Tulane Outbreak Daily – October 22, 2020

Featured Headlines

FDA OKs Remdesivir, First Drug for COVID-19 – Med Page Today

The FDA approved remdesivir (Veklury) on Thursday for treating hospitalized COVID-19 patients, a first for the disease that started a global pandemic. Remdesivir, an antiviral that works by limiting SARS-CoV-2 replication, is indicated for hospitalized patients age 12 and up (and at least 40 kg [88.2 lbs]). Previously, the intravenous drug was solely available under an emergency use authorization (EUA) from the agency. [Related – press release from Gilead]

Susceptibility to severe COVID-19 – Science

The coronavirus disease 2019 (COVID-19) pandemic has led to unprecedented changes in all aspects of our lives and has placed biomedical research at the forefront. One of the many pressing questions surrounding severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infections is identifying the determinants of the clinical spectrum, from people with asymptomatic disease to patients with severe COVID-19. Up to 40% of infections may be asymptomatic, suggesting that a large proportion of people may be protected from disease (1). On the other end of the spectrum is severe disease, with an overall estimated fatality rate near 1% (2). On pages 422 and 424 of this issue, Zhang et al. (3) and Bastard et al. (4), respectively, report analyses of >1600 patients infected with SARS-CoV-2 from >15 countries to identify endogenous factors that determine susceptibility to severe COVID-19.

Pandemic accelerates with 18.5 percent jump in new U.S. cases – NBC

The pandemic is accelerating as the United States climbs the third peak of Covid-19 infections that public health experts have been warning about, the latest NBC News analysis revealed Wednesday.

Racial minorities see largest uptick in excess deaths amid pandemic – CIDRAP

Three new studies add to growing evidence of the disproportionate effects of COVID-19 on racial and ethnic minorities in the United States, one of them finding that two of three excess deaths occurring so far in the pandemic were due to the novel coronavirus—with the largest increases seen in Hispanics and the 25-to-44-year age bracket.

5 Ways Families Can Prepare as Coronavirus Cases Surge – New York Times

While the onset of another surge may sound frightening, experts say there are things parents can do right now to start preparing. Here are five ways to help protect your family’s physical and mental health.

The engines of SARS-CoV-2 spread – Science

Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has spread rapidly across the globe, causing epidemics that range from quickly controlled local outbreaks (such as New Zealand) to large ongoing epidemics infecting millions (such as the United States). A tremendous volume of scientific literature has followed, as has vigorous debate about poorly understood facets of the disease, including the relative importance of various routes of transmission, the roles of asymptomatic and presymptomatic infections, and the susceptibility and transmissibility of specific age groups. This discussion may create the impression that our understanding of transmission is frequently overturned. Although our knowledge of SARS-CoV-2 transmission is constantly deepening in important ways, the fundamental engines that drive the pandemic are well established and provide a framework for interpreting this new information. [Related – Evidence review confirms CDC guidance about infectivity of novel coronavirus]

Airborne Transmission of SARS-CoV-2: Proceedings of a Workshop—in Brief (2020) National Academies of Science, Engineering, Medicine
Chapter: Airborne Transmission of SARS-CoV-2: Proceedings of a Workshop in Brief

The Biggest Scandal in Science – MedPageToday

If you’re writing a paper, you might reference 50 studies, which would be a huge expense. Luckily I get access through my university, who are in turn funded by me and other students through our fees and by the government. An establishment like UCL will pay something £10 to £12 million pounds a year for subscriptions to scientific journals, most of which belong to just five publishing companies.

Clinical Considerations

COVID-19: 4 physician lessons learned to guide next steps – AMA

The COVID-19 pandemic continues to raise questions about the country’s approach to public health as well as finance and delivery of health care. The disease also has exposed deep economic and related racial inequities in America. As the country continues to navigate the COVID-19 pandemic, how can lessons learned help to inform the future of health policy?

SARS-CoV-2 risk misclassification explains poor COVID-19 management – The Lancet

One of the most striking facts about the COVID-19 pandemic is the notable difference in approach, attitude, control measures, case incidence, and mortality rates between eastern and western hemispheres. Results of a recent analysis1
show lessons to be learnt from the experiences of these countries and regions. The differences in approach and mortality could be explained, at least partially, if not totally, by the misclassification of the infectious agent risk.

