SARS-CoV-2 and COVID-19 (14)
Dette er en fortsættelse af tråden SARS-CoV-2 and COVID-19 (13).
Denne tråd er fortsat i SARS-CoV-2 and COVID-19 (15).
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1margd
Moderna Covid-19 vaccine appears safe, shows signs of working in older adults: (Phase 2) Study
Reuters | Sep 30 2020,
...in older adults who received two injections of the 100 microgram dose 28 days apart, the vaccine produced immune responses roughly in line with those seen in younger adults. ...
https://www.deccanherald.com/business/business-news/moderna-covid-19-vaccine-app...
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Evan J. Anderson et al. 2020. Safety and Immunogenicity of SARS-CoV-2 mRNA-1273 Vaccine in Older Adults. NEJM ( Sept 29, 2020) DOI: 10.1056/NEJMoa2028436 https://www.nejm.org/doi/full/10.1056/NEJMoa2028436
ABSTRACT...
Results
Solicited adverse events were predominantly mild or moderate in severity and most frequently included fatigue, chills, headache, myalgia, and pain at the injection site. Such adverse events were dose-dependent and were more common after the second immunization. Binding-antibody responses increased rapidly after the first immunization. By day 57, among the participants who received the 25-μg dose, the anti–S-2P geometric mean titer (GMT) was 323,945 among those between the ages of 56 and 70 years and 1,128,391 among those who were 71 years of age or older; among the participants who received the 100-μg dose, the GMT in the two age subgroups was 1,183,066 and 3,638,522, respectively. After the second immunization, serum neutralizing activity was detected in all the participants by multiple methods. Binding- and neutralizing-antibody responses appeared to be similar to those previously reported among vaccine recipients between the ages of 18 and 55 years and were above the median of a panel of controls who had donated convalescent serum. The vaccine elicited a strong CD4 cytokine response involving type 1 helper T cells.
Conclusions
In this small study involving older adults, adverse events associated with the mRNA-1273 vaccine were mainly mild or moderate. The 100-μg dose induced higher binding- and neutralizing-antibody titers than the 25-μg dose, which supports the use of the 100-μg dose in a phase 3 vaccine trial...
Reuters | Sep 30 2020,
...in older adults who received two injections of the 100 microgram dose 28 days apart, the vaccine produced immune responses roughly in line with those seen in younger adults. ...
https://www.deccanherald.com/business/business-news/moderna-covid-19-vaccine-app...
-----------------------------------------------------------------------------------------------------------
Evan J. Anderson et al. 2020. Safety and Immunogenicity of SARS-CoV-2 mRNA-1273 Vaccine in Older Adults. NEJM ( Sept 29, 2020) DOI: 10.1056/NEJMoa2028436 https://www.nejm.org/doi/full/10.1056/NEJMoa2028436
ABSTRACT...
Results
Solicited adverse events were predominantly mild or moderate in severity and most frequently included fatigue, chills, headache, myalgia, and pain at the injection site. Such adverse events were dose-dependent and were more common after the second immunization. Binding-antibody responses increased rapidly after the first immunization. By day 57, among the participants who received the 25-μg dose, the anti–S-2P geometric mean titer (GMT) was 323,945 among those between the ages of 56 and 70 years and 1,128,391 among those who were 71 years of age or older; among the participants who received the 100-μg dose, the GMT in the two age subgroups was 1,183,066 and 3,638,522, respectively. After the second immunization, serum neutralizing activity was detected in all the participants by multiple methods. Binding- and neutralizing-antibody responses appeared to be similar to those previously reported among vaccine recipients between the ages of 18 and 55 years and were above the median of a panel of controls who had donated convalescent serum. The vaccine elicited a strong CD4 cytokine response involving type 1 helper T cells.
Conclusions
In this small study involving older adults, adverse events associated with the mRNA-1273 vaccine were mainly mild or moderate. The 100-μg dose induced higher binding- and neutralizing-antibody titers than the 25-μg dose, which supports the use of the 100-μg dose in a phase 3 vaccine trial...
2margd
Vilified Early Over Lax Virus Strategy, Sweden Seems to Have Scourge Controlled
Thomas Erdbrink | Sept. 29, 2020
After having weathered high death rates when it resisted a lockdown in the spring, Sweden now has one of Europe’s lowest rates of daily new cases. Whether that is an aberration remains to be seen.
...“There are indications that the Swedes have gained an element of immunity to the disease, which, together with everything else they are doing to prevent the infection from spreading, is enough to keep the disease down,” Kim Sneppen, professor of biocomplexity at the Niels Bohr Institute in Copenhagen, said in an interview.
He stressed that the country could have avoided the high death toll in the beginning, but said that Sweden had regained control from mid-April, when deaths declined steadily.
While the Swedes are far from having achieved herd immunity, he said, “we can conclude that their social distancing rules have proven essential.”
https://www.nytimes.com/2020/09/29/world/europe/sweden-coronavirus-strategy.html
Thomas Erdbrink | Sept. 29, 2020
After having weathered high death rates when it resisted a lockdown in the spring, Sweden now has one of Europe’s lowest rates of daily new cases. Whether that is an aberration remains to be seen.
...“There are indications that the Swedes have gained an element of immunity to the disease, which, together with everything else they are doing to prevent the infection from spreading, is enough to keep the disease down,” Kim Sneppen, professor of biocomplexity at the Niels Bohr Institute in Copenhagen, said in an interview.
He stressed that the country could have avoided the high death toll in the beginning, but said that Sweden had regained control from mid-April, when deaths declined steadily.
While the Swedes are far from having achieved herd immunity, he said, “we can conclude that their social distancing rules have proven essential.”
https://www.nytimes.com/2020/09/29/world/europe/sweden-coronavirus-strategy.html
3margd
Australian scientists develop a nasal spray that could stop SARS-CoV-2 infection
Angela Betsaida B. Laguipo | Sep 29 2020
...a biotech company in Australia, Ena Respiratory, said that a nasal spray it is developing might help boost the human immune system to fight flu and common colds, significantly reduced the growth of the coronavirus in a recent study in animals.
...The novel product, called INNA-051, is being developed by Ena Respiratory, and laboratory experiments have shown that it reduced viral replication by as much as 96 percent in the animal study...
Used as a nasal spray, it aims to boost the natural immune system of the body to fight common colds and flu. It works by triggering the innate immune system, which is the body’s first line of defense against infection from a pathogen. When the drug has enhanced the immune system, it also prevented the infection and replication of SARS-CoV-2 in the laboratory.
...To test the nasal spray, the team obtained nasal wash and throat swab samples four days before the viral challenge. Upon analyzing the viral RNA in nasal wash samples, the team confirmed infection in all treatment groups, with lower viral RNA levels seen in the INNA-051 treatment.
The team has found that prophylactic intra-nasal administration of INNA-051 in the SARS-CoV-2 ferret infection model has reduced levels of viral RNA in the nose and threat.
...Further, the research team added that the prophylactic approach is important to people at a high risk of community transmission or development of the severe disease from COVID-19, such as older adults, people with comorbidities, and those who are immunocompromised...
https://www.news-medical.net/news/20200929/Australian-scientists-develop-a-nasal...
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Proud, P., Tsitoura, D., Watson, R., Chua, W., et al. (2020). Prophylactic intranasal administration of a TLR2 agonist reduces upper respiratory tract viral shedding in a SARS-CoV-2 challenge ferret model. bioRxiv. https://www.biorxiv.org/content/10.1101/2020.09.25.309914v1 https://www.biorxiv.org/content/10.1101/2020.09.25.309914v1
Abstract...Like all respiratory viruses, the most recent novel human coronavirus SARS-CoV-2, initiates infection in the upper respiratory tract (URT). Infected individuals are often asymptomatic, yet highly infectious and readily transmit virus. A therapy that restricts initial replication in the URT has the potential to prevent progression of severe lower respiratory tract disease as well as limiting person-to-person transmission.
We show that prophylactic intra-nasal administration of the TLR2/6 agonist INNA-051 in a SARS-CoV-2 ferret infection model effectively reduces levels of viral RNA in the nose and throat. The results of our study support clinical development of a therapy based on prophylactic TLR2/6 innate immune activation in the URT to reduce SARS-CoV-2 transmission and provide protection against COVID-19...
Angela Betsaida B. Laguipo | Sep 29 2020
...a biotech company in Australia, Ena Respiratory, said that a nasal spray it is developing might help boost the human immune system to fight flu and common colds, significantly reduced the growth of the coronavirus in a recent study in animals.
...The novel product, called INNA-051, is being developed by Ena Respiratory, and laboratory experiments have shown that it reduced viral replication by as much as 96 percent in the animal study...
Used as a nasal spray, it aims to boost the natural immune system of the body to fight common colds and flu. It works by triggering the innate immune system, which is the body’s first line of defense against infection from a pathogen. When the drug has enhanced the immune system, it also prevented the infection and replication of SARS-CoV-2 in the laboratory.
...To test the nasal spray, the team obtained nasal wash and throat swab samples four days before the viral challenge. Upon analyzing the viral RNA in nasal wash samples, the team confirmed infection in all treatment groups, with lower viral RNA levels seen in the INNA-051 treatment.
The team has found that prophylactic intra-nasal administration of INNA-051 in the SARS-CoV-2 ferret infection model has reduced levels of viral RNA in the nose and threat.
...Further, the research team added that the prophylactic approach is important to people at a high risk of community transmission or development of the severe disease from COVID-19, such as older adults, people with comorbidities, and those who are immunocompromised...
https://www.news-medical.net/news/20200929/Australian-scientists-develop-a-nasal...
-------------------------------------------------------------------------
Proud, P., Tsitoura, D., Watson, R., Chua, W., et al. (2020). Prophylactic intranasal administration of a TLR2 agonist reduces upper respiratory tract viral shedding in a SARS-CoV-2 challenge ferret model. bioRxiv. https://www.biorxiv.org/content/10.1101/2020.09.25.309914v1 https://www.biorxiv.org/content/10.1101/2020.09.25.309914v1
Abstract...Like all respiratory viruses, the most recent novel human coronavirus SARS-CoV-2, initiates infection in the upper respiratory tract (URT). Infected individuals are often asymptomatic, yet highly infectious and readily transmit virus. A therapy that restricts initial replication in the URT has the potential to prevent progression of severe lower respiratory tract disease as well as limiting person-to-person transmission.
We show that prophylactic intra-nasal administration of the TLR2/6 agonist INNA-051 in a SARS-CoV-2 ferret infection model effectively reduces levels of viral RNA in the nose and throat. The results of our study support clinical development of a therapy based on prophylactic TLR2/6 innate immune activation in the URT to reduce SARS-CoV-2 transmission and provide protection against COVID-19...
4margd
Good news for recovered COVID patients no longer producing antibodies, as well as peeps with a history of common-cold coronaviruses:
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Eric Topol @EricTopol | 9:15 AM · Sep 30, 2020:
"The intensity of T cell responses does not correlate with disease severity."
"Natural development and vaccine-based induction of immunity to #SARSCoV2 requires recognition of multiple epitopes"
Annika Nelde et al. 2020.SARS-CoV-2-derived peptides define heterologous and COVID-19-induced T cell recognition. Nature Immunology (Sept 30 2020) https://www.nature.com/articles/s41590-020-00808-x
Abstract
T cell immunity is central for the control of viral infections. To characterize T cell immunity, but also for the development of vaccines, identification of exact viral T cell epitopes* is fundamental. Here we identify and characterize multiple dominant and subdominant SARS-CoV-2 HLA class I and HLA-DR peptides as potential T cell epitopes in COVID-19 convalescent and unexposed individuals. SARS-CoV-2-specific peptides enabled detection of post-infectious T cell immunity, even in seronegative convalescent individuals. Cross-reactive SARS-CoV-2 peptides revealed pre-existing T cell responses in 81% of unexposed individuals and validated similarity with common cold coronaviruses, providing a functional basis for heterologous immunity in SARS-CoV-2 infection. Diversity of SARS-CoV-2 T cell responses was associated with mild symptoms of COVID-19, providing evidence that immunity requires recognition of multiple epitopes. Together, the proposed SARS-CoV-2 T cell epitopes enable identification of heterologous and post-infectious T cell immunity and facilitate development of diagnostic, preventive and therapeutic measures for COVID-19...
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*An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells. For example, the epitope is the specific piece of the antigen to which an antibody binds. Wikipedia
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Eric Topol @EricTopol | 9:15 AM · Sep 30, 2020:
"The intensity of T cell responses does not correlate with disease severity."
"Natural development and vaccine-based induction of immunity to #SARSCoV2 requires recognition of multiple epitopes"
Annika Nelde et al. 2020.SARS-CoV-2-derived peptides define heterologous and COVID-19-induced T cell recognition. Nature Immunology (Sept 30 2020) https://www.nature.com/articles/s41590-020-00808-x
Abstract
T cell immunity is central for the control of viral infections. To characterize T cell immunity, but also for the development of vaccines, identification of exact viral T cell epitopes* is fundamental. Here we identify and characterize multiple dominant and subdominant SARS-CoV-2 HLA class I and HLA-DR peptides as potential T cell epitopes in COVID-19 convalescent and unexposed individuals. SARS-CoV-2-specific peptides enabled detection of post-infectious T cell immunity, even in seronegative convalescent individuals. Cross-reactive SARS-CoV-2 peptides revealed pre-existing T cell responses in 81% of unexposed individuals and validated similarity with common cold coronaviruses, providing a functional basis for heterologous immunity in SARS-CoV-2 infection. Diversity of SARS-CoV-2 T cell responses was associated with mild symptoms of COVID-19, providing evidence that immunity requires recognition of multiple epitopes. Together, the proposed SARS-CoV-2 T cell epitopes enable identification of heterologous and post-infectious T cell immunity and facilitate development of diagnostic, preventive and therapeutic measures for COVID-19...
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*An epitope, also known as antigenic determinant, is the part of an antigen that is recognized by the immune system, specifically by antibodies, B cells, or T cells. For example, the epitope is the specific piece of the antigen to which an antibody binds. Wikipedia
5margd
"transmission through inanimate surfaces is less frequent than hitherto recognised"
Mario U Mondelli et al. 2020. Low risk of SARS-CoV-2 transmission by fomites in real-life conditions. The Lancet Infectious Diseases (September 29, 2020) DOI:https://doi.org/10.1016/S1473-3099(20)30678-2 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30678-2/fullt...
...Our findings suggest that environmental contamination leading to SARS-CoV-2 transmission is unlikely to occur in real-life conditions, provided that standard cleaning procedures and precautions are enforced. These data would support Goldman's point that the chance of transmission through inanimate surfaces is less frequent than hitherto recognised.
Mario U Mondelli et al. 2020. Low risk of SARS-CoV-2 transmission by fomites in real-life conditions. The Lancet Infectious Diseases (September 29, 2020) DOI:https://doi.org/10.1016/S1473-3099(20)30678-2 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30678-2/fullt...
...Our findings suggest that environmental contamination leading to SARS-CoV-2 transmission is unlikely to occur in real-life conditions, provided that standard cleaning procedures and precautions are enforced. These data would support Goldman's point that the chance of transmission through inanimate surfaces is less frequent than hitherto recognised.
6margd
Huge Study of Coronavirus Cases in India Offers Some Surprises to Scientists
Apoorva Mandavilli | Sept. 30, 2020
...(India)...now has more than six million cases, second only to the United States.
An ambitious study of nearly 85,000 of those cases and nearly 600,000 of their contacts, published Wednesday in the journal Science, offers important insights not just for India, but for other low- and middle-income countries.
Among the surprises: The median hospital stay before death from Covid-19, the illness caused by the coronavirus, was five days in India, compared with two weeks in the United States, possibly because of limited access to quality care. And the trend in increasing deaths with age seemed to drop off after age 65 — perhaps because Indians who live past that age tend to be relatively wealthy and have access to good health care.
The contact tracing study also found that children of all ages can become infected with the coronavirus and spread it to others — offering compelling evidence on one of the most divisive questions about the virus.
And the report confirmed, as other studies have, that a small number of people are responsible for seeding a vast majority of new infections.
...Though its overall total of cases is huge, the per capita number of cases reported daily in India — and in many other low-income countries, including in Africa — is lower than in Spain, France or even the United States. And its number of deaths has not yet topped 100,000 — which has surprised some scientists.
...people infected first — known as index cases — were more likely to be male and older than their contacts. That may be because men are more likely to be out in situations where they might be infected
...researchers found, 71 percent of the people in the study did not seem to have transmitted the virus to anyone else; instead, just 5 percent of people accounted for 80 percent of the infections detected by contact tracing.
This is different from the idea of “super spreader” events in which a single person infected hundreds of people at a crowded gathering, Dr. (Joseph Lewnard, an epidemiologist at the University of California, Berkeley, who led the study) said.
The researchers noticed a key difference in those who did become sick and were hospitalized: They died on average within five days of being hospitalized, compared with two to eight weeks in other countries. The patients in India may deteriorate faster because of other underlying conditions like diabetes and high blood pressure or poor overall health
...Among those who died, the researchers found an overall case-fatality rate of 2 percent.
..(Dr. Ashish Jha, dean of the School of Public Health at Brown University, who has advised the Indian government on its health care infrastructure before the pandemic) said he appreciated the study over all, but cautioned against extrapolating its findings too far. He is from the state of Bihar, among the most rural and poor states in India, whereas Andhra Pradesh and Tamil Nadu, the two states in the study, are among the best equipped to deal with an outbreak, he said.
“It is really important to understand this is not the experience of Bihar, this is not the experience of D.R.C.,” he said, referring to the Democratic Republic of Congo. “This is a much rosier picture than what you are likely to see in those places.”...
https://www.nytimes.com/2020/09/30/health/covid-india-children.html
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Ramanan Laxminarayan et al. 2020. Epidemiology and transmission dynamics of COVID-19 in two Indian states. Science 30 Sep 2020:
eabd7672 DOI: 10.1126/science.abd7672 https://science.sciencemag.org/content/early/2020/09/29/science.abd7672
Abstract
Although most COVID-19 cases have occurred in low-resource countries, little is known about the epidemiology of the disease in such contexts. Data from the Indian states of Tamil Nadu and Andhra Pradesh provide a detailed view into SARS-CoV-2 transmission pathways and mortality in a high-incidence setting. Reported cases and deaths have been concentrated in younger cohorts than expected from observations in higher-income countries, even after accounting for demographic differences across settings. Among 575,071 individuals exposed to 84,965 confirmed cases, infection probabilities ranged from 4.7-10.7% for low-risk and high-risk contact types. Same-age contacts were associated with the greatest infection risk. Case-fatality ratios spanned 0.05% at ages 5-17 years to 16.6% at ages ≥85 years. Primary data are urgently needed from low-resource countries to guide control measures.
Apoorva Mandavilli | Sept. 30, 2020
...(India)...now has more than six million cases, second only to the United States.
An ambitious study of nearly 85,000 of those cases and nearly 600,000 of their contacts, published Wednesday in the journal Science, offers important insights not just for India, but for other low- and middle-income countries.
Among the surprises: The median hospital stay before death from Covid-19, the illness caused by the coronavirus, was five days in India, compared with two weeks in the United States, possibly because of limited access to quality care. And the trend in increasing deaths with age seemed to drop off after age 65 — perhaps because Indians who live past that age tend to be relatively wealthy and have access to good health care.
The contact tracing study also found that children of all ages can become infected with the coronavirus and spread it to others — offering compelling evidence on one of the most divisive questions about the virus.
And the report confirmed, as other studies have, that a small number of people are responsible for seeding a vast majority of new infections.
...Though its overall total of cases is huge, the per capita number of cases reported daily in India — and in many other low-income countries, including in Africa — is lower than in Spain, France or even the United States. And its number of deaths has not yet topped 100,000 — which has surprised some scientists.
...people infected first — known as index cases — were more likely to be male and older than their contacts. That may be because men are more likely to be out in situations where they might be infected
...researchers found, 71 percent of the people in the study did not seem to have transmitted the virus to anyone else; instead, just 5 percent of people accounted for 80 percent of the infections detected by contact tracing.
This is different from the idea of “super spreader” events in which a single person infected hundreds of people at a crowded gathering, Dr. (Joseph Lewnard, an epidemiologist at the University of California, Berkeley, who led the study) said.
The researchers noticed a key difference in those who did become sick and were hospitalized: They died on average within five days of being hospitalized, compared with two to eight weeks in other countries. The patients in India may deteriorate faster because of other underlying conditions like diabetes and high blood pressure or poor overall health
...Among those who died, the researchers found an overall case-fatality rate of 2 percent.
..(Dr. Ashish Jha, dean of the School of Public Health at Brown University, who has advised the Indian government on its health care infrastructure before the pandemic) said he appreciated the study over all, but cautioned against extrapolating its findings too far. He is from the state of Bihar, among the most rural and poor states in India, whereas Andhra Pradesh and Tamil Nadu, the two states in the study, are among the best equipped to deal with an outbreak, he said.
“It is really important to understand this is not the experience of Bihar, this is not the experience of D.R.C.,” he said, referring to the Democratic Republic of Congo. “This is a much rosier picture than what you are likely to see in those places.”...
https://www.nytimes.com/2020/09/30/health/covid-india-children.html
-----------------------------------------------------------------------------------------
Ramanan Laxminarayan et al. 2020. Epidemiology and transmission dynamics of COVID-19 in two Indian states. Science 30 Sep 2020:
eabd7672 DOI: 10.1126/science.abd7672 https://science.sciencemag.org/content/early/2020/09/29/science.abd7672
Abstract
Although most COVID-19 cases have occurred in low-resource countries, little is known about the epidemiology of the disease in such contexts. Data from the Indian states of Tamil Nadu and Andhra Pradesh provide a detailed view into SARS-CoV-2 transmission pathways and mortality in a high-incidence setting. Reported cases and deaths have been concentrated in younger cohorts than expected from observations in higher-income countries, even after accounting for demographic differences across settings. Among 575,071 individuals exposed to 84,965 confirmed cases, infection probabilities ranged from 4.7-10.7% for low-risk and high-risk contact types. Same-age contacts were associated with the greatest infection risk. Case-fatality ratios spanned 0.05% at ages 5-17 years to 16.6% at ages ≥85 years. Primary data are urgently needed from low-resource countries to guide control measures.
7Cubby.R.S.
Time to move on. COVID-19 isn't all that we hyped it up to be, and the death numbers are skewed. So many cases marked COVID... when it was likely diabetes or getting hit by a car.
https://www.theblaze.com/op-ed/horowitz-tennessee-data-exposes-the-lie-of-corona...
see also:
https://www.dailywire.com/news/viral-loads-in-covid-19-infected-patients-drop-al...
By the fifth week of the study, El Zein said, 70 percent of positive COVID-19 swabs fell into the low VL category. That, in turn, coincided with a decrease in patient deaths, the doctor said.
“Researchers say 45 percent of patients in the high VL group died from the virus. This number falls to 32 percent for COVID-19 patients with intermediate loads and 14 percent for the low VL group,” Study Finds reported.
There have been other reports about “viral loads.” The most used test to determine if someone has COVID-19, known as a PCR test, is either positive or negative, that’s it. But the test does not identify the viral load — the greater the amount of virus, the more likely it is that the patient is contagious or may get severely ill.
“In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus,” The New York Times reported in August after conducting a review of data.
I don't always agree with Musk, but this was interesting:
https://www.dailywire.com/news/elon-musk-says-he-and-his-family-wont-get-covid-v...
Swisher also asked Musk about lockdowns intended to stem the spread of the virus. The entrepreneur said that he opposed them because they did not “serve the greater good.”
“It has diminished my faith in humanity, the whole thing… the irrationality of people in general,” the South African said.
“Essentially, the right thing to do would be to not have done a lockdown for the whole country but to have, I think, anyone who’s at risk should be quarantined until the storm passes,” Musk said. “I mean, this is a hot button issue where rationality takes a back seat. In the grand scheme of things what we have is something with a very low mortality rate and high contagion.”
Fear sells, but let's move on. Old and unhealthy folks should also be wary of flu and other such coronaviruses, that has always been true.
https://www.theblaze.com/op-ed/horowitz-tennessee-data-exposes-the-lie-of-corona...
see also:
https://www.dailywire.com/news/viral-loads-in-covid-19-infected-patients-drop-al...
By the fifth week of the study, El Zein said, 70 percent of positive COVID-19 swabs fell into the low VL category. That, in turn, coincided with a decrease in patient deaths, the doctor said.
“Researchers say 45 percent of patients in the high VL group died from the virus. This number falls to 32 percent for COVID-19 patients with intermediate loads and 14 percent for the low VL group,” Study Finds reported.
There have been other reports about “viral loads.” The most used test to determine if someone has COVID-19, known as a PCR test, is either positive or negative, that’s it. But the test does not identify the viral load — the greater the amount of virus, the more likely it is that the patient is contagious or may get severely ill.
“In three sets of testing data that include cycle thresholds, compiled by officials in Massachusetts, New York and Nevada, up to 90 percent of people testing positive carried barely any virus,” The New York Times reported in August after conducting a review of data.
I don't always agree with Musk, but this was interesting:
https://www.dailywire.com/news/elon-musk-says-he-and-his-family-wont-get-covid-v...
Swisher also asked Musk about lockdowns intended to stem the spread of the virus. The entrepreneur said that he opposed them because they did not “serve the greater good.”
“It has diminished my faith in humanity, the whole thing… the irrationality of people in general,” the South African said.
“Essentially, the right thing to do would be to not have done a lockdown for the whole country but to have, I think, anyone who’s at risk should be quarantined until the storm passes,” Musk said. “I mean, this is a hot button issue where rationality takes a back seat. In the grand scheme of things what we have is something with a very low mortality rate and high contagion.”
Fear sells, but let's move on. Old and unhealthy folks should also be wary of flu and other such coronaviruses, that has always been true.
8margd
Is this part of Africa's secret--virtually no Neanderthal genes?
Not good news for South Asians?
Eric Topol @EricTopol | 8:49 AM · Sep 30, 2020:
The major genetic risk factor associated with severe #COVID19, a chromosome 3 genomic cluster, is derived from a Neanderthal haplotype, and carried by ~50% of people in South Asia and ~15% of people in Europe
Just out nature https://nature.com/articles/s41586-020-2818-3 *
(Map) image ( https://twitter.com/EricTopol/status/1311287097806872577/photo/1 )
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Krishnendu Roy @KrishRoyLab · 1h
Paper indicates Bangladeshis in the UK have a 2x death rate than rest & 63% of Bangladeshis have the haplotype.
Are data available for US and other countries on South Asian's COVID death-rate? India & Bangladesh ~1.5% death, US at 2.85% (from JHU). Underreport, other factors?
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Hugo Zeberg & Svante Pääbo. 2020. The major genetic risk factor for severe COVID-19 is inherited from Neanderthals. Nature (30 Sept 2020) https://www.nature.com/articles/s41586-020-2818-3
This is an unedited manuscript that has been accepted for publication.
Abstract
A recent genetic association study1 identified a gene cluster on chromosome 3 as a risk locus for respiratory failure upon SARS-CoV-2 infection. A new study comprising 3,199 hospitalized COVID-19 patients and controls finds that this is the major genetic risk factor for severe SARS-CoV-2 infection and hospitalization (COVID-19 Host Genetics Initiative). Here, we show that the risk is conferred by a genomic segment of ~50 kb that is inherited from Neanderthals and is carried by ~50% of people in South Asia and ~16% of people in Europe today.
Not good news for South Asians?
Eric Topol @EricTopol | 8:49 AM · Sep 30, 2020:
The major genetic risk factor associated with severe #COVID19, a chromosome 3 genomic cluster, is derived from a Neanderthal haplotype, and carried by ~50% of people in South Asia and ~15% of people in Europe
Just out nature https://nature.com/articles/s41586-020-2818-3 *
(Map) image ( https://twitter.com/EricTopol/status/1311287097806872577/photo/1 )
-----------------------------------------------------------------------------------
Krishnendu Roy @KrishRoyLab · 1h
Paper indicates Bangladeshis in the UK have a 2x death rate than rest & 63% of Bangladeshis have the haplotype.
Are data available for US and other countries on South Asian's COVID death-rate? India & Bangladesh ~1.5% death, US at 2.85% (from JHU). Underreport, other factors?
-----------------------------------------------------------------------------------
Hugo Zeberg & Svante Pääbo. 2020. The major genetic risk factor for severe COVID-19 is inherited from Neanderthals. Nature (30 Sept 2020) https://www.nature.com/articles/s41586-020-2818-3
This is an unedited manuscript that has been accepted for publication.
Abstract
A recent genetic association study1 identified a gene cluster on chromosome 3 as a risk locus for respiratory failure upon SARS-CoV-2 infection. A new study comprising 3,199 hospitalized COVID-19 patients and controls finds that this is the major genetic risk factor for severe SARS-CoV-2 infection and hospitalization (COVID-19 Host Genetics Initiative). Here, we show that the risk is conferred by a genomic segment of ~50 kb that is inherited from Neanderthals and is carried by ~50% of people in South Asia and ~16% of people in Europe today.
9margd
Plague-chickens won't come home to roost until AFTER the election...
White House Blocked C.D.C. Order to Keep Cruise Ships Docked
Sheila Kaplann | Sept. 30, 2020
The White House has blocked a new order from the Centers for Disease Control and Prevention to keep cruise ships docked until mid-February, a step that would have displeased the politically powerful tourism industry in the crucial swing state of Florida.
The current “no sail” policy is set to expire on Wednesday. Dr. Robert R. Redfield, the director of the C.D.C., had recommended the extension, worried that cruise ships could become viral hot spots, as they did at the beginning of the pandemic.
But at a meeting of the coronavirus task force on Tuesday, Dr. Redfield’s plan was overruled, according to a senior federal health official who was not authorized to comment and so spoke on condition of anonymity. The administration will instead allow the ships to sail after Oct. 31, the date the industry had already agreed to in its own, voluntary plan...
https://www.nytimes.com/2020/09/30/health/covid-cruise-ships.html
------------------------------------------------------------------
ETA
Florian Krammer @florian_krammer | 2:06 PM · Sep 30, 2020:
Well, maybe a good setting for Phase III vaccine studies? We would likely know about efficacy soon. (sarcasm off)
White House Blocked C.D.C. Order to Keep Cruise Ships Docked
Sheila Kaplann | Sept. 30, 2020
The White House has blocked a new order from the Centers for Disease Control and Prevention to keep cruise ships docked until mid-February, a step that would have displeased the politically powerful tourism industry in the crucial swing state of Florida.
The current “no sail” policy is set to expire on Wednesday. Dr. Robert R. Redfield, the director of the C.D.C., had recommended the extension, worried that cruise ships could become viral hot spots, as they did at the beginning of the pandemic.
