Tulane Outbreak Daily | March 25, 2020

Reader contributions

Lost Smell and Taste Hint COVID-19 Can Target the Nervous System – The Scientist The symptoms suggest SARS-CoV-2 might infect neurons, raising questions about whether there could be effects on the brain that play a role in patients’ deaths, but the data are preliminary. [Related Study] [Another related study from 2016]

Featured Headlines

Spain registers more than 700 deaths from coronavirus overnight – Reuters Spain registered 738 fatalities from the coronavirus over the past 24 hours in the steepest increase of the death toll since the epidemic hit the country. Spain surpasses China in the overall number of coronavirus deaths, now second to only Italy. Spain’s armed forces on Tuesday asked NATO for humanitarian assistance.

India Declares ‘Total’ Lockdown In Bid To Prioritize Coronavirus FightNPR Indian Prime Minister Narendra Modi declared a 21-day lockdown during an address to the country Tuesday, instructing its more than 1.3 billion residents to stay right where they are, beginning at midnight Tuesday night.

New York Infection Rate Is “Doubling About Every 3 Days” – NPR New York had 25,665 coronavirus cases — roughly half of the U.S. total. The state says at least 210 people there have died from COVID-19.

World COVID-19 total surges past 400,000; more nations lock down – CIDRAP Yesterday, the World Health Organization (WHO) warned that pandemic activity was accelerating, noting that it took only 4 days for cases to jump from 200,000 to 300,000. It took only 3 days for cases to make the jump to 400,000. The total is currently at 417,698.

FDA now allows treatment of life-threatening COVID-19 cases using blood from patients who have recovered – Tech Crunch The FDA has updated its rules around use of experimental treatments for the ongoing COVID-19 pandemic to include use of “convalescent plasma,” in cases where the patient’s life is seriously or immediately threatened. This isn’t an approval of the procedure as a certified treatment, but rather an emergency clearance that applies only on a case-by-case basis, and only in extreme cases, as a means of helping further research being done into the possible efficacy of plasma collected from patients who have already contracted, and subsequently recovered from, a case of COVID-19.

COVID-19 in Europe: the Italian lesson – Lancet Italy has the second-largest number of confirmed cases, after China. A rapid surge of cases is posing a serious threat to the Italian national health system because of the limited capacity of intensive care unit departments. 


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

24-Mar-20 (Global) WHO ECDC Johns Hopkins
Confirmed Cases 372,757 416,916 436,159
Deaths 16,231 18, 565 19,648

WHO SITREP #63 MAR 24

Total (new) cases in last 24 hours

Globally: 372 757 confirmed (39 827) 16 231 deaths (1722)
Western Pacific Region: 96 580 confirmed (943) 3502 deaths (29)
European Region: 195 511 confirmed (24 087) 10 189 deaths (1447)
South-East Asia Region: 1990 confirmed (214) 65 deaths (7)
Eastern Mediterranean Region: 27 215 confirmed (1840) 1877 deaths (136)
Region of the Americas:  49 444 confirmed (12 428) 565 deaths (100)
African Region: 1305 confirmed (315) 26 deaths (3)

As of March 24, 2020 (ECDC)

(Globally)
Confirmed Cases: 416,916
Deaths: 18,565
Cases < 15 Days: 302,288

Total cases: 44,183
Total deaths: 544
Jurisdictions reporting cases: 54 (50 states, District of Columbia, Puerto Rico, Guam, and US Virgin Islands)
 

Travel Related: 479
Close Contact: 569
Under Investigation: 43,135
Total Cases: 15,219

Total Cases: 44,183

As of March 25, 2020
(Globally)
Total Confirmed Cases: 436,159
Total Deaths: 19,648
Total Recovered: 111,847

Surveillance Headlines

USA

Pennsylvania & New Jersey: COVID-19 crisis worsens, Pa. and N.J. have even fewer life-saving ventilators than anticipated – Philadelphia Inquirer

New York: Four Sites Identified by Army Corps of Engineers on Initial List of Temporary Hospitals – NY.gov

 

Caribbean: COVID-19 Death Toll In The Caribbean Reaches 15 – NewsAmerica

Europe

Italy: After slight decreases in reported daily cases over the past 2 days, Italy’s number today was higher, with 5,249 cases, compared with 4,789 yesterday, for a total of 69,176, according to the health ministry. Similarly, the number of deaths today, at 743, were up from the 601 reported yesterday.

