Tulane Outbreak Daily | May 20, 2020

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Featured Headlines

Elderly covid-19 patients on ventilators usually do not survive, New York hospitals report – Washington Post

Most elderly covid-19 patients put on ventilators at two New York hospitals did not survive, according to a sweeping study published Tuesday that captured the brutal nature of this new disease and the many ways it attacks the body.

Scientists isolate live COVID-19 virus from feces, detect RNA on surfaces – CIDRAP

Chinese researchers have isolated live COVID-19 virus from the feces of patients who died from the disease. [Related Study]

Why do some COVID-19 patients infect many others, whereas most don’t spread the virus at all? – Science Magazine

When 61 people met for a choir practice in a church in Mount Vernon, Washington, on 10 March, everything seemed normal. For 2.5 hours the chorists sang, snacked on cookies and oranges, and sang some more. But one of them had been suffering for 3 days from what felt like a cold—and turned out to be COVID-19. In the following weeks, 53 choir members got sick, three were hospitalized, and two died, according to a 12 May report by the U.S. Centers for Disease Control and Prevention (CDC) that meticulously reconstructed the tragedy.

How COVID-19 Deaths Are Counted – Scientific American

Assigning a cause of death is never straightforward, but data on excess deaths suggest coronavirus death tolls are likely an underestimate

Unusual Symptoms of Coronavirus: What We Know So Far – Time

While most people are familiar with the hallmark symptoms of COVID-19 by now—cough, fever, muscle aches, headaches and difficulty breathing—a new crop of medical conditions are emerging from the more than 4 million confirmed cases of the disease around the world.

On the Other Side of the Curve: NYC Clinicians Catch Their Breath – MedPageToday

For 59 days, Craig Smith, MD, surgeon-in-chief at NewYork-Presbyterian Hospital, had been posting a daily update about working through the COVID-19 crisis in New York. His messages came to an end last week, as his hospital and others in the state had reached the declining side of the coronavirus curve.

What causes hypoxemia in COVID-19? (Part II) – FLARE

In last night’s FLARE, we discussed the differences between hypoxemia and hypoxia, and reviewed the fundamental mechanisms of hypoxemia with an emphasis on V/Q mismatch and shunt. In tonight’s Part II, we discuss the mechanisms of hypoxemia in ARDS. We go on to examine the published observations of hypoxemia in COVID-19 and conclude that nothing in the available literature suggests a novel mechanism of hypoxemia. In case you missed it, What causes hypoxemia in COVID-19 Part I is here

The girl who died twice – Washington Post

Juliet Daly was a healthy 12-year-old in Covington, La., until the coronavirus infected her heart, making its electrical signals go haywire and stop working.

HHS, Industry Partners Expand U.S.-Based Pharmaceutical Manufacturing for COVID-19 Response – HHS

The U.S. Department of Health and Human Services will work with a team of private industry partners led by Phlow Corporation of Richmond, Virginia, to expand pharmaceutical manufacturing in the United States for use in producing medicines needed during the COVID-19 response and future public health emergencies.

World Health Organization members agree response probe – BBC

The resolution, approved without objection by the WHO’s 194-member annual assembly meeting virtually in Geneva, also allows for the inquiry to look into the health body’s own role.

Magic Six Feet Not Enough To Prevent SARS-CoV-2 Transmission in a Light Breeze – Technology Networks

Airborne transmission of viruses, like the virus causing COVID-19, is not well understood, but a good baseline for study is a deeper understanding of how particles travel through the air when people cough.

Is there a genetic predisposition to COVID-19? – Business Report

A large number of people with COVID-19 are asymptomatic. Others recover quickly while many suffer severe symptoms including profound respiratory distress. A significant number die from the infection. What are the driving causes of this variability?

COVID-19 Researchers Study Llama’s Special Antibodies – NPR

[2 min audio at link] The global search for a treatment targeting the coronavirus has led to an unlikely potential savior: a cocoa-colored llama named Winter, whose blood could hold a weapon to blunt the virus.