But at a meeting of the coronavirus task force on Tuesday, Dr. Redfield’s plan was overruled, according to a senior federal health official who was not authorized to comment and so spoke on condition of anonymity. The administration will instead allow the ships to sail after Oct. 31, the date the industry had already agreed to in its own, voluntary plan...
https://www.nytimes.com/2020/09/30/health/covid-cruise-ships.html
------------------------------------------------------------------
ETA
Florian Krammer @florian_krammer | 2:06 PM · Sep 30, 2020:
Well, maybe a good setting for Phase III vaccine studies? We would likely know about efficacy soon. (sarcasm off)
10margd
Coronavirus is causing the 'historic decimation' of Latinos, medical expert says
Susan Gamboa | Sept 30, 2020
... said that hospitalizations among Latinos as of Sept. 19 were 359 per 100,000 compared to 78 in whites. Deaths related to Covid-19 are 61 per 100,000 in the Latino population compared to 40 in whites, and Latinos represent 45 percent of deaths of people younger than 21...
(Dr. Anthony Fauci, the nation’s leading infectious disease expert) said the country can begin to address this “extraordinary problem” now by making sure the community gets adequate testing and immediate access to care. But he said this is not a one-shot resolution.
“This must now reset and re-shine a light on this disparity related to social determinants of health that are experienced by the Latinx community — the fact that they have a higher incidence of co-morbidities, which put you at risk...That’s something that you do not fix in a month or a year. It’s something that requires a decades-long commitment to change those social determinants, which make that community more susceptible to diabetes, to obesity, to hypertension, to kidney disease...We need to look at what we need to do now to make this to be an enduring and burning lesson of a challenge that we have for the Latino community."
Fauci also urged the Latino congressional members on the call to get their Latino constituents to consider enrolling in vaccination trials so they can be proven to be safe in everyone, including African Americans and Latinos.
...Texas is one of the states that did not expand Medicaid to provide more access to health care for its population under the Affordable Care Act...It has the highest percent of people without health insurance coverage in the country, and Latinos are the largest share of people lacking coverage...the lead plaintiff in a lawsuit challenging the Affordable Care Act. A U.S. Supreme Court hearing on the state’s challenge is set for Nov. 10...lagged behind other states in closing businesses and mandating wearing of masks as the virus began its virulent spread in the spring....recently begun to ease restrictions that were put in place in the summer, reopening restaurants while restricting crowd sizes and mandating the reopening of schools...
https://www.nbcnews.com/news/latino/coronavirus-causing-historic-decimation-lati...
Susan Gamboa | Sept 30, 2020
... said that hospitalizations among Latinos as of Sept. 19 were 359 per 100,000 compared to 78 in whites. Deaths related to Covid-19 are 61 per 100,000 in the Latino population compared to 40 in whites, and Latinos represent 45 percent of deaths of people younger than 21...
(Dr. Anthony Fauci, the nation’s leading infectious disease expert) said the country can begin to address this “extraordinary problem” now by making sure the community gets adequate testing and immediate access to care. But he said this is not a one-shot resolution.
“This must now reset and re-shine a light on this disparity related to social determinants of health that are experienced by the Latinx community — the fact that they have a higher incidence of co-morbidities, which put you at risk...That’s something that you do not fix in a month or a year. It’s something that requires a decades-long commitment to change those social determinants, which make that community more susceptible to diabetes, to obesity, to hypertension, to kidney disease...We need to look at what we need to do now to make this to be an enduring and burning lesson of a challenge that we have for the Latino community."
Fauci also urged the Latino congressional members on the call to get their Latino constituents to consider enrolling in vaccination trials so they can be proven to be safe in everyone, including African Americans and Latinos.
...Texas is one of the states that did not expand Medicaid to provide more access to health care for its population under the Affordable Care Act...It has the highest percent of people without health insurance coverage in the country, and Latinos are the largest share of people lacking coverage...the lead plaintiff in a lawsuit challenging the Affordable Care Act. A U.S. Supreme Court hearing on the state’s challenge is set for Nov. 10...lagged behind other states in closing businesses and mandating wearing of masks as the virus began its virulent spread in the spring....recently begun to ease restrictions that were put in place in the summer, reopening restaurants while restricting crowd sizes and mandating the reopening of schools...
https://www.nbcnews.com/news/latino/coronavirus-causing-historic-decimation-lati...
11margd
Soojong Kim et al. 2020. Political partisanship influences behavioral responses to governors’ recommendations for COVID-19 prevention in the United States. PNAS (September 29, 2020)117 (39) 24144-24153; https://doi.org/10.1073/pnas.2007835117 https://www.pnas.org/content/117/39/24144
Significance
We examine the role of partisanship in engagement in physical distancing following the outbreak of the novel coronavirus COVID-19 in the United States. We use data on daily mobility patterns for US counties along with information on county-level political preferences and the timing of state government leaders’ recommendations for individuals to stay at home. We find that state government leaders’ recommendations were more effective in reducing mobility in Democratic-leaning counties than in Republican-leaning counties. Among Democratic-leaning counties, recommendations from Republican leaders generated larger mobility reductions than recommendations from Democratic leaders. This study highlights the nuanced role of political partisanship in influencing how leaders’ COVID-19 prevention recommendations affect individuals’ voluntary decisions to engage in physical distancing.
Abstract
Voluntary physical distancing is essential for preventing the spread of COVID-19. We assessed the role of political partisanship in individuals’ compliance with physical distancing recommendations of political leaders using data on mobility from a sample of mobile phones in 3,100 counties in the United States during March 2020, county-level partisan preferences, information about the political affiliation of state governors, and the timing of their communications about COVID-19 prevention. Regression analyses examined how political preferences influenced the association between governors’ COVID-19 communications and residents’ mobility patterns. Governors’ recommendations for residents to stay at home preceded stay-at-home orders and led to a significant reduction in mobility that was comparable to the effect of the orders themselves. Effects were larger in Democratic- than in Republican-leaning counties, a pattern more pronounced under Republican governors. Democratic-leaning counties also responded more strongly to recommendations from Republican than from Democratic governors. Political partisanship influences citizens’ decisions to voluntarily engage in physical distancing in response to communications by their governor...
Significance
We examine the role of partisanship in engagement in physical distancing following the outbreak of the novel coronavirus COVID-19 in the United States. We use data on daily mobility patterns for US counties along with information on county-level political preferences and the timing of state government leaders’ recommendations for individuals to stay at home. We find that state government leaders’ recommendations were more effective in reducing mobility in Democratic-leaning counties than in Republican-leaning counties. Among Democratic-leaning counties, recommendations from Republican leaders generated larger mobility reductions than recommendations from Democratic leaders. This study highlights the nuanced role of political partisanship in influencing how leaders’ COVID-19 prevention recommendations affect individuals’ voluntary decisions to engage in physical distancing.
Abstract
Voluntary physical distancing is essential for preventing the spread of COVID-19. We assessed the role of political partisanship in individuals’ compliance with physical distancing recommendations of political leaders using data on mobility from a sample of mobile phones in 3,100 counties in the United States during March 2020, county-level partisan preferences, information about the political affiliation of state governors, and the timing of their communications about COVID-19 prevention. Regression analyses examined how political preferences influenced the association between governors’ COVID-19 communications and residents’ mobility patterns. Governors’ recommendations for residents to stay at home preceded stay-at-home orders and led to a significant reduction in mobility that was comparable to the effect of the orders themselves. Effects were larger in Democratic- than in Republican-leaning counties, a pattern more pronounced under Republican governors. Democratic-leaning counties also responded more strongly to recommendations from Republican than from Democratic governors. Political partisanship influences citizens’ decisions to voluntarily engage in physical distancing in response to communications by their governor...
12margd
Oxford-Astra Covid Vaccine Review to Start in Europe
Suzi Ring | September 30, 2020
European regulators are set to start an accelerated review of a Covid-19 vaccine front-runner from the University of Oxford and AstraZeneca Plc, according to a person with knowledge of the situation, in a sign the shot could be the first to seek approval in the region.
The European Medicines Agency is expected to announce the “rolling review” as soon as this week, according to the person, who didn’t want to be identified because the decision is still private. Such assessments are used in emergencies to allow regulators to see trial data while the development is ongoing to speed up approvals of drugs and vaccines that are urgently needed...
https://www.bloomberg.com/news/articles/2020-09-30/oxford-astra-covid-vaccine-re...
Suzi Ring | September 30, 2020
European regulators are set to start an accelerated review of a Covid-19 vaccine front-runner from the University of Oxford and AstraZeneca Plc, according to a person with knowledge of the situation, in a sign the shot could be the first to seek approval in the region.
The European Medicines Agency is expected to announce the “rolling review” as soon as this week, according to the person, who didn’t want to be identified because the decision is still private. Such assessments are used in emergencies to allow regulators to see trial data while the development is ongoing to speed up approvals of drugs and vaccines that are urgently needed...
https://www.bloomberg.com/news/articles/2020-09-30/oxford-astra-covid-vaccine-re...
13margd
Moderna CEO tells Financial Times that coronavirus vaccine won’t be ready by election day
Mike Murphy | Sept. 30, 2020
...CEO Stéphane Bancel told the FT in an interview that Moderna... -- front-runner in the COVID-19 vaccine race — will not seek emergency-use authorization from the U.S. Food and Drug Administration until Nov. 25 at the earliest, and does not expect to have approval for distribution of the vaccine to the general public until spring 2021...
https://www.marketwatch.com/story/moderna-ceo-tells-ft-that-coronavirus-vaccine-...
Mike Murphy | Sept. 30, 2020
...CEO Stéphane Bancel told the FT in an interview that Moderna... -- front-runner in the COVID-19 vaccine race — will not seek emergency-use authorization from the U.S. Food and Drug Administration until Nov. 25 at the earliest, and does not expect to have approval for distribution of the vaccine to the general public until spring 2021...
https://www.marketwatch.com/story/moderna-ceo-tells-ft-that-coronavirus-vaccine-...
14margd
Study Finds ‘Single Largest Driver’ of Coronavirus Misinformation: Trump
Sheryl Gay Stolberg and Noah Weiland | Sept. 30, 2020
Cornell University researchers analyzing 38 million English-language articles about the pandemic found that President Trump was the largest driver of the “infodemic.”
...“There is a science of rumors. It’s when there is uncertainty and fear,” said (Dr. Joshua Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health and a former principal deputy commissioner at the Food and Drug Administration), who teaches on public health crisis communications. In the absence of treatments or vaccines, he said, honest and consistent messaging is essential.
“This is what we need to save lives,” he said. “If it’s not done well, you get far more infections and deaths.”....
https://www.nytimes.com/2020/09/30/us/politics/trump-coronavirus-misinformation....
---------------------------------------------------------
Coronavirus misinformation: quantifying sources and themes in the COVID-19 ‘infodemic’
Sarah Evanega, Mark Lynas, Jordan Adams, Karinne Smolenyak
13 p
Abstract
TheCOVID-19 pandemic has unfolded alongside what the World Health Organization has termed an “infodemic” of misinformation. This study identifies and analyzes the most prominent topics of COVID-related misinformation that emerged in traditional media between January 1 and May 26, 2020 based on a total sample of over 38 million articles published in English-language media around the world. To our knowledge, our analysis is the first comprehensive survey of the traditional and online media landscape on this issue. We found that media mentions of US President Donald Trump within the context of COVID-19 misinformation made up by far the largest share of the infodemic. Trump mentions comprised 37.9% of the overall misinformation conversation, well ahead of any other topics. We conclude that the President of the United States was likely the largest driver of the COVID-19 misinformation “infodemic”. Only 16.4% of the misinformation conversation was “fact-checking” in nature, suggesting that the majority of COVID misinformation is conveyed by the media without question or correction.
...Conclusion
...It is especially notable that while misinformation and conspiracy theories promulgated by ostensibly grassroots sources, such as anti-vaccination groups, 5G opponents, and political extremists, do appear in our analysis in several of the topics, they contributed far less to the overall volume of misinformation than more powerful actors, in particular the US President.
This underscores the outsized role that media professionals play in disseminating misinformation through choices made in who and what to cover...
...In previous pandemics, such as the HIV/AIDS outbreak, misinformation and its effect on policy was estimated to have led to an additional 300,000 deaths in South Africa alone... If similar or worse outcomes are to be avoided in the present COVID-19 pandemic, greater efforts will need to be made to combat the infodemic that is already substantially polluting the wider media discourse.
https://int.nyt.com/data/documenttools/evanega-et-al-coronavirus-misinformation-...
Sheryl Gay Stolberg and Noah Weiland | Sept. 30, 2020
Cornell University researchers analyzing 38 million English-language articles about the pandemic found that President Trump was the largest driver of the “infodemic.”
...“There is a science of rumors. It’s when there is uncertainty and fear,” said (Dr. Joshua Sharfstein, a vice dean at the Johns Hopkins Bloomberg School of Public Health and a former principal deputy commissioner at the Food and Drug Administration), who teaches on public health crisis communications. In the absence of treatments or vaccines, he said, honest and consistent messaging is essential.
“This is what we need to save lives,” he said. “If it’s not done well, you get far more infections and deaths.”....
https://www.nytimes.com/2020/09/30/us/politics/trump-coronavirus-misinformation....
---------------------------------------------------------
Coronavirus misinformation: quantifying sources and themes in the COVID-19 ‘infodemic’
Sarah Evanega, Mark Lynas, Jordan Adams, Karinne Smolenyak
13 p
Abstract
TheCOVID-19 pandemic has unfolded alongside what the World Health Organization has termed an “infodemic” of misinformation. This study identifies and analyzes the most prominent topics of COVID-related misinformation that emerged in traditional media between January 1 and May 26, 2020 based on a total sample of over 38 million articles published in English-language media around the world. To our knowledge, our analysis is the first comprehensive survey of the traditional and online media landscape on this issue. We found that media mentions of US President Donald Trump within the context of COVID-19 misinformation made up by far the largest share of the infodemic. Trump mentions comprised 37.9% of the overall misinformation conversation, well ahead of any other topics. We conclude that the President of the United States was likely the largest driver of the COVID-19 misinformation “infodemic”. Only 16.4% of the misinformation conversation was “fact-checking” in nature, suggesting that the majority of COVID misinformation is conveyed by the media without question or correction.
...Conclusion
...It is especially notable that while misinformation and conspiracy theories promulgated by ostensibly grassroots sources, such as anti-vaccination groups, 5G opponents, and political extremists, do appear in our analysis in several of the topics, they contributed far less to the overall volume of misinformation than more powerful actors, in particular the US President.
This underscores the outsized role that media professionals play in disseminating misinformation through choices made in who and what to cover...
...In previous pandemics, such as the HIV/AIDS outbreak, misinformation and its effect on policy was estimated to have led to an additional 300,000 deaths in South Africa alone... If similar or worse outcomes are to be avoided in the present COVID-19 pandemic, greater efforts will need to be made to combat the infodemic that is already substantially polluting the wider media discourse.
https://int.nyt.com/data/documenttools/evanega-et-al-coronavirus-misinformation-...
15margd
In this genetic study Montreal had no introductions from China--mostly Europe.
(That COVID projection for the next year might want to add "spring break travel" if such a thing is permitted in 2021... )
First genetic sequencing of COVID in Quebec shows roots of outbreak
Junji Nishihata | September 23, 2020
Initial results of study show that an estimated 250 independent events following spring break travel in March led to 60,000 people being infected
...Within the dataset examined by the team, travel-history data suggested that nearly one third of infections (32.7 per cent) came from Europe (with France having the highest amount at 12.1 per cent), 31 per cent originated from the Caribbean/Latin America, and nearly one quarter were derived from the USA (23.9 per cent). Few introductions came from Asia (1.2 per cent) and none from China.
This confirms the notion that COVID had spread much more widely than earlier believed and that by the early spring of 2020 it was much more than an endemic disease in China. Indeed, based on the phylogeny of the earliest reported cases, it is possible the first case reached Quebec City from the United Kingdom as early as January 30 – but the precise date is still not known with certainty....
https://reporter.mcgill.ca/first-genetic-sequencing-of-covid-in-quebec-shows-roo...
-------------------------------------------------------------------------------------------
Jesse Shapiro et al. 2020. Genomic epidemiology of early introductions of SARS-CoV-2 into the Canadian province of Québec
Novel 2019 coronavirus. nCoV-2019 Genomic Epidemiology (Sept 18, 2020). https://virological.org/t/genomic-epidemiology-of-early-introductions-of-sars-co...
Summary
Québec was the hardest-hit Canadian province early in the COVID-19 pandemic with more than 62,000 positive cases as of September 1, 2020.
We report 734 high-quality SARS-Cov-2 consensus sequences from the first month of the pandemic in the province
Added to a global phylogeny, these sequences help refine the number of introduction events into Québec, conservatively estimated at >200 independent events by late March
We place the inferred introduction events in the context of travel destinations and frequencies, the majority of which happened between the end of spring break and a week after the border closed
As expected, phylogenetic analysis places the introduction events systematically earlier (during spring break) than observed from case reports and travel history (after spring break)
Consistent with common spring break travel destinations, most of the introduced sequences were from clades common in Europe and the Americas, and only rarely from Asia
Sequencing efforts are ongoing to track the relative transmission rates of the various SARS-CoV-2 clades introduced into Québec...
(That COVID projection for the next year might want to add "spring break travel" if such a thing is permitted in 2021... )
First genetic sequencing of COVID in Quebec shows roots of outbreak
Junji Nishihata | September 23, 2020
Initial results of study show that an estimated 250 independent events following spring break travel in March led to 60,000 people being infected
...Within the dataset examined by the team, travel-history data suggested that nearly one third of infections (32.7 per cent) came from Europe (with France having the highest amount at 12.1 per cent), 31 per cent originated from the Caribbean/Latin America, and nearly one quarter were derived from the USA (23.9 per cent). Few introductions came from Asia (1.2 per cent) and none from China.
This confirms the notion that COVID had spread much more widely than earlier believed and that by the early spring of 2020 it was much more than an endemic disease in China. Indeed, based on the phylogeny of the earliest reported cases, it is possible the first case reached Quebec City from the United Kingdom as early as January 30 – but the precise date is still not known with certainty....
https://reporter.mcgill.ca/first-genetic-sequencing-of-covid-in-quebec-shows-roo...
-------------------------------------------------------------------------------------------
Jesse Shapiro et al. 2020. Genomic epidemiology of early introductions of SARS-CoV-2 into the Canadian province of Québec
Novel 2019 coronavirus. nCoV-2019 Genomic Epidemiology (Sept 18, 2020). https://virological.org/t/genomic-epidemiology-of-early-introductions-of-sars-co...
Summary
Québec was the hardest-hit Canadian province early in the COVID-19 pandemic with more than 62,000 positive cases as of September 1, 2020.
We report 734 high-quality SARS-Cov-2 consensus sequences from the first month of the pandemic in the province
Added to a global phylogeny, these sequences help refine the number of introduction events into Québec, conservatively estimated at >200 independent events by late March
We place the inferred introduction events in the context of travel destinations and frequencies, the majority of which happened between the end of spring break and a week after the border closed
As expected, phylogenetic analysis places the introduction events systematically earlier (during spring break) than observed from case reports and travel history (after spring break)
Consistent with common spring break travel destinations, most of the introduced sequences were from clades common in Europe and the Americas, and only rarely from Asia
Sequencing efforts are ongoing to track the relative transmission rates of the various SARS-CoV-2 clades introduced into Québec...
16margd
We run Cornell. Here’s how we’ve kept low covid-19 rates on campus.
Martha E. Pollack and Michael I. Kotlikoff | September 30, 2020
...We modified our classrooms, dining halls and study areas to ensure proper social distancing. We upgraded our ventilation systems, mandated mask-wearing on campus and created a public health campaign. Students were required to sign a behavior compact, and we stood up mechanisms to enforce it. Contrary to the assumptions of many, college students can adhere to these guidelines and, as our experience shows, take enormous pride in doing so.
But most important, we took the steps that are at the heart of any public health initiative to control infection: establishing robust programs for testing with rapid turnaround, contact tracing, and isolation and quarantine. We tested every student upon their return to campus. All of our undergraduate students are being tested twice per week, while graduate students, faculty and staff are being tested at varying rates, depending on the frequency and nature of their on-campus interactions.
Fighting an epidemic means stopping its spread. A student who tests positive is immediately put into isolation in a hotel room that the university pays for and where we provide support. We work with the county health department to conduct contact tracing, and we also immediately test everyone within the student’s social network. We are currently testing more than 30,000 individuals per week.
Understandably, our approach may not be feasible for every university. Cornell is fortunate to have the expertise and resources to create and support its own testing lab. And we recognize that the battle isn’t over. This virus is relentless, and it’s still possible for a superspreader event to occur...
https://www.washingtonpost.com/opinions/2020/09/30/cornell-coronavirus-college-c...
Martha E. Pollack and Michael I. Kotlikoff | September 30, 2020
...We modified our classrooms, dining halls and study areas to ensure proper social distancing. We upgraded our ventilation systems, mandated mask-wearing on campus and created a public health campaign. Students were required to sign a behavior compact, and we stood up mechanisms to enforce it. Contrary to the assumptions of many, college students can adhere to these guidelines and, as our experience shows, take enormous pride in doing so.
But most important, we took the steps that are at the heart of any public health initiative to control infection: establishing robust programs for testing with rapid turnaround, contact tracing, and isolation and quarantine. We tested every student upon their return to campus. All of our undergraduate students are being tested twice per week, while graduate students, faculty and staff are being tested at varying rates, depending on the frequency and nature of their on-campus interactions.
Fighting an epidemic means stopping its spread. A student who tests positive is immediately put into isolation in a hotel room that the university pays for and where we provide support. We work with the county health department to conduct contact tracing, and we also immediately test everyone within the student’s social network. We are currently testing more than 30,000 individuals per week.
Understandably, our approach may not be feasible for every university. Cornell is fortunate to have the expertise and resources to create and support its own testing lab. And we recognize that the battle isn’t over. This virus is relentless, and it’s still possible for a superspreader event to occur...
https://www.washingtonpost.com/opinions/2020/09/30/cornell-coronavirus-college-c...
17margd
CMS requires less testing in rural counties. Rural retirees and nursing home residents, beware...
Eric Feigl-Ding @DrEricDing | 7:17 AM · Oct 1, 2020:
https://twitter.com/DrEricDing/status/1311626377146372102
BLOODY HELL—Trump’s CMS is now changing #COVID19 positivity ratings & muzzling bad numbers.
How? If a rural county has 10%.”
4) CMS claims governors of rural states complained
“rural counties had seemingly high comparative positivity rates as a result of low amounts of testing, rather than actual positivity in the community.”
while valid concern, it makes no sense to automatically rate them “Green”!
5) If rural state governors (read: Trump state governors) want to protect their community and nursing home residents,
TESTING MORE is always better. But under these new rules, it allows them to test less — as if low positivity.
This does NOT serve nursing home residents well.
6) As a matter of fact, rural America has a large number of retirees and nursing homes.
And as a consequence, this with further depress testing in these high risk areas.
In fact, rural America has huge upswings and new records. We need MORE rural testing not less.
ALARMING surge in cases — **7** states have now set new record highs. #COVID19. The summer bad trajectory is repeating again. It’s feels like deja Vu.
7) And we know nursing homes are among the HIGHEST RISK outbreak clusters.
So why the hell would Trump WH want to tests nursing home residents and staff LESS?!?!
Like for crying out loud!!! I pay taxes so that we protect our Medicare seniors and Medicaid nursing resident damnit!
8) in the very least, don’t simply default rural counties rating to a rosy “green” — make it “grey” color and test more to find out what the true situation is, and still cautiously test nursing homes. You can never be too careful with nursing homes. We are talking LIVES at risk.
----------------------------------------------------------------------------------
Press release
Center for Medicare and Medicaid Services (CMS) Updates COVID-19 Testing Methodology for Nursing Homes
Sep 29, 2020
Today, the Centers for Medicare & Medicaid Services (CMS) announced an update to the methodology the agency employs to determine the rate of coronavirus disease 2019 (COVID-19) positivity in counties across the country. Counties with 20 or fewer tests over 14 days will now move to “green” in the color-coded system of assessing COVID-19 community prevalence. Counties with both fewer than 500 tests and fewer than 2,000 tests per 100,000 residents, and greater than 10 percent positivity over 14 days – which would have been “red” under the previous methodology – will move to “yellow.” This information is critical to nursing homes, which are required to test their staff for COVID-19 at a frequency based on the positivity rate of their respective counties.
Under guidance CMS issued on August 26, 2020, nursing homes must test staff at a frequency of once monthly if the facility’s county positivity rate is less than five percent. Staff testing frequency increases to once weekly if the county positivity rate is between five and 10 percent. Finally, testing frequency increases to twice weekly if the county positivity rate exceeds 10 percent.
CMS heard concerns from some governors of rural states that the frequency guidelines did not work well for some rural areas. They were concerned that some rural counties had seemingly high comparative positivity rates as a result of low amounts of testing, rather than actual positivity in the community. This resulted in a significant burden for nursing homes being required to conduct staff testing at a higher frequency than necessary. In response to these concerns, the Trump Administration acted swiftly and decisively, and implemented the change to the positivity rate calculation in order to accommodate rural counties. The new, resulting methodology reduces burden while still requiring facilities to conduct testing to at a frequency that can detect COVID-19 early to keep nursing home residents safe.
The requirement came on the heels of President Trump’s announcement that the Administration would offer point-of-care testing machines to America’s Medicare and Medicaid certified nursing homes – on the condition that they have secured a Clinical Laboratory Improvement Amendments waiver. The administration has also sent over $21 billion to nursing homes to facilitate testing and offset other costs.
https://www.cms.gov/newsroom/press-releases/cms-updates-covid-19-testing-methodo...
Eric Feigl-Ding @DrEricDing | 7:17 AM · Oct 1, 2020:
https://twitter.com/DrEricDing/status/1311626377146372102
BLOODY HELL—Trump’s CMS is now changing #COVID19 positivity ratings & muzzling bad numbers.
How? If a rural county has 10%.”
4) CMS claims governors of rural states complained
“rural counties had seemingly high comparative positivity rates as a result of low amounts of testing, rather than actual positivity in the community.”
while valid concern, it makes no sense to automatically rate them “Green”!
5) If rural state governors (read: Trump state governors) want to protect their community and nursing home residents,
TESTING MORE is always better. But under these new rules, it allows them to test less — as if low positivity.
This does NOT serve nursing home residents well.
6) As a matter of fact, rural America has a large number of retirees and nursing homes.
And as a consequence, this with further depress testing in these high risk areas.
In fact, rural America has huge upswings and new records. We need MORE rural testing not less.
ALARMING surge in cases — **7** states have now set new record highs. #COVID19. The summer bad trajectory is repeating again. It’s feels like deja Vu.
7) And we know nursing homes are among the HIGHEST RISK outbreak clusters.
So why the hell would Trump WH want to tests nursing home residents and staff LESS?!?!
Like for crying out loud!!! I pay taxes so that we protect our Medicare seniors and Medicaid nursing resident damnit!
8) in the very least, don’t simply default rural counties rating to a rosy “green” — make it “grey” color and test more to find out what the true situation is, and still cautiously test nursing homes. You can never be too careful with nursing homes. We are talking LIVES at risk.
----------------------------------------------------------------------------------
Press release
Center for Medicare and Medicaid Services (CMS) Updates COVID-19 Testing Methodology for Nursing Homes
Sep 29, 2020
Today, the Centers for Medicare & Medicaid Services (CMS) announced an update to the methodology the agency employs to determine the rate of coronavirus disease 2019 (COVID-19) positivity in counties across the country. Counties with 20 or fewer tests over 14 days will now move to “green” in the color-coded system of assessing COVID-19 community prevalence. Counties with both fewer than 500 tests and fewer than 2,000 tests per 100,000 residents, and greater than 10 percent positivity over 14 days – which would have been “red” under the previous methodology – will move to “yellow.” This information is critical to nursing homes, which are required to test their staff for COVID-19 at a frequency based on the positivity rate of their respective counties.
Under guidance CMS issued on August 26, 2020, nursing homes must test staff at a frequency of once monthly if the facility’s county positivity rate is less than five percent. Staff testing frequency increases to once weekly if the county positivity rate is between five and 10 percent. Finally, testing frequency increases to twice weekly if the county positivity rate exceeds 10 percent.
CMS heard concerns from some governors of rural states that the frequency guidelines did not work well for some rural areas. They were concerned that some rural counties had seemingly high comparative positivity rates as a result of low amounts of testing, rather than actual positivity in the community. This resulted in a significant burden for nursing homes being required to conduct staff testing at a higher frequency than necessary. In response to these concerns, the Trump Administration acted swiftly and decisively, and implemented the change to the positivity rate calculation in order to accommodate rural counties. The new, resulting methodology reduces burden while still requiring facilities to conduct testing to at a frequency that can detect COVID-19 early to keep nursing home residents safe.
The requirement came on the heels of President Trump’s announcement that the Administration would offer point-of-care testing machines to America’s Medicare and Medicaid certified nursing homes – on the condition that they have secured a Clinical Laboratory Improvement Amendments waiver. The administration has also sent over $21 billion to nursing homes to facilitate testing and offset other costs.
https://www.cms.gov/newsroom/press-releases/cms-updates-covid-19-testing-methodo...
18margd
(short)
Rui Pombal et al. 2020. Risk of COVID-19 During Air Travel. JAMA (October 1, 2020). doi:10.1001/jama.2020.1910 https://jamanetwork.com/journals/jama/fullarticle/2771435
The risk of contracting coronavirus disease 2019 (COVID-19) during air travel is lower than from an office building, classroom, supermarket, or commuter train.
How Is COVID-19 Transmitted?
How Clean Is the Air in Passenger Aircraft?
Risk Reduction Steps by Airports and Airlines
Steps Passengers Can Take
Rui Pombal et al. 2020. Risk of COVID-19 During Air Travel. JAMA (October 1, 2020). doi:10.1001/jama.2020.1910 https://jamanetwork.com/journals/jama/fullarticle/2771435
The risk of contracting coronavirus disease 2019 (COVID-19) during air travel is lower than from an office building, classroom, supermarket, or commuter train.
How Is COVID-19 Transmitted?
How Clean Is the Air in Passenger Aircraft?
Risk Reduction Steps by Airports and Airlines
Steps Passengers Can Take
19margd
Germans embrace fresh air to ward off coronavirus
Angela Merkel says ventilation may be one of cheapest and most effective ways of containing virus
Kate Connolly | 30 Sep 2020 10.18 EDT
Ventilating rooms...is something of a national obsession, with many Germans habitually opening windows twice a day, even in winter. Often the requirement is included as a legally binding clause in rental agreements, mainly to protect against mould and bad smells.
But while some people may dismiss the method as primitive, “it may be one of the cheapest and most effective ways” of containing the spread of the virus, Angela Merkel insisted on Tuesday.
The German chancellor explained that the government’s guidelines to tackle the virus, encapsulated in the acronym AHA, which stands for distancing, hygiene and face coverings, will be extended to become AHACL. The “C” stands for the government’s coronavirus warning app, and “L” for Lüften or airing a room.
“Regular impact ventilation in all private and public rooms can considerably reduce the danger of infection,” the government’s recommendation explains.
