossible precautions and others encouraged to believe their children can’t get infected.
AMA: Docs Must Fight False Facts, Belittlement of Science – MedPageToday
Physicians cannot allow misinformation and denigration of science to interfere with healthcare workers’ efforts to treat patients affected by the COVID-19 pandemic, American Medical Association (AMA) President Susan Bailey, MD, said Friday evening at the opening session of the AMA Special Meeting of its House of Delegates.
Coping in 2020
Watch this German Government ad for how to deal with COVID. It’s funny!
If you liked the first one, you will also like this one
and this is the third installment, also funny!
A Comic Just For Kids: How To Stay Safe From The Coronavirus – NPR
Kids, this comic is just for you. The coronavirus pandemic started in March and in many countries, thousands and thousands of people are getting sick. You may have questions about what exactly this virus is — and how to stay safe. Here are some answers.