Tulane Outbreak Daily | April 20, 2020

Featured Headlines

Linking Air Pollution To Higher Coronavirus Death Rates – Harvard

In an analysis of 3,080 counties in the United States, researchers at the Harvard University T.H. Chan School of Public Health found that higher levels of the tiny, dangerous particles in air known as PM 2.5 were associated with higher death rates from the disease. [Related Study]

Singapore had a model coronavirus response, then cases spiked. What happened? – CNN

Less than a month ago, Singapore was being hailed as one of the countries that had got its coronavirus response right. Since March 17, Singapore’s number of confirmed coronavirus cases grew from 266 to over 5,900, according to data from Johns Hopkins University.

What Does Coronavirus Look Like? CDC Releases Images From First American COVID-19 Patient – Forbes

The new images from the CDC Public Health Image Library (PHIL) show the SARS-CoV2 virus looking like small pepperoni pizzas (colored blue in the image above). But, these images are hard and labor-intensive to produce and for most people with COVID-19, pictures like this will never be made.

Notes From the Field – Tulane University School of Public Health & Tropical Medicine
Tulane Outbreak Daily is happy to present Notes From the Field, a new segment that seeks to cover stories about the activities and experiences of the COVID-19 epidemic from around the world and places that are not always prominent in the news. The virus arrived early to many places in Asia and is arriving last in South America and Africa. These places have government and health care structures, as well as experiences in neighborhoods and on streets, that are both similar and different from that experienced in the United States. Tulane faculty and staff conduct the video interviews of faculty, alumni, public officials, community workers, and friends. From time to time messages submitted from students, faculty, and alumni studying and working abroad will also be included. The interviews are edited to be short (2-3 min), but links to the full interviews are included with each video.

COVID-19 Patients Need to be Tested for Bacteria and Fungi, Not Just the Coronavirus – Scientific American

Many hospitalized victims are developing potentially lethal secondary co-infections such as bacterial pneumonia and sepsis [Related Study]

These Are the Drugs and Vaccines That Might End the Coronavirus Pandemic – Bloomberg

Clinical trials are almost all in the early stages, and it could take weeks or months to get answers on what works.

C.D.C. Labs Were Contaminated, Delaying Coronavirus Testing, Officials Say – New York Times

Fallout from the agency’s failed rollout of national coronavirus kits two months ago continues to haunt U.S. efforts to combat the spread of the highly infectious virus.

An Overlooked, Possibly Fatal Coronavirus Crisis: A Dire Need for Kidney Dialysis – New York Times

Ventilators aren’t the only machines in intensive care units that are in short supply. Doctors have been confronting an unexpected rise in patients with failing kidneys.

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 20, 2020

WHO SITREP #90 ECDC | Country Data Johns Hopkins
Confirmed Cases 2,241,778 2,355,853 2,435,876
Deaths 152,551 164,656 167,369

 

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

Surveillance Headlines

USA

USA: States grapple with timing of reopening as COVID-19 deaths spike – CIDRAP

New York: coronavirus deaths still ‘horrifically high’ even as outbreak appears to slow – CNBC

Maryland: secures 500,000 coronavirus test kits from South Korea – Baltimore Sun

Michigan: Coronavirus Devastates Detroit Police, From the Chief on Down – New York Times

Massachusetts: In rare but growing number of cases, children hospitalized with coronavirus in Massachusetts – Boston Globe

EUROPE

Germany: Relaxes Shop Closures – BBC

Spain: confirmed coronavirus cases surpass 200,000, health ministry says – CNBC

Turkey: Coronavirus Crisis Grows as Infections Exceed China’s – Foreign Policy

MIDDLE EAST

Afghanistan: Dozens Test Positive for Coronavirus at Afghan President’s Palace – New York Times

ASIA

Singapore: 1,369 of the 1,426 coronavirus cases confirmed in S’pore are foreign workers living in dormitories – Straights Times

Japan: Coronavirus total surpasses 10,000 as Tokyo adds 181 cases – Japan Times

Science and Tech

From mice to monkeys, animals studied for coronavirus answers – Science Magazine

Beloved as pets, Syrian hamsters are winning another kind of attention from scientists trying to understand and defeat COVID-19. Fifteen years ago, scientists found the hamsters could readily be infected with the coronavirus that causes severe acute respiratory syndrome (SARS). Their symptoms were subtle, so the animals didn’t get much traction as a model for the disease. But with COVID-19, caused by a related virus, SARS-CoV-2, the model’s prospects appear brighter.

How does coronavirus kill? Clinicians trace a ferocious rampage through the body, from brain to toes – Science Magazine

On rounds in a 20-bed intensive care unit (ICU) one recent day, physician Joshua Denson assessed two patients with seizures, many with respiratory failure and others whose kidneys were on a dangerous downhill slide. Days earlier, his rounds had been interrupted as his team tried, and failed, to resuscitate a young woman whose heart had stopped. All shared one thing, says Denson, a pulmonary and critical care physician at the Tulane University School of Medicine. “They are all COVID positive.”

Bats Are a Key Source of Human Viruses—but They May Not Be Special – Scientific American

Bats and rodents are considered high-risk viral reservoirs—a source for diseases that can hop over to humans, and sometimes lead to epidemics. Some scientists have even argued that the animals have certain traits that increase the likelihood of spillover events from animal to people, and that they should be monitored more closely as a result. But a new analysis suggests that bats and rodents are “unexceptional” in their propensity to host viruses that infect humans.

Hydroxychloroquine Phase 3 Study Launching in the USA – Precision Vaccinations

April 20, 2020 – The US Food and Drug Administration (FDA) has reached an agreement with Switzerland based Novartis to proceed with a Phase 3 clinical trial to evaluate the use of hydroxychloroquine for the treatment of hospitalized patients with COVID-19 disease. Announced on April 20, 2020, the randomized, double-blind, placebo-controlled clinical trial with approximately 440 patients will be conducted at more than a dozen sites in the USA.

Antivirals

Remdesivir shows promising results – CIDRAP
In medical news, the antiviral drug remdesivir showed promising results when used on severely ill COVID-19 patients at the University of Chicago. The trial, however, was not randomized and did not contain a control arm of patients who did not receive the drug, so the data are not definitive.

Diagnostics

Dozens of coronavirus antibody tests on the market were never vetted by the FDA, leading to accuracy concerns – Washington Post

Aggressive marketing of the tests could confuse those clamoring for the products to determine who may have developed disease-fighting antibodies