...Impact ventilation, or Stosslüften, which needs explanation for most people unfamiliar with Germany except for experts in air hygiene, involves widely opening a window in the morning and evening for at least five minutes to allow the air to circulate. Even more efficient is Querlüften, or cross ventilation, whereby all the windows in a house or apartment are opened letting stale air flow out and fresh air come in.
In Germany, windows are designed with sophisticated hinge technology that allows them to be opened in various directions to enable varying degrees of Lüften.
Since it has become known that 90% of Covid-19 patients pick up the virus indoors, the practice has come into its own. With winter on the doorstep, it will become even more important, experts insist...
https://www.theguardian.com/world/2020/sep/30/germans-embrace-fresh-air-to-ward-...
Angela Merkel says ventilation may be one of cheapest and most effective ways of containing virus
Kate Connolly | 30 Sep 2020 10.18 EDT
Ventilating rooms...is something of a national obsession, with many Germans habitually opening windows twice a day, even in winter. Often the requirement is included as a legally binding clause in rental agreements, mainly to protect against mould and bad smells.
But while some people may dismiss the method as primitive, “it may be one of the cheapest and most effective ways” of containing the spread of the virus, Angela Merkel insisted on Tuesday.
The German chancellor explained that the government’s guidelines to tackle the virus, encapsulated in the acronym AHA, which stands for distancing, hygiene and face coverings, will be extended to become AHACL. The “C” stands for the government’s coronavirus warning app, and “L” for Lüften or airing a room.
“Regular impact ventilation in all private and public rooms can considerably reduce the danger of infection,” the government’s recommendation explains.
...Impact ventilation, or Stosslüften, which needs explanation for most people unfamiliar with Germany except for experts in air hygiene, involves widely opening a window in the morning and evening for at least five minutes to allow the air to circulate. Even more efficient is Querlüften, or cross ventilation, whereby all the windows in a house or apartment are opened letting stale air flow out and fresh air come in.
In Germany, windows are designed with sophisticated hinge technology that allows them to be opened in various directions to enable varying degrees of Lüften.
Since it has become known that 90% of Covid-19 patients pick up the virus indoors, the practice has come into its own. With winter on the doorstep, it will become even more important, experts insist...
https://www.theguardian.com/world/2020/sep/30/germans-embrace-fresh-air-to-ward-...
20margd
COVID-19 is at least an order of magnitude more deadly than seasonal flu, according to current estimates
Iria Carballo-Carbajal | Viewed 10/2/2020
CLAIM
“COVID-19 is less deadly than seasonal flu”
VERDICT
SOURCE: Robert F. Kennedy Jr., Facebook, Instagram, 27 Sep. 2020
DETAILS
Inaccurate: Contrary to the claim, the lethality of COVID-19 measured as the infection fatality ratio is an order of magnitude, which means at least ten times, higher than that of the seasonal flu.
Lacks context: The CDC’s estimates of the infection fatality ratios for the different age groups do not represent percentages but proportions. A misinterpretation of these values may lead to underestimating the lethality of COVID-19 by a factor of 100.
KEY TAKE AWAY
The measure that best describes the lethality of an infectious disease is the infection fatality ratio (IFR). The IFR indicates the proportion of people who die from a disease among all the people infected, including both confirmed cases as well as undetected infections. According to their respective IFR estimates, COVID-19 is at least ten times more deadly than an average flu season, particularly for middle-aged and elderly. Furthermore, the lack of effective treatments or vaccines for COVID-19, along with potential long-term damage, make COVID-19 a serious health threat.
FULL CLAIM: “COVID-19 is less deadly than seasonal flu”
REVIEW...
https://healthfeedback.org/claimreview/covid-19-is-at-least-an-order-of-magnitud...
Iria Carballo-Carbajal | Viewed 10/2/2020
CLAIM
“COVID-19 is less deadly than seasonal flu”
VERDICT
SOURCE: Robert F. Kennedy Jr., Facebook, Instagram, 27 Sep. 2020
DETAILS
Inaccurate: Contrary to the claim, the lethality of COVID-19 measured as the infection fatality ratio is an order of magnitude, which means at least ten times, higher than that of the seasonal flu.
Lacks context: The CDC’s estimates of the infection fatality ratios for the different age groups do not represent percentages but proportions. A misinterpretation of these values may lead to underestimating the lethality of COVID-19 by a factor of 100.
KEY TAKE AWAY
The measure that best describes the lethality of an infectious disease is the infection fatality ratio (IFR). The IFR indicates the proportion of people who die from a disease among all the people infected, including both confirmed cases as well as undetected infections. According to their respective IFR estimates, COVID-19 is at least ten times more deadly than an average flu season, particularly for middle-aged and elderly. Furthermore, the lack of effective treatments or vaccines for COVID-19, along with potential long-term damage, make COVID-19 a serious health threat.
FULL CLAIM: “COVID-19 is less deadly than seasonal flu”
REVIEW...
https://healthfeedback.org/claimreview/covid-19-is-at-least-an-order-of-magnitud...
21margd
Vitamin D sufficiency may reduce complications of COVID-19
A recent small-scale study has concluded that hospitalized patients with COVID-19 are less likely to have life threatening complications if they have sufficient vitamin D levels.
Timothy Huzar | Sept 30, 2020
https://www.medicalnewstoday.com/articles/vitamin-d-sufficiency-may-reduce-compl...
----------------------------------------------------------------------------------
Maghbooli Z, Sahraian MA, Ebrahimi M, Pazoki M, Kafan S, Tabriz HM, et al. (2020) Vitamin D sufficiency, a serum 25-hydroxyvitamin D at least 30 ng/mL reduced risk for adverse clinical outcomes in patients with COVID-19 infection. PLoS ONE 15(9): e0239799. https://doi.org/10.1371/journal.pone.0239799
Abstract
Background
To investigate the association between serum 25-hydroxyvitamin D levels and its effect on adverse clinical outcomes, and parameters of immune function and mortality due to a SARS-CoV-2 infection.
Study design
The hospital data of 235 patients infected with COVID-19 were analyzed.
Results
Based on CDC criteria, among our study patients, 74% had severe COVID-19 infection and 32.8% were vitamin D sufficient. After adjusting for confounding factors, there was a significant association between vitamin D sufficiency and reduction in clinical severity, inpatient mortality serum levels of C-reactive protein (CRP) and an increase in lymphocyte percentage. Only 9.7% of patients older than 40 years who were vitamin D sufficient succumbed to the infection compared to 20% who had a circulating level of 25(OH)D
22margd
President Trump's physician:
"I release the following information with the Permission of President Donald J. Trump.
Following PCR-confirmation of the President’s diagnosis, as a precautionary measure he received a single 8 gram dose of Regeneron’s polyclonal antibody cocktail. He completed the infusion without incident. In addition to the polyclonal antibodies, the President has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin.
As of this afternoon the President remains fatigued but in good spirits. He’s being evaluated by a team of experts, and together we’ll be making recommendations to the President and First Lady in regards to next best steps.
First Lady Melania Trump remains well with only a mild cough and headache, and the remainder of the First Family are well and tested negative for SARS-CoV-2 today."
https://www.cnn.com/politics/live-news/trump-coronavirus-positive/h_16a6e0e1d4f9...
"I release the following information with the Permission of President Donald J. Trump.
Following PCR-confirmation of the President’s diagnosis, as a precautionary measure he received a single 8 gram dose of Regeneron’s polyclonal antibody cocktail. He completed the infusion without incident. In addition to the polyclonal antibodies, the President has been taking zinc, vitamin D, famotidine, melatonin and a daily aspirin.
As of this afternoon the President remains fatigued but in good spirits. He’s being evaluated by a team of experts, and together we’ll be making recommendations to the President and First Lady in regards to next best steps.
First Lady Melania Trump remains well with only a mild cough and headache, and the remainder of the First Family are well and tested negative for SARS-CoV-2 today."
https://www.cnn.com/politics/live-news/trump-coronavirus-positive/h_16a6e0e1d4f9...
23margd
Nitric Oxide a Possible Treatment for COVID-19 – Only Substance to Have a Direct Effect on SARS-CoV-2
Uppsala University | October 2, 2020
Researchers at Uppsala University have found that an effective way of treating the coronavirus behind the 2003 SARS epidemic also works on the closely related SARS-CoV-2 virus, the culprit in the ongoing COVID-19 pandemic. The substance concerned is nitric oxide (NO), a compound with antiviral properties that is produced by the body itself. The study is published in the journal Redox Biology.
“To our knowledge, nitric oxide is the only substance shown so far to have a direct effect on SARS-CoV-2,” says Åke Lundkvist, a professor at Uppsala University, who led the study.
Since there is still no effective cure for COVID-19, the main emphasis in the treatments tested has been on relieving symptoms. This can shorten hospital stays and reduce mortality. To date, however, it has not been possible to prove that any of these treatments has affected the actual virus behind the infection.
Nitric oxide (NO) is a compound produced naturally in the body. Its functions include acting like a hormone in controlling various organs. It regulates, for example, tension in the blood vessels and blood flow between and within organs. In acute lung failure, NO can be administered as inhaled gas, in low concentrations, to boost the blood-oxygen saturation level. During the SARS (severe acute respiratory syndrome) coronavirus epidemic of 2003, this therapy was tried out with success. One key reason for the successful results was that inflammation in the patients’ lungs decreased. This property of nitric oxide — the protection it affords against infections, by being both antibacterial and antiviral — is the very one that now interests the researchers.
Their study builds further on a discovery about the coronavirus that caused the first SARS epidemic. In 2003, NO released from S-Nitroso-N-acetylpenicillamine (SNAP) proved to have a distinct antiviral effect. The researchers from Uppsala University and Karolinska Institute have now investigated how the novel coronavirus involved in the current pandemic, SARS CoV-2, reacts to the compound. And SNAP was shown to a clear antiviral effect on this virus, too — and an effect that grew stronger as the dose was raised.
“Until we get a vaccine that works, our hope is that inhalation of NO might be an effective form of treatment. The dosage and timing of starting treatment probably play an important part in the outcome, and now need to be explored as soon as possible,” Åke Lundkvist says.
The research group are now planning to proceed by investigating the antiviral effects of NO emitted in gas form. To do so, they will construct a model in the laboratory in order to safely simulate a conceivable form of therapy for patients.
https://scitechdaily.com/nitric-oxide-a-possible-treatment-for-covid-19-only-sub...
---------------------------------------------------------------------
Akaberi, D. et al. 2020. Mitigation of the replication of SARS-CoV-2 by nitric oxide in vitro. Redox Biology (2 October 2020)
DOI: 10.1016/j.redox.2020.10173 https://www.medfarm.uu.se/nyheter/artikel/?id=15404&typ=artikel&lang=sv (SWEDISH)
Uppsala University | October 2, 2020
Researchers at Uppsala University have found that an effective way of treating the coronavirus behind the 2003 SARS epidemic also works on the closely related SARS-CoV-2 virus, the culprit in the ongoing COVID-19 pandemic. The substance concerned is nitric oxide (NO), a compound with antiviral properties that is produced by the body itself. The study is published in the journal Redox Biology.
“To our knowledge, nitric oxide is the only substance shown so far to have a direct effect on SARS-CoV-2,” says Åke Lundkvist, a professor at Uppsala University, who led the study.
Since there is still no effective cure for COVID-19, the main emphasis in the treatments tested has been on relieving symptoms. This can shorten hospital stays and reduce mortality. To date, however, it has not been possible to prove that any of these treatments has affected the actual virus behind the infection.
Nitric oxide (NO) is a compound produced naturally in the body. Its functions include acting like a hormone in controlling various organs. It regulates, for example, tension in the blood vessels and blood flow between and within organs. In acute lung failure, NO can be administered as inhaled gas, in low concentrations, to boost the blood-oxygen saturation level. During the SARS (severe acute respiratory syndrome) coronavirus epidemic of 2003, this therapy was tried out with success. One key reason for the successful results was that inflammation in the patients’ lungs decreased. This property of nitric oxide — the protection it affords against infections, by being both antibacterial and antiviral — is the very one that now interests the researchers.
Their study builds further on a discovery about the coronavirus that caused the first SARS epidemic. In 2003, NO released from S-Nitroso-N-acetylpenicillamine (SNAP) proved to have a distinct antiviral effect. The researchers from Uppsala University and Karolinska Institute have now investigated how the novel coronavirus involved in the current pandemic, SARS CoV-2, reacts to the compound. And SNAP was shown to a clear antiviral effect on this virus, too — and an effect that grew stronger as the dose was raised.
“Until we get a vaccine that works, our hope is that inhalation of NO might be an effective form of treatment. The dosage and timing of starting treatment probably play an important part in the outcome, and now need to be explored as soon as possible,” Åke Lundkvist says.
The research group are now planning to proceed by investigating the antiviral effects of NO emitted in gas form. To do so, they will construct a model in the laboratory in order to safely simulate a conceivable form of therapy for patients.
https://scitechdaily.com/nitric-oxide-a-possible-treatment-for-covid-19-only-sub...
---------------------------------------------------------------------
Akaberi, D. et al. 2020. Mitigation of the replication of SARS-CoV-2 by nitric oxide in vitro. Redox Biology (2 October 2020)
DOI: 10.1016/j.redox.2020.10173 https://www.medfarm.uu.se/nyheter/artikel/?id=15404&typ=artikel&lang=sv (SWEDISH)
24margd
Wisconsin! It's largely red! (Red = % increase over previous week)
Coronavirus in the U.S.: Where cases are growing and declining (interactive map by county)
National Geographic | Updated Oct. 2, 2020
The United States has surpassed 200,000 coronavirus deaths, meaning the pandemic has claimed nearly twice as many American lives as those lost in every U.S-involved conflict since World War II combined. And the toughest roads could be ahead.
Parts of the nation may be witnessing the first days of an autumn surge, as the seven-day average for new coronavirus cases has been steadily rising above 34,000 since September 13. Tallies are high and rising in 15 states—mainly in the Midwest, where the virus is spreading uncontrollably. Nationwide, deaths are still hovering around 900 to 1,000 per day.
The global death tally has surpassed one million. And as autumn approaches and people move indoors, where the virus is more likely to spread, concerns are rising of a resurgence in the U.S. akin to what is already occurring in some parts of Europe. These worries are buttressed by a continuous flow of micro-surges at grade schools and colleges. The New York Times has identified 88,000 coronavirus cases at nearly 1,200 colleges across the U.S.
The map below shows the regions where cases and deaths are either decreasing or increasing the most, based on the last seven days compared to the previous week...
https://www.nationalgeographic.com/science/2020/05/graphic-tracking-coronavirus-...
Coronavirus in the U.S.: Where cases are growing and declining (interactive map by county)
National Geographic | Updated Oct. 2, 2020
The United States has surpassed 200,000 coronavirus deaths, meaning the pandemic has claimed nearly twice as many American lives as those lost in every U.S-involved conflict since World War II combined. And the toughest roads could be ahead.
Parts of the nation may be witnessing the first days of an autumn surge, as the seven-day average for new coronavirus cases has been steadily rising above 34,000 since September 13. Tallies are high and rising in 15 states—mainly in the Midwest, where the virus is spreading uncontrollably. Nationwide, deaths are still hovering around 900 to 1,000 per day.
The global death tally has surpassed one million. And as autumn approaches and people move indoors, where the virus is more likely to spread, concerns are rising of a resurgence in the U.S. akin to what is already occurring in some parts of Europe. These worries are buttressed by a continuous flow of micro-surges at grade schools and colleges. The New York Times has identified 88,000 coronavirus cases at nearly 1,200 colleges across the U.S.
The map below shows the regions where cases and deaths are either decreasing or increasing the most, based on the last seven days compared to the previous week...
https://www.nationalgeographic.com/science/2020/05/graphic-tracking-coronavirus-...
25margd
Damn gun-toting, anti-masker Rs will get us all killed in MI. :(
Hopefully Ds will take the MI House of Reps and somehow save the day: https://ballotpedia.org/Michigan_House_of_Representatives_elections,_2020
Rs hold the Senate, however: https://ballotpedia.org/Michigan_State_Senate#Elections .
Redistricting effort underway...
Four judges on MI Supreme Court were appointed by previous R governors. The other three were nominated by Ds and won election. Marred by partisanship in past, Court is improving: https://www.freep.com/story/opinion/editorials/2020/10/01/mccormack-and-welch-mi...
------------------------------------------------------------------------------
Michigan Supreme Court rules against Whitmer on emergency powers but effect unclear
Dave Boucher and Todd Spangler | Oct 2, 2020
...the court had effectively stripped Whitmer of authority she insisted she had to respond to the crisis. "My opinion would be that it's binding. Because it's not a Michigan (state court) case there aren't going to be any injunctions or the like. But it is a decision of the Michigan Supreme Court," said Wayne State University Law School professor Robert Sedler. "The existing stay-at-home orders would not be valid... This is going to have quite an impact."
In the 4-3 ruling, the court determined the governor did not have the authority under state law to issue any additional emergency declarations pertaining to the pandemic after April 30. That was the last date when the Legislature allowed the governor to declare an emergency, having declined to extend an earlier declaration.
"The governor’s declaration of a state of emergency or state of disaster may only endure for 28 days absent legislative approval of an extension. So, if the Legislature does nothing, as it did here, the governor is obligated to terminate the state of emergency or state of disaster after 28 days," said the majority opinion, written by Judge Stephen Markman.
The governor relied on her interpretation of the law to broadly mandate business closures, mask requirements, sports restrictions and more. While many of those restrictions have been lifted, many more remain. Just hours before the ruling, the governor determined the Upper Peninsula* needed to abide by stricter rules for gatherings and masks because of an uptick in coronavirus cases.
Now, the authority of orders dictating everything from clubs and bars operating at limited capacity to mask mandates for high school athletes has been thrown into question...
https://www.freep.com/story/news/politics/2020/10/02/michigan-supreme-court-rule...
* now a hot spot
Hopefully Ds will take the MI House of Reps and somehow save the day: https://ballotpedia.org/Michigan_House_of_Representatives_elections,_2020
Rs hold the Senate, however: https://ballotpedia.org/Michigan_State_Senate#Elections .
Redistricting effort underway...
Four judges on MI Supreme Court were appointed by previous R governors. The other three were nominated by Ds and won election. Marred by partisanship in past, Court is improving: https://www.freep.com/story/opinion/editorials/2020/10/01/mccormack-and-welch-mi...
------------------------------------------------------------------------------
Michigan Supreme Court rules against Whitmer on emergency powers but effect unclear
Dave Boucher and Todd Spangler | Oct 2, 2020
...the court had effectively stripped Whitmer of authority she insisted she had to respond to the crisis. "My opinion would be that it's binding. Because it's not a Michigan (state court) case there aren't going to be any injunctions or the like. But it is a decision of the Michigan Supreme Court," said Wayne State University Law School professor Robert Sedler. "The existing stay-at-home orders would not be valid... This is going to have quite an impact."
In the 4-3 ruling, the court determined the governor did not have the authority under state law to issue any additional emergency declarations pertaining to the pandemic after April 30. That was the last date when the Legislature allowed the governor to declare an emergency, having declined to extend an earlier declaration.
"The governor’s declaration of a state of emergency or state of disaster may only endure for 28 days absent legislative approval of an extension. So, if the Legislature does nothing, as it did here, the governor is obligated to terminate the state of emergency or state of disaster after 28 days," said the majority opinion, written by Judge Stephen Markman.
The governor relied on her interpretation of the law to broadly mandate business closures, mask requirements, sports restrictions and more. While many of those restrictions have been lifted, many more remain. Just hours before the ruling, the governor determined the Upper Peninsula* needed to abide by stricter rules for gatherings and masks because of an uptick in coronavirus cases.
Now, the authority of orders dictating everything from clubs and bars operating at limited capacity to mask mandates for high school athletes has been thrown into question...
https://www.freep.com/story/news/politics/2020/10/02/michigan-supreme-court-rule...
* now a hot spot
26margd
Remdesivir
Virus drug review after reports of 'possible' acute kidney damage
Updated / Friday, 2 Oct 2020 20:35
The EU's medicines regulator said it is investigating reports of possible "acute" kidney damage in patients taking the coronavirus drug remdesivir, made by US pharma giant Gilead.
The European Medicines Agency recommended the use of the anti-viral drug, sold under the brand name Veklury, in June after studies showed it could reduce the length of hospital stays for Covid-19 sufferers.
"EMA's safety committee has started a review... to assess reports of acute kidney injury in some patients with Covid-19 taking Veklury (remdesivir)," it said in a statement.
The regulator said it had "not been determined whether there is a causal relationship" between remdesivir and kidney problems, but that the issue "warrants further investigation."
Covid-19 itself could also cause kidney injuries, the regulator noted.
Recommendations for using the drug had not changed for now, the EMA said, adding that approval had been fast-tracked for use with coronavirus patients on the basis that further tests would be carried out.
If a link to kidney problems was proved, any change would probably be limited to making leaflets with the drug alerting users to possible side-effects, it said...
https://www.rte.ie/news/2020/1002/1169088-covid-medicine-review/
Virus drug review after reports of 'possible' acute kidney damage
Updated / Friday, 2 Oct 2020 20:35
The EU's medicines regulator said it is investigating reports of possible "acute" kidney damage in patients taking the coronavirus drug remdesivir, made by US pharma giant Gilead.
The European Medicines Agency recommended the use of the anti-viral drug, sold under the brand name Veklury, in June after studies showed it could reduce the length of hospital stays for Covid-19 sufferers.
"EMA's safety committee has started a review... to assess reports of acute kidney injury in some patients with Covid-19 taking Veklury (remdesivir)," it said in a statement.
The regulator said it had "not been determined whether there is a causal relationship" between remdesivir and kidney problems, but that the issue "warrants further investigation."
Covid-19 itself could also cause kidney injuries, the regulator noted.
Recommendations for using the drug had not changed for now, the EMA said, adding that approval had been fast-tracked for use with coronavirus patients on the basis that further tests would be carried out.
If a link to kidney problems was proved, any change would probably be limited to making leaflets with the drug alerting users to possible side-effects, it said...
https://www.rte.ie/news/2020/1002/1169088-covid-medicine-review/
27Molly3028
What is playing out in the White House "community" this week is
exactly what has been playing out in communities throughout the
country this year. Covid took a meandering route around the
country before it ended up there.
exactly what has been playing out in communities throughout the
country this year. Covid took a meandering route around the
country before it ended up there.
28margd
White House Objects to FDA Plans on Authorizing Covid-19 Vaccine
Thomas M. Burton | Oct 3, 2020
Senior White House officials have raised objections to the U.S. Food and Drug Administration’s proposed standards for deciding whether a Covid-19 vaccine should be given widely and don’t appear likely to sign off on the agency’s guidelines...
In talks with the FDA in recent days, White House officials expressed a number of concerns about the draft guidelines, including a proposal that would require researchers to monitor study subjects for side effects for two months after getting a shot...
The disagreement could put the administration on a collision course with the FDA over whether and when to authorize use of a Covid-19 vaccine, once the late-stage trials that are testing the shots start providing data—perhaps in as little as a few weeks—on how the injections are performing.
...The White House doesn’t need to approve the guidelines, because they simply indicate the FDA’s thinking, rather than carrying the force of, say, a regulation. Yet the agency often seeks an administration’s stamp of approval so companies and the public will know what goals medicines need to meet in order to be cleared for use.
The FDA wanted the administration’s blessing in this case to reassure Americans that any vaccines they might be offered would meet high standards...
The refusal so far to sign off could reignite concerns that the Trump administration might interfere in science-based decision making at the FDA and pressure the agency to rush out a vaccine for political reasons...
...Among the White House officials raising concerns were chief of staff Mark Meadows and some high-ranking aides in the Office of Management and Budget...
https://www.msn.com/en-us/news/us/white-house-objects-to-fda-plans-on-authorizin...
Thomas M. Burton | Oct 3, 2020
Senior White House officials have raised objections to the U.S. Food and Drug Administration’s proposed standards for deciding whether a Covid-19 vaccine should be given widely and don’t appear likely to sign off on the agency’s guidelines...
In talks with the FDA in recent days, White House officials expressed a number of concerns about the draft guidelines, including a proposal that would require researchers to monitor study subjects for side effects for two months after getting a shot...
The disagreement could put the administration on a collision course with the FDA over whether and when to authorize use of a Covid-19 vaccine, once the late-stage trials that are testing the shots start providing data—perhaps in as little as a few weeks—on how the injections are performing.
...The White House doesn’t need to approve the guidelines, because they simply indicate the FDA’s thinking, rather than carrying the force of, say, a regulation. Yet the agency often seeks an administration’s stamp of approval so companies and the public will know what goals medicines need to meet in order to be cleared for use.
The FDA wanted the administration’s blessing in this case to reassure Americans that any vaccines they might be offered would meet high standards...
The refusal so far to sign off could reignite concerns that the Trump administration might interfere in science-based decision making at the FDA and pressure the agency to rush out a vaccine for political reasons...
...Among the White House officials raising concerns were chief of staff Mark Meadows and some high-ranking aides in the Office of Management and Budget...
https://www.msn.com/en-us/news/us/white-house-objects-to-fda-plans-on-authorizin...
29margd
Why Anthony Fauci is happy being the "skunk" on the Coronavirus Task Force
Jon Cohen | Oct. 3, 2020
...Q: Operation Warp Speed wanted vaccines that could be mass produced quickly. But what do you think of its portfolio? The obvious missing component is the inactivated virus vaccine. That’s moved very far with China-made vaccines and now Europe is investing big time in it.
A: In a perfect world, you would want to get all those platforms going. A decision was made regarding the broad effort. I wasn't the primary person in making that decision. I was and am responsible only for the NIH component of that multi-faceted effort. We do the research, and we say, these are the things we need to do. A decision was made that they were going to have an overarching process involving multiple agencies of the federal government. It wasn't completely in my hands. The one thing that I'm glad happened, because we were pushing for that, was to get a broader portfolio, a wide range of vaccine platforms including the more traditional one of recombinant proteins with an adjuvant.
Q: Most COVID-19 vaccines being tested in the United States only contain versions of the viral surface protein, spike. The inactivated virus vaccines have all the viral proteins. What do you think about broadening to include more viral components?
A: You know, it's an interesting psychodynamic, saying we are in this catastrophic outbreak and we've got to move as quickly as we possibly can. We’re relying on the companies that come forth and say, we're willing to make an investment in this approach. There was an emphasis on needing to do something about it right now, right away, because that's the only thing you have, as opposed to approaches with other diseases where there was less of an emergency nature to the process. Other antigens besides the spike likely will be pursued in the second generation of SARS-CoV-2 vaccines.
Q: The EUA situation raises an interesting problem. The way convalescent plasma was approved for an EUA combined with the EUA of hydroxychloroquine is tied together with confidence in the vaccine dropping.
A: I understand the need for and importance of EUAs, but I have long been of the opinion that the gold standard of determining conclusively if an intervention is safe and effective is conducting a randomized controlled clinical trial. An EUA is based on the principle that the benefit outweighs the risk in a situation where there is a reason to believe that the intervention may be effective. I am all for that--this can get life-saving interventions out quickly for people who need it. But this should only be done in a situation that doesn’t interfere with the process of ultimately proving whether that intervention is truly safe and effective. For convalescent plasma, an EUA was issued, and I hope that when the clinical trials are completed, we get a definitive answer.
Q: Convalescent plasma didn't work in Ebola.
A: Yes, exactly. And Cliff Lane, a deputy director of NIAID did a study in Southeast Asia, and convalescent plasma didn't work in influenza.
Q: And the data for convalescent plasma against COVID-19 are really soft.
A: One of the things that I learned, and that's the fun of continuing to learn as you get older and older, is the sophistication of modern-day statistics. When you examine something in a post hoc analysis of a non-pre-determined endpoint, boy, can you be led down the garden path. We used to kid around saying if you torture the data enough, it's going to ultimately tell you what you want it to tell you...
https://www.sciencemag.org/news/2020/10/why-anthony-fauci-happy-being-skunk-coro...
Jon Cohen | Oct. 3, 2020
...Q: Operation Warp Speed wanted vaccines that could be mass produced quickly. But what do you think of its portfolio? The obvious missing component is the inactivated virus vaccine. That’s moved very far with China-made vaccines and now Europe is investing big time in it.
A: In a perfect world, you would want to get all those platforms going. A decision was made regarding the broad effort. I wasn't the primary person in making that decision. I was and am responsible only for the NIH component of that multi-faceted effort. We do the research, and we say, these are the things we need to do. A decision was made that they were going to have an overarching process involving multiple agencies of the federal government. It wasn't completely in my hands. The one thing that I'm glad happened, because we were pushing for that, was to get a broader portfolio, a wide range of vaccine platforms including the more traditional one of recombinant proteins with an adjuvant.
Q: Most COVID-19 vaccines being tested in the United States only contain versions of the viral surface protein, spike. The inactivated virus vaccines have all the viral proteins. What do you think about broadening to include more viral components?
A: You know, it's an interesting psychodynamic, saying we are in this catastrophic outbreak and we've got to move as quickly as we possibly can. We’re relying on the companies that come forth and say, we're willing to make an investment in this approach. There was an emphasis on needing to do something about it right now, right away, because that's the only thing you have, as opposed to approaches with other diseases where there was less of an emergency nature to the process. Other antigens besides the spike likely will be pursued in the second generation of SARS-CoV-2 vaccines.
Q: The EUA situation raises an interesting problem. The way convalescent plasma was approved for an EUA combined with the EUA of hydroxychloroquine is tied together with confidence in the vaccine dropping.
A: I understand the need for and importance of EUAs, but I have long been of the opinion that the gold standard of determining conclusively if an intervention is safe and effective is conducting a randomized controlled clinical trial. An EUA is based on the principle that the benefit outweighs the risk in a situation where there is a reason to believe that the intervention may be effective. I am all for that--this can get life-saving interventions out quickly for people who need it. But this should only be done in a situation that doesn’t interfere with the process of ultimately proving whether that intervention is truly safe and effective. For convalescent plasma, an EUA was issued, and I hope that when the clinical trials are completed, we get a definitive answer.
Q: Convalescent plasma didn't work in Ebola.
A: Yes, exactly. And Cliff Lane, a deputy director of NIAID did a study in Southeast Asia, and convalescent plasma didn't work in influenza.
Q: And the data for convalescent plasma against COVID-19 are really soft.
A: One of the things that I learned, and that's the fun of continuing to learn as you get older and older, is the sophistication of modern-day statistics. When you examine something in a post hoc analysis of a non-pre-determined endpoint, boy, can you be led down the garden path. We used to kid around saying if you torture the data enough, it's going to ultimately tell you what you want it to tell you...
https://www.sciencemag.org/news/2020/10/why-anthony-fauci-happy-being-skunk-coro...
30margd
How COVID-19 Spreads
CDC | Updated Oct. 5, 2020
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads...
