Tulane Outbreak Daily | June 8, 2020

Featured Headlines

Shutdowns prevented 60 million coronavirus infections in the U.S., study finds – Washington Post

Shutdown orders prevented about 60 million novel coronavirus infections in the United States and 285 million in China, according to a research study published Monday that examined how stay-at-home orders and other restrictions limited the spread of the contagion. [Related Nature Study] [Imperial College London Study] [If Wash Post link does not work, try this]

The US government’s supply of the only proven Covid-19 drug runs out at the end of the month – CNN

The US government’s current supply of remdesivir, the only drug known to work against Covid-19, will run out at the end of the month, Dr. Robert Kadlec, a US Department of Health and Human Services official, told CNN. The government’s last shipment of the drug will go out the week of June 29. Gilead Sciences, the company that makes the drug, is ramping up to make more, but it’s unclear how much will be available this summer.

The original SARS virus disappeared – here’s why coronavirus won’t do the same – The Conversation

British cancer doctor Prof Karol Sikora recently claimed that the current COVID-19 pandemic would “burn itself out”. His thinking is that if there are more infections than we realize, and that those milder, unrecorded infections result in robust immunity, then this would quickly lead to “herd immunity”, leaving the virus nowhere to go but extinct. Extend this to the world’s population and the virus eradicates itself. But the idea that letting the virus run wild would protect us is unlikely to be valid. The antibody results coming in suggest that only a small proportion of people have been infected by SARS-CoV-2. In the UK, only an estimated 6.8% of people have had the virus; for France, the figure is just 4.4%.

Here’s How States Actually Determine Reopening – MedPageToday

See the criteria each used to get their economies back on track, and how that differs from federal guidance

Satellite data suggests coronavirus may have hit China earlier: Researchers – ABC News

Dramatic spikes in auto traffic around major hospitals in Wuhan last fall suggest the novel coronavirus may have been present and spreading through central China long before the outbreak was first reported to the world, according to a new Harvard Medical School study. [Related Harvard Study]

Coronavirus ‘second wave’: What lessons can we learn from Asia? – BBC

Asia was the first place to experience the coronavirus, impose lockdowns and then emerge from them. It was also the first to experience new groups of infections, with clusters from nightclubs in Seoul, the Russia-China border, and elsewhere. Although it is early for conclusions, can lessons be learned?

Clinical Considerations

Blood Test May Predict Clot Risk in Severe COVID-19 – MedPageToday

Test used to look for hypocoagulability accurate for hypercoagulation events in study. Hypercoagulability on thromboelastography (TEG) was a good predictor of thrombotic events among COVID-19 patients entering the ICU. [Related Study JAMA]

Indirect effects of SARS-CoV-2 on the kidneys: beware of the genetic background – EIN News

Kidney injury in COVID-19 patients may be caused not only directly by the virus, but also indirectly and APOL1 gene variants may increase the risk. [Related Italian Study]

Most Hospitalized COVID Patients Have Neurologic Symptoms – MedPageToday

More than half of COVID-19 patients admitted to two hospitals in Spain developed some form of neurologic symptoms. [Related Neurology Study]

Researchers map how coronavirus infection travels through cells of nasal cavity and respiratory tract – UNC Chapel Hill

A major study of coronavirus infection in human airways adds to evidence that wearing a mask is an important protective step toward limiting transmission of COVID-19. [Related Study]

Some covid-19 patients taken off ventilators are taking days or even weeks to wake up – Washington Post

After five days on a ventilator because of covid-19, Susham “Rita” Singh seemed to have turned a corner. Around midnight on April 8, doctors at Houston Methodist Hospital turned off the sedative drip that had kept the previously healthy 65-year-old in a medically induced coma. “The expectation is that you should start waking up after six hours, 12 hours or a day,” said her daughter, Silky Singh Pahlajani, a neurologist in New York City. “But it was six-and-a-half days before she started … opening her eyes. I thought she had suffered a massive stroke. [If Wash Post link above does not work, try this one]

