Tulane Outbreak Daily – October 21, 2020

CDC notes ‘distressing trend’ of rising COVID cases – CIDRAP

In their first press briefing in more than 2 months, Centers for Disease Control and Prevention (CDC) officials warned that the country is approaching a “critical phase” in the COVID-19 pandemic, while also expressing optimism that one or more vaccines will be available for distribution before the end of the year.

First COVID-19 Wave Offers ICUs Lessons for Next Time – MedPageToday

The first wave of COVID-19 forced hospitals to get creative when treating patients, and they can apply these lessons as the next wave of the pandemic approaches.

Covid-19’s wintry mix: As we move indoors, dry air will help the coronavirus spread – STAT

Winter in the northern United States will soon drive even the most diehard outdoor diners and backyard socializers indoors, bringing with them heightened risk for contracting and spreading Covid-19. The worry is not just that people might mingle more closely inside, but that the air they breathe will make the virus more dangerous.

‘It Has Hit Us With a Vengeance’: Virus Surges Again Across the United States – New York Times

Unlike earlier outbreaks concentrated in the Northeast and South, the virus is simmering at a worrisome level in most regions. As the coronavirus races across the country, it has reached every corner of a nursing home in Kansas, infecting all 62 residents inside. There are so few hospital beds available in North Dakota that patients sick with the virus are being ferried by ambulance to facilities 100 miles away. And in Ohio, more people are hospitalized with the virus than at any other time during the pandemic.

New Yorkers’ Risk of Covid Death Was Double Earlier Estimates – Bloomberg

Despite efforts to slow the contagion, 21,447 New Yorkers died from Covid-19 from March through early June, researchers from Columbia University and the city’s health department reported Monday in the medical journal Lancet Infectious Diseases. The risk of dying from a SARS-CoV-2 infection was 1.39% if both confirmed and probable Covid-related deaths were included; that compared with about 0.7% of infections reported earlier in China and France, the authors said.

COVID-19 activity intensifies in more US states, Europe – CIDRAP

For the second week in a row, North Dakota, South Dakota, Montana, and Wisconsin were among the top five states reporting the highest per capita levels. The White House task force shares the information only with governors, but the Center for Public Integrity continues to collect and report them.

Bloomberg Prognosis: What Herd Immunity Really Means

Audio file at the link

Clinical Considerations

COVID-19 With COPD: Fewer Hospitalizations, But Greater Mortality – Pulmonary Advisor

Chronic obstructive pulmonary disease (COPD) may be associated with higher rates of mortality in patients with coronavirus disease 2019 (COVID-19), according to research presented at the CHEST Annual Meeting, held virtually, October 18 to 21. However, COPD is also associated with a lower prevalence of COVID-19-related hospitalizations.

CDC Reduces Consecutive Minutes Of COVID-19 Exposure Needed To Be A ‘Close Contact’ – NPR

The Centers for Disease Control and Prevention has changed the amount of time it takes for someone to be considered a “close contact” of a person with COVID-19.

Official Reporting for October 21, 2020

World Health Organization

Weekly Epi Update October 16, 2020 (Last Updated)

Cumulative Cases: 40,665,438
Cumulative Deaths: 1,121,843

ECDC

Confirmed Cases: 40 856 197
Deaths: 1 125 756

Johns Hopkins

Confirmed Cases: 41,109,752
Deaths: 1,129,185

Centers for Disease Control and Prevention (CDC)

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

Surveillance Headlines

UNITED STATES

Illinois: COVID-19 Restrictions Return to Chicago’s South, Western Suburbs – WTTW

Wisconsin: After a college town’s coronavirus outbreak, deaths at nursing homes mount – Washington Post

Missouri: 3 members of same Missouri family die of coronavirus, 5 more sickened – NBC

New York: N.Y. Hits 2,000 Cases for First Time Since May – Bloomberg

EUROPE

Spain: Passes one million Covid-19 cases – BBC

Science and Tech

Diagnostics

Saliva is the Key Element for SARS-CoV-2 Mass Screening – Clinical Infectious Diseases

The current COVID-19 pandemic has shown clinicians and researchers the fundamental role played by asymptomatic carriers and pre-symptomatic individuals in the infectious outbreak, a feature that distinguishes SARS-CoV-2 from SARS-CoV and MERS-CoV [1]. Recent findings have pointed out how the viral load in COVID-19 is high at the very onset of the disease and then decreases over time, underlining a probably high load also in the pre-symptomatic phase [2].

Therapeutics

NIH Begins COVID-19 Trial of Remdesivir, Hyperimmune Intravenous Immunoglobulin – Pharmacy Times

A phase 3 clinical trial investigating the safety, tolerability, and efficacy of remdesivir plus hyperimmune intravenous immunoglobulin (IVIG) has begun in the United States, Mexico, and 16 other countries on 5 continents.

Inhaled antibody drug for COVID-19 clears coronavirus in animals – Fierce Biotech

Monoclonal antibodies for COVID-19 recently took center stage as Regeneron’s experimental cocktail was used to treat President Donald Trump, who went on to rave about it. But that therapy, as is typical for antibody drugs, needs to be injected into the body.

How Will The Limited Supply Of Antibody Drugs For COVID-19 Be Allocated? – NPR

3 minute audio at the link – Even though manufacturers are gearing up to produce more than a million doses before the end of the year, some 50,000 Americans are getting infected every day, so the clamor for these drugs is likely to be considerable. (If the current pace of infection keeps up, there will be another 3.5 million infected Americans before the end of the year).

Vaccine

AstraZeneca tipped to restart COVID-19 vaccine trial this week – Fierce Biotech

AstraZeneca could resume the U.S. clinical trial of its COVID-19 vaccine this week, according to a Reuters report. The trial has been paused since early September while the FDA reviews the safety of the vaccine in light of a reported case of a rare spinal inflammatory disorder in the wider program.

COVID-19 vaccines: time to talk about the uncertainties – Nature

Vaccines will be licensed only after they have been shown to be safe and effective in a general population. This leaves many unknowns: whether one vaccine is more effective than another, how vaccines will work in people who are at the greatest risk of severe illness (people who are often excluded or under-represented in trials), whether vaccines will prevent transmission or severe disease, how long immunity will last — and which groups might resist or reject immunization because of ideology, mistrust or misinformation.

Psychological and Sociological Impact

Covid-19 Is Forcing Women From The Workplace In Record Numbers—And We Don’t Know When They’ll Be Back – Forbes

A recent National Bureau of Economic Research (NBER) study found that unlike past recessions, where men were often unemployed at higher rates than women, the Covid-19 pandemic has forced women out of the workforce at disproportionately high rates. Recent data from the Labor Department bears this out: 865,000 women left the workforce in September, nearly four times more than the number of men who left.

Published Research

Transcriptional and proteomic insights into the host response in fatal COVID-19 cases – PNAS

Pre-Print Studies

None today

Misinformation, Disinformation, and Conspiracy Theories

No, Mouthwash Will Not Save You From the Coronavirus – New York Times

Even if people coated the inside of their mouths with a coronavirus-killing chemical, a substantial amount of the virus would still remain in the body. [Related – The study taken out of context that started the misinformation on this topic]

Doctors Fight ‘Infodemic’ With Americans Seeing Virus as a Hoax – Bloomberg

There’s a no shortage of what President Donald Trump might call fake news about the coronavirus floating around social media, with plenty of it coming from his own Twitter account. That’s a problem for a growing number of U.S. doctors.