_______________________________________________________
CDC Updates Covid-19 Guidelines, Acknowledging Virus Can Spread via Tiny Air Particles
The CDC made the changes to its Covid-19 guidelines about two weeks after deleting language recognizing a role played by the tiny airborne particles
Caitlin McCabe & Betsy McKay | Oct. 5, 2020
The U.S. Centers for Disease Control and Prevention said tiny particles that linger in the air can spread the coronavirus, revising its guidelines on the matter just a few weeks after the health agency had acknowledged a role for the particles and then abruptly removed it.
The guidelines on how the coronavirus spreads were initially updated last month to acknowledge a role, and possibly the primary one, played by tiny aerosol particles in spreading the virus. But the agency removed the changes only days later, saying a draft version of the proposed changes had been posted in error.
In its latest revisions to the guidelines Monday, the CDC acknowledged a role for the tiny airborne particles, though the latest wording says they aren’t the main way the virus spreads.
...the virus can spread under certain conditions via the smaller airborne particles to people who were more than 6 feet away.
“These transmissions occurred within enclosed spaces that had inadequate ventilation,” the CDC said. “Sometimes the person was breathing heavily, for example while singing or exercising.”...
https://www.wsj.com/articles/cdc-updates-covid-19-guidelines-acknowledging-virus...
CDC | Updated Oct. 5, 2020
https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/how-covid-spreads...
_______________________________________________________
CDC Updates Covid-19 Guidelines, Acknowledging Virus Can Spread via Tiny Air Particles
The CDC made the changes to its Covid-19 guidelines about two weeks after deleting language recognizing a role played by the tiny airborne particles
Caitlin McCabe & Betsy McKay | Oct. 5, 2020
The U.S. Centers for Disease Control and Prevention said tiny particles that linger in the air can spread the coronavirus, revising its guidelines on the matter just a few weeks after the health agency had acknowledged a role for the particles and then abruptly removed it.
The guidelines on how the coronavirus spreads were initially updated last month to acknowledge a role, and possibly the primary one, played by tiny aerosol particles in spreading the virus. But the agency removed the changes only days later, saying a draft version of the proposed changes had been posted in error.
In its latest revisions to the guidelines Monday, the CDC acknowledged a role for the tiny airborne particles, though the latest wording says they aren’t the main way the virus spreads.
...the virus can spread under certain conditions via the smaller airborne particles to people who were more than 6 feet away.
“These transmissions occurred within enclosed spaces that had inadequate ventilation,” the CDC said. “Sometimes the person was breathing heavily, for example while singing or exercising.”...
https://www.wsj.com/articles/cdc-updates-covid-19-guidelines-acknowledging-virus...
31margd
"...one is far more likely to inhale aerosols than be sprayed by a droplet, and so the balance of attention must be shifted to protecting against airborne transmission. In addition to existing mandates of mask-wearing, social distancing, and hygiene efforts, we urge public health officials to add clear guidance about the importance of moving activities outdoors, improving indoor air using ventilation and filtration, and improving protection for high-risk workers..."
Kimberly A. Pratheretal. 2020. Airborne transmission of SARS-CoV-2 (Letter).nScience 05 Oct 2020: eabf0521. DOI: 10.1126/science.abf0521 https://science.sciencemag.org/content/early/2020/10/02/science.abf0521
There is overwhelming evidence that inhalation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a major transmission route for coronavirus disease 2019 (COVID-19). There is an urgent need to harmonize discussions about modes of virus transmission across disciplines to ensure the most effective control strategies and provide clear and consistent guidance to the public. To do so, we must clarify the terminology to distinguish between aerosols and droplets using a size threshold of 100 μm, not the historical 5 μm... This size more effectively separates their aerodynamic behavior, ability to be inhaled, and efficacy of interventions.
Viruses in droplets (larger than 100 μm) typically fall to the ground in seconds within 2 m of the source and can be sprayed like tiny cannonballs onto nearby individuals. Because of their limited travel range, physical distancing reduces exposure to these droplets. Viruses in aerosols (smaller than 100 μm) can remain suspended in air for many seconds to hours, like smoke, and be inhaled. They are highly concentrated near an infected person, so they can infect people most easily in close proximity. But aerosols containing infectious virus...can also travel more than 2 m and accumulate in poorly ventilated indoor air, leading to superspreading events...
Individuals with COVID-19, many of whom have no symptoms, release thousands of virus-laden aerosols and far fewer droplets when breathing and talking... Thus, one is far more likely to inhale aerosols than be sprayed by a droplet, and so the balance of attention must be shifted to protecting against airborne transmission. In addition to existing mandates of mask-wearing, social distancing, and hygiene efforts, we urge public health officials to add clear guidance about the importance of moving activities outdoors, improving indoor air using ventilation and filtration, and improving protection for high-risk workers...
Kimberly A. Pratheretal. 2020. Airborne transmission of SARS-CoV-2 (Letter).nScience 05 Oct 2020: eabf0521. DOI: 10.1126/science.abf0521 https://science.sciencemag.org/content/early/2020/10/02/science.abf0521
There is overwhelming evidence that inhalation of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) represents a major transmission route for coronavirus disease 2019 (COVID-19). There is an urgent need to harmonize discussions about modes of virus transmission across disciplines to ensure the most effective control strategies and provide clear and consistent guidance to the public. To do so, we must clarify the terminology to distinguish between aerosols and droplets using a size threshold of 100 μm, not the historical 5 μm... This size more effectively separates their aerodynamic behavior, ability to be inhaled, and efficacy of interventions.
Viruses in droplets (larger than 100 μm) typically fall to the ground in seconds within 2 m of the source and can be sprayed like tiny cannonballs onto nearby individuals. Because of their limited travel range, physical distancing reduces exposure to these droplets. Viruses in aerosols (smaller than 100 μm) can remain suspended in air for many seconds to hours, like smoke, and be inhaled. They are highly concentrated near an infected person, so they can infect people most easily in close proximity. But aerosols containing infectious virus...can also travel more than 2 m and accumulate in poorly ventilated indoor air, leading to superspreading events...
Individuals with COVID-19, many of whom have no symptoms, release thousands of virus-laden aerosols and far fewer droplets when breathing and talking... Thus, one is far more likely to inhale aerosols than be sprayed by a droplet, and so the balance of attention must be shifted to protecting against airborne transmission. In addition to existing mandates of mask-wearing, social distancing, and hygiene efforts, we urge public health officials to add clear guidance about the importance of moving activities outdoors, improving indoor air using ventilation and filtration, and improving protection for high-risk workers...
32Limelite
Where is there any evidence in medical opinion that patients in the middle of I.V remdesivir therapy should be discharged from hospitalization "standard practice" ?
Where is it in medical ethics that under HIPPA regulation it's OK to release actual vital statistics numbers of a patient to the public but illegal to disclose lung function/damage data? That's a pivot too far.
Where is it in medical ethics that under HIPPA regulation it's OK to release actual vital statistics numbers of a patient to the public but illegal to disclose lung function/damage data? That's a pivot too far.
33stellarexplorer
>32 Limelite: No one else gets remdesivir in Trump’s situation. Because there is a shortage, and because there are only randomized controlled trials in very sick patients at later stages of illness than Trump, only those patients are getting it at this point. There is no set of standard guidelines on this. Frankly, since remdesivir is an anti-viral, and week one of Covid-19 is when massive viral replication is taking place, on theoretical grounds it is likely to be more useful early - as in a case like Trump’s - than later. That said, there is virtually no experience with administering remdesivir during the first week of test positivity. This research should be done.
The foolishness of Trump’s departure (I deliberately don’t say discharge, as do we know whether his doctors actually willingly discharged him, following ordinary procedure?) isn’t so much about his receiving a course of remdesivir (I have no idea where he is in that course), but rather because he is apparently pretty sick, and cannot or will not isolate in a way that protects others. He may have infected dozens by his maskless behavior at the White House upon arrival. I don’t know the capacity of the White House to provide for safe isolation under conditions of a patient with good judgment. Maybe others would have to stop working there temporarily to keep things safe?
As far as HIPPA, Trump as the patient in question can forbid his doctor from disclosing whatever part of his medical history he wishes. He can also permit this disclosure. Clearly, he is calling the shots here. Perhaps the argument is what the American people have a right to know about their President’s health. And one can speculate about whether and what political consequences there might be Trump in hiding and concealing.
The foolishness of Trump’s departure (I deliberately don’t say discharge, as do we know whether his doctors actually willingly discharged him, following ordinary procedure?) isn’t so much about his receiving a course of remdesivir (I have no idea where he is in that course), but rather because he is apparently pretty sick, and cannot or will not isolate in a way that protects others. He may have infected dozens by his maskless behavior at the White House upon arrival. I don’t know the capacity of the White House to provide for safe isolation under conditions of a patient with good judgment. Maybe others would have to stop working there temporarily to keep things safe?
As far as HIPPA, Trump as the patient in question can forbid his doctor from disclosing whatever part of his medical history he wishes. He can also permit this disclosure. Clearly, he is calling the shots here. Perhaps the argument is what the American people have a right to know about their President’s health. And one can speculate about whether and what political consequences there might be Trump in hiding and concealing.
34lriley
Trump's reaction--sick as he was at going to Walter Reed was to ask at least several times whether he was going to die. He was obviously extremely concerned. Now that he's feeling better from the treatments he was given--he's beating his chest and inferring Covid is no big deal. He can't help but dishonor those people who suffered and died and he seemingly never learns from anything. I don't think any of us know what was in that drug cocktail he was given or whether his Covid has gone away--but when someone was sick like he was it always takes a while to recover. Right now I'm thinking there is a good chance he'll have a relapse.
35jjwilson61
>33 stellarexplorer: In that case the doctor should be open and tell us what Trump allows him to disclose and what he doesn't.
36stellarexplorer
>34 lriley: Week one is about viral replication, and few people die (although I personally lost someone during this time). It’s week two when the body’s immune response can overwhelm a patient with a powerful maladaptive response. Trump may be in great danger in a few days or a week. Even if he avoids this, he will face the risks of dangerous clots and potentially infections with other pathogens. To say nothing of severe fatigue and neuropsychiatric complications. Incarceration after he is voted out could be a walk in the park in comparison.
>35 jjwilson61: I am as disgusted as the next person about the way this is being handled, but the fact is everyone who works with Trump is a toady or they can’t stay in the job. These doctors are under his thumb. To your point, in general, doctors are not at liberty to disclose anything their patients don’t want them to disclose, including what limits the patient has placed on their disclosures. Thus, “I am not at liberty to discuss”. This is on Trump. He could grant them permission to speak freely if he wished. He doesn’t.
>35 jjwilson61: I am as disgusted as the next person about the way this is being handled, but the fact is everyone who works with Trump is a toady or they can’t stay in the job. These doctors are under his thumb. To your point, in general, doctors are not at liberty to disclose anything their patients don’t want them to disclose, including what limits the patient has placed on their disclosures. Thus, “I am not at liberty to discuss”. This is on Trump. He could grant them permission to speak freely if he wished. He doesn’t.
37margd
FDA circulated draft guidelines to vaccine developers. Will they play along with a Trump increasingly likely to lose election and request an EUA--at risk of having public snub their vaccines? Could Trump invoke the Defense Production Act if vaccine companies don't play along? Would that work for such a technologically complex product if developers are not 100% cooperative?
Trump Determined to Get Vaccine Before Election, Reportedly Overrules FDA Guidelines
Jonathan Chait | Oct. 5, 2020
...What now seems likely to happen is that Trump will announce a vaccine before the election. He will find some appropriately credentialed scientist to vouchsafe his claim. (It only takes one scientist sufficiently susceptible to Trump’s pressure to supply the necessary televised endorsement by “science.”) Scientific authorities in the bureaucracy will revolt, perhaps resigning in protest. Will those voters who don’t trust Trump — that is, a clear majority of them — believe he has delivered a vaccine? Probably not. Will the government be able to develop public trust whenever it does produce what its scientists deem a safe and effective vaccine? We can only hope.
https://nymag.com/intelligencer/2020/10/trump-vaccine-overrules-fda-election-cor...
----------------------------------------------------------------------
Most Americans say Trump acted irresponsibly and distrust White House on his health
Jennifer Agiesta | October 5, 2020
...And perhaps most concerning, division over whether to get a coronavirus vaccine if one were available at low cost has increased. Overall, 51% say they would try to get vaccinated, the smallest share in CNN polling since May. While most Americans say they are confident that the ongoing vaccine trials are properly balancing safety and speed (61%), the poll suggests a shifting partisan divide over whether to get vaccinated as Trump touts a fast-moving process for approval.
In an August poll, Trump's supporters drove much of the shift against seeking a vaccination, shifting from 51% saying they would get one in May to 38% in August. Their willingness to get a coronavirus vaccination remains about the same, at 41%. Among Democratic presidential nominee Joe Biden's supporters, however, a broad majority saying they would seek a vaccination in May and August (79% said they would get one in May, 74% in August) has shrunk to 60% saying they would get one now...
https://www.cnn.com/2020/10/05/politics/cnn-poll-coronavirus-trump/index.html
Trump Determined to Get Vaccine Before Election, Reportedly Overrules FDA Guidelines
Jonathan Chait | Oct. 5, 2020
...What now seems likely to happen is that Trump will announce a vaccine before the election. He will find some appropriately credentialed scientist to vouchsafe his claim. (It only takes one scientist sufficiently susceptible to Trump’s pressure to supply the necessary televised endorsement by “science.”) Scientific authorities in the bureaucracy will revolt, perhaps resigning in protest. Will those voters who don’t trust Trump — that is, a clear majority of them — believe he has delivered a vaccine? Probably not. Will the government be able to develop public trust whenever it does produce what its scientists deem a safe and effective vaccine? We can only hope.
https://nymag.com/intelligencer/2020/10/trump-vaccine-overrules-fda-election-cor...
----------------------------------------------------------------------
Most Americans say Trump acted irresponsibly and distrust White House on his health
Jennifer Agiesta | October 5, 2020
...And perhaps most concerning, division over whether to get a coronavirus vaccine if one were available at low cost has increased. Overall, 51% say they would try to get vaccinated, the smallest share in CNN polling since May. While most Americans say they are confident that the ongoing vaccine trials are properly balancing safety and speed (61%), the poll suggests a shifting partisan divide over whether to get vaccinated as Trump touts a fast-moving process for approval.
In an August poll, Trump's supporters drove much of the shift against seeking a vaccination, shifting from 51% saying they would get one in May to 38% in August. Their willingness to get a coronavirus vaccination remains about the same, at 41%. Among Democratic presidential nominee Joe Biden's supporters, however, a broad majority saying they would seek a vaccination in May and August (79% said they would get one in May, 74% in August) has shrunk to 60% saying they would get one now...
https://www.cnn.com/2020/10/05/politics/cnn-poll-coronavirus-trump/index.html
38margd
Nearly One-Third of Covid Patients in Study Had Altered Mental State
Pam Belluck | Oct. 5, 2020
Nearly a third of hospitalized Covid-19 patients experienced some type of altered mental function — ranging from confusion to delirium to unresponsiveness — in the largest study to date of neurological symptoms among coronavirus patients in an American hospital system.
...These patients stayed three times as long in the hospital as patients without altered mental function.
After they were discharged, only 32 percent of the patients with altered mental function were able to handle routine daily activities like cooking and paying bills... In contrast, 89 percent of patients without altered mental function were able to manage such activities without assistance.
Patients with altered mental function — the medical term is encephalopathy — were also nearly seven times as likely to die as those who did not have that type of problem...with attention and concentration, loss of short-term memory, disorientation, stupor and “profound unresponsiveness” or a coma-like level of consciousness.
...most experts say neurological effects are probably triggered by inflammatory and immune system responses that often affect other organs, as well as the brain.
...patients with encephalopathy were more likely to be older and male. They were also more likely to have underlying medical conditions, including a history of any neurological disorder, cancer, cerebrovascular disease, chronic kidney disease, diabetes, high cholesterol, heart failure, hypertension or smoking.
...Younger patients were more likely to develop neurological symptoms over all, except for encephalopathy, which was more common in older people
...Black and Latino patients were not more likely than other groups to develop neurological symptoms.
...“It is also interesting but concerning that they found differences in the outcome of patients between the various hospitals which they attribute to differences in the quality of care provided,” (Dr. Avindra Nath, chief of the section on infections of the nervous system at the National Institute of Neurological Disorders and Stroke, who was not involved in the study) said. “This means that the hospitalized patients require a high level of care, which is not readily available in most places.”
https://www.nytimes.com/2020/10/05/health/Covid-patients-mental-state.html
----------------------------------------------------------------------------------------------------
Eric M. Liotta et al. 2020. Frequent neurologic manifestations and encephalopathy‐associated morbidity in Covid‐19 patients. Annals of Clinical and Translational Neurology (05 October 2020) https://doi.org/10.1002/acn3.51210 https://onlinelibrary.wiley.com/doi/full/10.1002/acn3.51210
Abstract
Objective
Covid‐19 can involve multiple organs including the nervous system. We sought to characterize the neurologic manifestations, their risk factors, and associated outcomes in hospitalized patients with Covid‐19.
Methods
We examined neurologic manifestations in 509 consecutive patients admitted with confirmed Covid‐19 within a hospital network in Chicago, Illinois. We compared the severity of Covid‐19 and outcomes in patients with and without neurologic manifestations. We also identified independent predictors of any neurologic manifestations, encephalopathy, and functional outcome using binary logistic regression.
Results
Neurologic manifestations were present at Covid‐19 onset in 215 (42.2%), at hospitalization in 319 (62.7%), and at any time during the disease course in 419 patients (82.3%). The most frequent neurologic manifestations were myalgias (44.8%), headaches (37.7%), encephalopathy (31.8%), dizziness (29.7%), dysgeusia (15.9%), and anosmia (11.4%). Strokes, movement disorders, motor and sensory deficits, ataxia, and seizures were uncommon (0.2 to 1.4% of patients each). Severe respiratory disease requiring mechanical ventilation occurred in 134 patients (26.3%). Independent risk factors for developing any neurologic manifestation were severe Covid‐19 (OR 4.02; 95% CI 2.04–8.89; P less than 0.001) and younger age (OR 0.982; 95% CI 0.968–0.996; P = 0.014). Of all patients, 362 (71.1%) had a favorable functional outcome at discharge (modified Rankin Scale 0–2). However, encephalopathy was independently associated with worse functional outcome (OR 0.22; 95% CI 0.11–0.42; P less than 0.001) and higher mortality within 30 days of hospitalization (35 21.7% vs. 11 3.2% patients; P less than 0.001).
Interpretation
Neurologic manifestations occur in most hospitalized Covid‐19 patients. Encephalopathy was associated with increased morbidity and mortality, independent of respiratory disease severity.
Pam Belluck | Oct. 5, 2020
Nearly a third of hospitalized Covid-19 patients experienced some type of altered mental function — ranging from confusion to delirium to unresponsiveness — in the largest study to date of neurological symptoms among coronavirus patients in an American hospital system.
...These patients stayed three times as long in the hospital as patients without altered mental function.
After they were discharged, only 32 percent of the patients with altered mental function were able to handle routine daily activities like cooking and paying bills... In contrast, 89 percent of patients without altered mental function were able to manage such activities without assistance.
Patients with altered mental function — the medical term is encephalopathy — were also nearly seven times as likely to die as those who did not have that type of problem...with attention and concentration, loss of short-term memory, disorientation, stupor and “profound unresponsiveness” or a coma-like level of consciousness.
...most experts say neurological effects are probably triggered by inflammatory and immune system responses that often affect other organs, as well as the brain.
...patients with encephalopathy were more likely to be older and male. They were also more likely to have underlying medical conditions, including a history of any neurological disorder, cancer, cerebrovascular disease, chronic kidney disease, diabetes, high cholesterol, heart failure, hypertension or smoking.
...Younger patients were more likely to develop neurological symptoms over all, except for encephalopathy, which was more common in older people
...Black and Latino patients were not more likely than other groups to develop neurological symptoms.
...“It is also interesting but concerning that they found differences in the outcome of patients between the various hospitals which they attribute to differences in the quality of care provided,” (Dr. Avindra Nath, chief of the section on infections of the nervous system at the National Institute of Neurological Disorders and Stroke, who was not involved in the study) said. “This means that the hospitalized patients require a high level of care, which is not readily available in most places.”
https://www.nytimes.com/2020/10/05/health/Covid-patients-mental-state.html
----------------------------------------------------------------------------------------------------
Eric M. Liotta et al. 2020. Frequent neurologic manifestations and encephalopathy‐associated morbidity in Covid‐19 patients. Annals of Clinical and Translational Neurology (05 October 2020) https://doi.org/10.1002/acn3.51210 https://onlinelibrary.wiley.com/doi/full/10.1002/acn3.51210
Abstract
Objective
Covid‐19 can involve multiple organs including the nervous system. We sought to characterize the neurologic manifestations, their risk factors, and associated outcomes in hospitalized patients with Covid‐19.
Methods
We examined neurologic manifestations in 509 consecutive patients admitted with confirmed Covid‐19 within a hospital network in Chicago, Illinois. We compared the severity of Covid‐19 and outcomes in patients with and without neurologic manifestations. We also identified independent predictors of any neurologic manifestations, encephalopathy, and functional outcome using binary logistic regression.
Results
Neurologic manifestations were present at Covid‐19 onset in 215 (42.2%), at hospitalization in 319 (62.7%), and at any time during the disease course in 419 patients (82.3%). The most frequent neurologic manifestations were myalgias (44.8%), headaches (37.7%), encephalopathy (31.8%), dizziness (29.7%), dysgeusia (15.9%), and anosmia (11.4%). Strokes, movement disorders, motor and sensory deficits, ataxia, and seizures were uncommon (0.2 to 1.4% of patients each). Severe respiratory disease requiring mechanical ventilation occurred in 134 patients (26.3%). Independent risk factors for developing any neurologic manifestation were severe Covid‐19 (OR 4.02; 95% CI 2.04–8.89; P less than 0.001) and younger age (OR 0.982; 95% CI 0.968–0.996; P = 0.014). Of all patients, 362 (71.1%) had a favorable functional outcome at discharge (modified Rankin Scale 0–2). However, encephalopathy was independently associated with worse functional outcome (OR 0.22; 95% CI 0.11–0.42; P less than 0.001) and higher mortality within 30 days of hospitalization (35 21.7% vs. 11 3.2% patients; P less than 0.001).
Interpretation
Neurologic manifestations occur in most hospitalized Covid‐19 patients. Encephalopathy was associated with increased morbidity and mortality, independent of respiratory disease severity.
40margd
>37 margd: Vaccine EUA, contd. :)
Gregg Gonsalves (Yale) @gregggonsalves | 9:53 AM · Oct 6, 2020:
So, my colleague @jasonlschwartz does the big reveal. @US_FDA did not come to play. They've release #COVID19 vaccine #EUA guidance as Appendix 2 in their materials for its vaccine advisory committee. Bravo. FDA. This is courage. So nice to say that.
Jason L. Schwartz (Yale) @jasonlschwartz | 9:33 AM · Oct 6, 2020:
To translate, FDA--through briefing materials to its vaccine advisory committee--has made public what evidence it wants for a COVID vaccine emergency use authorization. The information that the White House has blocked from release via a guidance document.
FDA Briefing Document
Vaccines and Related Biological Products Advisory Committee Meeting, October 22, 2020
Development, authorization and licensure of vaccines to prevent COVID-19
38 p
https://www.fda.gov/media/142723/download
The key pages from that FDA briefing document re: COVID vaccine EUAs.
Image ( https://twitter.com/jasonlschwartz/status/1313472730025603075/photo/1 )
Image ( https://twitter.com/jasonlschwartz/status/1313472730025603075/photo/2 )
ETA Key pages with Eric Topol highlights:
Image ( https://twitter.com/EricTopol/status/1313535704580849664/photo/1 )
Image ( https://twitter.com/EricTopol/status/1313535704580849664/photo/2 )
-------------------------------------------------------------
Derrick @dgingery | 9:20 AM · Oct 6, 2020:
The VRBPAC doc appendix II includes a summary of answers to questions about EUA requirements, including the median 2 months of safety follow-up. So the info gets published anyway...
Gregg Gonsalves (Yale) @gregggonsalves | 9:53 AM · Oct 6, 2020:
So, my colleague @jasonlschwartz does the big reveal. @US_FDA did not come to play. They've release #COVID19 vaccine #EUA guidance as Appendix 2 in their materials for its vaccine advisory committee. Bravo. FDA. This is courage. So nice to say that.
Jason L. Schwartz (Yale) @jasonlschwartz | 9:33 AM · Oct 6, 2020:
To translate, FDA--through briefing materials to its vaccine advisory committee--has made public what evidence it wants for a COVID vaccine emergency use authorization. The information that the White House has blocked from release via a guidance document.
FDA Briefing Document
Vaccines and Related Biological Products Advisory Committee Meeting, October 22, 2020
Development, authorization and licensure of vaccines to prevent COVID-19
38 p
https://www.fda.gov/media/142723/download
The key pages from that FDA briefing document re: COVID vaccine EUAs.
Image ( https://twitter.com/jasonlschwartz/status/1313472730025603075/photo/1 )
Image ( https://twitter.com/jasonlschwartz/status/1313472730025603075/photo/2 )
ETA Key pages with Eric Topol highlights:
Image ( https://twitter.com/EricTopol/status/1313535704580849664/photo/1 )
Image ( https://twitter.com/EricTopol/status/1313535704580849664/photo/2 )
-------------------------------------------------------------
Derrick @dgingery | 9:20 AM · Oct 6, 2020:
The VRBPAC doc appendix II includes a summary of answers to questions about EUA requirements, including the median 2 months of safety follow-up. So the info gets published anyway...
41margd
Could a common antioxidant enzyme help treat COVID-19?
Lori Uildriks | October 5, 2020
New research suggests that catalase, a naturally occurring enzyme in humans, plants, and animals, can suppress the replication of the new coronavirus in rhesus monkeys. The results also indicate that this low cost enzyme could dampen the inflammatory response that occurs in severe COVID-19.
...Immunosuppressive medications that doctors currently use to treat cytokine storm include steroids, intravenous immune globulin, Janus kinase inhibitors, and cytokine blockers, such as anakinra or tocilizumab. However, some of these medications are expensive, and side effects may complicate therapy.
This is where catalase comes into play. Catalase is a naturally occurring antioxidant enzyme present in the liver, red blood cells, and alveolar epithelial cells — the cells that line the insides of the alveoli in the lungs.
It effectively breaks down hydrogen peroxide in the body into oxygen and water. Catalase is also currently available as a dietary supplement and food additive.
Researchers from the University of California, Los Angeles (UCLA), the Beijing University of Chemical Technology in China, and other Chinese institutions recently speculated that catalase could decrease hydrogen peroxide levels in the body.
This, they said, could minimize downstream ROS levels and cytokine release, ultimately suppressing the excess inflammation, oxidative cell injury, and viral replication that occur in severe COVID-19.
To confirm their hypothesis, the team of scientists set out to conduct several experiments — in cell cultures and rhesus macaque monkeys — using n(CAT), catalase nanocapsules that consist of catalase molecules coated with a thin shell of polymer. This coating enhances stability and prolongs the time that catalase remains in the blood.
https://www.medicalnewstoday.com/articles/could-a-common-antioxidant-enzyme-help...
------------------------------------------------------------------------------------
Meng Qin et al. 2020. An Antioxidant Enzyme Therapeutic for COVID‐19 (Communication). Advanced Materials (13 September 2020) https://doi.org/10.1002/adma.202004901 https://onlinelibrary.wiley.com/doi/10.1002/adma.202004901
Abstract
The COVID‐19 pandemic has taken a significant toll on people worldwide, and there are currently no specific antivirus drugs or vaccines. Herein it is a therapeutic based on catalase, an antioxidant enzyme that can effectively breakdown hydrogen peroxide and minimize the downstream reactive oxygen species, which are excessively produced resulting from the infection and inflammatory process, is reported. Catalase assists to regulate production of cytokines, protect oxidative injury, and repress replication of SARS‐CoV‐2, as demonstrated in human leukocytes and alveolar epithelial cells, and rhesus macaques, without noticeable toxicity. Such a therapeutic can be readily manufactured at low cost as a potential treatment for COVID‐19.
Lori Uildriks | October 5, 2020
New research suggests that catalase, a naturally occurring enzyme in humans, plants, and animals, can suppress the replication of the new coronavirus in rhesus monkeys. The results also indicate that this low cost enzyme could dampen the inflammatory response that occurs in severe COVID-19.
...Immunosuppressive medications that doctors currently use to treat cytokine storm include steroids, intravenous immune globulin, Janus kinase inhibitors, and cytokine blockers, such as anakinra or tocilizumab. However, some of these medications are expensive, and side effects may complicate therapy.
This is where catalase comes into play. Catalase is a naturally occurring antioxidant enzyme present in the liver, red blood cells, and alveolar epithelial cells — the cells that line the insides of the alveoli in the lungs.
It effectively breaks down hydrogen peroxide in the body into oxygen and water. Catalase is also currently available as a dietary supplement and food additive.
Researchers from the University of California, Los Angeles (UCLA), the Beijing University of Chemical Technology in China, and other Chinese institutions recently speculated that catalase could decrease hydrogen peroxide levels in the body.
This, they said, could minimize downstream ROS levels and cytokine release, ultimately suppressing the excess inflammation, oxidative cell injury, and viral replication that occur in severe COVID-19.
To confirm their hypothesis, the team of scientists set out to conduct several experiments — in cell cultures and rhesus macaque monkeys — using n(CAT), catalase nanocapsules that consist of catalase molecules coated with a thin shell of polymer. This coating enhances stability and prolongs the time that catalase remains in the blood.
https://www.medicalnewstoday.com/articles/could-a-common-antioxidant-enzyme-help...
------------------------------------------------------------------------------------
Meng Qin et al. 2020. An Antioxidant Enzyme Therapeutic for COVID‐19 (Communication). Advanced Materials (13 September 2020) https://doi.org/10.1002/adma.202004901 https://onlinelibrary.wiley.com/doi/10.1002/adma.202004901
Abstract
The COVID‐19 pandemic has taken a significant toll on people worldwide, and there are currently no specific antivirus drugs or vaccines. Herein it is a therapeutic based on catalase, an antioxidant enzyme that can effectively breakdown hydrogen peroxide and minimize the downstream reactive oxygen species, which are excessively produced resulting from the infection and inflammatory process, is reported. Catalase assists to regulate production of cytokines, protect oxidative injury, and repress replication of SARS‐CoV‐2, as demonstrated in human leukocytes and alveolar epithelial cells, and rhesus macaques, without noticeable toxicity. Such a therapeutic can be readily manufactured at low cost as a potential treatment for COVID‐19.
42margd
>40 margd: contd. :)
Eric Topol @EricTopol | 2:52 PM · Oct 6, 2020
Emergency Use Authorization for Vaccines to Prevent COVID-19
Guidance for Industry
October 2020 | Final
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/emergen...
Why it's important: @US_FDA is trying to raise the bar for a vaccine EUA. Trump, quoting last evening, said it will be here "momentarily."
HHS @SecAzar has authority when an EUA is submitted to override/approve w/o FDA.
