Tulane Outbreak Daily – November 20, 2020

Featured Headlines

The End of the Pandemic Is Now in Sight – The Atlantic

A year of scientific uncertainty is over. Two vaccines look like they will work, and more should follow.

Evaluating COVID Risk on Planes, Trains and Automobiles – Scientific American

With COVID-19 reaching the most dangerous levels the U.S. has seen since the pandemic began, the country faces a problematic holiday season. Despite the risk, many people are likely to travel using various forms of transportation that will inevitably put them in relatively close contact with others. Many transit companies have established frequent cleaning routines, but evidence suggests that airborne transmission of the novel coronavirus poses a greater danger than surfaces.

When will COVID-19 vaccines be widely available? Feds lay out an ambitious timeline – Fierce Pharma

With Moderna and Pfizer both reporting sky-high response rates to their COVID-19 vaccines, the pressure is on federal health officials to ensure a rapid—but smooth—rollout. Wednesday, they unveiled a detailed timeline that provides some clues about when most Americans can expect to be vaccinated.

The Coronavirus Is Airborne Indoors. Why Are We Still Scrubbing Surfaces? – New York Times

Scientists who initially warned about contaminated surfaces now say that the virus spreads primarily through inhaled droplets, and that there is little to no evidence that deep cleaning mitigates the threat indoors.

Here’s How to Think About the Danish Mask Study – MedPageToday

What the DANMASK-19 trial showed and didn’t show about mask use and COVID-19

905 Mayo Clinic Staff Have COVID-19 – MedPageToday

Diagnosed in last 2 weeks alone: “It shows you how easy it is to get COVID-19 in the Midwest”

Clinical Considerations

Mysteries of COVID Smell Loss Finally Yield Some Answers – Scientific American

Explanations begin to arise at the molecular level for this vexing but commonplace symptom. It dawned on Eian Kantor on a Saturday in early April as he brewed a cup of tea from fresh mint leaves: he had lost his sense of smell. The tea suspiciously smelled of nothing at all. Kantor proceeded to rifle through the fridge, sniffing jars of pickles, chili sauce and garlic—nothing.

Higher COVID Infection Risk Seen in Those With Genetic Obesity, ‘Bad’ Cholesterol – Genetic Obesity

People who are genetically predisposed toward obesity or having high levels of so-called “bad” cholesterol — low-density lipoprotein (LDL) cholesterol — are at increased risk of contracting COVID-19, a study reported. [Related study in Frontiers in Genetics]

Delirium fairly common in older COVID-19 patients – CIDRAP

A study published today in JAMA Network Open shows that 28% of older COVID-19 patients at seven US emergency departments (EDs) had delirium, putting them at higher risk of an intensive care unit (ICU) stay and death. [Related JAMA Study]

Official Reporting for November 20, 2020

World Health Organization

Weekly Epi Update

Confirmed Cases: 55 928 327

Deaths: 1 344 003


Confirmed Cases: 56,822,606

Deaths: 1 350 713

Johns Hopkins

Confirmed Cases: 56,822,606
Deaths: 1,359,120

Centers for Disease Control and Prevention (CDC)

Total cases: 11,465,722 (+165,087 New Cases)
Total deaths: 249,670 (+1,836 New Deaths)

Surveillance Headlines


Maryland: Maryland reports 2,910 new coronavirus cases, by far the highest daily total during pandemic – Baltimore Sun

An American tragedy: Inside the towns hardest hit by coronavirus – ABC News


Europe Finally Sees Coronavirus Case Decrease, WHO Reports – Forbes

Dr. Hans Kluge, the World Health Organization’s European director, said at a press conference Thursday that the number of new coronavirus cases in Europe has decreased for the first time in months, signaling that the lockdown orders and restrictions in many countries may be helping to slow the spread though cases are still alarmingly high.

Science and Tech

Mini-Lungs in a Lab Dish Mimic Early COVID-19 Infection – NIH Director’s Blog

Researchers have become skilled at growing an array of miniature human organs in the lab. Such lab-grown “organoids” have been put to work to better understand diabetes, fatty liver disease, color vision, and much more. Now, NIH-funded researchers have applied this remarkable lab tool to produce mini-lungs to study SARS-CoV-2, the coronavirus that causes COVID-19.

T Cells May Tell Us More About COVID Immunity – MedPageToday

Many hope T cell response will mirror that for SARS and MERS: 2 to 10 years. While antibodies have been the focus of testing for past infection with COVID-19, T cells will also provide some insights — potentially better ones, experts say.