Spain: Reported 4,540 new cases, up from 4,321 reported yesterday, to bring the overall number to 39,636. The country also reported 489 more deaths, up from 435 reported yesterday, for a total of 2,800.

UK: stay-at-home order that will last for 3 weeks and be enforced by the police, affecting a population of about 66.5 million. The order shutters nonessential businesses, closes public gathering places, and bars gatherings of more than two people, except for those who live in households and those attending funerals. UK health officials today said they are working with military planners and engineers to open a new 500-bed hospital in London next week to treat COVID-19 patients. CIDRAP

UK: Prince Charles tests positive but ‘remains in good health’ BBC

Scotland: Reports 6 new cases, and 51 people who have tested positive for the virus were being treated in intensive care units. BBC

Germany: Why is Covid-19 death rate so low in Germany? – CNN

Asia

China: Restrictions eased in most of Hubei province, which has been on lockdown for the past 2 months. The exception is the city of Wuhan, where restrictions remain until Apr 8. China today reported 78 new cases, including the first from Hubei province (Wuhan) in 5 days. Of the new cases, 74 were linked to international travel. CIDRAP

Hong Kong: Reported 30 more cases, 19 linked to travel.

Singapore: Reported 49 new cases, 17 of them linked to travel

Malaysia: Reported 106 new cases. 

Japan: Tokyo Cherry Blossom Festival Draws Crowds Despite Coronavirus Warnings – NPR

Middle East

Iran: Reported 1,762 cases, up from 1,411 reported yesterday, lifting the overall total to 24,811. The country also reported 122 more deaths, putting the death count at 1,934. The WHO said yesterday that it has delivered another shipment of medical supplies to Iran, the seventh so far. Among the contents were lopinavir and ritonavir medications to allow health workers to treat patients enrolled in research studies that are part of a large international collaboration. Iran’s health ministry has launched a self-assessment tool that directs sick patients, if needed, to 16-hour treatment clinics that can diagnose and treat the disease, then refers patients to hospital or home care, as needed. CIRAP

Africa

WHO’s African regional office: COVID-19 activity is intensifying in Africa, with 12 more countries reporting their first cases over the past week, bringing the affected number of countries on the continent to 43. Also, the region reported 868 cases last week, the highest so far in a single week. South Africa, Algeria, Burkina Faso, Senegal, and Cameroon. All but six countries in the region have reported local infections in contacts of imported cases. The WHO said many of the cases are still linked to travel and that the region still has a window of opportunity to contain the disease. CIDRAP

Nigeria: Reports 46 cases Premium Times


Travel Advisories

Look up current travel advisories at US Department of State

U.S. CDC Travel Advisories


Infection Prevention

Q: Can Coronavirus be transmitted on mail or packages?

A few articles on the topic will provide a yes and no answer.

Can telehealth help flatten the curve of COVID-19? – Harvard HealthTelehealth, the virtual care platforms that allow health care professionals and patients to meet by phone or video chat, seems tailor-made for this moment in time. Also known as telemedicine or digital health, it’s often touted as a convenience for patients who are busy or far away, or when travel isn’t feasible due to severe weather or an urgent condition like a stroke.

Can homemade masks protect you from COVID-19? – LivescienceIn the past, infectious disease experts questioned the value of homemade cloth masks as a defense against viruses like the flu. But now urging medical professionals who only have access to limited protective equipment to use homemade cloth masks if they have absolutely no other option. The CDC now recommends that health care providers with absolutely no other option use a bandana or scarf when treating patients with COVID-19. However,this should ideally be paired with a face shield, and even then, the impact on disease reduction is unknown. 