--------------------------------------------------------
Eric Topol @EricTopol |
Good news: the pressure against WhiteHouse HHS @MarkMeadows for their opposition to the tightened guidelines has worked. Dropped.
Quote Tweet
Jonathan Rockoff @jonathanrockoff | 3:23 PM · Oct 6, 2020
Breaking: WhiteHouse has dropped its objections and signed off on @US_FDA's guidelines for vetting Covid-19 vaccines, @TomBurtonWSJ and @rebeccaballhaus report. The ok likely means a vaccine won't be ready for wide use before Election Day. Story coming to WSJ soon.
Eric Topol @EricTopol | 2:52 PM · Oct 6, 2020
Emergency Use Authorization for Vaccines to Prevent COVID-19
Guidance for Industry
October 2020 | Final
https://www.fda.gov/regulatory-information/search-fda-guidance-documents/emergen...
Why it's important: @US_FDA is trying to raise the bar for a vaccine EUA. Trump, quoting last evening, said it will be here "momentarily."
HHS @SecAzar has authority when an EUA is submitted to override/approve w/o FDA.
--------------------------------------------------------
Eric Topol @EricTopol |
Good news: the pressure against WhiteHouse HHS @MarkMeadows for their opposition to the tightened guidelines has worked. Dropped.
Quote Tweet
Jonathan Rockoff @jonathanrockoff | 3:23 PM · Oct 6, 2020
Breaking: WhiteHouse has dropped its objections and signed off on @US_FDA's guidelines for vetting Covid-19 vaccines, @TomBurtonWSJ and @rebeccaballhaus report. The ok likely means a vaccine won't be ready for wide use before Election Day. Story coming to WSJ soon.
43margd
Arizona stay-at-home order lifted, average number of daily cases increased approximately ~151%.
Masks etc. required, cases declined by ~75%
Gallaway MS, Rigler J, Robinson S, et al. Trends in COVID-19 Incidence After Implementation of Mitigation Measures — Arizona, January 22–August 7, 2020. MMWR Morb Mortal Wkly Rep. ePub: 6 October 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6940e3 https://www.cdc.gov/mmwr/volumes/69/wr/mm6940e3.htm
Summary
What is already known about this topic?
Community mitigation measures can help slow the spread of COVID-19.
What is added by this report?
The number of COVID-19 cases in Arizona stabilized and then decreased after sustained implementation and enforcement of statewide and locally enhanced mitigation measures, beginning approximately 2 weeks after implementation and enforcement of mask mandates and enhanced sanitations practices began on June 17; further decreases were observed during July 13–August 7, after statewide limitations and closures of certain services and businesses.
What are the implications for public health practice?
Widespread implementation and enforcement of sustained community mitigation measures, including mask wearing, informed by state and local officials’ continual data monitoring and collaboration can help prevent transmission of SARS-CoV-2 and decrease the numbers of COVID-19 cases.
...The average number of daily cases increased approximately 151%, from 808 on June 1, 2020 to 2,026 on June 15, 2020 (after stay-at-home order lifted), necessitating increased preventive measures. On June 17, local officials began implementing and enforcing mask wearing (via county and city mandates), affecting approximately 85% of the state population. Statewide mitigation measures included limitation of public events; closures of bars, gyms, movie theaters, and water parks; reduced restaurant dine-in capacity; and voluntary resident action to stay at home and wear masks (when and where not mandated). The number of COVID-19 cases in Arizona peaked during June 29–July 2, stabilized during July 3–July 12, and further declined by approximately 75% during July 13–August 7...
Masks etc. required, cases declined by ~75%
Gallaway MS, Rigler J, Robinson S, et al. Trends in COVID-19 Incidence After Implementation of Mitigation Measures — Arizona, January 22–August 7, 2020. MMWR Morb Mortal Wkly Rep. ePub: 6 October 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6940e3 https://www.cdc.gov/mmwr/volumes/69/wr/mm6940e3.htm
Summary
What is already known about this topic?
Community mitigation measures can help slow the spread of COVID-19.
What is added by this report?
The number of COVID-19 cases in Arizona stabilized and then decreased after sustained implementation and enforcement of statewide and locally enhanced mitigation measures, beginning approximately 2 weeks after implementation and enforcement of mask mandates and enhanced sanitations practices began on June 17; further decreases were observed during July 13–August 7, after statewide limitations and closures of certain services and businesses.
What are the implications for public health practice?
Widespread implementation and enforcement of sustained community mitigation measures, including mask wearing, informed by state and local officials’ continual data monitoring and collaboration can help prevent transmission of SARS-CoV-2 and decrease the numbers of COVID-19 cases.
...The average number of daily cases increased approximately 151%, from 808 on June 1, 2020 to 2,026 on June 15, 2020 (after stay-at-home order lifted), necessitating increased preventive measures. On June 17, local officials began implementing and enforcing mask wearing (via county and city mandates), affecting approximately 85% of the state population. Statewide mitigation measures included limitation of public events; closures of bars, gyms, movie theaters, and water parks; reduced restaurant dine-in capacity; and voluntary resident action to stay at home and wear masks (when and where not mandated). The number of COVID-19 cases in Arizona peaked during June 29–July 2, stabilized during July 3–July 12, and further declined by approximately 75% during July 13–August 7...
44margd
Coughing produces 35X more aerosolized particles than tracheal extubation, and (50X?) more than intubation?
J. Brown et al. 2020. A quantitative evaluation of aerosol generation during tracheal intubation and extubation. Anesthesia (06 October 2020)
https://doi.org/10.1111/anae.15292 https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/abs/...
This article has been accepted for publication and undergone full peer review but has not been through the copyediting...
Summary
...Tracheal intubation including face‐mask ventilation produced very low quantities of aerosolised particles... Tracheal extubation, particularly when the patient coughed, produced a detectable aerosol...which was 15‐fold greater than intubation...but 35‐fold less than a volitional cough...
J. Brown et al. 2020. A quantitative evaluation of aerosol generation during tracheal intubation and extubation. Anesthesia (06 October 2020)
https://doi.org/10.1111/anae.15292 https://associationofanaesthetists-publications.onlinelibrary.wiley.com/doi/abs/...
This article has been accepted for publication and undergone full peer review but has not been through the copyediting...
Summary
...Tracheal intubation including face‐mask ventilation produced very low quantities of aerosolised particles... Tracheal extubation, particularly when the patient coughed, produced a detectable aerosol...which was 15‐fold greater than intubation...but 35‐fold less than a volitional cough...
45margd
"dispel the myth of invulnerability"
Flurry of coronavirus reinfections leaves scientists puzzled
Though far from common, some patients developed worse symptoms the second time they became infected with Covid-19
Ian Sample | Tue 6 Oct 2020
...In August, Shiv Pillai, an immunologist at the Ragon Institute of Massachusetts general hospital, examined tissue taken from dead Covid-19 patients. He looked for structures called “germinal centres” in the spleen and lymph nodes. These are where B-cells go to develop antibodies before they are stored in the immune system’s memory. Pillai failed to find any, suggesting the patients were unable to generate highly effective, long-lasting antibodies that would fight the virus for years.
He believes the same problem may arise in people with milder Covid-19 too. “If we want antibodies that will persist for a few years and protect us, it’s not clear that’s going to happen,” he said. The good news is that a vaccine should not cause the same problem as the virus. “I don’t see why the vaccines won’t work. They may not be fantastic, but I believe that’s what’s going to protect us,” he said.
If the virus spreads further through the autumn and winter, Iwasaki expects to see more reinfections, with some patients infectious enough to pass the virus on.
According to Stephen Reicher, professor of social psychology at the University of St Andrews, and a member of the behavioural science subgroup of Sage, that poses another problem. People who have recovered from Covid-19, and many who falsely believe they had it, may believe they are protected in the second wave. “I think it is important, all ways round, to dispel the myth of invulnerability,” he said.
https://www.theguardian.com/world/2020/oct/06/flurry-of-coronavirus-reinfections...
--------------------------------------------------------------------
"achieving herd immunity through natural infection may be difficult"
NaokiKaneko...ShivPillai. 2020. Loss of Bcl-6-Expressing T Follicular Helper Cells and Germinal Centers in COVID-19. Cell
Volume 183, Issue 1, 1 October 2020, Pages 143-157.e13. https://doi.org/10.1016/j.cell.2020.08.025 https://www.sciencedirect.com/science/article/pii/S0092867420310679#!
Highlights
• Germinal centers are lost in lymph nodes and spleens in acute COVID-19
• Bcl-6+ GC B cells and Bcl-6+ T follicular helper cells are markedly diminished
• Abundant TH1 cells and aberrant TNF-α production are seen in COVID-19 lymph nodes
• SARS-CoV-2-specific activated B cells accumulate in the blood of patients
Summary
Humoral responses in coronavirus disease 2019 (COVID-19) are often of limited durability, as seen with other human coronavirus epidemics. To address the underlying etiology, we examined post mortem thoracic lymph nodes and spleens in acute SARS-CoV-2 infection and observed the absence of germinal centers and a striking reduction in Bcl-6+ germinal center B cells but preservation of AID+ B cells. Absence of germinal centers correlated with an early specific block in Bcl-6+ TFH cell differentiation together with an increase in T-bet+ TH1 cells and aberrant extra-follicular TNF-α accumulation. Parallel peripheral blood studies revealed loss of transitional and follicular B cells in severe disease and accumulation of SARS-CoV-2-specific “disease-related” B cell populations. These data identify defective Bcl-6+ TFH cell generation and dysregulated humoral immune induction early in COVID-19 disease, providing a mechanistic explanation for the limited durability of antibody responses in coronavirus infections, and suggest that achieving herd immunity through natural infection may be difficult.
Flurry of coronavirus reinfections leaves scientists puzzled
Though far from common, some patients developed worse symptoms the second time they became infected with Covid-19
Ian Sample | Tue 6 Oct 2020
...In August, Shiv Pillai, an immunologist at the Ragon Institute of Massachusetts general hospital, examined tissue taken from dead Covid-19 patients. He looked for structures called “germinal centres” in the spleen and lymph nodes. These are where B-cells go to develop antibodies before they are stored in the immune system’s memory. Pillai failed to find any, suggesting the patients were unable to generate highly effective, long-lasting antibodies that would fight the virus for years.
He believes the same problem may arise in people with milder Covid-19 too. “If we want antibodies that will persist for a few years and protect us, it’s not clear that’s going to happen,” he said. The good news is that a vaccine should not cause the same problem as the virus. “I don’t see why the vaccines won’t work. They may not be fantastic, but I believe that’s what’s going to protect us,” he said.
If the virus spreads further through the autumn and winter, Iwasaki expects to see more reinfections, with some patients infectious enough to pass the virus on.
According to Stephen Reicher, professor of social psychology at the University of St Andrews, and a member of the behavioural science subgroup of Sage, that poses another problem. People who have recovered from Covid-19, and many who falsely believe they had it, may believe they are protected in the second wave. “I think it is important, all ways round, to dispel the myth of invulnerability,” he said.
https://www.theguardian.com/world/2020/oct/06/flurry-of-coronavirus-reinfections...
--------------------------------------------------------------------
"achieving herd immunity through natural infection may be difficult"
NaokiKaneko...ShivPillai. 2020. Loss of Bcl-6-Expressing T Follicular Helper Cells and Germinal Centers in COVID-19. Cell
Volume 183, Issue 1, 1 October 2020, Pages 143-157.e13. https://doi.org/10.1016/j.cell.2020.08.025 https://www.sciencedirect.com/science/article/pii/S0092867420310679#!
Highlights
• Germinal centers are lost in lymph nodes and spleens in acute COVID-19
• Bcl-6+ GC B cells and Bcl-6+ T follicular helper cells are markedly diminished
• Abundant TH1 cells and aberrant TNF-α production are seen in COVID-19 lymph nodes
• SARS-CoV-2-specific activated B cells accumulate in the blood of patients
Summary
Humoral responses in coronavirus disease 2019 (COVID-19) are often of limited durability, as seen with other human coronavirus epidemics. To address the underlying etiology, we examined post mortem thoracic lymph nodes and spleens in acute SARS-CoV-2 infection and observed the absence of germinal centers and a striking reduction in Bcl-6+ germinal center B cells but preservation of AID+ B cells. Absence of germinal centers correlated with an early specific block in Bcl-6+ TFH cell differentiation together with an increase in T-bet+ TH1 cells and aberrant extra-follicular TNF-α accumulation. Parallel peripheral blood studies revealed loss of transitional and follicular B cells in severe disease and accumulation of SARS-CoV-2-specific “disease-related” B cell populations. These data identify defective Bcl-6+ TFH cell generation and dysregulated humoral immune induction early in COVID-19 disease, providing a mechanistic explanation for the limited durability of antibody responses in coronavirus infections, and suggest that achieving herd immunity through natural infection may be difficult.
46margd
>25 margd: Michigan emergency powers contd.
What a 6–3 Supreme Court Could Do
Michigan is a preview of how far Republican judges will go to obstruct Democrats in office.
Nicholas Bagley Law professor at the University of Michigan | 10/7/2020
Last week, in a 4–3 party-line vote, Republican judges on the Michigan Supreme Court invalidated a law that had empowered a historically popular Democratic chief executive to take emergency actions to combat COVID-19. The basis for the decision was an antiquated doctrine that conservatives on the United States Supreme Court have signaled they want to revive.
...Like other governors around the country, Michigan’s Gretchen Whitmer declared a state of emergency in March and enacted aggressive emergency measures to fight COVID-19. Those efforts found support in two separate laws, one of which—the Emergency Powers of Governor Act—was adopted in 1945.
By mid-June, statewide cases had dropped to fewer than 200 a day from a peak of more than 1,600. A study out of Imperial College London and the University of Oxford suggested that Whitmer’s efforts saved as many as 74,000 lives. (Full disclosure: I served as special counsel to Whitmer on her COVID-19 response and aided in drafting many of her executive orders.)
As in other states, lawsuits challenging the governor’s executive orders came fast. Republican judges proved receptive, even when the legal arguments were appallingly thin...
As a result of last week’s decision, Michigan became the only state in the nation that is not operating under some type of state of emergency.
For now, that doesn’t mean the end of all COVID-19 protections. The state’s public-health director has the independent power, not at issue in the Supreme Court’s decision, to take emergency actions to control epidemics. On Monday, the director issued a series of orders incorporating the governor’s prior restrictions, including her mask mandate and limits on gatherings. These orders, too, will surely be challenged....
https://www.theatlantic.com/ideas/archive/2020/10/america-will-be-michigan-soon/...
What a 6–3 Supreme Court Could Do
Michigan is a preview of how far Republican judges will go to obstruct Democrats in office.
Nicholas Bagley Law professor at the University of Michigan | 10/7/2020
Last week, in a 4–3 party-line vote, Republican judges on the Michigan Supreme Court invalidated a law that had empowered a historically popular Democratic chief executive to take emergency actions to combat COVID-19. The basis for the decision was an antiquated doctrine that conservatives on the United States Supreme Court have signaled they want to revive.
...Like other governors around the country, Michigan’s Gretchen Whitmer declared a state of emergency in March and enacted aggressive emergency measures to fight COVID-19. Those efforts found support in two separate laws, one of which—the Emergency Powers of Governor Act—was adopted in 1945.
By mid-June, statewide cases had dropped to fewer than 200 a day from a peak of more than 1,600. A study out of Imperial College London and the University of Oxford suggested that Whitmer’s efforts saved as many as 74,000 lives. (Full disclosure: I served as special counsel to Whitmer on her COVID-19 response and aided in drafting many of her executive orders.)
As in other states, lawsuits challenging the governor’s executive orders came fast. Republican judges proved receptive, even when the legal arguments were appallingly thin...
As a result of last week’s decision, Michigan became the only state in the nation that is not operating under some type of state of emergency.
For now, that doesn’t mean the end of all COVID-19 protections. The state’s public-health director has the independent power, not at issue in the Supreme Court’s decision, to take emergency actions to control epidemics. On Monday, the director issued a series of orders incorporating the governor’s prior restrictions, including her mask mandate and limits on gatherings. These orders, too, will surely be challenged....
https://www.theatlantic.com/ideas/archive/2020/10/america-will-be-michigan-soon/...
47margd
Face masks have negligible negative effect on CO2 and O2 levels
A new study suggests that face masks have a negligible negative effect on the levels of carbon dioxide and oxygen that a person breathes.
Tim Huzar | Oct 7, 2020
...small study recruited 15 house staff physicians, who had no health issues affecting their lungs, and 15 veterans with COPD.
The veterans were in the hospital so that doctors could check their oxygen levels as part of their regular COPD monitoring.
The monitoring involved, among other things, blood oxygen levels checked with a blood test before and after a 6-minute walking exercise. This exercise was done while wearing a mask, as per hospital protocol during a pandemic.
The researchers used a LifeSense monitor to check the baseline room air, and then continually took measurements throughout the time that the participants were wearing masks.
The researchers found no clinically significant changes in any of the participants’ end tidal carbon dioxide measurements — the amount of carbon dioxide in an exhalation. They also found no changes in blood oxygen levels after 5 or 30 minutes of wearing a mask while resting.
As expected, the participants with COPD had lower blood oxygen levels than those without the respiratory disease. No participant with COPD had any major changes in their gas exchanges due to wearing a mask.
In the words of senior study author Dr. Michael Campos, of the Miami Veterans Administration Medical Center and the University of Miami’s Miller School of Medicine, “We show that the effects are minimal at most, even in people with very severe lung impairment.”
If a person experiences shortness of breath while wearing a mask, the study suggests, this does not result from reduced oxygen levels or an increase in carbon dioxide levels.
Dr. Campos explains, “Dyspnea, the feeling of shortness of breath felt with masks by some, is not synonymous with alterations in gas exchange. It likely occurs from restriction of air flow with the mask in particular when higher ventilation is needed on exertion.”...
https://www.medicalnewstoday.com/articles/face-masks-have-negligible-negative-ef...
-------------------------------------------------------------------------
Rajesh Samannan et al. 2020. Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with COPD. Annals of American Thoracic Society
(Oct 2, 2020) https://doi.org/10.1513/AnnalsATS.202007-812RL https://www.atsjournals.org/doi/10.1513/AnnalsATS.202007-812RL
A new study suggests that face masks have a negligible negative effect on the levels of carbon dioxide and oxygen that a person breathes.
Tim Huzar | Oct 7, 2020
...small study recruited 15 house staff physicians, who had no health issues affecting their lungs, and 15 veterans with COPD.
The veterans were in the hospital so that doctors could check their oxygen levels as part of their regular COPD monitoring.
The monitoring involved, among other things, blood oxygen levels checked with a blood test before and after a 6-minute walking exercise. This exercise was done while wearing a mask, as per hospital protocol during a pandemic.
The researchers used a LifeSense monitor to check the baseline room air, and then continually took measurements throughout the time that the participants were wearing masks.
The researchers found no clinically significant changes in any of the participants’ end tidal carbon dioxide measurements — the amount of carbon dioxide in an exhalation. They also found no changes in blood oxygen levels after 5 or 30 minutes of wearing a mask while resting.
As expected, the participants with COPD had lower blood oxygen levels than those without the respiratory disease. No participant with COPD had any major changes in their gas exchanges due to wearing a mask.
In the words of senior study author Dr. Michael Campos, of the Miami Veterans Administration Medical Center and the University of Miami’s Miller School of Medicine, “We show that the effects are minimal at most, even in people with very severe lung impairment.”
If a person experiences shortness of breath while wearing a mask, the study suggests, this does not result from reduced oxygen levels or an increase in carbon dioxide levels.
Dr. Campos explains, “Dyspnea, the feeling of shortness of breath felt with masks by some, is not synonymous with alterations in gas exchange. It likely occurs from restriction of air flow with the mask in particular when higher ventilation is needed on exertion.”...
https://www.medicalnewstoday.com/articles/face-masks-have-negligible-negative-ef...
-------------------------------------------------------------------------
Rajesh Samannan et al. 2020. Effect of Face Masks on Gas Exchange in Healthy Persons and Patients with COPD. Annals of American Thoracic Society
(Oct 2, 2020) https://doi.org/10.1513/AnnalsATS.202007-812RL https://www.atsjournals.org/doi/10.1513/AnnalsATS.202007-812RL
48margd
Coronavirus can survive on skin for 9 hours
Rachael Rettner | 10/7/2020
...Earlier in the pandemic, researchers in the U.S. analyzed how long SARS-CoV-2 could last on surfaces and found it remained viable on copper surfaces for up to 4 hours, on cardboard for up to 24 hours and on plastic and stainless steel for up to 72 hours... However, for ethical reasons, examining how long the virus can last on human skin is more complicated — you can't just put samples of a potentially lethal virus on people's hands.
So for the new study, the researchers, from Kyoto Prefectural University of Medicine in Japan, created a skin model using samples of human skin obtained from autopsies. The samples were collected approximately one day after death. The authors note that even 24 hours after death, human skin can still be used for skin grafts, meaning that it retains much of its function for some time after death. Thus, the collected samples could be a suitable model for human skin, the authors argued.
Using their model, the authors found SARS-CoV-2 survived on the human skin samples for 9.04 hours, compared with 1.82 hours for the influenza A virus. When these viruses were mixed with mucus, to mimic the release of viral particles in a cough or sneeze, SARS-CoV-2 lasted an even longer time, about 11 hours.
However, both viruses were inactivated on skin 15 seconds after using hand sanitizer that was 80% ethanol...
https://www.livescience.com/coronavirus-survives-9-hours-on-skin.html
------------------------------------------------------------------------------------------
Ryohei Hirose et al. 2020. Survival of SARS-CoV-2 and influenza virus on the human skin: Importance of hand hygiene in COVID-19. Clinical Infectious Diseases, ciaa1517 (03 October 2020) https://doi.org/10.1093/cid/ciaa1517 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1517/5917611
Abstract
...
Results
SARS-CoV-2 and IAV (influenza A virus) were inactivated more rapidly on skin surfaces than on other surfaces (stainless steel/glass/plastic); the survival time was significantly longer for SARS-CoV-2 than for IAV (9.04 h...) vs. 1.82 h .... IAV on other surfaces was inactivated faster in mucus versus medium conditions, while SARS-CoV-2 showed similar stability in the mucus and medium; the survival time was significantly longer for SARS-CoV-2 than for IAV (11.09 h ).... vs. 1.69 h ... Moreover, both SARS-CoV-2 and IAV in the mucus/medium on human skin were completely inactivated within 15 s by ethanol treatment.
Conclusions
The 9-h survival of SARS-CoV-2 on human skin may increase the risk of contact transmission in comparison with IAV, thus accelerating the pandemic. Proper hand hygiene is important to prevent the spread of SARS-CoV-2 infections.
Rachael Rettner | 10/7/2020
...Earlier in the pandemic, researchers in the U.S. analyzed how long SARS-CoV-2 could last on surfaces and found it remained viable on copper surfaces for up to 4 hours, on cardboard for up to 24 hours and on plastic and stainless steel for up to 72 hours... However, for ethical reasons, examining how long the virus can last on human skin is more complicated — you can't just put samples of a potentially lethal virus on people's hands.
So for the new study, the researchers, from Kyoto Prefectural University of Medicine in Japan, created a skin model using samples of human skin obtained from autopsies. The samples were collected approximately one day after death. The authors note that even 24 hours after death, human skin can still be used for skin grafts, meaning that it retains much of its function for some time after death. Thus, the collected samples could be a suitable model for human skin, the authors argued.
Using their model, the authors found SARS-CoV-2 survived on the human skin samples for 9.04 hours, compared with 1.82 hours for the influenza A virus. When these viruses were mixed with mucus, to mimic the release of viral particles in a cough or sneeze, SARS-CoV-2 lasted an even longer time, about 11 hours.
However, both viruses were inactivated on skin 15 seconds after using hand sanitizer that was 80% ethanol...
https://www.livescience.com/coronavirus-survives-9-hours-on-skin.html
------------------------------------------------------------------------------------------
Ryohei Hirose et al. 2020. Survival of SARS-CoV-2 and influenza virus on the human skin: Importance of hand hygiene in COVID-19. Clinical Infectious Diseases, ciaa1517 (03 October 2020) https://doi.org/10.1093/cid/ciaa1517 https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1517/5917611
Abstract
...
Results
SARS-CoV-2 and IAV (influenza A virus) were inactivated more rapidly on skin surfaces than on other surfaces (stainless steel/glass/plastic); the survival time was significantly longer for SARS-CoV-2 than for IAV (9.04 h...) vs. 1.82 h .... IAV on other surfaces was inactivated faster in mucus versus medium conditions, while SARS-CoV-2 showed similar stability in the mucus and medium; the survival time was significantly longer for SARS-CoV-2 than for IAV (11.09 h ).... vs. 1.69 h ... Moreover, both SARS-CoV-2 and IAV in the mucus/medium on human skin were completely inactivated within 15 s by ethanol treatment.
Conclusions
The 9-h survival of SARS-CoV-2 on human skin may increase the risk of contact transmission in comparison with IAV, thus accelerating the pandemic. Proper hand hygiene is important to prevent the spread of SARS-CoV-2 infections.
49margd
Breaking—Wisconsin activates emergency field hospital, says healthcare systems are "beginning to become overwhelmed" as number of #COVID19 patients triples from 289 to 853 in one month
- Eric Feigl-Ding @DrEricDing | 2:27 PM · Oct 7, 2020
State of Wisconsin sent this bulletin at 10/07/2020 12:30 PM CDT
Office of Governor Tony Evers
FOR IMMEDIATE RELEASE: October 7, 2020
Contact: GovPress@wisconsin.gov or 608-219-7443
Due to Increased Hospitalizations in the Fox Valley, Gov. Evers Announces Wisconsin State Fair Park Alternate Care Facility to Accept COVID-19 Patients October 14
Record COVID-19 surges throughout the state increases pressure on Wisconsin health systems
MADISON — Due to increased COVID-19 hospitalizations and at the request of hospital systems, Gov. Tony Evers announced today the Alternate Care Facility (ACF) at Wisconsin State Fair Park will begin accepting COVID-19 patients within the next week. The announcement comes as Wisconsin health systems experience rising pressure to manage record surges in COVID-19 patient hospitalizations. As of yesterday, there were 853 COVID-19 hospitalizations, an increase of 71 over the day before. ...
https://content.govdelivery.com/accounts/WIGOV/bulletins/2a4aff3
- Eric Feigl-Ding @DrEricDing | 2:27 PM · Oct 7, 2020
State of Wisconsin sent this bulletin at 10/07/2020 12:30 PM CDT
Office of Governor Tony Evers
FOR IMMEDIATE RELEASE: October 7, 2020
Contact: GovPress@wisconsin.gov or 608-219-7443
Due to Increased Hospitalizations in the Fox Valley, Gov. Evers Announces Wisconsin State Fair Park Alternate Care Facility to Accept COVID-19 Patients October 14
Record COVID-19 surges throughout the state increases pressure on Wisconsin health systems
MADISON — Due to increased COVID-19 hospitalizations and at the request of hospital systems, Gov. Tony Evers announced today the Alternate Care Facility (ACF) at Wisconsin State Fair Park will begin accepting COVID-19 patients within the next week. The announcement comes as Wisconsin health systems experience rising pressure to manage record surges in COVID-19 patient hospitalizations. As of yesterday, there were 853 COVID-19 hospitalizations, an increase of 71 over the day before. ...
https://content.govdelivery.com/accounts/WIGOV/bulletins/2a4aff3
50margd
COVID-19 Situation worsens in the US
Reported new cases up 7%
Every region of the country is up
Every region is in the Red/Orange zones for cases
42 US States in the Red/Orange Zones
For the first time, no states are in the Green Zone
Image ( https://twitter.com/euromaestro/status/1313880825017118725/photo/1 )
- Euro Maestro (Fed Am Scientists) @euromaestro12:36 PM · Oct 7, 2020
Reported new cases up 7%
Every region of the country is up
Every region is in the Red/Orange zones for cases
42 US States in the Red/Orange Zones
For the first time, no states are in the Green Zone
Image ( https://twitter.com/euromaestro/status/1313880825017118725/photo/1 )
- Euro Maestro (Fed Am Scientists) @euromaestro12:36 PM · Oct 7, 2020
51John5918
COVID-19: examining theories for Africa’s low death rates (The Conversation)
Africa accounts for 17% of the global population but only 3.5% of the reported global COVID-19 deaths. All deaths are important, we should not discount apparently low numbers, and of course data collected over such a wide range of countries will be of variable quality, but the gap between predictions and what has actually happened is staggering. There has been much discussion on what accounts for this...
The emerging picture is that in many African countries, transmission has been higher but severity and mortality much lower than originally predicted based on experience in China and Europe. We argue that Africa’s much younger population explains a very large part of the apparent difference. Some of the remaining gap is probably due to under reporting of events but there are a number of other plausible explanations. These range from climatic differences, pre-existing immunity, genetic factors and behavioural differences. Given the enormous variability in conditions across a continent – with 55 member states – the exact contribution of any one factor in a particular environment is likely to vary...
The most obvious factor for the low death rates is the population age structure... Other suggestions include the possibility of pre-existing protective immune responses due either to previous exposure to other pathogens or to BCG vaccination, a vaccine against tuberculosis provided at birth in most African countries... Genetic factors may also be important. A recently described haplotype (group of genes) associated with increased risk of severity and present in 30% of south Asian genomes and 8% of Europeans is almost absent in Africa. The role of these and other factors – such as potential differences in social structures or mobility – are subject to ongoing investigation.
An important possibility is that public health response of African countries, prepared by previous experiences (such as outbreaks or epidemics) was simply more effective in limiting transmission than in other parts of the world...
there is another important possibility: the idea that viral load (the number of virus particles transmitted to a person) is a key determinant of severity. It has been suggested that masks reduce viral load and that their widespread wearing may limit the chances of developing severe disease. While WHO recommends mask wearing, uptake has been variable and has been lower in many European countries, compared with many parts of Africa.
So is Africa in the clear? Well, obviously not... However, one thing that does seem clear is that the secondary effects of the pandemic will be Africa’s real COVID-19 challenge. These stem from the severe interruptions of social and economic activities as well as the potentially devastating effects of reduced delivery of services which protect millions of people, including routine vaccination as well as malaria, TB and HIV control programmes...
Once again a boost for wearing masks. From what I've seen, people here may get lazy about wearing masks or about wearing them properly, but there is no irrational political or ideological resistance to the idea as there is in the USA.
Africa accounts for 17% of the global population but only 3.5% of the reported global COVID-19 deaths. All deaths are important, we should not discount apparently low numbers, and of course data collected over such a wide range of countries will be of variable quality, but the gap between predictions and what has actually happened is staggering. There has been much discussion on what accounts for this...
The emerging picture is that in many African countries, transmission has been higher but severity and mortality much lower than originally predicted based on experience in China and Europe. We argue that Africa’s much younger population explains a very large part of the apparent difference. Some of the remaining gap is probably due to under reporting of events but there are a number of other plausible explanations. These range from climatic differences, pre-existing immunity, genetic factors and behavioural differences. Given the enormous variability in conditions across a continent – with 55 member states – the exact contribution of any one factor in a particular environment is likely to vary...
