Tulane Outbreak Daily | June 2, 2020

COVID-19 Response: Promising Practices in Health Equity June 2, 2020 3-4pm ET

Several articles out on impact of COVID-19 and protests in the United States, here are a few:

A combination of genetic shuffling and evolutionary selection of near-identical genetic sequences among specific bat and pangolin coronaviruses may have led to the evolution of SARS-CoV-2 and its introduction into humans, a new study suggests. [Related Study]

These Scenarios Show What a Second Wave of COVID-19 Could Look Like – Science

Combining various public health approaches, countries such as Slovenia and New Zealand have eradicated the virus within their borders. Other countries, including the UK, achieved significant progress in arresting the spread of the disease.

Dogs Hunt for the Virus – Bloomberg (podcast)

Jason Gale reports dogs may have untapped powers to help stop the spread of coronavirus. Plus: How coronavirus created the conditions for the recent U.S. protests.

SARS-CoV-2 looks like a hybrid of viruses from two different species – ARS Technica

One of the longest-running questions about this pandemic is a simple one: where did it come from? How did a virus that had seemingly never infected a human before make a sudden appearance in our species, equipped with what it needed to sweep from China through the globe in a matter of months?

Monster or Machine? A Profile of the Coronavirus at 6 Months – New York Times

A virus, at heart, is information, a packet of data that benefits from being shared. The information at stake is genetic: instructions to make more virus. Unlike a truly living organism, a virus cannot replicate on its own; it cannot move, grow, persist or perpetuate. It needs a host. The viral code breaks into a living cell, hijacks the genetic machinery and instructs it to produce new code — new virus. [try this link if the other does not work for you]

Large Review Finds Good Evidence for Masks, Distancing in Stopping COVID-19 – MedPageToday

A review of at least 172 studies on SARS, MERS, and SARS-CoV-2, the virus that causes COVID-19, found transmission of viruses was lower with physical distancing of more than about 3 feet versus less than about 3 feet, reported Holger J Schünemann, MD, of McMaster University in Ontario, Canada, and colleagues of the COVID-19 Systematic Urgent Review Effort. [Related Study/Lancet)

CMS Releases Data on COVID-19 in Nursing Homes – MedPageToday

More than 60,000 U.S. nursing home residents have contracted COVID-19 and nearly 26,000 have died, the Centers for Medicare & Medicaid Services (CMS) reported Monday.

No evidence that mutations to SARS-CoV-2 increase transmissibility – Medical News Today

An analysis of more than 15,000 SARS-CoV-2 genomes finds that mutations to the virus do not increase its transmissibility and are instead either neutral or detrimental to its spread. [Related pre-print study]

Clinical Considerations

No specific COVID-19-linked lesions found despite extensive organ injury – Medical News.net

May 2020 reports autopsy results on COVID-19 patients, and concludes that there were no specific hallmark lesions of COVID-19 in any of the many organs found to be injured by the infection in patients who died of the disease. [Related pre-print paper]

COVID-19 mortality is significantly higher in hospitalized patients with diabetes – Medical News.net

The likelihood of death is 65% higher in hospitalized coronavirus disease (COVID-19) patients with diabetes when compared to non-diabetics – urging the adequate glucose control in the era of the pandemic. [Related pre-print paper]

Loss of taste and smell is best indicator of COVID-19, study shows – Harvard Gazette

Researchers deploying a smartphone app to 2.6 million users have determined that the loss of smell and taste are most predictive symptoms of COVID-19. [Related Study/Nature]

Obese COVID Patients More Likely to Have Pulmonary Embolism, Even Outside the ICU – Med Page Today

Pre-admission statin therapy may reduce odds of PE, single-center study suggests. [Related Study]

ICUs become a ‘delirium factory’ for Covid-19 patients – CNN

Although Covid-19 is best known for damaging the lungs, it also increases the risk of life-threatening brain injuries — from mental confusion to hallucinations, seizures, coma, stroke and paralysis. The virus may invade the brain, and it can starve the brain of oxygen by damaging the lungs. To fight the infection, the immune system sometimes overreacts, battering the brain and other organs it normally protects.

Is the coronavirus more of a vascular disease than a respiratory disease? – Innovation Origins

Although it was initially assumed that Covid-19 was a respiratory disease, autopsy results have shown that the virus affects a wide variety of organs in the body. The list of symptoms is growing longer almost by the day. Coughing, fever, and aching limbs are still considered ‘typical’ symptoms of COVID-19. Yet according to a study by the University of Göttingen, (Germany), only a fraction of all infections are detected. The reason for this is that the disease frequently seems to run its course without symptoms, especially in young people.