 

Official Reporting for May 20, 2020

WHO SITREP #120 ECDC Johns Hopkins
Confirmed Cases 4,248,389 4,861,456 4,931,057
Deaths 292,046 322,483 324,240

 

NEW:

Infectious SARS-CoV-2 in Feces of Patient with Severe COVID-19 – CDC

CDC Activities and Initiatives Supporting the COVID-19 Response and the President’s Plan for Opening America Up Again (60 Page Document)

Performing Facility-wide SARS-CoV-2 Testing in Nursing Homes

High COVID-19 Attack Rate Among Attendees at Events at a Church — Arkansas, March 2020 – CDC

Total cases: 1,504,830
Total deaths: 90,340
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines

USA

Southern California: Imperial County hospitals turning away COVID-19 patients after surge in cases from Mexico – Local News

Navajo Nation: COVID-19 impacts every corner of the Navajo Nation – High Country News

Arkansas: CDC Publishes A Report About The Coronavirus Outbreak In Arkansas – NPR

CDC plans sweeping COVID-19 antibody study in 25 metropolitan areas – NBC

Science and Tech

Study shows how RNA editing affects the replication of COVID-19 virus – Medical news

Two human deaminase enzymes edit the RNA of the SARS-CoV-2 virus when it enters a patient’s body, with implications for the evolution of the virus and the spread of the infection, according to a new study.

Diagnostics

Roche highly accurate antibody test for COVID-19 goes live at more than 20 initial lab sites in the US – Ortho Spine News

Roche today announced its Elecsys® Anti-SARS-CoV-2 antibody test is live at more than 20 commercial and hospital lab sites throughout the United States, with plans in the next several weeks to increase to more than 200 commercial and hospital lab sites with the ability to perform millions of tests per week. The Elecsys® Anti-SARS-CoV-2 antibody test received Emergency Use Authorization from the FDA earlier this month.

Antivirals

Remdesivir Safety Forecast: Watch the Liver, Kidneys – MedPageToday

The adverse event profile for remdesivir as a treatment for COVID-19 remains murky, although liver and kidney risks are emerging. [Related Study]

How Remdesivir Blocks SARS-CoV-2 Replication Read more from Asian Scientist Magazine at: https://www.asianscientist.com/2020/05/in-the-lab/remdesivir-blocks-sarscov2-replication/ – Asian Scientist

In a study published in Science, researchers report the high-resolution structure of Remdesivir-bound RNA replicase complex from SARS-CoV-2, the infective virus of COVID-19. These results could be used to design more powerful and specific drugs for COVID-19.

Vaccine

 


Infection Prevention

10 Indoor Places To Avoid Due To Covid-19 Coronavirus – Forbes

Now that various places are re-opening after being closed to reduce the spread of the Covid-19 coronavirus, it’s time to treat your favorite locations like high school crushes whom you haven’t seen in years. Times have changed and the virus is still circulating, so don’t go running into their open arms just yet.

Personal Protective Equipment and Covid-19 – NEJM

Given the threat of coronavirus disease 2019, or Covid-19, it is important to emphasize the use of proper precautions for infection control in health care settings. Severe acute respiratory syndrome coronavirus 2, or SARS-CoV-2, is the virus that causes Covid-19.1 The routes of SARS-CoV-2 transmission include direct contact — that is, contact with the respiratory droplets and aerosols from an affected person — and indirect contact, such as contact with contaminated surfaces or supplies.2

 


Published Research

Horizontal transmission of severe acute respiratory syndrome coronavirus 2 to a premature infant: multiple organ injury and association with markers of inflammation – The Lancet

Musculoskeletal symptoms in SARS-CoV-2 (COVID-19) patients – Journal of Orthopedic Surgery

COVID-19 and vaping: risk for increased susceptibility to SARS-CoV-2 infection? – European Respiratory Journal

On coughing and airborne droplet transmission to humans – AIP Physics of Fluids

Tale of three seeding patterns of SARS-CoV-2 in Saudi Arabia – The Lancet

SARS-CoV-2 and Legionella Co-Infection in a Person Returning From a Nile Cruise – Travel Medicine

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

 


Coping in Quarantine

Your quarantine experience, reviewed like a hotel – Washington Post

Since the pandemic shut down travel around the world, By The Way has been encouraging readers to “travel from their couch,” from virtual museum tours to hotel-inspired recipes. But let’s face it: Quarantine isn’t exactly the vacation of your dreams. The meals are repetitive and leave a lot to be desired (is the chef even trained?), and no matter how many times you put out the Do Not Disturb sign, it never works (other guests, a.k.a your kids, are always barging in).

Amid Pandemic, Finding Normalcy in the Abnormal – NYT

In a city that is no stranger to outbreaks, life has a way of going on.Two blocks from my apartment on the western edge of Hong Kong Island, a Starbucks has been transformed into what looks like a construction zone, or maybe a strange art installation.