The most obvious factor for the low death rates is the population age structure... Other suggestions include the possibility of pre-existing protective immune responses due either to previous exposure to other pathogens or to BCG vaccination, a vaccine against tuberculosis provided at birth in most African countries... Genetic factors may also be important. A recently described haplotype (group of genes) associated with increased risk of severity and present in 30% of south Asian genomes and 8% of Europeans is almost absent in Africa. The role of these and other factors – such as potential differences in social structures or mobility – are subject to ongoing investigation.
An important possibility is that public health response of African countries, prepared by previous experiences (such as outbreaks or epidemics) was simply more effective in limiting transmission than in other parts of the world...
there is another important possibility: the idea that viral load (the number of virus particles transmitted to a person) is a key determinant of severity. It has been suggested that masks reduce viral load and that their widespread wearing may limit the chances of developing severe disease. While WHO recommends mask wearing, uptake has been variable and has been lower in many European countries, compared with many parts of Africa.
So is Africa in the clear? Well, obviously not... However, one thing that does seem clear is that the secondary effects of the pandemic will be Africa’s real COVID-19 challenge. These stem from the severe interruptions of social and economic activities as well as the potentially devastating effects of reduced delivery of services which protect millions of people, including routine vaccination as well as malaria, TB and HIV control programmes...
Once again a boost for wearing masks. From what I've seen, people here may get lazy about wearing masks or about wearing them properly, but there is no irrational political or ideological resistance to the idea as there is in the USA.
52margd
Regeneron asks FDA for emergency authorization of its Covid-19 antibody therapy given to Trump last week
Shelby Lin Erdman | October 8, 2020
(CNN)Regeneron says it has applied to the US Food and Drug Administration for emergency use authorization for its experimental monoclonal antibody therapy, the same antibody cocktail given to President Donald Trump Friday after he was diagnosed with the virus.
"Under our agreement with the U.S. government for the initial doses of REGN-COV2, if an EUA is granted the government has committed to making these doses available to the American people at no cost and would be responsible for their distribution," the statement said. "At this time, there are doses available for approximately 50,000 patients, and we expect to have doses available for 300,000 patients in total within the next few months.
Regeneron's experimental antibody treatment is still in large-scale clinical trials, but has been available for compassionate use, something the FDA has to approve on an individual basis, like it did for the President.
The antibody therapy is a combination of two monoclonal antibodies that is designed specifically to block infectivity of SARS-CoV-2, the virus that causes Covid-19, according to the company's statement...includes a monoclonal antibody that targets the spike protein the virus uses to drill into healthy cells, and another antibody that targets a different part of the novel coronavirus. With two, the hope is to trap and shut down viral replication.
...Early data from the company's antibody trials released recently showed it worked fairly safely with few side effects.
...Dr. Richard Besser, a former acting director of the US Centers for Disease Control and Prevention who now heads the Robert Wood Johnson Foundation...said peer review will find any holes or pitfalls.
Dr. Thomas Frieden, also a former CDC director...Although Regeneron's antibody therapy is unproven, it is "a promising treatment...There's a report that only fewer than 300 patients have received it...It seems to be most effective early in the disease, especially before patients make antibodies of their own....We don't know if it'll be helpful, but it's something that is not unreasonable to try"...
Regeneron isn't the only company working on antibody therapies for the coronavirus...at least 70 different antibody treatments for Covid-19 under investigation.
https://www.cnn.com/2020/10/08/health/regneron-eua-antibody-therapy/index.html
___________________________________________________
ETA
NBC News @NBCNews · 1h
A Regeneron executive and one of its directors sold $1,000,000 worth of stocks two days after President Trump announced he was taking their therapeutic, recent filings from the U.S. Securities and Exchange Commission reveal. https://nbcnews.to/3jOyHGI
Shelby Lin Erdman | October 8, 2020
(CNN)Regeneron says it has applied to the US Food and Drug Administration for emergency use authorization for its experimental monoclonal antibody therapy, the same antibody cocktail given to President Donald Trump Friday after he was diagnosed with the virus.
"Under our agreement with the U.S. government for the initial doses of REGN-COV2, if an EUA is granted the government has committed to making these doses available to the American people at no cost and would be responsible for their distribution," the statement said. "At this time, there are doses available for approximately 50,000 patients, and we expect to have doses available for 300,000 patients in total within the next few months.
Regeneron's experimental antibody treatment is still in large-scale clinical trials, but has been available for compassionate use, something the FDA has to approve on an individual basis, like it did for the President.
The antibody therapy is a combination of two monoclonal antibodies that is designed specifically to block infectivity of SARS-CoV-2, the virus that causes Covid-19, according to the company's statement...includes a monoclonal antibody that targets the spike protein the virus uses to drill into healthy cells, and another antibody that targets a different part of the novel coronavirus. With two, the hope is to trap and shut down viral replication.
...Early data from the company's antibody trials released recently showed it worked fairly safely with few side effects.
...Dr. Richard Besser, a former acting director of the US Centers for Disease Control and Prevention who now heads the Robert Wood Johnson Foundation...said peer review will find any holes or pitfalls.
Dr. Thomas Frieden, also a former CDC director...Although Regeneron's antibody therapy is unproven, it is "a promising treatment...There's a report that only fewer than 300 patients have received it...It seems to be most effective early in the disease, especially before patients make antibodies of their own....We don't know if it'll be helpful, but it's something that is not unreasonable to try"...
Regeneron isn't the only company working on antibody therapies for the coronavirus...at least 70 different antibody treatments for Covid-19 under investigation.
https://www.cnn.com/2020/10/08/health/regneron-eua-antibody-therapy/index.html
___________________________________________________
ETA
NBC News @NBCNews · 1h
A Regeneron executive and one of its directors sold $1,000,000 worth of stocks two days after President Trump announced he was taking their therapeutic, recent filings from the U.S. Securities and Exchange Commission reveal. https://nbcnews.to/3jOyHGI
53margd
Michael Mina (Harvard PH/Medical School) @michaelmina_lab | 12:30 PM · Oct 7, 2020:
https://twitter.com/michaelmina_lab/status/1313879257202995200
Winter is coming!
If we do not get this virus under control now, we are in for a perfect and terrible storm
We are not taking the expected seasonality of this SEASONAL virus seriously!
Instead, we've assumed our efforts are responsible for decreased cases this summer... 1/x
Image--seasonal graph of human Coronvirus incidence ( https://twitter.com/michaelmina_lab/status/1313879257202995200/photo/1 )
I worry very much that people are confusing the fact that this virus has transmitted in the summer for it not being very seasonal.
This is a grave mistake and misinterpretation... 2/x
The 'force of infection' of this virus is massive! Think of it like the momentum that the virus has to transmit
The huge number of susceptible people is what is allowing the virus to maintain transmission through the summer months - when other coronaviruses go to near zero. 3/x
Mistaking ongoing transmission in the summer for a "less seasonal virus" is not smart. All evidence points in the other direction
Instead, continued transmission reflects force of infection 'going uphill'... which means that as winter sets in, we may see massive increases. 4/x
This virus got out of control because of a handful of imports.
We now have literally 10,000's of cases in the US daily...
all potentially ready to explode into massive outbreaks once the weather / other natural or social biology becomes optimal for spread. 5/x
Meanwhile we're not acting now to stop it. We're barely acting to improve any semblance of surveillance. At same time we're saying - we must open back up.
Yes! But, one must come before the other - ideally it would be control first, open fully second, once we're ready. 6/x
We could have been much more ready now. But instead we are just giving the virus a major headstart at the very time when it has its guard down. that we are not taking advantage of it is going to be reflected in many more infections and deaths moving forward I fear. End 7/7
.
.
.
Here is a review of what’s known about seasonality of coronaviruses.*
.
.
.
People say we don’t have evidence of seasonality for this virus - and suggest seasonality may not even be a thing for a pandemic virus. That’s just wrong.
True we don’t have a lot of evidence for THIS virus - but we do it’s closest neighbors. That gets us far... 15/x
But while we don’t have evidence of seasonality in the northern hemisphere - of course... it’s not been a year yet - we can look to the southern...16/x
In the South Hemisphere - not on equator - most nations with a lot of cases were in the clear until ~June. And then cases started. Some July. The dynamics and timing is quite different than North. Almost no outbreaks requiring shutdowns when North did - were all months later.
---------------------------------------------------------------------------------------
* You Li, Xin Wang, Harish Nair. 2020. Global Seasonality of Human Seasonal Coronaviruses: A Clue for Postpandemic Circulating Season of Severe Acute Respiratory Syndrome Coronavirus 2? The Journal of Infectious Diseases, Volume 222, Issue 7, 1 October 2020, Pages 1090–1097, https://doi.org/10.1093/infdis/jiaa436 https://academic.oup.com/jid/article/222/7/1090/5874220
Abstract
Background
The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could recur as seasonal outbreaks, a circulating pattern observed among other preexisting human seasonal coronaviruses (sCoVs). However, little is known about seasonality of sCoVs on a global scale.
Methods
We conducted a systematic review of data on seasonality of sCoVs. We compared seasonality of sCoVs with influenza virus and respiratory syncytial virus. We modeled monthly activity of sCoVs using site-specific weather data.
Results
We included sCoV seasonality data in 40 sites from 21 countries. sCoVs were prevalent in winter months in most temperate sites except for China, whereas sCoVs tended to be less seasonal in China and in tropical sites. In temperate sites excluding China, 53.1% of annual sCoV cases (interquartile range IQR, 34.6%–61.9%) occurred during influenza season and 49.6% (IQR, 30.2%–60.2%) of sCoV cases occurred during respiratory syncytial virus season. Low temperature combined with high relative humidity was associated with higher sCoV activity.
Conclusions
This is the first study that provides an overview of the global seasonality of sCoVs. Our findings offer clues to the possible postpandemic circulating season of SARS-CoV-2 and add to the knowledge pool necessary for postpandemic preparedness for SARS-CoV-2.
https://twitter.com/michaelmina_lab/status/1313879257202995200
Winter is coming!
If we do not get this virus under control now, we are in for a perfect and terrible storm
We are not taking the expected seasonality of this SEASONAL virus seriously!
Instead, we've assumed our efforts are responsible for decreased cases this summer... 1/x
Image--seasonal graph of human Coronvirus incidence ( https://twitter.com/michaelmina_lab/status/1313879257202995200/photo/1 )
I worry very much that people are confusing the fact that this virus has transmitted in the summer for it not being very seasonal.
This is a grave mistake and misinterpretation... 2/x
The 'force of infection' of this virus is massive! Think of it like the momentum that the virus has to transmit
The huge number of susceptible people is what is allowing the virus to maintain transmission through the summer months - when other coronaviruses go to near zero. 3/x
Mistaking ongoing transmission in the summer for a "less seasonal virus" is not smart. All evidence points in the other direction
Instead, continued transmission reflects force of infection 'going uphill'... which means that as winter sets in, we may see massive increases. 4/x
This virus got out of control because of a handful of imports.
We now have literally 10,000's of cases in the US daily...
all potentially ready to explode into massive outbreaks once the weather / other natural or social biology becomes optimal for spread. 5/x
Meanwhile we're not acting now to stop it. We're barely acting to improve any semblance of surveillance. At same time we're saying - we must open back up.
Yes! But, one must come before the other - ideally it would be control first, open fully second, once we're ready. 6/x
We could have been much more ready now. But instead we are just giving the virus a major headstart at the very time when it has its guard down. that we are not taking advantage of it is going to be reflected in many more infections and deaths moving forward I fear. End 7/7
.
.
.
Here is a review of what’s known about seasonality of coronaviruses.*
.
.
.
People say we don’t have evidence of seasonality for this virus - and suggest seasonality may not even be a thing for a pandemic virus. That’s just wrong.
True we don’t have a lot of evidence for THIS virus - but we do it’s closest neighbors. That gets us far... 15/x
But while we don’t have evidence of seasonality in the northern hemisphere - of course... it’s not been a year yet - we can look to the southern...16/x
In the South Hemisphere - not on equator - most nations with a lot of cases were in the clear until ~June. And then cases started. Some July. The dynamics and timing is quite different than North. Almost no outbreaks requiring shutdowns when North did - were all months later.
---------------------------------------------------------------------------------------
* You Li, Xin Wang, Harish Nair. 2020. Global Seasonality of Human Seasonal Coronaviruses: A Clue for Postpandemic Circulating Season of Severe Acute Respiratory Syndrome Coronavirus 2? The Journal of Infectious Diseases, Volume 222, Issue 7, 1 October 2020, Pages 1090–1097, https://doi.org/10.1093/infdis/jiaa436 https://academic.oup.com/jid/article/222/7/1090/5874220
Abstract
Background
The ongoing pandemic of coronavirus disease 2019 (COVID-19) caused by the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) could recur as seasonal outbreaks, a circulating pattern observed among other preexisting human seasonal coronaviruses (sCoVs). However, little is known about seasonality of sCoVs on a global scale.
Methods
We conducted a systematic review of data on seasonality of sCoVs. We compared seasonality of sCoVs with influenza virus and respiratory syncytial virus. We modeled monthly activity of sCoVs using site-specific weather data.
Results
We included sCoV seasonality data in 40 sites from 21 countries. sCoVs were prevalent in winter months in most temperate sites except for China, whereas sCoVs tended to be less seasonal in China and in tropical sites. In temperate sites excluding China, 53.1% of annual sCoV cases (interquartile range IQR, 34.6%–61.9%) occurred during influenza season and 49.6% (IQR, 30.2%–60.2%) of sCoV cases occurred during respiratory syncytial virus season. Low temperature combined with high relative humidity was associated with higher sCoV activity.
Conclusions
This is the first study that provides an overview of the global seasonality of sCoVs. Our findings offer clues to the possible postpandemic circulating season of SARS-CoV-2 and add to the knowledge pool necessary for postpandemic preparedness for SARS-CoV-2.
54margd
In reversal, China joins global Covax initiative to distribute coronavirus vaccines
Gerry Shih | Oct. 9, 2020
TAIPEI, Taiwan — China said Friday it will join Covax, an international effort to distribute covid-19 vaccines to about two-thirds of the world population by 2022, in a reversal that makes the country the biggest player in the vaccine development race to join the initiative.
China, along with the United States and Russia, previously declined to join the World Health Organization-led program, known as the Covid-19 Vaccines Global Access Facility, on its Sept. 18 enrollment deadline. Beijing has already promised vaccines to a number of allied countries and geopolitically important states it has sought to woo, such as Pakistan and the Philippines, and Chinese officials said in recent weeks they were not sure they could join Covax and still fulfill those bilateral commitments.
In a statement announcing the Covax deal, Chinese Foreign Ministry spokeswoman Hua Chunying said China is confident it could ramp up manufacturing. “We are taking this concrete step to ensure equitable distribution of vaccines, especially to developing countries, and hope more capable countries will also join and support Covax,” Hua said...
https://www.washingtonpost.com/world/asia_pacific/coronavirus-vaccine-china-cova...
Gerry Shih | Oct. 9, 2020
TAIPEI, Taiwan — China said Friday it will join Covax, an international effort to distribute covid-19 vaccines to about two-thirds of the world population by 2022, in a reversal that makes the country the biggest player in the vaccine development race to join the initiative.
China, along with the United States and Russia, previously declined to join the World Health Organization-led program, known as the Covid-19 Vaccines Global Access Facility, on its Sept. 18 enrollment deadline. Beijing has already promised vaccines to a number of allied countries and geopolitically important states it has sought to woo, such as Pakistan and the Philippines, and Chinese officials said in recent weeks they were not sure they could join Covax and still fulfill those bilateral commitments.
In a statement announcing the Covax deal, Chinese Foreign Ministry spokeswoman Hua Chunying said China is confident it could ramp up manufacturing. “We are taking this concrete step to ensure equitable distribution of vaccines, especially to developing countries, and hope more capable countries will also join and support Covax,” Hua said...
https://www.washingtonpost.com/world/asia_pacific/coronavirus-vaccine-china-cova...
55margd
Matthew Katz, MD @subatomicdoc | 7:27 AM · Oct 9, 2020:
Possibly useful tip for those wearing goggles or face shields and having trouble with fogging up.
Shaving cream seems to minimize the fogging.
(photo of Barbasol original)
Nataniel Lester-Coll, MD @DrLesterColl · 1h
This is typically from air escaping up. Can try:
1) Tape to seal mask on bridge of nose
2) twisting ear loops to form a figure 8 (tighter seal)
This should help air flowing downward, away from glasses/shield
3) If using safety goggles can also rest them on the mask, over the seal
Nicholas Zaorsky, MD MS @NicholasZaorsky · 1h
Surgical tape on the upper horizontal portion of the mask (half on mask, half on nose) keeps it from fogging up your glasses and also prevents it from sliding off.
John Spikowski @JSpikowski · 2h
...These are the gasketed eye protection I use.
3M Safety Glasses, Virtua CCS Protective Eyewear 11872, Removable Foam Gasket, Clear Anti-Fog Lenses, Corded Ear Plug Control System (2 Pack)
amazon.com
Doctor George @DoctorGeorge15 · 1h
Saliva!
Divers use it to prevent fogging inside masks
It acts as a surfactant, decreasing water tension, thus preventing tiny droplets from forming
Possibly useful tip for those wearing goggles or face shields and having trouble with fogging up.
Shaving cream seems to minimize the fogging.
(photo of Barbasol original)
Nataniel Lester-Coll, MD @DrLesterColl · 1h
This is typically from air escaping up. Can try:
1) Tape to seal mask on bridge of nose
2) twisting ear loops to form a figure 8 (tighter seal)
This should help air flowing downward, away from glasses/shield
3) If using safety goggles can also rest them on the mask, over the seal
Nicholas Zaorsky, MD MS @NicholasZaorsky · 1h
Surgical tape on the upper horizontal portion of the mask (half on mask, half on nose) keeps it from fogging up your glasses and also prevents it from sliding off.
John Spikowski @JSpikowski · 2h
...These are the gasketed eye protection I use.
3M Safety Glasses, Virtua CCS Protective Eyewear 11872, Removable Foam Gasket, Clear Anti-Fog Lenses, Corded Ear Plug Control System (2 Pack)
amazon.com
Doctor George @DoctorGeorge15 · 1h
Saliva!
Divers use it to prevent fogging inside masks
It acts as a surfactant, decreasing water tension, thus preventing tiny droplets from forming
56margd
UK, but could have been FL:
Alex Andreoun @sturdyAlex | 9:49 AM · Oct 9, 2020
Comparing the gov’t Covid19 maps for end of September and start of October, it looks as if things are getting better.
UNTIL you notice they’ve changed the numbers corresponding to each colour.
Had they used the same ones, most of the country would be red or dark red.
#BitSneaky
https://twitter.com/sturdyAlex/status/1314563677144657922/photo/1
https://twitter.com/sturdyAlex/status/1314563677144657922/photo/2
Alex Andreoun @sturdyAlex | 9:49 AM · Oct 9, 2020
Comparing the gov’t Covid19 maps for end of September and start of October, it looks as if things are getting better.
UNTIL you notice they’ve changed the numbers corresponding to each colour.
Had they used the same ones, most of the country would be red or dark red.
#BitSneaky
https://twitter.com/sturdyAlex/status/1314563677144657922/photo/1
https://twitter.com/sturdyAlex/status/1314563677144657922/photo/2
57margd
Alina Baum et al. 2020. REGN-COV2 antibodies prevent and treat SARS-CoV-2 infection in rhesus macaques and hamsters. Science 09 Oct 2020:
eabe2402 DOI: 10.1126/science.abe2402 https://science.sciencemag.org/content/early/2020/10/08/science.abe2402
Abstract
An urgent global quest for effective therapies to prevent and treat COVID-19 disease is ongoing. We previously described REGN-COV2, a cocktail of two potent neutralizing antibodies (REGN10987+REGN10933) targeting non-overlapping epitopes on the SARS-CoV-2 spike protein. In this report, we evaluate the in vivo efficacy of this antibody cocktail in both rhesus macaques, which may model mild disease, and golden hamsters, which may model more severe disease. We demonstrate that REGN-COV-2 can greatly reduce virus load in lower and upper airways and decrease virus induced pathological sequalae when administered prophylactically or therapeutically in rhesus macaques. Similarly, administration in hamsters limits weight loss and decreases lung titers and evidence of pneumonia in the lungs. Our results provide evidence of the therapeutic potential of this antibody cocktail.
eabe2402 DOI: 10.1126/science.abe2402 https://science.sciencemag.org/content/early/2020/10/08/science.abe2402
Abstract
An urgent global quest for effective therapies to prevent and treat COVID-19 disease is ongoing. We previously described REGN-COV2, a cocktail of two potent neutralizing antibodies (REGN10987+REGN10933) targeting non-overlapping epitopes on the SARS-CoV-2 spike protein. In this report, we evaluate the in vivo efficacy of this antibody cocktail in both rhesus macaques, which may model mild disease, and golden hamsters, which may model more severe disease. We demonstrate that REGN-COV-2 can greatly reduce virus load in lower and upper airways and decrease virus induced pathological sequalae when administered prophylactically or therapeutically in rhesus macaques. Similarly, administration in hamsters limits weight loss and decreases lung titers and evidence of pneumonia in the lungs. Our results provide evidence of the therapeutic potential of this antibody cocktail.
58margd
Now that ought to appeal to a certain demographic! :D
Peat & Diesel: That's the way we wash them in the Western Isles (1:12)
https://vimeo.com/466529787
Peat & Diesel: That's the way we wash them in the Western Isles (1:12)
https://vimeo.com/466529787
59John5918
Herd immunity letter signed by fake experts including 'Dr Johnny Bananas' (Guardian)
An open letter that made headlines calling for a herd immunity approach to Covid-19 lists a number of apparently fake names among its expert signatories, including “Dr Johnny Bananas” and “Professor Cominic Dummings”.
The Great Barrington declaration, which was said to have been signed by more than 15,000 scientists and medical practitioners around the world, was found by Sky News to contain numerous false names, as well as those of several homeopaths. Others listed include a resident at the “university of your mum” and another supposed specialist whose name was the first verse of the Macarena. Sky News discovered 18 self-declared homeopaths in the list of expert names and more than 100 therapists whose expertise included massage, hypnotherapy and Mongolian khoomii singing...
It is not clear how many of the names in the declaration’s list of experts are fake, or when they appeared. However, many scientists have already criticised the letter’s conclusions. Dr Michael Head, a senior research fellow in global health at the University of Southampton, said the declaration was “a very bad idea” and doubted that vulnerable people would be able to avoid the virus if it was allowed to become widespread. “Ultimately, the Barrington Declaration is based on principles that are dangerous to national and global public health”...
An open letter that made headlines calling for a herd immunity approach to Covid-19 lists a number of apparently fake names among its expert signatories, including “Dr Johnny Bananas” and “Professor Cominic Dummings”.
The Great Barrington declaration, which was said to have been signed by more than 15,000 scientists and medical practitioners around the world, was found by Sky News to contain numerous false names, as well as those of several homeopaths. Others listed include a resident at the “university of your mum” and another supposed specialist whose name was the first verse of the Macarena. Sky News discovered 18 self-declared homeopaths in the list of expert names and more than 100 therapists whose expertise included massage, hypnotherapy and Mongolian khoomii singing...
It is not clear how many of the names in the declaration’s list of experts are fake, or when they appeared. However, many scientists have already criticised the letter’s conclusions. Dr Michael Head, a senior research fellow in global health at the University of Southampton, said the declaration was “a very bad idea” and doubted that vulnerable people would be able to avoid the virus if it was allowed to become widespread. “Ultimately, the Barrington Declaration is based on principles that are dangerous to national and global public health”...
60margd
Coronavirus Hit the U.S. Long Before We Knew
Rob Barry, Joel Eastwood and Paul Overberg | Oct. 8, 2020
Months before travel bans and lockdowns, Americans were transmitting the virus across the country
(By state, e.g.,) ...Retrospective testing in Ohio found that 5 women and a man who had developed Covid-like symptoms in early January had antibodies for the virus, qualifying as "probable" infections. They lived at opposite corners of the state, up to 200 miles apart....
https://www.wsj.com/graphics/when-did-covid-hit-earliest-death/
Rob Barry, Joel Eastwood and Paul Overberg | Oct. 8, 2020
Months before travel bans and lockdowns, Americans were transmitting the virus across the country
(By state, e.g.,) ...Retrospective testing in Ohio found that 5 women and a man who had developed Covid-like symptoms in early January had antibodies for the virus, qualifying as "probable" infections. They lived at opposite corners of the state, up to 200 miles apart....
https://www.wsj.com/graphics/when-did-covid-hit-earliest-death/
61margd
Dr. Tom Frieden (Frmr Director CDC) @DrTomFrieden | 12:15 PM · Oct 10, 2020
More evidence Vitamin D deficiency weakens immune response.
Another good reason to eat healthy, get at least 15 minutes of sunshine/day.
Vitamin D not likely to help in treatment of acute infection, but supplementation (500-1000 IU/day) may help prevent.
-------------------------------------------------------------
Patterson, B. et al. 2020. Vitamin D deficiency predicts latent TB reactivation independent of preventive therapy: a longitudinal study. The International Journal of Tuberculosis and Lung Disease, Volume 24, Number 9, 1 September 2020, pp. 916-921(6) DOI: https://doi.org/10.5588/ijtld.19.0605 https://www.ingentaconnect.com/content/iuatld/ijtld/2020/00000024/00000009/art00... https://bit.ly/3dfXPDA
Abstract
BACKGROUND: Vitamin D deficiency is associated with progression of latent tuberculosis (TB) infection to active disease. The impact of preventive therapy on this association is unknown.
METHOD: Serum 25-hydroxyvitamin D (25(OH)D) levels were retrospectively linked to adults diagnosed with latent TB between April 2010 and January 2019 in a hospital in London, UK. Individuals in the cohort who progressed to active TB were identified by matching to a national notification register. A logistic regression model was used to examine baseline vitamin D deficiency and use of preventive therapy with subsequent incidence of TB disease.
RESULTS: Of 1509 latently infected individuals with 3902 patient-years of follow-up, 687 (45.5%) were identified as vitamin D deficient and 691 (45.8%) individuals had a LTBI regimen prescribed. There were 29 (1.9%) instances of TB reactivation. On multivariate analysis, profound (less than 25 nmol/L) vitamin D deficiency (aHR* 5.68, 95%CI 2.18–14.82; P = 0.0003) and the absence of preventive therapy (aHR 3.84, 95%CI 1.46–10.08; P = 0.006) were associated with progression to active TB disease. There was no evidence that preventive therapy modified the association between vitamin D status and TB reactivation.
CONCLUSION: Our results show an independent association between vitamin D deficiency and progression from latent TB infection to active disease.
* aHR - adjusted Hazard Ratio (?)
More evidence Vitamin D deficiency weakens immune response.
Another good reason to eat healthy, get at least 15 minutes of sunshine/day.
Vitamin D not likely to help in treatment of acute infection, but supplementation (500-1000 IU/day) may help prevent.
-------------------------------------------------------------
Patterson, B. et al. 2020. Vitamin D deficiency predicts latent TB reactivation independent of preventive therapy: a longitudinal study. The International Journal of Tuberculosis and Lung Disease, Volume 24, Number 9, 1 September 2020, pp. 916-921(6) DOI: https://doi.org/10.5588/ijtld.19.0605 https://www.ingentaconnect.com/content/iuatld/ijtld/2020/00000024/00000009/art00... https://bit.ly/3dfXPDA
Abstract
BACKGROUND: Vitamin D deficiency is associated with progression of latent tuberculosis (TB) infection to active disease. The impact of preventive therapy on this association is unknown.
METHOD: Serum 25-hydroxyvitamin D (25(OH)D) levels were retrospectively linked to adults diagnosed with latent TB between April 2010 and January 2019 in a hospital in London, UK. Individuals in the cohort who progressed to active TB were identified by matching to a national notification register. A logistic regression model was used to examine baseline vitamin D deficiency and use of preventive therapy with subsequent incidence of TB disease.
RESULTS: Of 1509 latently infected individuals with 3902 patient-years of follow-up, 687 (45.5%) were identified as vitamin D deficient and 691 (45.8%) individuals had a LTBI regimen prescribed. There were 29 (1.9%) instances of TB reactivation. On multivariate analysis, profound (less than 25 nmol/L) vitamin D deficiency (aHR* 5.68, 95%CI 2.18–14.82; P = 0.0003) and the absence of preventive therapy (aHR 3.84, 95%CI 1.46–10.08; P = 0.006) were associated with progression to active TB disease. There was no evidence that preventive therapy modified the association between vitamin D status and TB reactivation.
CONCLUSION: Our results show an independent association between vitamin D deficiency and progression from latent TB infection to active disease.
* aHR - adjusted Hazard Ratio (?)
62margd
We should still mask up, but here's a spot of good news on plane ventilation:
Michael Mina (Harvard) @michaelmina_lab | 1:32 AM · Oct 10, 2020:
This is the type of ambitious experimentation and development we need.
DoD setup to test potential virus spread on commercial flights.
Spoiler, not surprising but with high air exchange + HEPA filters, virus spread LOWER than other indoor settings
US Dept of Defense (DoD) Test of Viral Spread on Commercial Planes Reveals Good News, General Says
Military.com | By Hope Hodge Seck | 7 Oct 2020
...Speaking at the National Defense Transportation Association's annual fall meeting, Gen. Stephen Lyons cited an aerosol test held Aug. 24-31 aboard two large passenger aircraft: the Boeing 767-300 and 777-200. The Defense Advanced Research Projects Agency, better known as DARPA, teamed up with biodefense company Zeteo Tech Inc. to evaluate in-flight spread of airborne particles. Industry partners included Boeing and United Airlines.
"...their results, as were the results when we looked at this from the COVID patient movement challenge, are very, very encouraging."
There are some qualifiers, Lyons noted. The conditions that yielded positive results, he said, involved aircraft with HEPA filtration and "a very, very high air exchange rate of every two to five minutes or two to three minutes."
But under those conditions, he indicated, particle spread rates were even lower than in a conventional indoor setting...."And those test reports will be out very, very soon."
According to a September Defense Department test, TRANSCOM undertook this research in order to determine the safety of DoD-contracted Patriot Express, or commercial charter flights, used to transport military family members and others on official duty. The tests were conducted on a 767 and 777, officials said, because those are the aircraft most typically used for these flights.
...Once released, the full results of the test could change procedures for passenger transport.
"This data collected will eventually inform the Department of Defense on contact tracing requirements needed for specific aircraft," ( Navy Lt. Cmdr. Joseph Pope, TRANSCOM operations directorate liaison for the airflow particle test) said in the September release. "It will also be used to develop strategies like cabin loading and seating configurations to mitigate potential risk of inter-person transmission of the aerosol particles."
In addition, he said, the tests could help determine who needs to self-quarantine if it's discovered a passenger on their aircraft tested positive for COVID-19...
https://www.military.com/daily-news/2020/10/07/dod-test-of-viral-spread-commerci...
