Tulane Outbreak Daily | April 14, 2020

Featured Headlines

Small Chloroquine Study Halted Over Risk of Fatal Heart Complications – New York Times

A research trial of coronavirus patients in Brazil ended after patients taking a higher dose of chloroquine, one of the drugs President Trump has promoted, developed irregular heart rates. [Related Pre-Pub Study]

Study finds evidence of COVID-19 in air, on hospital surfaces – CIDRAP

Findings of the environmental sampling study do not indicate the amount of live virus, if any, or precisely determine the distance of aerosol transmission, the authors say that they confirm that the virus spreads in aerosols in addition to large respiratory droplets.[Related Study]

What We Know About The Silent Spreaders Of COVID-19 – NPR

Silent spreaders can be divided into three categories: asymptomatic, presymptomatic and very mildly symptomatic. Here’s what we know about these variations.

How much of the coronavirus does it take to make you sick? The science, explained – Stat

The minimum infectious dose of SARS-CoV-2, the virus that causes Covid-19, is unknown so far, but researchers suspect it is low. “The virus is spread through very, very casual interpersonal contact. A high infectious dose may lead to a higher viral load, which can impact the severity of Covid-19 symptoms. [Related Study]

SARS-CoV-2 Can Be Transmitted Via Shoes And Spread Up To 13 Feet In The Air – IFLScience

New evidence suggests the novel coronavirus can be distributed up to 4 meters (13 feet) in the air from infected individuals and be transported by way of shoes, prompting healthcare experts to release new recommendations for stopping the spread of SARS-CoV-2. [related study]

Loss of Smell and Taste Validated as COVID-19 Symptoms in Patients with High Recovery Rate – UC San Diego

Loss of smell and taste has been anecdotally linked to COVID-19 infections. In a study published April 12, 2020 in the journal International Forum of Allergy & Rhinology , researchers at UC San Diego Health report the first empirical findings that strongly associate sensory loss with COVID-19, the respiratory disease caused by the novel coronavirus. [Related Study]

ACEI/ARB Treatment May Benefit Patients With COVID-19 and Hypertension – Cardiology Advisor

The case fatality rate in patients with SARS-CoV-2 was found to be greater in patients with cardiovascular disease (10.5%) and hypertension (6.0%) compared with that in the general population (2.3%).2 The renin-angiotensin system (RAS) regulates blood pressure via the ACE/Angiotensin (Ang) II/ Ang type 1 receptor (AT1R) and the ACE2/Ang 1 to 7/Mas receptor signaling pathways. It is believed that ACEIs and ARBs inhibit and modulate the former and latter pathways, respectively.

Prepare for a ‘new normal’ as lockdown restrictions ease: Monday’s COVID-19 WHO briefing – World Economic Forum

Half the world has been under some form of lockdown to slow the spread of COVID-19. While many are eager to see restrictions lifted, especially as numbers stabilize in some countries, we must remain patient and vigilant, said officials at the World Health Organization (WHO) briefing on Monday 13 April.

There’s More Bad News on the Long-Term Effects of the Coronavirus – NY Magazine

Several new reports on the nature of the coronavirus showed how much more we need to learn about the pathogen before the effects of reopening the country can be fully anticipated. Below are four such alarming studies — though approach with some caution, as the clinical understanding of the outbreak continues to change as testing expands.[Related Paper]

Assessing the effect of the COVID-19 pandemic on correctional institutions – Harvard Gazette

Working in real time, Harvard researchers are surveying correctional facilities to find out how they are being affected by the pandemic


Editor’s note: Regarding the case counts below, please consider due to limited testing capabilities in some locations, the real number of cases could be considerably higher.

Official Reporting for April 14, 2020

WHO SITREP #84 ECDC | Country Data Johns Hopkins
Confirmed Cases 1,773,084 1,873,265 1,934,583
Deaths 111,652 118,854 120,914


Total cases: 554,849
Total deaths: 21,942
(Numbers close out at 4 p.m. the day before reporting.)

