Tulane Outbreak Daily | April 21, 2020

Featured Headlines

COVID-19 Numbers Are Bad In Ecuador. The President Says The Real Story Is Even Worse – NPR

Ecuador has one of the highest rates of COVID-19 in all of Latin America – with 10,128 cases and 507 deaths in a country of just 17 million people. But the situation may be far worse than what the official numbers show. In fact, one Ecuadorian official says it appears that thousands more people may have died of the disease than his government is reporting.

COVID-19: Not Your Typical ARDS? – MedPageToday

Experts weigh in on popular theories about HAPE, PEEP, and clotting.Clinicians treating hospitalized COVID-19 patients have remarked about how it differs from typical acute respiratory distress syndrome (ARDS), sparking debate about the best course of treatment. Driving their concerns is the fact that many of these patients have severe hypoxemia, but their respiratory compliance — the ability of the lung to expand when taking in air — frequently remains normal. [Related paper] [Related video by NYC Doc] [Related paper] [More reading on HAPE] [More reading on ARDS]

Antibody Treatments May Be the Best Hope Against the Virus Until a Vaccine – Bloomberg

Older coronaviruses, such as the one that caused severe acute respiratory syndrome, or SARS, are similar to COVID-19. The spikes of the new coronavirus, though, clasp human cells much more tightly, which appears to be one reason it spreads more easily. Neutralizing those spikes may be the best way to prevent the virus from harming its host. And among the most promising approaches to doing that is finding the right antibodies. Unlike existing medicines being tested on the virus—such as hydroxychloroquine, the malaria drug, and remdesivir, an antiviral compound designed specifically to disable the new virus where it’s most vulnerable.

The Covid-19 Newsletter That’s by Doctors for Doctors – Wired

COVID-19 has revealed how different critical care doctors are from the rest of us—and how similar. Different: They log heroic hours in the ICU, putting their own health and well-being at risk, to save as many lives as they can. Similar: Some of them pay too much attention to Twitter.

What Don’t We Know About COVID-19 Severity, Seasonality – Med Page Today

Peter Hotez, MD, PhD, describes known unknowns about the virus that may complicate “reopening America”

WHO chief warns the worst of the coronavirus is still ahead – NBC

The World Health Organization chief warned Monday that “the worst is yet ahead of us” in the coronavirus outbreak, reviving the alarm just as many countries ease restrictive measures aimed at reducing its spread.

What are ‘COVID toes?’ Doctors discover new symptom of coronavirus mostly seen in kids – USA Today

Doctors have identified a new symptom of COVID-19, caused by the novel coronavirus, informally dubbed “COVID toes.” The new symptom – a presence of purple or blue lesions on the patient’s feet and toes – is puzzling infectious disease experts.

Georgia Will Reopen Gyms, Hair Salons And Bowling Alleys As Early As Friday – Forbes

Editor’s Note: As of today, the Johns Hopkins COVID-19 map, and Georgia DPH Georgia has reported 19,398 confirmed cases, and 774 deaths. Georgia governor Brian Kemp said some businesses, including gyms, hair salons and bowling alleys, will be able to reopen as early as this week, the most aggressive state action to reopen business after issuing an earlier stay-at-home order.

The tricky math of lifting coronavirus lockdowns – MIT Technology Review

[Opinion] The Infection That’s Silently Killing Coronavirus Patients – New York Times

At the end of March, as a crush of Covid-19 patients began overwhelming hospitals in New York City, I volunteered to spend 10 days at Bellevue, helping at the hospital where I trained. Over those days, I realized that we are not detecting the deadly pneumonia the virus causes early enough and that we could be doing more to keep patients off ventilators — and alive.

Surveillance

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 21, 2020

WHO SITREP #91 ECDC | Country Data Johns Hopkins
Confirmed Cases 2,314,621 2,431,890 2,501,156
Deaths 157,847 169,859 171,810

 

Total cases: 746,625
Total deaths: 39,083
(Numbers close out at 4 p.m. the day before reporting.)

Surveillance Headlines

USA

New York: Cuomo says COVID-19 cases have peaked in New York – CIDRAP

EUROPE

Italy: Expects to Gradually Ease Lockdown From May 4 – Bloomberg

Turkey: Builds Coronavirus Hospital Over Istanbul Airport Runways – Haaretz

Russia: Remote Region Orders a Lockdown on Information as Cases Spike – NYT

Russia: Russia’s confirmed coronavirus cases surge past 52,000 – Reuters

MIDDLE EAST

ASIA

Singapore: extends lockdown amid surge in cases – AP

Science and Tech

Antivirals

Diagnostics

US OKs 1st coronavirus test that allows self-swab at home – AP

U.S. health regulators on Tuesday OK’d the first coronavirus test that allows people to collect their own sample at home, a new approach that could help expand testing options in most states.

 


Published Research

Clinical Characteristics of Covid-19 in New York City – NEJM

The characteristics of household transmission of COVID-19 – Clinical Infectious Diseases

Safety and immunogenicity of a candidate Middle East respiratory syndrome coronavirus viral-vectored vaccine: a dose-escalation, open-label, non-randomised, uncontrolled, phase 1 trial – The Lancet

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


Infection Prevention

How The Virus Spreads, Disinfecting Your Home – NPR [40 min audio program]

On this broadcast of The National Conversation, a doctor on the front line addresses some of your common questions. We’ll also take a look at how to best disinfect your home and food.


Economic Impact

Oil Spirals Below Zero in ‘Devastating Day’ for Global Industry – Bloomberg

The day started like any other gloomy Monday in the oil market’s worst crisis in a generation. It ended with prices falling below zero, thrusting markets into a parallel universe where traders were willing to pay $40 a barrel just to get somebody to take crude off their hands.


Coping in Quarantine

Currently sprouting in our greenhouse: lettuce, tomatoes, cucumbers, squash, eggplant, bell peppers, green beans and basil.

This Is A Good Time To Start A Garden. Here’s How – NPR

A Century Later, Victory Gardens Connect Americans Again – NYT

How To Compost At Home – NPR

Is your mask fogging your glasses? Tips from the front line workers – NYT