Kidney enzyme renalase a potential therapy for severe COVID-19 – MedicalNews.net

Researchers from Yale School of Medicine have discovered that a low blood level of an enzyme called renalase is associated with severe coronavirus disease 2019 (COVID-19). The team says the findings suggest that renalase, which has potent anti-inflammatory effects, could serve as a useful biomarker for identifying patients with more severe disease. They also point towards a potential mechanism underlying the pathology involved in COVID-19. [Related pre-print]

SARS-CoV-2–Related Inflammatory Multisystem Syndrome in Children – JAMA

Different or Shared Etiology and Pathophysiology as Kawasaki Disease? The pediatric inflammatory multisystem syndrome (PIMS) now described in association with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection has generated considerable interest, both for its severity and delayed emergence in an age group largely spared the complications of primary infection, but also for its overlapping clinical features with Kawasaki disease (KD), the leading cause of acquired heart disease in children in high-income countries.1 This has prompted considerable discussion that the 2 conditions could have different or shared etiologic and pathophysiologic pathways.

COVID-19 Can Last for Several Months – The Atlantic

The disease’s “long-haulers” have endured relentless waves of debilitating symptoms—and disbelief from doctors and friends. Hours after British Prime Minister Boris Johnson instated stringent social-distancing measures to halt the SARS-CoV-2 coronavirus, LeClerc, a Glasgow-based journalist, arrived home feeling shivery and flushed. Over the next few days, she developed a cough, chest pain, aching joints, and a prickling sensation on her skin. After a week of bed rest, she started improving. But on day 12, every old symptom returned, amplified and with reinforcements: She spiked an intermittent fever, lost her sense of taste and smell, and struggled to breathe.

Official Reporting for June 8, 2020

WHO SITREP #139 ECDC Johns Hopkins
Confirmed Cases 6,799,713 6,960,259 7,065,597
Deaths 397,388 401,970 404,021

 

NEW:
Total cases: 1,938,823
Total deaths: 110,375
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines

UNITED STATES

New York City: After Lockdown And Unrest, New York City Begins Reopening During Pandemic – NPR

Arizona: Arizona COVID-19 hospitalization data shows record-high metrics – AZ News

Oregon: Oregon Reports Highest Daily Coronavirus Count Since Start Of Pandemic – Oregon News

Houston, Texas:COVID-19 Hospitalizations, Cases Going Up In Houston Area – Houston Public Media

Washington DC: Hundreds Of Positive COVID-19 Cases At D.C.’s Children’s National Hospital – NPR

California: Coronavirus Jumps the Border, Overwhelming Hospitals in California – NYT

OCEANIA

New Zealand: With No Current Cases, New Zealand Lifts Remaining COVID-19 Restrictions – NPR

ASIA

India: India Reopens Public Places Even As Coronavirus Cases Rise – NPR

Singapore: Half of Singapore’s new COVID-19 cases are symptomless – Reuters

LATIN AMERICA

Brazil: In a Coronavirus free fall – NYT

Brazil: Brazil stops releasing Covid-19 death toll and wipes data from official site – Guardian

Brazil: Brazil Surpasses Italy in Coronavirus Deaths; Toll Tops 34,000 – Bloomberg


Science and Tech

How Covid-19 Contact Tracing Works on Your Phone – Wired

OUR SMARTPHONES ARE set to play a significant role in helping navigate our way out of the coronavirus pandemic, with countries and companies around the world preparing their own apps as part of a track-and-trace system to keep infection levels low.

Vaccine

A third COVID-19 vaccine effort is quietly underway at Pitt – Post Gazette

The public has known for months now about two efforts at the University of Pittsburgh to create a vaccine that would help end the worldwide COVID-19 pandemic and get us back to normal.