Singapore modelling study estimates impact of physical distancing on reducing spread of COVID-19 – Science Daily A new modelling study conducted in a simulated Singapore setting has estimated that a combined approach of physical distancing interventions, comprising quarantine (for infected individuals and their families), school closure, and workplace distancing, is most effective at reducing the number of SARS-CoV-2 cases compared with other intervention scenarios included in the study. [Related Study]

Rational use of face masks in the COVID-19 pandemic – Lancet

Since the outbreak of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), the virus that caused coronavirus disease 2019 (COVID-19), the use of face masks has become ubiquitous in China and other Asian countries such as South Korea and Japan. Some provinces and municipalities in China have enforced compulsory face mask policies in public areas; however, China’s national guideline has adopted a risk-based approach in offering recommendations for using face masks among health-care workers and the general public. We compared face mask use recommendations by different health authorities (panel). Despite the consistency in the recommendation that symptomatic individuals and those in health-care settings should use face masks, discrepancies were observed in the general public and community settings. For example, the US Surgeon General advised against buying masks for use by healthy people. One important reason to discourage widespread use of face masks is to preserve limited supplies for professional use in health-care settings. Universal face mask use in the community has also been discouraged with the argument that face masks provide no effective protection against coronavirus infection.


Science and Tech

Ford Helps Make Medical Devices From F-150 Parts – Torque  Ford works with 3M, GE, UAW to speed production of medical respirators and face shields for healthcare workers. Parts made from F-150 will help Corona virus patients and first responders.

Vaccine

The coronavirus isn’t mutating quickly, suggesting a vaccine would offer lasting protection – Washington PostAll viruses evolve over time, accumulating mutations as they replicate imperfectly inside a host’s cells in tremendous numbers and then spread through a population, with some of those mutations persisting through natural selection. The new coronavirus has proofreading machinery, however, and that reduces the “error rate” and the pace of mutation. It looks pretty much the same everywhere it has appeared, the scientists say, and there is no evidence that some strains are deadlier than others.

Diagnostics

FDA Approves More ‘Rapid’ COVID-19 Coronavirus Tests For Use On Frontlines – ForbesThe U.S. Food and Drug Administration is approving more rapid molecular diagnostic tests that can be used in temporary screening locations, doctor’s office labs and nursing homes to detect the Coronavirus strain COVID-19 within a half hour.

Roche Receives Emergency Use FDA Approval for Automated Coronavirus Test – Hospimedica

Up Close – NIH NIAID

Colorized scanning electron micrograph of an apoptotic cell (blue) heavily infected with SARS-COV-2 virus particles (yellow), isolated from a patient sample

Colorized scanning electron micrograph of an apoptotic cell (blue) heavily infected with SARS-COV-2 virus particles (yellow), isolated from a patient sample. Image captured and color-enhanced at the NIAID Integrated Research Facility (IRF) in Fort Detrick, Maryland. Credit: NIAID

 


Published Research

Treating COVID-19—Off-Label Drug Use, Compassionate Use, and Randomized Clinical Trials During Pandemics – JAMA

Lung Recruitability in SARS-CoV-2 Associated Acute Respiratory Distress Syndrome: A Single-center, Observational Study. – Respiratory Critical Care

Interventions to mitigate early spread of SARS-CoV-2 in Singapore: a modelling study – Lancet

The first infant case of COVID-19 acquired from a secondary transmission in Vietnam – Lancet

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

 


Policy & Guidance

 


Economic Impact

China’s COVID-19 Lockdown Crushed Every Form Of Energy Generation Except Solar – Forbes As China shuttered industries during its coronavirus lockdown in January and February, every form of energy production dropped from prior-year performance but one. Solar was up 12 percent.


Coping in Quarantine

Free At-Home Services Available To Consumers During The COVID-19 Pandemic – Forbes