Official Reporting for October 22, 2020

World Health Organization

Weekly Epi Update October 16, 2020 (Last Updated)

Cumulative Cases: 41,104,946
Cumulative Deaths: 1,128,325

ECDC

Confirmed Cases: 41 299 301
Deaths: 1 132 500

Johns Hopkins

Confirmed Cases: 41,584,690
Deaths: 1,135,767

Centers for Disease Control and Prevention (CDC)

Total cases: 8,249,011
Total deaths: 220,362

Surveillance Headlines

UNITED STATES

Wisconsin: Opens A Field Hospital At State Fair Grounds As Coronavirus Cases Spike – NPR

ASIA

South Korea: 7 service members from US test positive for COVID-19 – Military Times

AFRICA

Kenya: COVID-19 in Africa: Ground-Level View from a Clinician in Kenya – MedPageToday

COVID-19 in Africa: A Ground Level View

EUROPE

Spain, France Exceed 1 Million Confirmed Coronavirus Cases Each – NPR

Czechia: First rescEU ventilators dispatched to Czechia

Science and Tech

Vaccine

Why decoding the immune response to COVID matters for vaccines – Nature

The race is on to develop a vaccine to protect people against the new coronavirus, SARS-CoV-2. Less than a year after the virus was identified, almost 200 vaccines are in development and more than 40 are in clinical trials — thanks, in part, to an unprecedented collaborative effort by researchers around the world. The vaccine quest makes it necessary for researchers to answer questions about how the body’s immune system responds to the virus, and why some people experience severe symptoms, whereas others recover quickly.

First large-scale US Covid-19 vaccine trial reaches target enrollment of 30,000 participants – CNN

Moderna, the first company to start US clinical trials of a Covid-19 vaccine, on Thursday finished enrolling all 30,000 of its participants.
All 30,000 have received their first shot, and most of them have also received the required second shot.

Study finds AstraZeneca’s COVID-19 vaccine follows genetic instructions – Reuters

AstraZeneca’s AZN.L Oxford COVID-19 vaccine accurately follows the genetic instructions programmed into it by its developers to successfully provoke a strong immune response, according to a detailed analysis carried out by independent UK scientists.

Coronavirus vaccine volunteer in Brazil’s AstraZeneca trial dies — but authorities say trial to continue – CNN

A volunteer in Brazil’s trial of AstraZeneca’s experimental coronavirus vaccine has died, the Brazilian health agency Anvisa announced on Wednesday, but organizers said there was no reason to stop the trial — an indication that the death is not linked to the vaccine.

Psychological and Sociological Impact

7 Months Into the Pandemic and I’m Losing Motivation. Help?! – New York Times

You don’t feel motivated, your inspiration is just gone, your excitement for work is just not what it used to be. This is all fine! Whatever your job is, this is going to happen.

New York Among Top Cities for Relocators During the Pandemic – Bloomberg

Contrary to popular belief, more people headed to the New York metro region than moved out during the Covid-19 era, according to an analysis of cell-phone data.

Covid Forced the World to Change in Ways We May Keep – Bloomberg

But not everyone is happy with the prospect, especially desperate businesses who want things to go back to normal.

Published Research

The temporal association of introducing and lifting non-pharmaceutical interventions with the time-varying reproduction number (R) of SARS-CoV-2: a modelling study across 131 countries – The Lancet

Human coronaviruses SARS-CoV, MERS-CoV, and SARS-CoV-2 in children – Journal of Pediatric Nursing

Understanding Viral Shedding of SARS-CoV-2: Review of Current Literature – Infection Control & Hospital Epidemiology

Loss of Anti–SARS-CoV-2 Antibodies in Mild Covid-19 – NEJM

Prolonged SARS-CoV-2 replication in an immunocompromised patient – Journal of Infectious Diseases

Pre-Print Studies

None today

Misinformation, Disinformation, and Conspiracy Theories

Treating Patients During an ‘Infodemic’ in America – Bloomberg

The coronavirus is both a medical problem and a public-health problem – that’s baked into its biology. But the pandemic in the U.S. has been exacerbated by another challenge of our own making: a pervasive atmosphere of distrust where misinformation about the virus flourishes, sometimes amplified by the man with the country’s loudest megaphone, President Donald Trump.

A guide to overcoming COVID-19 misinformation – National Geographic

False information about the pandemic is rampant, but seasoned defenders of climate science can offer tips for how to fight it. In the internet era, when research papers are readily available, everyone can become an expert on COVID-19 or climate change. But pundits can also cherry-pick the data that matches their beliefs and seem to speak with authority. These types of personalities appear in traditional media such as television, but their work truly thrives on social and video-streaming platforms. Part of the reason is social media remains largely unregulated, and the attention—the “likes” and engagement—we receive on a post can incentivize us to share.