Vibrations of coronavirus proteins may play a role in infection – MIT News

Study suggests mechanical properties of spike proteins can predict infectivity and lethality of different coronaviruses. When someone struggles to open a lock with a key that doesn’t quite seem to work, sometimes jiggling the key a bit will help. Now, new research from MIT suggests that coronaviruses, including the one that causes Covid-19, may use a similar method to trick cells into letting the viruses inside. The findings could be useful for determining how dangerous different strains or mutations of coronaviruses may be, and might point to a new approach for developing treatments. [Related Study in Cell]

What Platelets and Endothelial Cells May Reveal About the Coronavirus Disease – Yale Medicine

Yale researchers have helped identify the mechanisms behind a major cause of morbidity and mortality in COVID-19 patients. Extensive blood clots in both large and small blood vessels in the lungs and throughout many major organs in the body have been linked to worse outcomes in patients hospitalized with severe COVID-19 infection. The researchers demonstrate that both platelet and endothelial dysfunction are key components of COVID-19 pathology. [Related study in Nature]


FDA Authorizes Drug Combination for Treatment of COVID-19 – FDA

Today, the U.S. Food and Drug Administration issued an emergency use authorization (EUA) for the drug baricitinib, in combination with remdesivir, for the treatment of suspected or laboratory confirmed COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO).


AstraZeneca’s COVID-19 vaccine shows midphase promise in seniors – Fierce Biotech

A phase 2 clinical trial has found AstraZeneca’s COVID-19 vaccine delivers similar immune responses in people aged over and under 70 years. The update, which suggests the vaccine is better tolerated by seniors, provides further evidence that prophylactics may work in the people most vulnerable to the coronavirus.

Psychological and Sociological Impact

Sedentary Pandemic Life Is Bad for Our Happiness – The Atlantic

The times when we most want comfort and rest may paradoxically be the times we most need to move, for the sake of our well-being. Gallup’s polling data show that the percentage of Americans who say they are getting less exercise now than before the start of the pandemic is 38 percent, while 14 percent say they’re getting more. The rest say their activity levels haven’t changed—which in most cases likely means that they didn’t exercise much in the first place; after all, more than 80 percent of adults do not meet government guidelines for both aerobic and muscle-strengthening activities, and fewer than 5 percent participate in 30 minutes of physical activity a day. Meanwhile, the percentage who say they are eating an unhealthier diet now than before the pandemic is 28 percent, versus 13 percent who say they are eating better. (The rest say their diet has not changed.)

Published Research

Causal Inference for Genetic Obesity, Cardiometabolic Profile and COVID-19 Susceptibility: A Mendelian Randomization Study – Frontiers in Genetics

Neuropathology of SARS-CoV-2 Infection – NEJM

Pregnancy Outcomes Among Women With and Without Severe Acute Respiratory Syndrome Coronavirus 2 Infection – JAMA

Safety and immunogenicity of ChAdOx1 nCoV-19 vaccine administered in a prime-boost regimen in young and old adults (COV002): a single-blind, randomised, controlled, phase 2/3 trial – The Lancet

Comparative Analysis of Nanomechanical Features of Coronavirus Spike Proteins and Correlation with Lethality and Infection Rate – Cell

Thrombocytopathy and endotheliopathy: crucial contributors to COVID-19 thromboinflammation – Nature

Delirium in Older Patients With COVID-19 Presenting to the Emergency Department – JAMA

Misinformation, Disinformation, and Conspiracy Theories


Coping in 2020

How to Pretend you are in Paris Tonight – New York Times

While your travel plans may be on hold, you can pretend you’re somewhere new for the night. Around the World at Home invites you to channel the spirit of a new place each week with recommendations on how to explore the culture, all from the comfort of your home.

If you have mastered sourdough bread by now, give this a try…

Salt-Rising Bread: A Delicious and Nearly Lost Tradition

Its smell has been compared to the stink of overripe cheese, rotting tomatoes, dirty socks, but the delegation of bakers who make salt-rising bread still agree: You want to wake up to it! You want it to hit you the second you walk into the kitchen because it’s the auspicious whiff of a successful salt-rising starter, the first sign that efficient bacteria have been working hard all night, metabolizing protein in a fast, wild fermentation, filling the starter with hydrogen sulfide and other gases. It’s a promise that within several hours, if all goes well, a flat-topped, fine-crumbed loaf will come out a rich yellow gold from the oven.

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