Tulane Outbreak Daily | April 30, 2020

Featured Headlines

Hopes rise on coronavirus drug remdesivir – Nature

Despite conflicting data, results from largest trial that show the antiviral speeds up recovery will make the treatment a standard of care in the United States.

Pick of the coronavirus papers: SARS-CoV-2 might invade by hijacking its host’s immune defences

The new coronavirus invades human cells after one of its proteins binds with ACE2, a protein found in cells in many human organs. But little has been known about that crucial interaction. [Related Paper]

Anticoagulation Recommended Even After Discharge – MedPageToday

Clinicians treating COVID-19 patients have described pervasive clots in the lungs on autopsy, breakthrough clotting clogging dialysis lines despite antithrombotic medication, and even clots forming in real-time during mechanical thrombectomy for ischemic stroke. [Related Study and Guidelines] [Anticoagulation Guidance Webinar] [Guidelines from Netherlands]

Spike in US deaths and cases flagged as pneumonia suggest even greater COVID-19 impact – USA Today

Federal data released this week shows that the number of deaths recorded in the U.S. this year is higher than normal, outpacing deaths attributed to COVID-19 in states that have been hit hardest by the virus. [Related Study]

For COVID-19, Beware the Calm, Not Just the Storm – Hospital Leader.org

For the past week, I’ve seen a glimmer of optimism in my New Orleans health care colleagues. The emergence of hope is no small thing. This pandemic has been inches from overwhelming those of us on the front lines for weeks. Louisiana has one of the cases in the country, and St. John the Baptist Parish—just outside New Orleans—has the highest per capita death rate in the country. As the pandemic continues, infections will spread, and the death toll will rise. But there are signs that the city and the state are beginning to “flatten the curve.” The spread of new cases has slowed, and hospital admissions are stable.

Nature Publication Presents New ‘Blueprint’ Revealing How SARS-CoV-2 Virus Hijacks Human Cells Points to Drugs with Potential to Fight COVID-19, and a Drug that Promotes Infection – UCSF

An international team of more than 120 scientists has detailed the impact of 75 over-the-counter prescription and development-stage drug compounds on SARS-CoV-2, the virus that causes COVID-19. Several of these agents show promise in blocking SARS-CoV-2 replication in laboratory experiments. One compound investigated in the research, a common ingredient in over-the-counter cough medicines, appears to have the potential to promote the growth of the virus. [Related paper in Nature]

Coronavirus R0: Is this the crucial number? – BBC

There is a simple, but crucial number at the heart of understanding the threat posed by the coronavirus. It is guiding governments around the world on the actions needed to save lives, and it gives us clues to the extent that lockdown can be lifted.

The coronavirus czar – Science

The COVID-19 pandemic has made German virologist Christian Drosten an unlikely cult figure.

Receptors for SARS-CoV-2 Present in Wide Variety of Human Cells – The Scientist

Analyses from single-cell sequencing datasets support the idea that COVID-19 is not just a respiratory disease but an illness that can affect multiple organs. [Related Pre-Print]

COVID-19 In Children: How They Contract Infection And What Are The Symptoms – NPR

NPR’s Mary Louise Kelly talks with Dr. Roberta DeBiasi, chief of the infectious diseases department at Children’s National Hospital, about the COVID-19 cases among children.

What Do Testicles Have To Do With COVID-19 Coronavirus? – Forbes

Data have suggested that men who get infected with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) are more likely to suffer worse outcomes than women, as Nina Shapiro described for Forbes. This has prompted scientists to wonder what is different about men, not in general, but in regards to the COVID-19 coronavirus. Well, one difference (or perhaps two differences) is those things that men are adjusting all the time. No, not the television remote control, but testicles. [Related pre-print study]

What About Hydroxychloroquine? – FLARE

A discussion on the data from the FLARE team.


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 30, 2020

WHO SITREP #100 ECDC | Country Data Johns Hopkins
Confirmed Cases 3,018,681 3,130,800 3,247,648
Deaths 207,973 227,051 230,615


New CDC Publications:
  1. Characteristics and Clinical Outcomes of Adult Patients Hospitalized with COVID-19 — Georgia, March 2020
  2. Coronavirus Disease Outbreak in Call Center, South Korea
Total cases: 1,005,147
Total deaths: 57,505
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines


Massachusetts: Coronavirus kills 70 veterans at care home – BBC

Chicago, Illinois: firefighter, apparently recovered from COVID-19, suffers fatal stroke – Chicago Tribune

Los Angeles, California: Los Angeles City And County Offer Free Coronavirus Testing To All Residents – NPR


Germany: German social distancing will be extended to May 10 – Reuters

Germany: R0 has risen slightly from 0.7 earlier this month to 1.0 – CIDRAP


Africa: Pandemic activity is evolving rapidly in Africa, with cases rising 42% over the past week and deaths increasing by 24% – CIDRAP/WHO

Equatorial Guinea, Nigeria, and Tanzania: Reported exponential increases last week

South Africa, Cameroon, Ghana, Nigeria, Iory Coast, Guinea, Niger, Senegal and Burkina Faso: Account for 84% of all cases. Niger reports 126 health care workers infected – CIDRAP