Therapeutics

Inhibition of Bruton tyrosine kinase in patients with severe COVID-19 – Science

Patients with severe COVID-19 have a hyperinflammatory immune response suggestive of macrophage activation. Bruton tyrosine kinase (BTK) regulates macrophage signaling and activation. Acalabrutinib, a selective BTK inhibitor, was administered off-label to 19 patients hospitalized with severe COVID-19 (11 on supplemental oxygen; 8 on mechanical ventilation), 18 of whom had increasing oxygen requirements at baseline. Over a 10-14 day treatment course, acalabrutinib improved oxygenation in a majority of patients, often within 1-3 days, and had no discernable toxicity. Measures of inflammation – C-reactive protein and IL-6 – normalized quickly in most patients, as did lymphopenia, in correlation with improved oxygenation. At the end of acalabrutinib treatment, 8/11 (72.7%) patients in the supplemental oxygen cohort had been discharged on room air, and 4/8 (50%) patients in the mechanical ventilation cohort had been successfully extubated, with 2/8 (25%) discharged on room air. Ex vivo analysis revealed significantly elevated BTK activity, as evidenced by autophosphorylation, and increased IL-6 production in blood monocytes from patients with severe COVID-19 compared with blood monocytes from healthy volunteers. These results suggest that targeting excessive host inflammation with a BTK inhibitor is a therapeutic strategy in severe COVID-19 and has led to a confirmatory international prospective randomized controlled clinical trial.

End of the Road for HCQ in COVID-19? – MedPageToday

No indication of survival benefit was found for hydroxychloroquine (HCQ) in hospitalized COVID-19 patients in a large randomized trial

 


Infection Prevention

The WHO Updates Advice on the use of masks in the context of COVID-19 – WHO

This document provides advice on the use of masks in communities, during home care, and in health care settings in areas that have reported cases of COVID-19. It is intended for individuals in the community, public health and infection prevention and control (IPC) professionals, health care managers, health care workers (HCWs), and community health workers. This updated version includes a section on Advice to decision makers on the use of masks for healthy people in community settings.

COVID-19 pandemic e let’s not forget surfaces – Journal of Hospital Infection

Virus DNA left on a hospital bed rail was found in nearly half of all sites sampled across a ward within 10 hours and persisted for at least five days, according to a new study by UCL and Great Ormond Street Hospital (GOSH).


Social/Economic Impact

How Reskilling Can Soften the Economic Blow of Covid-19 – Harvard Business Review

In the early months of 2020, millions of workers worldwide were laid off as the Covid-19 pandemic shuttered entire industries. Yet not all industries suffered contractions: the healthcare sector, for instance, saw demand grow, as did schools, in some parts of the world, and online retail. Under normal conditions, workers constantly shift between different industries, albeit at a slow pace. However, the Covid-19 pandemic created an urgent need to make labor shifts happen much more quickly.


Published Research

Thromboelastographic Results and Hypercoagulability Syndrome in Patients With Coronavirus Disease 2019 Who Are Critically Ill – JAMA

Indirect effects of severe acute respiratory syndrome coronavirus 2 on the kidney in coronavirus disease patients – Clinical Kidney Journal

Air and environmental sampling for SARS-CoV-2 around hospitalized patients with coronavirus disease 2019 (COVID-19) – Infection Control and Hospital Epidemiology

Neurologic manifestations in hospitalized patients with COVID-19: The ALBACOVID registry – Neurology

Virus DNA spread across surfaces in hospital ward over 10 hours –

Analysis of hospital traffic and search engine data in Wuhan China indicates early disease activity in the Fall of 2019 – Harvard Univesity

SARS-CoV-2 Infection and Cardiovascular Disease: COVID-19 Heart – Heart, Lung, and Circulation

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


Coping in Quarantine

Zoom Psychiatrists Prep for COVID-19’s Endless Ride – Scientific American

An epidemiologist points to new stresses in the U.S. mental health system that may persist from the novel coronavirus pandemic

Coronavirus lockdown confessions – BBC

A few weeks ago, BBC asked for lockdown confessions. It turns out some of you have a lot to get off your chest. We’ve all had to sacrifice a lot while being stuck indoors. Some of you have new guilty secrets you wanted to share. And some of you have engaged in rule-breaking while others were behaving themselves.