Proteins in COVID-19 patients’ blood could predict severity of illness, study finds – Reuters

Scientists have found 27 key proteins in the blood of people infected with COVID-19 which they say could act as predictive biomarkers for how ill a patient could become with the disease.

Acute disseminated encephalomyelitis after SARS-CoV-2 infection – Neuroimmunology and Neuroinflammation

Acute disseminated encephalomyelitis (ADEM) is a rare autoimmune disease of the CNS that often after viral infections and mainly affecting children. ADEM is characterized by the onset of multifocal neurologic symptoms, encephalopathy, with brain MRI showing demyelinating abnormalities in the acute phase.1 Coronavirus disease 2019 (COVID-19) is a novel entity caused by the pandemic severe acute respiratory syndrome coronavirus-2 (SARS-CoV-2), which is characterized by influenza-like symptoms, pneumonia, and in severe cases respiratory insufficiency.2 Many neurologic complications occurring in patients with COVID-19 have been described,3 and it has been hypothesized that, in some cases, SARS-CoV-2 might exhibit a neurotropic behavior.

COVID-19 patients experience neurological symptoms – Medical News Today

Altered mental status and stroke are the most common neurological symptoms that hospitalized COVID-19 patients experience, according to a new study from Italy. [Related Study]

Lung complications noted in half of COVID-19 surgical patients – CIDRAP

Of 1,128 COVID-19 patients undergoing surgery at 235 hospitals in 24 countries, 577 (51.2%) had pulmonary complications, and 219 (38.0%) of them died. [Related Study/Lancet]

Official Reporting for June 1, 2020

WHO SITREP #133 ECDC Johns Hopkins
Confirmed Cases 6,057,853 6,136,085 6,318,040
Deaths 371,166 371,857 376,885

 

NEW:
Total cases: 1,787,680
Total deaths: 104,396
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines

USA

Chicago, Illinois: Illinois Coronavirus Cases Surpass 120K – NBC Chicago

Utah: Utah is averaging more than 200 new coronavirus cases a day over the past week as hot spots flare up from Logan to St. George

Michigan: Michigan, where stay-at-home mandates drew some of the fiercest opposition, will open bars and restaurants June 8 – Michigan.gov

ICELAND

How Iceland Beat the Coronavirus – New Yorker

AFRICA

Old Scourges Revived in Africa as the Pandemic Drains Resources – Bloomberg

MEXICO

Mexico begins to lift coronavirus lockdown, but officials say the country is still ‘in danger’ – Washington Post

Mexico’s hospitals strain to treat coronavirus as officials say cases are peaking – Washington Post

SOUTH AND CENTRAL AMERICA

COVID-19 outbreaks surge in Central, South America – CIDRAP

Brazil: SARS-CoV-2 prevalence varies widely across Brazil – Medical News Today

EUROPE

Italy: Italy’s funeral home workers are haunted by what they saw in the pandemic’s epicenter. National Geographic

UK: U.K. Schools Begin Reopening Despite Coronavirus Concerns – NPR


Science and Tech

How SARS-CoV-2 Could Be Prevented From Invading a Host Cell – Technology Networks

How might the novel coronavirus be prevented from entering a host cell in an effort to thwart infection? A team of biomedical scientists has made a discovery that points to a solution. [Related Study]

How is SARS-CoV-2 transmitted? – FLARE

Knowledge of an emerging pathogen’s mode of transmission is paramount for the development of effective infection control guidelines and public health policies to protect our healthcare facilities and communities. Classically, respiratory pathogens may be divided into those transmitted by the airborne route and by the droplet route. Several factors determine the primary mode of transmission of respiratory infections: respiratory particle size, pathogen-specific factors such as cellular tropism, infectious dose, airflow patterns, and host factors such as mucosal inflammation (Tellier et al. 2019). While we know a great deal about the biophysics of respiratory particles, the pathogen-specific factors that influence the mode of transmission are not easily predicted for a newly discovered disease such as COVID-19. In tonight’s FLARE, we will discuss droplet and airborne modes of transmission and review data from the SARS and COVID-19 pandemics to answer the following question: is there any evidence of airborne transmission of SARS-CoV-2?