Niger: 4.4% reported mortality rate – CIDRAP

Algeria: 12.6% reported mortality rate – CIDRAP

Liberia (9.7%) reported mortality rate – CIDRAP

Democratic Republic of the Congo (6.1%) reported mortality rate – CIDRAP

Mali (6.6%) reported mortality rate – CIDRAP

Burkina Faso (6.6%). reported mortality rate – CIDRAP


Japan: Low testing rate raises questions – BBC

South Korea: Reports No New Domestic Coronavirus Cases – NPR

Science and Tech



The race for coronavirus vaccines: a graphical guide – Nature

More than 90 vaccines are being developed against SARS-CoV-2 by research teams in companies and universities across the world. Researchers are trialling different technologies, some of which haven’t been used in a licensed vaccine before. At least six groups have already begun injecting formulations into volunteers in safety trials; others have started testing in animals. Nature’s graphical guide explains each vaccine design.

AstraZeneca and Oxford University announce landmark agreement for COVID-19 vaccine – AstraZeneca

The collaboration aims to bring to patients the potential vaccine known as ChAdOx1 nCoV-19, being developed by the Jenner Institute and Oxford Vaccine Group, at the University of Oxford. Under the agreement, AstraZeneca would be responsible for development and worldwide manufacturing and distribution of the vaccine.

Pfizer and BioNTech Plan to Initiate U.S. COVID-19 Vaccine Trial Next Week – BioSpace

Pfizer and Germany-based BioNTech are collaborating on a messenger RNA vaccine against SARS-CoV-2, the novel coronavirus that causes COVID-19. The two companies have already begun Phase I/II clinical testing in Germany. The companies now plan to start testing in the U.S. once the U.S. Food and Drug Administration (FDA) gives approval.


New Scottish drug shows promise in battle against Covid-19 – University of St. Andrews



Johns Hopkins launches COVID-19 testing hub to provide public access to testing data – TechCrunch

The COVID-19 testing picture in the U.S. is far from easy to understand, given the disparate agencies and public and private health organizations involved. Johns Hopkins, building on its excellent work developing COVID-19 case tracking and basic information resources, has developed a new hub called the COVID-19 Testing Insights Initiative that breaks down what kinds of tests are available, as well as where they’re being administered in the U.S., and in what volume.

NIH launches competition to speed COVID-19 diagnostics – Science

The U.S. National Institutes of Health (NIH) today announced a $1.5 billion initiative to speed breakthroughs in diagnostic tests for the virus that causes COVID-19. The program aims to increase the U.S. capacity for SARS-CoV-2 testing up to 100-fold by late summer, in time for the start of the flu season.


Published Research

A SARS-CoV-2 protein interaction map reveals targets for drug repurposing – Nature

[Letter to editor] Out-of-Hospital Cardiac Arrest during the Covid-19 Outbreak in Italy – NEJM

Aerodynamic analysis of SARS-CoV-2 in two Wuhan hospitals – Nature

COVID-19 and Thrombotic or Thromboembolic Disease: Implications for Prevention, Antithrombotic Therapy, and Follow-up – Journal of the American College of Cardiology

Diagnosis, Prevention, and Treatment of Thromboembolic Complications in COVID-19: Report of the National Institute for Public Health of the Netherlands – RSNA

SARS‑Cov‑2 (human) and COVID‑19: Primer 2020 – Hepatology International

COVID-19 and malaria: A symptom screening challenge for malaria endemic countries – International Journal of Infectious Diseases

Clinically suspected myocarditis in the course of coronavirus infection – European Heart Journal

Myocarditis revealing COVID-19 infection in a young patient – European Cardiovascular Imaging

Acute Hyperglycemic Crises with Coronavirus Disease-19: Case Reports – Diabetes Metabolism Journal

Kallikrein-kinin blockade in patients with COVID-19 to prevent acute respiratory distress syndrome – Lifesciences.org

COVID-19: A Geriatric Emergency – Geriatrics

Variation in COVID-19 Hospitalizations and Deaths Across New York City Boroughs – [Research Letter] JAMA

Prevalence and fatality rates of COVID-19: What are the reasons for the wide variations worldwide? – Travel Medicine and Infectious Disease

Moving Personal Protective Equipment Into the Community – [Viewpoint] JAMA

Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2) – Science

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

SARS-CoV-2 receptor ACE2 is an interferon-stimulated gene in human airway epithelial cells and is detected in specific cell subsets across tissues – Cell

Delayed clearance of SARS-CoV2 in male compared to female patients: High ACE2 expression in testes suggests possible existence of gender-specific viral reservoirs – MedRXiv

Integrated analyses of single-cell atlases reveal age, gender, and smoking status associations with cell type-specific expression of mediators of SARS-CoV-2 viral entry and highlights inflammatory programs in putative target cells – BioRXiv


Coping in Quarantine

What happens when you mix art history with the internet and millions of people at home? This happens! If you enjoy these as much as I do, there are more on Instagram

Taking care of yourself during the pandemic, from head to toe – Washington Post

It’s been more than a month since many of us have been to work, the gym or the hairdressers. We’re still not sleeping well, our hands are dry from too much hand sanitizer, and our brains are foggy from reading too much about covid-19. Take a step back and pay attention to your mental and physical needs during this time. You’ll be glad you did. [if you hit a paywall at the link, let me know and I’ll post entire article]