Michael Mina (Harvard) @michaelmina_lab | 1:32 AM · Oct 10, 2020:
This is the type of ambitious experimentation and development we need.
DoD setup to test potential virus spread on commercial flights.
Spoiler, not surprising but with high air exchange + HEPA filters, virus spread LOWER than other indoor settings
US Dept of Defense (DoD) Test of Viral Spread on Commercial Planes Reveals Good News, General Says
Military.com | By Hope Hodge Seck | 7 Oct 2020
...Speaking at the National Defense Transportation Association's annual fall meeting, Gen. Stephen Lyons cited an aerosol test held Aug. 24-31 aboard two large passenger aircraft: the Boeing 767-300 and 777-200. The Defense Advanced Research Projects Agency, better known as DARPA, teamed up with biodefense company Zeteo Tech Inc. to evaluate in-flight spread of airborne particles. Industry partners included Boeing and United Airlines.
"...their results, as were the results when we looked at this from the COVID patient movement challenge, are very, very encouraging."
There are some qualifiers, Lyons noted. The conditions that yielded positive results, he said, involved aircraft with HEPA filtration and "a very, very high air exchange rate of every two to five minutes or two to three minutes."
But under those conditions, he indicated, particle spread rates were even lower than in a conventional indoor setting...."And those test reports will be out very, very soon."
According to a September Defense Department test, TRANSCOM undertook this research in order to determine the safety of DoD-contracted Patriot Express, or commercial charter flights, used to transport military family members and others on official duty. The tests were conducted on a 767 and 777, officials said, because those are the aircraft most typically used for these flights.
...Once released, the full results of the test could change procedures for passenger transport.
"This data collected will eventually inform the Department of Defense on contact tracing requirements needed for specific aircraft," ( Navy Lt. Cmdr. Joseph Pope, TRANSCOM operations directorate liaison for the airflow particle test) said in the September release. "It will also be used to develop strategies like cabin loading and seating configurations to mitigate potential risk of inter-person transmission of the aerosol particles."
In addition, he said, the tests could help determine who needs to self-quarantine if it's discovered a passenger on their aircraft tested positive for COVID-19...
https://www.military.com/daily-news/2020/10/07/dod-test-of-viral-spread-commerci...
63margd
Fig 1. Graph of major symptoms and outcomes and duration of viral shedding from illness onset in patients hospitalised with COVID-19
https://twitter.com/DrEricDing/status/1314728624503877632/photo/1
Eric Feigl-Ding* used interesting figure (above) in Twitter discussion of when Trump was likely to have last tested negative.
Unattributed, it uses British spellings, so not published in US, e.g., "hospitalised", "dypsnoea".
(Dypsnoea/dypsnea means difficult or labored breathing, which usually occurs 6-7 days after first fever/cough symptom onset.
Trump's developed after one day, if WH is to be believed.)
* Eric Feigl-Ding (@DrEricDing)--Epidemiologist and Health Economist. Senior Fellow FAS. Fmr 16 yrs HarvardChanSPH. Harvard
& JohnsHopkins alum. #COVID19 updates since Jan ‘20. Views my own.
https://twitter.com/DrEricDing/status/1314728624503877632/photo/1
Eric Feigl-Ding* used interesting figure (above) in Twitter discussion of when Trump was likely to have last tested negative.
Unattributed, it uses British spellings, so not published in US, e.g., "hospitalised", "dypsnoea".
(Dypsnoea/dypsnea means difficult or labored breathing, which usually occurs 6-7 days after first fever/cough symptom onset.
Trump's developed after one day, if WH is to be believed.)
* Eric Feigl-Ding (@DrEricDing)--Epidemiologist and Health Economist. Senior Fellow FAS. Fmr 16 yrs HarvardChanSPH. Harvard
& JohnsHopkins alum. #COVID19 updates since Jan ‘20. Views my own.
64margd
>58 margd: contd.
Coronavirus Safety Runs Into a Stubborn Barrier: Masculinity
Daniel Victor | Oct. 10, 2020
...Some experts who study masculinity and public health say the perception that wearing masks and following social distancing guidelines are unmanly has carried a destructive cost. The virus has infected more men than women and killed far more of them.
...Men’s resistance to showing weakness — and their tendency to take risks — was demonstrated by scientists long before Covid-19. Studies have shown men are less likely than women to wear seatbelts and helmets, or to get flu shots. They’re more likely to speed or drive drunk. They are less likely to seek out medical care.
Some initial research* indicates a similar pattern is playing out with the coronavirus. Surveys have found that women are more likely than men to wear masks in the United States. And recent polls have found men give higher marks to President Trump than women on his handling of the pandemic...
https://www.nytimes.com/2020/10/10/us/politics/trump-biden-masks-masculinity.htm...
------------------------------------------------------------------------------------------------------
* MDX academic's joint research finds men less likely to wear masks to protect against COVID-19
Middlesex U | 14/05/2020
https://www.mdx.ac.uk/news/2020/05/COVID-19-face-masks
----------------------------------------------------------------------------------------------------
* Valerio Capraro and Hélène Barcelo. 2020. The effect of messaging and gender on intentions to wear a face covering to slow down COVID-19 transmission. PsyArXiv (Last edited May 16, 2020) 16 p. 10.31234/osf.io/tg7vz https://psyarxiv.com/tg7vz
Abstract
... We find that men less than women intend to wear a face covering, but this difference almost disappears in counties where wearing a face covering is mandatory. We also find that men less than women believe that they will be seriously affected by the coronavirus, and this partly mediates gender differences in intentions to wear a face covering (this is particularly ironic because official statistics actually show that men are affected by the COVID-19 more seriously than women). Finally, we also find gender differences in self-reported negative emotions felt when wearing a face covering. Men more than women agree that wearing a face covering is shameful, not cool, a sign of weakness, and a stigma; and these gender differences also mediate gender differences in intentions to wear a face covering.
Coronavirus Safety Runs Into a Stubborn Barrier: Masculinity
Daniel Victor | Oct. 10, 2020
...Some experts who study masculinity and public health say the perception that wearing masks and following social distancing guidelines are unmanly has carried a destructive cost. The virus has infected more men than women and killed far more of them.
...Men’s resistance to showing weakness — and their tendency to take risks — was demonstrated by scientists long before Covid-19. Studies have shown men are less likely than women to wear seatbelts and helmets, or to get flu shots. They’re more likely to speed or drive drunk. They are less likely to seek out medical care.
Some initial research* indicates a similar pattern is playing out with the coronavirus. Surveys have found that women are more likely than men to wear masks in the United States. And recent polls have found men give higher marks to President Trump than women on his handling of the pandemic...
https://www.nytimes.com/2020/10/10/us/politics/trump-biden-masks-masculinity.htm...
------------------------------------------------------------------------------------------------------
* MDX academic's joint research finds men less likely to wear masks to protect against COVID-19
Middlesex U | 14/05/2020
https://www.mdx.ac.uk/news/2020/05/COVID-19-face-masks
----------------------------------------------------------------------------------------------------
* Valerio Capraro and Hélène Barcelo. 2020. The effect of messaging and gender on intentions to wear a face covering to slow down COVID-19 transmission. PsyArXiv (Last edited May 16, 2020) 16 p. 10.31234/osf.io/tg7vz https://psyarxiv.com/tg7vz
Abstract
... We find that men less than women intend to wear a face covering, but this difference almost disappears in counties where wearing a face covering is mandatory. We also find that men less than women believe that they will be seriously affected by the coronavirus, and this partly mediates gender differences in intentions to wear a face covering (this is particularly ironic because official statistics actually show that men are affected by the COVID-19 more seriously than women). Finally, we also find gender differences in self-reported negative emotions felt when wearing a face covering. Men more than women agree that wearing a face covering is shameful, not cool, a sign of weakness, and a stigma; and these gender differences also mediate gender differences in intentions to wear a face covering.
65margd
"...viable virus was isolated for up to 28 days at 20 °C from common surfaces such as glass, stainless steel and both paper and polymer banknotes. Conversely, infectious virus survived less than 24 h at 40 °C on some surfaces..."
Image ( https://twitter.com/EricTopol/status/1315305024621223936/photo/1 )
Shane Riddell et al. 2020. The effect of temperature on persistence of SARS-CoV-2 on common surfaces. Virology Journal volume 17, Article number: 145 (07 October 2020) https://virologyj.biomedcentral.com/articles/10.1186/s12985-020-01418-7
Abstract
Background
The rate at which COVID-19 has spread throughout the globe has been alarming. While the role of fomite transmission is not yet fully understood, precise data on the environmental stability of SARS-CoV-2 is required to determine the risks of fomite transmission from contaminated surfaces.
Methods
This study measured the survival rates of infectious SARS-CoV-2, suspended in a standard ASTM E2197 matrix, on several common surface types. All experiments were carried out in the dark, to negate any effects of UV light. Inoculated surfaces were incubated at 20 °C, 30 °C and 40 °C and sampled at various time points.
Results
Survival rates of SARS-CoV-2 were determined at different temperatures and D-values, Z-values and half-life were calculated. We obtained half lives of between 1.7 and 2.7 days at 20 °C, reducing to a few hours when temperature was elevated to 40 °C. With initial viral loads broadly equivalent to the highest titres excreted by infectious patients, viable virus was isolated for up to 28 days at 20 °C from common surfaces such as glass, stainless steel and both paper and polymer banknotes. Conversely, infectious virus survived less than 24 h at 40 °C on some surfaces.
Conclusion
These findings demonstrate SARS-CoV-2 can remain infectious for significantly longer time periods than generally considered possible. These results could be used to inform improved risk mitigation procedures to prevent the fomite spread of COVID-19.
Image ( https://twitter.com/EricTopol/status/1315305024621223936/photo/1 )
Shane Riddell et al. 2020. The effect of temperature on persistence of SARS-CoV-2 on common surfaces. Virology Journal volume 17, Article number: 145 (07 October 2020) https://virologyj.biomedcentral.com/articles/10.1186/s12985-020-01418-7
Abstract
Background
The rate at which COVID-19 has spread throughout the globe has been alarming. While the role of fomite transmission is not yet fully understood, precise data on the environmental stability of SARS-CoV-2 is required to determine the risks of fomite transmission from contaminated surfaces.
Methods
This study measured the survival rates of infectious SARS-CoV-2, suspended in a standard ASTM E2197 matrix, on several common surface types. All experiments were carried out in the dark, to negate any effects of UV light. Inoculated surfaces were incubated at 20 °C, 30 °C and 40 °C and sampled at various time points.
Results
Survival rates of SARS-CoV-2 were determined at different temperatures and D-values, Z-values and half-life were calculated. We obtained half lives of between 1.7 and 2.7 days at 20 °C, reducing to a few hours when temperature was elevated to 40 °C. With initial viral loads broadly equivalent to the highest titres excreted by infectious patients, viable virus was isolated for up to 28 days at 20 °C from common surfaces such as glass, stainless steel and both paper and polymer banknotes. Conversely, infectious virus survived less than 24 h at 40 °C on some surfaces.
Conclusion
These findings demonstrate SARS-CoV-2 can remain infectious for significantly longer time periods than generally considered possible. These results could be used to inform improved risk mitigation procedures to prevent the fomite spread of COVID-19.
66margd
>65 margd: OTOH: "Low risk of SARS-CoV-2 transmission by fomites in real-life conditions"
Mario U Mondelli et al. 2020. Low risk of SARS-CoV-2 transmission by fomites in real-life conditions (Correspondence). The Lancet Infectious Disease (September 29, 2020) DOI:https://doi.org/10.1016/S1473-3099(20)30678-2. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30678-2/fullt...
...Our findings (Italian hospital) suggest that environmental contamination leading to SARS-CoV-2 transmission is unlikely to occur in real-life conditions, provided that standard cleaning procedures and precautions are enforced...
Mario U Mondelli et al. 2020. Low risk of SARS-CoV-2 transmission by fomites in real-life conditions (Correspondence). The Lancet Infectious Disease (September 29, 2020) DOI:https://doi.org/10.1016/S1473-3099(20)30678-2. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30678-2/fullt...
...Our findings (Italian hospital) suggest that environmental contamination leading to SARS-CoV-2 transmission is unlikely to occur in real-life conditions, provided that standard cleaning procedures and precautions are enforced...
67margd
"Children 1–2 years of age might be effective SARS-CoV-2 spreaders....The overall positivity rate in our cluster was 27%. COVID-19 prevalence in Poland is low...1%..."
Okarska-Napierała M, Mańdziuk J, Kuchar E. 2020. SARS-CoV-2 cluster in nursery, Poland (Research Letter). CDC Emerg Infect Dis. 2021 Jan (Early Release: October 09, 2020). https://doi.org/10.3201/eid2701.203849 https://wwwnc.cdc.gov/eid/article/27/1/20-3849_article
Abstract
We report a cluster of surprisingly high spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated with a single nursery in Poland. Our findings contrast with the presumed negligible role of children in driving the SARS-CoV-2 pandemic. Children 1–2 years of age might be effective SARS-CoV-2 spreaders.
Okarska-Napierała M, Mańdziuk J, Kuchar E. 2020. SARS-CoV-2 cluster in nursery, Poland (Research Letter). CDC Emerg Infect Dis. 2021 Jan (Early Release: October 09, 2020). https://doi.org/10.3201/eid2701.203849 https://wwwnc.cdc.gov/eid/article/27/1/20-3849_article
Abstract
We report a cluster of surprisingly high spread of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) associated with a single nursery in Poland. Our findings contrast with the presumed negligible role of children in driving the SARS-CoV-2 pandemic. Children 1–2 years of age might be effective SARS-CoV-2 spreaders.
68margd
MASKS: comprehensive, referenced review
Lynne Peeples. 2020. Face masks: what the data say. Nature 586, 186-189 ( 06 October 2020) doi: 10.1038/d41586-020-02801-8
https://www.nature.com/articles/d41586-020-02801-8
The science supports that face coverings are saving lives during the coronavirus pandemic, and yet the debate trundles on. How much evidence is enough?
...scientists are confident that they can say something prescriptive about wearing masks. It’s not the only solution, says Gandhi, “but I think it is a profoundly important pillar of pandemic control”. As Digard puts it: “Masks work, but they are not infallible. And, therefore, keep your distance.”
Lynne Peeples. 2020. Face masks: what the data say. Nature 586, 186-189 ( 06 October 2020) doi: 10.1038/d41586-020-02801-8
https://www.nature.com/articles/d41586-020-02801-8
The science supports that face coverings are saving lives during the coronavirus pandemic, and yet the debate trundles on. How much evidence is enough?
...scientists are confident that they can say something prescriptive about wearing masks. It’s not the only solution, says Gandhi, “but I think it is a profoundly important pillar of pandemic control”. As Digard puts it: “Masks work, but they are not infallible. And, therefore, keep your distance.”
69John5918
Coronavirus: WHO head calls herd immunity approach 'immoral' (BBC)
The head of the World Health Organization has ruled out a herd immunity response to the pandemic... WHO chief Tedros Ghebreyesus said such an approach was "scientifically and ethically problematic"...
The head of the World Health Organization has ruled out a herd immunity response to the pandemic... WHO chief Tedros Ghebreyesus said such an approach was "scientifically and ethically problematic"...
70margd
Good that J&J and Astrazeneca are conducting clinical trials that will catch safety issue, if any, before a vaccine is released to millions.
Also vindication for FDA resistance to political pressure for granting an Emergency Use Authorization (EUA) before election and before clinical trials complete. (Perhaps warranted, IMO, if the virus takes off this winter and healthworkers are in such danger that a vaccine-in-development is lesser risk.)
Russia's vaccine and at least one of China's are also based on adenoviruses.
Johnson & Johnson Covid-19 vaccine study paused due to unexplained illness in participant
Matthew Herper | October 12, 2020
...A document sent to outside researchers running the 60,000-patient clinical trial states that a “pausing rule” has been met, that the online system used to enroll patients in the study has been closed, and that the data and safety monitoring board — an independent committee that watches over the safety of patients in the clinical trial — would be convened.
...“We must respect this participant’s privacy. We’re also learning more about this participant’s illness, and it’s important to have all the facts before we share additional information,” the company said in a statement.
J&J emphasized that so-called adverse events — illnesses, accidents, and other bad medical outcomes — are an expected part of a clinical study, and also emphasized the difference between a study pause and a clinical hold, which is a formal regulatory action that can last much longer. The vaccine study is not currently under a clinical hold. J&J said that while it normally communicates clinical holds to the public, it does not usually inform the public of study pauses.
...“it is not always immediately apparent” whether the participant who experienced an adverse event received a study treatment or a placebo.
Though clinical trial pauses are not uncommon — and in some cases last only a few days — they are generating outsized attention in the race to test vaccines against SARS-CoV-2, the virus that causes Covid-19.
...“If we do a study of 60,000 people, that is a small village,” the source said. “In a small village there are a lot of medical events that happen.”
On Sept. 8, a large study of another Covid-19 vaccine being developed by AstraZeneca and Oxford University was put on hold because of a suspected adverse reaction in a patient in the United Kingdom. It’s believed that the patient had transverse myelitis, a spinal cord problem. Studies of the vaccine resumed roughly a week after it was paused in the United Kingdom, and have since been restarted in other countries as well. It remains on hold, however, in the United States...
https://www.statnews.com/2020/10/12/johnson-johnson-covid-19-vaccine-study-pause...
Also vindication for FDA resistance to political pressure for granting an Emergency Use Authorization (EUA) before election and before clinical trials complete. (Perhaps warranted, IMO, if the virus takes off this winter and healthworkers are in such danger that a vaccine-in-development is lesser risk.)
Russia's vaccine and at least one of China's are also based on adenoviruses.
Johnson & Johnson Covid-19 vaccine study paused due to unexplained illness in participant
Matthew Herper | October 12, 2020
...A document sent to outside researchers running the 60,000-patient clinical trial states that a “pausing rule” has been met, that the online system used to enroll patients in the study has been closed, and that the data and safety monitoring board — an independent committee that watches over the safety of patients in the clinical trial — would be convened.
...“We must respect this participant’s privacy. We’re also learning more about this participant’s illness, and it’s important to have all the facts before we share additional information,” the company said in a statement.
J&J emphasized that so-called adverse events — illnesses, accidents, and other bad medical outcomes — are an expected part of a clinical study, and also emphasized the difference between a study pause and a clinical hold, which is a formal regulatory action that can last much longer. The vaccine study is not currently under a clinical hold. J&J said that while it normally communicates clinical holds to the public, it does not usually inform the public of study pauses.
...“it is not always immediately apparent” whether the participant who experienced an adverse event received a study treatment or a placebo.
Though clinical trial pauses are not uncommon — and in some cases last only a few days — they are generating outsized attention in the race to test vaccines against SARS-CoV-2, the virus that causes Covid-19.
...“If we do a study of 60,000 people, that is a small village,” the source said. “In a small village there are a lot of medical events that happen.”
On Sept. 8, a large study of another Covid-19 vaccine being developed by AstraZeneca and Oxford University was put on hold because of a suspected adverse reaction in a patient in the United Kingdom. It’s believed that the patient had transverse myelitis, a spinal cord problem. Studies of the vaccine resumed roughly a week after it was paused in the United Kingdom, and have since been restarted in other countries as well. It remains on hold, however, in the United States...
https://www.statnews.com/2020/10/12/johnson-johnson-covid-19-vaccine-study-pause...
71lriley
Look at these knuckleheaded freedumb loving assclowns:
https://www.news.yahoo.com/authorities-investigating-large-religious-event-03222...
I would assume that the vast majority of this crowd if they vote will vote for Donald. Jam 10,000 people together (with no precautions necessary) into a small space and see what happens.The organizers of this event should not be running around free. At the least they should be locked up for the duration of the pandemic.
https://www.news.yahoo.com/authorities-investigating-large-religious-event-03222...
I would assume that the vast majority of this crowd if they vote will vote for Donald. Jam 10,000 people together (with no precautions necessary) into a small space and see what happens.The organizers of this event should not be running around free. At the least they should be locked up for the duration of the pandemic.
72margd
>71 lriley: Reminds one of plague-days almost. Even with so much more knowledge, fear still is powerful driver. Today is our first day out of Canadian 2-week quarantine, so we plan a trip to the bank (one reason we're here). I had heard of some mild harassment of vehicles with US license plates, but paid little heed (other than switching to less obviously MI plates). Paid little heed that is until my Ont cousin offered us use of his truck for our errand... Sure hope fear hasn't gotten the best of Canadians, too...
__________________________________________________________
On my TBR file. Review/opinion (below), written over the summer concludes "with few exceptions, the development of protective humoral immunity* of more than a year is the norm. Immunity to SARS-CoV-2 is likely to follow the same pattern."
* Humoral immunity or humoural immunity is the aspect of immunity that is mediated by macromolecules found in extracellular fluids such as secreted ANTIBODIES (emphasis margd's), complement proteins, and certain antimicrobial peptides. Humoral immunity is so named because it involves substances found in the humors, or body fluids. (wikipedia)
Nicole Baumgarth et al. 2020. Antibody Responses to SARS-CoV-2: Let’s Stick to Known Knowns (Review/Opinion). J Immunol September 4, 2020, ji2000839; DOI: https://doi.org/10.4049/jimmunol.2000839 https://www.jimmunol.org/content/early/2020/09/03/jimmunol.2000839 https://www.jimmunol.org/content/jimmunol/early/2020/09/03/jimmunol.2000839.full...
Abstract
The scale of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has thrust immunology into the public spotlight in unprecedented ways. In this article, which is part opinion piece and part review, we argue that the normal cadence by which we discuss science with our colleagues failed to properly convey likelihoods of the immune response to SARS-CoV-2 to the public and the media. As a result, biologically implausible outcomes were given equal weight as the principles set by decades of viral immunology. Unsurprisingly, questionable results and alarmist news media articles have filled the void. We suggest an emphasis on setting expectations based on prior findings while avoiding the overused approach of assuming nothing. After reviewing Ab(antibody)-mediated immunity after coronavirus and other acute viral infections, we posit that, with few exceptions, the development of protective humoral immunity of more than a year is the norm. Immunity to SARS-CoV-2 is likely to follow the same pattern.
Communicating with the public, decision-makers, and media
Defining “immunity”
...Challenges with Ab testing and data interpretation for SARS-CoV2.
Fundamentals of B cell responses to acute viral infections
...Extrafollicular and germinal center–derived Ab responses toinfections shape the serum Ab titers.
...Humoral immunity in respiratory tract.
...Role of memory B cells in viral infections.
Duration of humoral immunity after coronavirus and other acuteviral infections
...Duration of immunity to common coronaviruses.
...Duration of immunity to SARS-CoV-1 and SARS-CoV-2.
...Durability of Ab responses to other acute respiratory viruses.
Immune responses in vulnerable populations against SARS-CoV-2 and against the potential COVID-19 vaccines
Conclusions
The purpose of this article is not to paint an excessively rosy picture of the SARS-CoV-2/COVID-19 pandemic. Rather,the intent is to offer an objective perspective of Ab immunity.Doing so allows for a proper calibration of likelihoods, expectations, and uncertainty, thereby balancing particularly worrisome aspects of the virus with those that are of much less concern. There are many highly problematic immunopathological and epidemiological aspects of this virus, but we do not believe that subversion of fundamental immunological principles is among them.
__________________________________________________________
On my TBR file. Review/opinion (below), written over the summer concludes "with few exceptions, the development of protective humoral immunity* of more than a year is the norm. Immunity to SARS-CoV-2 is likely to follow the same pattern."
* Humoral immunity or humoural immunity is the aspect of immunity that is mediated by macromolecules found in extracellular fluids such as secreted ANTIBODIES (emphasis margd's), complement proteins, and certain antimicrobial peptides. Humoral immunity is so named because it involves substances found in the humors, or body fluids. (wikipedia)
Nicole Baumgarth et al. 2020. Antibody Responses to SARS-CoV-2: Let’s Stick to Known Knowns (Review/Opinion). J Immunol September 4, 2020, ji2000839; DOI: https://doi.org/10.4049/jimmunol.2000839 https://www.jimmunol.org/content/early/2020/09/03/jimmunol.2000839 https://www.jimmunol.org/content/jimmunol/early/2020/09/03/jimmunol.2000839.full...
Abstract
The scale of the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) pandemic has thrust immunology into the public spotlight in unprecedented ways. In this article, which is part opinion piece and part review, we argue that the normal cadence by which we discuss science with our colleagues failed to properly convey likelihoods of the immune response to SARS-CoV-2 to the public and the media. As a result, biologically implausible outcomes were given equal weight as the principles set by decades of viral immunology. Unsurprisingly, questionable results and alarmist news media articles have filled the void. We suggest an emphasis on setting expectations based on prior findings while avoiding the overused approach of assuming nothing. After reviewing Ab(antibody)-mediated immunity after coronavirus and other acute viral infections, we posit that, with few exceptions, the development of protective humoral immunity of more than a year is the norm. Immunity to SARS-CoV-2 is likely to follow the same pattern.
Communicating with the public, decision-makers, and media
Defining “immunity”
...Challenges with Ab testing and data interpretation for SARS-CoV2.
Fundamentals of B cell responses to acute viral infections
...Extrafollicular and germinal center–derived Ab responses toinfections shape the serum Ab titers.
...Humoral immunity in respiratory tract.
...Role of memory B cells in viral infections.
Duration of humoral immunity after coronavirus and other acuteviral infections
...Duration of immunity to common coronaviruses.
...Duration of immunity to SARS-CoV-1 and SARS-CoV-2.
...Durability of Ab responses to other acute respiratory viruses.
Immune responses in vulnerable populations against SARS-CoV-2 and against the potential COVID-19 vaccines
Conclusions
The purpose of this article is not to paint an excessively rosy picture of the SARS-CoV-2/COVID-19 pandemic. Rather,the intent is to offer an objective perspective of Ab immunity.Doing so allows for a proper calibration of likelihoods, expectations, and uncertainty, thereby balancing particularly worrisome aspects of the virus with those that are of much less concern. There are many highly problematic immunopathological and epidemiological aspects of this virus, but we do not believe that subversion of fundamental immunological principles is among them.
73margd
Neat graphic: the Swiss Cheese Respiratory Virus Defence, updated to explain that only a few interventions, carefully chosen for each situation, may be needed.
Tacit Subtext @TSubtext | 2:05 AM · Oct 13, 2020
Interventions are additive
Image ( https://twitter.com/TSubtext/status/1315896428439322625/photo/1 )
Tacit Subtext @TSubtext | 2:05 AM · Oct 13, 2020
Interventions are additive
Image ( https://twitter.com/TSubtext/status/1315896428439322625/photo/1 )
74margd
Yale Prof. Akiko Iwasaki @VirusesImmunity | 8:29 PM · Oct 12, 2020:
What do #COVID19 reinfection cases mean? Here is a commentary I wrote on this topic for @TheLancetInfDis.
Recovery from #SARSCoV2 infection does not guarantee protection from reinfection, disease or becoming infectious again. But a good vaccine can.
-------------------------------------------------------------------------------------
Akiko Iwasaki. 2020. What reinfections mean for COVID-19 (comment). The Lancet Infectious Diseases. Published:October 12, 2020. DOI:https://doi.org/10.1016/S1473-3099(20)30783-0 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30783-0/fullt...
One of the key questions in predicting the course of the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is how well and how long the immune responses protect the host from reinfection. For some viruses, the first infection can provide lifelong immunity; for seasonal coronaviruses, protective immunity is short-lived.\\
In The Lancet Infectious Diseases, Richard L Tillett and colleagues describe the first confirmed case of SARS-CoV-2 reinfection in the USA. A 25-year-old man from the US state of Nevada, who had no known immune disorders...What is worrisome is that SARS-CoV-2 reinfection resulted in worse disease than did the first infection, requiring oxygen support and hospitalisation. The patient had positive antibodies after the reinfection, but whether he had pre-existing antibody after the first infection is unknown (table).
...This case report adds to rapidly growing evidence of COVID-19 reinfection, in which viral genomic sequences were used to confirm infections by distinct isolates of SARS-CoV-2. What do reinfection cases mean for public health and vaccination endeavors to stop the COVID-19 pandemic?
Do reinfections occur because of a scant antibody response after first infection?...
Does immunity protect an individual from disease on reinfection? ...not necessarily...It is important to keep in mind that the reinfection cases in general are being picked up because of symptoms and are biased towards detection of symptomatic cases...Why do some reinfections result in milder disease,
whereas others are more severe? Further investigation is needed of pre-existing immune responses before second exposure, and viral inoculum load.
Does infection by different viral isolates mean we need a vaccine for each type?... There is currently no evidence that a SARS-CoV-2 variant has emerged as a result of immune evasion. For now, one vaccine will be sufficient to confer protection against all circulating variants...
Does immunity prevent transmission from those who are reinfected? ...reinfection cases tell us that we cannot rely on immunity acquired by natural infection to confer herd immunity; not only is this strategy lethal for many but also it is not effective. Herd immunity requires safe and effective vaccines and robust vaccination implementation.
As more cases of reinfection surface, the scientific community will have the opportunity to understand better the correlates of protection and how frequently natural infections with SARS-CoV-2 induce that level of immunity. This information is key to understanding which vaccines are capable of crossing that threshold to confer individual and herd immunity.
What do #COVID19 reinfection cases mean? Here is a commentary I wrote on this topic for @TheLancetInfDis.
Recovery from #SARSCoV2 infection does not guarantee protection from reinfection, disease or becoming infectious again. But a good vaccine can.
-------------------------------------------------------------------------------------
Akiko Iwasaki. 2020. What reinfections mean for COVID-19 (comment). The Lancet Infectious Diseases. Published:October 12, 2020. DOI:https://doi.org/10.1016/S1473-3099(20)30783-0 https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30783-0/fullt...
One of the key questions in predicting the course of the COVID-19 pandemic, caused by severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), is how well and how long the immune responses protect the host from reinfection. For some viruses, the first infection can provide lifelong immunity; for seasonal coronaviruses, protective immunity is short-lived.\\
In The Lancet Infectious Diseases, Richard L Tillett and colleagues describe the first confirmed case of SARS-CoV-2 reinfection in the USA. A 25-year-old man from the US state of Nevada, who had no known immune disorders...What is worrisome is that SARS-CoV-2 reinfection resulted in worse disease than did the first infection, requiring oxygen support and hospitalisation. The patient had positive antibodies after the reinfection, but whether he had pre-existing antibody after the first infection is unknown (table).
...This case report adds to rapidly growing evidence of COVID-19 reinfection, in which viral genomic sequences were used to confirm infections by distinct isolates of SARS-CoV-2. What do reinfection cases mean for public health and vaccination endeavors to stop the COVID-19 pandemic?
Do reinfections occur because of a scant antibody response after first infection?...
Does immunity protect an individual from disease on reinfection? ...not necessarily...It is important to keep in mind that the reinfection cases in general are being picked up because of symptoms and are biased towards detection of symptomatic cases...Why do some reinfections result in milder disease,
whereas others are more severe? Further investigation is needed of pre-existing immune responses before second exposure, and viral inoculum load.