Travel Related: 6,515
Close Contact: 13,341
Under Investigation: 534,993
Total Cases: 554,849

Surveillance Headlines


Mexico: Nurses say they were told to avoid masks – Reuters


California: California projected to reach COVID-19 death peak this week – KTVU

Virginia: New UVA model shows COVID-19 peak in next few weeks, but potential 2nd wave this summer – WHSV

USS Theodore Roosevelt: Sailor Dies From COVID-19 Complications – NPR

New York: A stunning 1 in 100 New York residents have now tested positive for coronavirus – Washington Post


Brazil: Coronavirus fears grow for Brazil’s indigenous groups – CNN


Saudi Arabia: Races to Contain Epidemic in Islam’s Holiest City – Bloomberg

Iran: Iran records 4,585 coronavirus deaths as restrictions eased – Reuters


UK: More than 2,000 British nursing homes have confirmed coronavirus cases. – NYT

UK: Likely to Announce Lockdown Extension This Week – Bloomberg

Germany: New Coronavirus Cases Fall for the Fifth Day – Bloomberg

Austria: Thousands of stores reopen, but with strict guidelines. – NYT


South Africa: Ramps up COVID-19 screening as cases rise to 2,272 – Gulf News


Pakistan: confirms 348 new coronavirus cases – Anadolu News

India: Extends nationwide lockdown, ordering more than 1 billion people to remain at home. – NYT

Science and Tech

SARS-CoV-2 Antibodies Undetectable in Some Recovered Patients – NEJM

Researchers in China measured SARS-CoV-2-specific neutralizing antibodies in 175 patients who had recovered from COVID-19. All patients had been hospitalized with confirmed, albeit “mild,” infection. Antibodies were measured in plasma collected at the time of discharge.

Investigational COVID-19 Convalescent Plasma – FDA.gov

FDA is issuing this guidance to provide recommendations to health care providers and investigators on the administration and study of investigational convalescent plasma collected from individuals who have recovered from COVID-19 (COVID-19 convalescent plasma) during the public health emergency.

FDA quickly authorizes its 2nd blood filtering device for COVID-19 – Fierce Biotech

Shortly after granting an emergency authorization to Terumo BCT’s blood filtering device for COVID-19, the FDA did the same for CytoSorbents’ system. Both are designed to strip out the immune system proteins that fuel the deadly cytokine-storm reactions associated with the disease.

Ford partners with Thermo Fisher on COVID-19 collection kits, expands production to face masks, gowns – Tech Crunch

Ford has expanded its plan to produce critical medical equipment and supplies, including a new effort to make reusable gowns from airbag materials as well as a partnership with scientific instrument provider Thermo Fisher Scientific to ramp up production of COVID-19 collection kits to test for the virus.


Researchers Determine Structure of SARS-CoV-2 Main Protease and Identify Inhibitors – Technology Networks

A team of Chinese scientists has reported the high-resolution crystal structure of the main protease (Mpro) of the COVID-19 virus and has identified drugs that may hold promise in combating the virus.

Molecular Investigation of SARS–CoV-2 Proteins and Their Interactions with Antiviral Drugs – Viruses

A new Coronavirus strain, named SARS-CoV-2, suddenly emerged in early December 2019. SARS-CoV-2 resulted in being dramatically infectious, with thousands of people infected. In this scenario, and without effective vaccines available, the importance of an immediate tool to support patients and against viral diffusion becomes evident. In this study, we exploit the molecular docking approach to analyze the affinity between different viral proteins and several inhibitors, originally developed for other viral infections.


Sanofi and GlaxoSmithKline collaborate to speed up coronavirus vaccine development – Stat

The French drug giant Sanofi said Tuesday that it plans to use technology from GlaxoSmithKline to accelerate the development of its experimental vaccine against the novel coronavirus, SARS-CoV-2.