NIH-halted study unveils its massive analysis of bat coronaviruses – Science

An international team of scientists whose funding for research on bat coronaviruses was recently yanked by the U.S. government has published what it calls the most comprehensive analysis ever done of such viruses. In a preprint posted yesterday on bioRxiv, the researchers examine partial genetic sequences of 781 coronaviruses found in bats in China, more than one-third of which have never been published. [Related pre-print study]

AntiVirals

Russia Approves Avifavir For COVID-19 Treatment – Precision Vaccintions

Avifavir, a Favipiravir-based drug, is Russia’s first COVID-19 drug and has shown high efficacy in treating patients diagnosed with COVID-19 disease during human clinical trials.

Gilead’s next step on coronavirus: inhaled remdesivir, other easier-to-use versions – Reuters

Gilead is developing easier-to-administer versions of its antiviral treatment remdesivir for COVID-19 that could be used outside of hospitals, including ones that can be inhaled, after trials showed moderate effectiveness for the drug given by infusion.

Therapeutics

Eli Lilly begins first human tests of an antibody drug against Covid-19 – Stat

Researchers have begun testing what appears to be the first new medicine developed specifically against Covid-19, in a milestone for drug companies aiming to combat the disease.

Diagnostics

Siemens Healthineers Receives FDA Emergency Use Authorization for its SARS-CoV-2 Total Antibody Test that Delivers Superior Clinical Performance – Siemens

Siemens Healthineers announced today the U.S. Food and Drug Administration (FDA) has issued an Emergency Use Authorization (EUA) for its laboratory-based total antibody test to detect the presence of SARS-CoV-2 antibodies including IgM and IgG in blood. Test data demonstrated 100 percent sensitivity2 and 99.8 percent specificity. The total antibody test allows for identification of patients who have developed an adaptive immune response, which indicates recent infection or prior exposure. Testing can begin immediately with more than one million tests already shipped to health systems and laboratories.

 


Infection Prevention

Can We Flatten the Second Wave Without Universal Masking? – Med Page Today

Video at the link – With the U.S. recently passing the milestone of 100,000 deaths from COVID-19, MedPage Today Editor-in-Chief Martin Makary, MD, of Johns Hopkins University, discusses reasons behind a potential spike in cases in our nation’s Sun Belt states, what China has taught us about the value of masks, and what vaccines and treatments in the pipeline are most exciting to him.

Medical Workers Should Use Respirator Masks, Not Surgical Masks – New York Times

The surgical masks used in risky settings like hospitals offer much less protection against the coronavirus, an analysis found. [If first link does not work for you, try this one] [Related study]


Published Research

Emergence of SARS-CoV-2 through recombination and strong purifying selection – Science

Introductions and early spread of SARS-CoV-2 in the New York City area – Science

Physical distancing, face masks, and eye protection to prevent person-to-person transmission of SARS-CoV-2 and COVID-19: a systematic review and meta-analysis – The Lancet

Covid-19-associated coagulopathy – J Thromb Thrombolysis

SARS‐CoV‐2 and Guillain‐Barré syndrome: AIDP variant with favorable outcome – European Journal of Neurology

Hospitalization and Mortality among Black Patients and White Patients with Covid-19 – NEJM

Mortality and pulmonary complications in patients undergoing surgery with perioperative SARS-CoV-2 infection: an international cohort study – The Lancet

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

No evidence for increased transmissibility from recurrent mutations in SARS-CoV-2 – BioRXiv


Coping in Quarantine

Mental Health Monday (on a Tuesday)

Keeping Patients Calm During the Pandemic— One expert lays out strategies nurses can use – Med Page Today

With visitors being banned at most hospitals and healthcare facilities because of the spread of the coronavirus, nurses are often now one of the only contacts that patients have. So how can you help keep your patients calm during this scary time?

Anxiety High Among Docs, PAs; Outpatient Clinics Revive – Med Page Today

More than 1,200 physicians, NPs, and PAs responded to a recent survey on the COVID-19 pandemic and how it has affected their lives. The top findings show a significant increase in anxiety, a strong desire to resume work as normal, and how provider lives have been affected by changes in healthcare delivery.

Pfizer’s Zoloft Falls Into Shortage as Virus Strains Supplies – Bloomberg

The Food and Drug Administration added Zoloft tablets to its list of drugs in shortage on Friday. Zoloft, which is sold under the generic name sertraline, was first approved in the U.S. in 1991. It’s used to treat a range of conditions, including depression, obsessive-compulsive disorder and posttraumatic-stress disorder.

In Other Coping in Quarantine News…

What New York’s Trash Reveals About Life Under Lockdown – NYT

New Yorkers seem to be drinking more at home. But they’re also being productive, decluttering and gardening during the pandemic. If the link above does not work, try this one

If you need to take a break from reality, I found this list of 50 best movies on Netflix to watch. If that link did not work, try this one.