Global race to a COVID-19 vaccine – Harvard Gazette

The lab developed a vaccine in collaboration with Janssen Pharmaceutical Cos., the drug-making arm of Johnson & Johnson. It plans to launch clinical trials in the fall as part of a joint $1 billion collaboration agreement announced by the U.S. government and Johnson & Johnson on March 30.

No evidence that the Bacille Calmette-Guérin vaccine (BCG) protects against COVID-19 – WHO SITREP 84
Two clinical trials addressing this question are underway, and WHO will evaluate the evidence when it is available. In the absence of evidence, WHO does not recommend BCG vaccination for the prevention of COVID-19.


NIH “Serosurvey” Aims to Quantify U.S. Adults with SARS-CoV-2 Antibodies – clinicalomics

Researchers from four NIH institutes and centers plan to collect and analyze blood samples from up to 10,000 volunteers, with the aim of providing critical data for epidemiological models. The results will help illuminate the extent to which the novel coronavirus has spread undetected in the U.S. and provide insights into which communities and populations are most affected, according to the agency.

Published Research

Loss of Smell and Taste Validated as COVID-19 Symptoms in Patients with High Recovery Rate – Journal of Allergy and Rhinology

SARS-CoV-2 infects T lymphocytes through its spike protein-mediated membrane fusion – Cellular and Molecular Immunology

Whole genome and phylogenetic analysis of two SARS-CoV-2 strains isolated in Italy in January and February 2020: additional clues on multiple introductions and further circulation in Europe – Eurosurveillance

SARS-CoV-2 Antibodies Undetectable in Some Recovered Patients – NEJM

Universal Screening for SARS-CoV-2 in Women Admitted for Delivery – NEJM

Pharmacologic Treatments for Coronavirus Disease 2019 (COVID-19) – JAMA

Pre-Pub (not yet peer reviewed, should not be regarded as conclusive)

Chloroquine diphosphate in two different dosages as adjunctive therapy of hospitalized patients with severe respiratory syndrome in the context of coronavirus (SARS-CoV-2) infection: Preliminary safety results of a randomized, double-blinded, phase IIb clinical trial (CloroCovid-19 Study)

Supply Chain Impact

U.S. Meat Supply Is ‘Perilously Close’ To A Shortage, CEO Warns – NPR

One of the country’s largest pork-producing plants closed indefinitely after nearly 300 of its employees tested positive for COVID-19. And the company’s CEO warned that the coronavirus pandemic is pushing the nation’s meat supply “perilously close” to the edge.

JBS Shutters Greeley Beef Plant, National closes Tama – Ag Web

Two of America’s largest beef packing companies have announced plant closings due to COVID-19. The two plants have a combined harvest capacity of 6,500 cattle per day.

Poultry Worker’s Death Highlights Spread of Coronavirus in Meat Plants – NYT

Some employees are coming in sick, and one woman died after being ordered back to work. “Our work conditions are out of control,” a longtime Tyson employee said.

Economic Impact

To restart the economy, employers need to lead the way on Covid-19 testing, vaccination – Stat

The federal government has not been able to rapidly and effectively institute Covid-19 testing, from actively blocking early efforts to providing false reassurance on testing availability. In the absence of national leadership, states and counties are left to their own judgments, to procure their own essential supplies, and to set their own policies, making large-scale coordinated testing even more challenging. And the county-level public health institutions we defer to for policymaking do not control the financial or health care delivery resources required to implement the testing and contact tracing we need today and the vaccinations we will need tomorrow.

The Great Lockdown: Worst Economic Downturn Since the Great Depression – IMF

The world has changed dramatically in the three months since our last update of the World Economic Outlook in January. A rare disaster, a coronavirus pandemic, has resulted in a tragically large number of human lives being lost. As countries implement necessary quarantines and social distancing practices to contain the pandemic, the world has been put in a Great Lockdown. The magnitude and speed of collapse in activity that has followed is unlike anything experienced in our lifetimes.

Coping in Quarantine

Become a master of Adobe Photoshop with the help of this training – BoingBoing