Does infection by different viral isolates mean we need a vaccine for each type?... There is currently no evidence that a SARS-CoV-2 variant has emerged as a result of immune evasion. For now, one vaccine will be sufficient to confer protection against all circulating variants...
Does immunity prevent transmission from those who are reinfected? ...reinfection cases tell us that we cannot rely on immunity acquired by natural infection to confer herd immunity; not only is this strategy lethal for many but also it is not effective. Herd immunity requires safe and effective vaccines and robust vaccination implementation.
As more cases of reinfection surface, the scientific community will have the opportunity to understand better the correlates of protection and how frequently natural infections with SARS-CoV-2 induce that level of immunity. This information is key to understanding which vaccines are capable of crossing that threshold to confer individual and herd immunity.
76Molly3028
Trump appears to be on the final leg of the final tour of his rock-
star political career. The rocket he rode up on is burning out. His
music ~ MAGA crapola ~ is no longer at the top of the charts.
Covid-19 is at the top of the charts, now. AMEN.
star political career. The rocket he rode up on is burning out. His
music ~ MAGA crapola ~ is no longer at the top of the charts.
Covid-19 is at the top of the charts, now. AMEN.
77margd
Eli Lilly antibody trial is paused because of potential safety concerns.
Oct 13, 2020
A government-sponsored clinical trial testing an antibody treatment made by the drug company Eli Lilly has been paused because of a “potential safety concern,” according to emails that government officials sent on Tuesday to researchers at testing sites, and confirmed by the company.
...The Eli Lilly trial was designed to test the benefits of the therapy on hundreds of people hospitalized with Covid-19, compared with a placebo. All study participants also received another experimental drug, remdesivir, which has become commonly used to treat patients with Covid-19. It is unclear how many volunteers were sick, or any details about their illness.
In large clinical trials, such pauses are not unusual, and illness in volunteers is not necessarily the result of the experimental drug or vaccine. Such halts are meant to allow an independent board of scientific experts to review the data and determine whether the event may have been related to the treatment, or occurred by chance.
Enrollment for the Eli Lilly trial, which was sponsored by several branches of the National Institutes of Health and the Department of Veterans Affairs, among others, had been ongoing. But emails sent Tuesday from multiple officials told researchers to stop adding volunteers to the study out of an “abundance of caution.”
...Eli Lilly’s product is similar to a treatment designed by drug company Regeneron, which developed an antibody therapy given to President Trump after he was diagnosed with Covid-19 earlier this month. Mr. Trump has promoted the treatments, without evidence, as a “cure” for his condition, and has suggested that their approval and widespread distribution could be imminent. The week after the president was treated, both companies applied for emergency clearance for their products from the Food and Drug Administration. Eli Lilly has applied for authorization of its drug for mild cases of Covid-19, not for use in hospitalized patients like those tested in the halted trial.
Antibodies can block the coronavirus from infecting cells, and preliminary data from Eli Lilly and Regeneron have hinted they may be able to tamp down the amount of virus in an infected person’s body and reduce their symptoms.
https://www.nytimes.com/live/2020/10/13/world/coronavirus-covid?campaign_id=60&a...
Oct 13, 2020
A government-sponsored clinical trial testing an antibody treatment made by the drug company Eli Lilly has been paused because of a “potential safety concern,” according to emails that government officials sent on Tuesday to researchers at testing sites, and confirmed by the company.
...The Eli Lilly trial was designed to test the benefits of the therapy on hundreds of people hospitalized with Covid-19, compared with a placebo. All study participants also received another experimental drug, remdesivir, which has become commonly used to treat patients with Covid-19. It is unclear how many volunteers were sick, or any details about their illness.
In large clinical trials, such pauses are not unusual, and illness in volunteers is not necessarily the result of the experimental drug or vaccine. Such halts are meant to allow an independent board of scientific experts to review the data and determine whether the event may have been related to the treatment, or occurred by chance.
Enrollment for the Eli Lilly trial, which was sponsored by several branches of the National Institutes of Health and the Department of Veterans Affairs, among others, had been ongoing. But emails sent Tuesday from multiple officials told researchers to stop adding volunteers to the study out of an “abundance of caution.”
...Eli Lilly’s product is similar to a treatment designed by drug company Regeneron, which developed an antibody therapy given to President Trump after he was diagnosed with Covid-19 earlier this month. Mr. Trump has promoted the treatments, without evidence, as a “cure” for his condition, and has suggested that their approval and widespread distribution could be imminent. The week after the president was treated, both companies applied for emergency clearance for their products from the Food and Drug Administration. Eli Lilly has applied for authorization of its drug for mild cases of Covid-19, not for use in hospitalized patients like those tested in the halted trial.
Antibodies can block the coronavirus from infecting cells, and preliminary data from Eli Lilly and Regeneron have hinted they may be able to tamp down the amount of virus in an infected person’s body and reduce their symptoms.
https://www.nytimes.com/live/2020/10/13/world/coronavirus-covid?campaign_id=60&a...
78margd
About 75,000 more Americans died from COVID-19 pandemic than reported in spring and summer, study finds
Adrianna Rodriguez | Ot 12, 2020
...“There have been some conspiracy theories that the number of deaths from COVID-19 have been exaggerated,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University in Richmond. “The opposite is the case. We’re actually experiencing more death than we thought we were.”
Woolf says the deaths indirectly caused by the pandemic came from illnesses such as Alzheimer's disease, diabetes and heart disease, which sharply increased in the same five states that recorded the most COVID-19 deaths.
Delayed care, fear of seeking care or emotional crises stemming from the pandemic could have also contributed to these deaths, he says, as well as inaccurate death certificates that may have misidentified a COVID-19 death...
https://www.usatoday.com/story/news/health/2020/10/12/us-covid-deaths-75-k-more-...
----------------------------------------------------------------------
Steven H. Woolf et al. 2020. Excess Deaths From COVID-19 and Other Causes, March-July 2020 (Research Letter). JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19545 https://jamanetwork.com/journals/jama/fullarticle/2771761
Previous studies of excess deaths (the gap between observed and expected deaths) during the coronavirus disease 2019 (COVID-19) pandemic found that publicly reported COVID-19 deaths underestimated the full death toll, which includes documented and undocumented deaths from the virus and non–COVID-19 deaths caused by disruptions from the pandemic.1,2 A previous analysis found that COVID-19 was cited in only 65% of excess deaths in the first weeks of the pandemic (March-April 2020); deaths from non–COVID-19 causes (eg, Alzheimer disease, diabetes, heart disease) increased sharply in 5 states with the most COVID-19 deaths.1 This study updates through August 1, 2020, the estimate of excess deaths and explores temporal relationships with state reopenings (lifting of coronavirus restrictions)...
Results
Between March 1 and August 1, 2020, 1 336 561 deaths occurred in the US, a 20% increase over expected deaths ... The 10 states with the highest per capita rate of excess deaths were New York, New Jersey, Massachusetts, Louisiana, Arizona, Mississippi, Maryland, Delaware, Rhode Island, and Michigan. The states with the highest per capita rate of excess deaths changed from week to week (Video). The increase in absolute deaths in these states relative to expected values ranged from 22% in Rhode Island and Michigan to 65% in New York (Table). Three states with the highest death rates (New Jersey, New York, and Massachusetts) accounted for 30% of US excess deaths but had the shortest epidemics (ED90 less than 10 weeks). States that experienced acute surges in April (and reopened later) had shorter epidemics that returned to baseline in May, whereas states that reopened earlier experienced more protracted increases in excess deaths that extended into the summer (Figure).
Of the 225 530 excess deaths, 150 541 (67%) were attributed to COVID-19. Joinpoint analyses revealed an increase in deaths attributed to causes other than COVID-19, with 2 reaching statistical significance. US mortality rates for heart disease increased between weeks ending March 21 and April 11 (APC*, 5.1 ...), driven by the spring surge in COVID-19 cases. Mortality rates for Alzheimer disease/dementia increased twice, between weeks ending March 21 and April 11 (APC, 7.3 ...) and between weeks ending June 6 and July 25 (APC, 1.5 ...), the latter coinciding with the summer surge in sunbelt states.
Discussion
Although total US death counts are remarkably consistent from year to year, US deaths increased by 20% during March-July 2020. COVID-19 was a documented cause of only 67% of these excess deaths. Some states had greater difficulty than others in containing community spread, causing protracted elevations in excess deaths that extended into the summer. US deaths attributed to some noninfectious causes increased during COVID-19 surges. Excess deaths attributed to causes other than COVID-19 could reflect deaths from unrecognized or undocumented infection with severe acute respiratory syndrome coronavirus 2 or deaths among uninfected patients resulting from disruptions produced by the pandemic. Study limitations include the reliance on provisional data, inaccuracies in death certificates, and assumptions applied to the model.
* Annual Percent Change
Adrianna Rodriguez | Ot 12, 2020
...“There have been some conspiracy theories that the number of deaths from COVID-19 have been exaggerated,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University in Richmond. “The opposite is the case. We’re actually experiencing more death than we thought we were.”
Woolf says the deaths indirectly caused by the pandemic came from illnesses such as Alzheimer's disease, diabetes and heart disease, which sharply increased in the same five states that recorded the most COVID-19 deaths.
Delayed care, fear of seeking care or emotional crises stemming from the pandemic could have also contributed to these deaths, he says, as well as inaccurate death certificates that may have misidentified a COVID-19 death...
https://www.usatoday.com/story/news/health/2020/10/12/us-covid-deaths-75-k-more-...
----------------------------------------------------------------------
Steven H. Woolf et al. 2020. Excess Deaths From COVID-19 and Other Causes, March-July 2020 (Research Letter). JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19545 https://jamanetwork.com/journals/jama/fullarticle/2771761
Previous studies of excess deaths (the gap between observed and expected deaths) during the coronavirus disease 2019 (COVID-19) pandemic found that publicly reported COVID-19 deaths underestimated the full death toll, which includes documented and undocumented deaths from the virus and non–COVID-19 deaths caused by disruptions from the pandemic.1,2 A previous analysis found that COVID-19 was cited in only 65% of excess deaths in the first weeks of the pandemic (March-April 2020); deaths from non–COVID-19 causes (eg, Alzheimer disease, diabetes, heart disease) increased sharply in 5 states with the most COVID-19 deaths.1 This study updates through August 1, 2020, the estimate of excess deaths and explores temporal relationships with state reopenings (lifting of coronavirus restrictions)...
Results
Between March 1 and August 1, 2020, 1 336 561 deaths occurred in the US, a 20% increase over expected deaths ... The 10 states with the highest per capita rate of excess deaths were New York, New Jersey, Massachusetts, Louisiana, Arizona, Mississippi, Maryland, Delaware, Rhode Island, and Michigan. The states with the highest per capita rate of excess deaths changed from week to week (Video). The increase in absolute deaths in these states relative to expected values ranged from 22% in Rhode Island and Michigan to 65% in New York (Table). Three states with the highest death rates (New Jersey, New York, and Massachusetts) accounted for 30% of US excess deaths but had the shortest epidemics (ED90 less than 10 weeks). States that experienced acute surges in April (and reopened later) had shorter epidemics that returned to baseline in May, whereas states that reopened earlier experienced more protracted increases in excess deaths that extended into the summer (Figure).
Of the 225 530 excess deaths, 150 541 (67%) were attributed to COVID-19. Joinpoint analyses revealed an increase in deaths attributed to causes other than COVID-19, with 2 reaching statistical significance. US mortality rates for heart disease increased between weeks ending March 21 and April 11 (APC*, 5.1 ...), driven by the spring surge in COVID-19 cases. Mortality rates for Alzheimer disease/dementia increased twice, between weeks ending March 21 and April 11 (APC, 7.3 ...) and between weeks ending June 6 and July 25 (APC, 1.5 ...), the latter coinciding with the summer surge in sunbelt states.
Discussion
Although total US death counts are remarkably consistent from year to year, US deaths increased by 20% during March-July 2020. COVID-19 was a documented cause of only 67% of these excess deaths. Some states had greater difficulty than others in containing community spread, causing protracted elevations in excess deaths that extended into the summer. US deaths attributed to some noninfectious causes increased during COVID-19 surges. Excess deaths attributed to causes other than COVID-19 could reflect deaths from unrecognized or undocumented infection with severe acute respiratory syndrome coronavirus 2 or deaths among uninfected patients resulting from disruptions produced by the pandemic. Study limitations include the reliance on provisional data, inaccuracies in death certificates, and assumptions applied to the model.
* Annual Percent Change
79margd
Is Canada focused on the wrong COVID-19 tests (6:04)
Oct 11, 2020
There is a growing push to have Canada focus on COVID-19 tests that detect who is contagious rather than who is positive for the virus. These tests are available elsewhere in the world, cheaper and can be done at home, but they aren’t approved in Canada.
https://www.youtube.com/watch?v=hQwvCgRDxtA
Oct 11, 2020
There is a growing push to have Canada focus on COVID-19 tests that detect who is contagious rather than who is positive for the virus. These tests are available elsewhere in the world, cheaper and can be done at home, but they aren’t approved in Canada.
https://www.youtube.com/watch?v=hQwvCgRDxtA
80margd
About 75,000 more Americans died from COVID-19 pandemic than reported in spring and summer, study finds
Adrianna Rodriguez | Ot 12, 2020
...“There have been some conspiracy theories that the number of deaths from COVID-19 have been exaggerated,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University in Richmond. “The opposite is the case. We’re actually experiencing more death than we thought we were.”
Woolf says the deaths indirectly caused by the pandemic came from illnesses such as Alzheimer's disease, diabetes and heart disease, which sharply increased in the same five states that recorded the most COVID-19 deaths.
Delayed care, fear of seeking care or emotional crises stemming from the pandemic could have also contributed to these deaths, he says, as well as inaccurate death certificates that may have misidentified a COVID-19 death...
https://www.usatoday.com/story/news/health/2020/10/12/us-covid-deaths-75-k-more-...
----------------------------------------------------------------------
Steven H. Woolf et al. 2020. Excess Deaths From COVID-19 and Other Causes, March-July 2020 (Research Letter). JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19545 https://jamanetwork.com/journals/jama/fullarticle/2771761
Previous studies of excess deaths (the gap between observed and expected deaths) during the coronavirus disease 2019 (COVID-19) pandemic found that publicly reported COVID-19 deaths underestimated the full death toll, which includes documented and undocumented deaths from the virus and non–COVID-19 deaths caused by disruptions from the pandemic.1,2 A previous analysis found that COVID-19 was cited in only 65% of excess deaths in the first weeks of the pandemic (March-April 2020); deaths from non–COVID-19 causes (eg, Alzheimer disease, diabetes, heart disease) increased sharply in 5 states with the most COVID-19 deaths.1 This study updates through August 1, 2020, the estimate of excess deaths and explores temporal relationships with state reopenings (lifting of coronavirus restrictions)...
Results
Between March 1 and August 1, 2020, 1 336 561 deaths occurred in the US, a 20% increase over expected deaths ... The 10 states with the highest per capita rate of excess deaths were New York, New Jersey, Massachusetts, Louisiana, Arizona, Mississippi, Maryland, Delaware, Rhode Island, and Michigan. The states with the highest per capita rate of excess deaths changed from week to week (Video). The increase in absolute deaths in these states relative to expected values ranged from 22% in Rhode Island and Michigan to 65% in New York (Table). Three states with the highest death rates (New Jersey, New York, and Massachusetts) accounted for 30% of US excess deaths but had the shortest epidemics (ED90 less than 10 weeks). States that experienced acute surges in April (and reopened later) had shorter epidemics that returned to baseline in May, whereas states that reopened earlier experienced more protracted increases in excess deaths that extended into the summer (Figure).
Of the 225 530 excess deaths, 150 541 (67%) were attributed to COVID-19. Joinpoint analyses revealed an increase in deaths attributed to causes other than COVID-19, with 2 reaching statistical significance. US mortality rates for heart disease increased between weeks ending March 21 and April 11 (APC*, 5.1 ...), driven by the spring surge in COVID-19 cases. Mortality rates for Alzheimer disease/dementia increased twice, between weeks ending March 21 and April 11 (APC, 7.3 ...) and between weeks ending June 6 and July 25 (APC, 1.5 ...), the latter coinciding with the summer surge in sunbelt states.
Discussion
Although total US death counts are remarkably consistent from year to year, US deaths increased by 20% during March-July 2020. COVID-19 was a documented cause of only 67% of these excess deaths. Some states had greater difficulty than others in containing community spread, causing protracted elevations in excess deaths that extended into the summer. US deaths attributed to some noninfectious causes increased during COVID-19 surges. Excess deaths attributed to causes other than COVID-19 could reflect deaths from unrecognized or undocumented infection with severe acute respiratory syndrome coronavirus 2 or deaths among uninfected patients resulting from disruptions produced by the pandemic. Study limitations include the reliance on provisional data, inaccuracies in death certificates, and assumptions applied to the model.
* Annual Percent Change
Adrianna Rodriguez | Ot 12, 2020
...“There have been some conspiracy theories that the number of deaths from COVID-19 have been exaggerated,” said Dr. Steven Woolf, director emeritus of the Center on Society and Health at Virginia Commonwealth University in Richmond. “The opposite is the case. We’re actually experiencing more death than we thought we were.”
Woolf says the deaths indirectly caused by the pandemic came from illnesses such as Alzheimer's disease, diabetes and heart disease, which sharply increased in the same five states that recorded the most COVID-19 deaths.
Delayed care, fear of seeking care or emotional crises stemming from the pandemic could have also contributed to these deaths, he says, as well as inaccurate death certificates that may have misidentified a COVID-19 death...
https://www.usatoday.com/story/news/health/2020/10/12/us-covid-deaths-75-k-more-...
----------------------------------------------------------------------
Steven H. Woolf et al. 2020. Excess Deaths From COVID-19 and Other Causes, March-July 2020 (Research Letter). JAMA. Published online October 12, 2020. doi:10.1001/jama.2020.19545 https://jamanetwork.com/journals/jama/fullarticle/2771761
Previous studies of excess deaths (the gap between observed and expected deaths) during the coronavirus disease 2019 (COVID-19) pandemic found that publicly reported COVID-19 deaths underestimated the full death toll, which includes documented and undocumented deaths from the virus and non–COVID-19 deaths caused by disruptions from the pandemic.1,2 A previous analysis found that COVID-19 was cited in only 65% of excess deaths in the first weeks of the pandemic (March-April 2020); deaths from non–COVID-19 causes (eg, Alzheimer disease, diabetes, heart disease) increased sharply in 5 states with the most COVID-19 deaths.1 This study updates through August 1, 2020, the estimate of excess deaths and explores temporal relationships with state reopenings (lifting of coronavirus restrictions)...
Results
Between March 1 and August 1, 2020, 1 336 561 deaths occurred in the US, a 20% increase over expected deaths ... The 10 states with the highest per capita rate of excess deaths were New York, New Jersey, Massachusetts, Louisiana, Arizona, Mississippi, Maryland, Delaware, Rhode Island, and Michigan. The states with the highest per capita rate of excess deaths changed from week to week (Video). The increase in absolute deaths in these states relative to expected values ranged from 22% in Rhode Island and Michigan to 65% in New York (Table). Three states with the highest death rates (New Jersey, New York, and Massachusetts) accounted for 30% of US excess deaths but had the shortest epidemics (ED90 less than 10 weeks). States that experienced acute surges in April (and reopened later) had shorter epidemics that returned to baseline in May, whereas states that reopened earlier experienced more protracted increases in excess deaths that extended into the summer (Figure).
Of the 225 530 excess deaths, 150 541 (67%) were attributed to COVID-19. Joinpoint analyses revealed an increase in deaths attributed to causes other than COVID-19, with 2 reaching statistical significance. US mortality rates for heart disease increased between weeks ending March 21 and April 11 (APC*, 5.1 ...), driven by the spring surge in COVID-19 cases. Mortality rates for Alzheimer disease/dementia increased twice, between weeks ending March 21 and April 11 (APC, 7.3 ...) and between weeks ending June 6 and July 25 (APC, 1.5 ...), the latter coinciding with the summer surge in sunbelt states.
Discussion
Although total US death counts are remarkably consistent from year to year, US deaths increased by 20% during March-July 2020. COVID-19 was a documented cause of only 67% of these excess deaths. Some states had greater difficulty than others in containing community spread, causing protracted elevations in excess deaths that extended into the summer. US deaths attributed to some noninfectious causes increased during COVID-19 surges. Excess deaths attributed to causes other than COVID-19 could reflect deaths from unrecognized or undocumented infection with severe acute respiratory syndrome coronavirus 2 or deaths among uninfected patients resulting from disruptions produced by the pandemic. Study limitations include the reliance on provisional data, inaccuracies in death certificates, and assumptions applied to the model.
* Annual Percent Change
81margd
Cross-reactivity (SARS and COVID-19):
Antibodies in serum samples from patients infected during the 2003 SARS-CoV outbreak effectively neutralized SARS-CoV-2 infection in cultured cells.
"Interestingly, we found that a palm civet SARS-CoV-derived RBD elicited more potent cross-neutralizing responses in immunized animals than the RBD (Receptor Binding Domain) from a human SARS-CoV strain, informing a strategy to develop universe vaccines against emerging CoVs."
Yuanmei Zhu et al. 2020. Cross-reactive neutralization of SARS-CoV-2 by serum antibodies from recovered SARS patients and immunized animals (Research Article) Science Advances 09 Oct 2020:eabc9999 DOI: 10.1126/sciadv.abc9999 https://advances.sciencemag.org/content/early/2020/10/08/sciadv.abc9999
Abstract
The current COVID-19 pandemic is caused by SARS-CoV-2, a novel coronavirus genetically close to SARS-CoV, thus it is important to define the between antigenic cross-reactivity and neutralization. In this study, we first analyzed 20 convalescent serum samples collected from SARS-CoV infected individuals during the 2003 SARS outbreak. All patient sera reacted strongly with the S1 subunit and receptor-binding domain (RBD) of SARS-CoV, cross-reacted with the S ectodomain, S1, RBD, and S2 proteins of SARS-CoV-2, and neutralized both SARS-CoV and SARS-CoV-2 S protein-driven infections. Multiple panels of antisera from mice and rabbits immunized with a full-length S and RBD immunogens of SARS-CoV were also characterized, verifying the cross-reactive neutralization against SARS-CoV-2. Interestingly, we found that a palm civet SARS-CoV-derived RBD elicited more potent cross-neutralizing responses in immunized animals than the RBD from a human SARS-CoV strain, informing a strategy to develop universe vaccines against emerging CoVs.
Antibodies in serum samples from patients infected during the 2003 SARS-CoV outbreak effectively neutralized SARS-CoV-2 infection in cultured cells.
"Interestingly, we found that a palm civet SARS-CoV-derived RBD elicited more potent cross-neutralizing responses in immunized animals than the RBD (Receptor Binding Domain) from a human SARS-CoV strain, informing a strategy to develop universe vaccines against emerging CoVs."
Yuanmei Zhu et al. 2020. Cross-reactive neutralization of SARS-CoV-2 by serum antibodies from recovered SARS patients and immunized animals (Research Article) Science Advances 09 Oct 2020:eabc9999 DOI: 10.1126/sciadv.abc9999 https://advances.sciencemag.org/content/early/2020/10/08/sciadv.abc9999
Abstract
The current COVID-19 pandemic is caused by SARS-CoV-2, a novel coronavirus genetically close to SARS-CoV, thus it is important to define the between antigenic cross-reactivity and neutralization. In this study, we first analyzed 20 convalescent serum samples collected from SARS-CoV infected individuals during the 2003 SARS outbreak. All patient sera reacted strongly with the S1 subunit and receptor-binding domain (RBD) of SARS-CoV, cross-reacted with the S ectodomain, S1, RBD, and S2 proteins of SARS-CoV-2, and neutralized both SARS-CoV and SARS-CoV-2 S protein-driven infections. Multiple panels of antisera from mice and rabbits immunized with a full-length S and RBD immunogens of SARS-CoV were also characterized, verifying the cross-reactive neutralization against SARS-CoV-2. Interestingly, we found that a palm civet SARS-CoV-derived RBD elicited more potent cross-neutralizing responses in immunized animals than the RBD from a human SARS-CoV strain, informing a strategy to develop universe vaccines against emerging CoVs.
82margd
Hearing loss after COVID-19: not common(?), but sheesh!
Young people deliberately exposing themselves obviously over-learned early reports that they are at less risk ( https://www.sltrib.com/news/education/2020/10/13/byu-idaho-says-students/ )
Foteini Stefania Koumpa et al. 2020. Sudden irreversible hearing loss post COVID-19. BMJ Case Reports. Volume 13, Issue 11 https://casereports.bmj.com/content/13/11/e238419
Abstract
Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.
...Discussion
...Despite the low numbers of studies, it is significant to consider the possibility of a relationship between COVID-19 and SSNHL. Histopathological studies of patients with SSNHL have shown loss of hair cells and supporting cells of the organ of Corti without inflammatory cell infiltrate, suggesting that the pathology of idiopathic SSNHL may be related to cellular stress pathways... SARS-CoV-2 is believed to bind to the ACE-2 receptor which is present on alveolar epithelial cells and endothelial cells. It was recently also seen to be expressed in epithelial cells of the middle ear, as well as the stria vascularis and spiral ganglion in mice... Furthermore, SARS-CoV-2 causes an inflammatory response and an increase in cytokines such as tumour necrosis factor-α, interleukin 1 and interleukin 6.... Both a direct entry into the cochlea and inflammation leading to cell stress are mechanisms that have been implicated in persistent sensorineural hearing loss and could be occurring in the case of the SARS-CoV-2 infection.
This is the first reported case of sensorineural hearing loss following COVID-19 infection in the UK. Given the widespread presence of the virus in the population and the significant morbidity of hearing loss, it is important to investigate this further. This is especially true given the need to promptly identify and treat the hearing loss15 and the current difficulty in accessing medical services. We suggest that patients are asked about hearing loss in the ITU environments when applicable, and any patient reporting acute hearing loss should be referred to otolaryngology on an emergency basis.
Young people deliberately exposing themselves obviously over-learned early reports that they are at less risk ( https://www.sltrib.com/news/education/2020/10/13/byu-idaho-says-students/ )
Foteini Stefania Koumpa et al. 2020. Sudden irreversible hearing loss post COVID-19. BMJ Case Reports. Volume 13, Issue 11 https://casereports.bmj.com/content/13/11/e238419
Abstract
Sudden onset sensorineural hearing loss (SSNHL) is frequently seen by otolaryngologists. The exact pathophysiology of the disease is still unknown, with the most likely causative factor being following a viral infection. Immediate steroids are the best treatment to improve prognosis. Despite a plethora of papers in the literature describing SSNHL, there are only a few reported cases of hearing loss following COVID-19, none of which have been reported in the UK. This paper presents the first UK case of SSNHL following COVID-19. Physical examination and imaging excluded any other cause of hearing loss. A literature review showed that four other cases have been previously described. Hearing loss can be a significant cause of morbidity and can easily be missed in the intensive care setting. Being aware and screening for SSNHL following COVID-19 enables an early course of steroids, which offers the best chance of recovering hearing.
...Discussion
...Despite the low numbers of studies, it is significant to consider the possibility of a relationship between COVID-19 and SSNHL. Histopathological studies of patients with SSNHL have shown loss of hair cells and supporting cells of the organ of Corti without inflammatory cell infiltrate, suggesting that the pathology of idiopathic SSNHL may be related to cellular stress pathways... SARS-CoV-2 is believed to bind to the ACE-2 receptor which is present on alveolar epithelial cells and endothelial cells. It was recently also seen to be expressed in epithelial cells of the middle ear, as well as the stria vascularis and spiral ganglion in mice... Furthermore, SARS-CoV-2 causes an inflammatory response and an increase in cytokines such as tumour necrosis factor-α, interleukin 1 and interleukin 6.... Both a direct entry into the cochlea and inflammation leading to cell stress are mechanisms that have been implicated in persistent sensorineural hearing loss and could be occurring in the case of the SARS-CoV-2 infection.
This is the first reported case of sensorineural hearing loss following COVID-19 infection in the UK. Given the widespread presence of the virus in the population and the significant morbidity of hearing loss, it is important to investigate this further. This is especially true given the need to promptly identify and treat the hearing loss15 and the current difficulty in accessing medical services. We suggest that patients are asked about hearing loss in the ITU environments when applicable, and any patient reporting acute hearing loss should be referred to otolaryngology on an emergency basis.
83margd
White House embraces a declaration from scientists that opposes lockdowns and relies on ‘herd immunity.’
Sheryl Gay Stolberg | Oct. 13, 2020
https://www.nytimes.com/2020/10/13/world/white-house-embraces-a-declaration-from...
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The Great Barrington Declaration
https://gbdeclaration.org/
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White House Cites Herd-Immunity Petition Signed by Fake Experts Including ‘Dr. Johnny Bananas’
Jamie Ross | Oct. 14, 2020
The White House has reportedly embraced a declaration by a group of scientists arguing for a “herd immunity” strategy to deal with America’s coronavirus pandemic—days after the validity of the declaration came under question due to a number of apparently fake names among its expert signatories, including “Dr. Johnny Bananas.” According to The New York Times, on a call convened Monday by the White House, two anonymous administration officials cited the petition, titled The Great Barrington Declaration, which argues that COVID-19 should be allowed to spread through the population. The declaration’s website claims the petition has been signed by more than 15,000 scientists, but, last week, Sky News found dozens of fake names on the list of medical signatories, including Dr. I.P. Freely, Dr. Person Fakename, and Dr. Johnny Bananas.
https://www.thedailybeast.com/white-house-cites-herd-immunity-petition-signed-by...
_________________________________________
The John Snow Memorandum
Dr. Angela Rasmussen (virologist) @angie_rasmussen | 6:31 PM Oct 14, 2020:
Proud to be a signatory of the #JohnSnowMemorandum.
This statement, out now in @TheLancet, is the scientific consensus on the COVID-19 pandemic directly refutes
the Great Barrington Declaration proposal of "focused protection" as a route to herd immunity.
http://johnsnowmemo.com
And here is a link to the piece in @TheLancet
Scientific consensus on the COVID-19 pandemic: we need to act now (Correspondence)
https://thelancet.com/lancet/article/s0140-6736(20)32153-x
https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S014067362032153X....
This is named after the epidemiologist who stopped a cholera epidemic by taking the handle off the pump.
Sheryl Gay Stolberg | Oct. 13, 2020
https://www.nytimes.com/2020/10/13/world/white-house-embraces-a-declaration-from...
-------------------------------------------------------
The Great Barrington Declaration
https://gbdeclaration.org/
-------------------------------------------------------
White House Cites Herd-Immunity Petition Signed by Fake Experts Including ‘Dr. Johnny Bananas’
Jamie Ross | Oct. 14, 2020
The White House has reportedly embraced a declaration by a group of scientists arguing for a “herd immunity” strategy to deal with America’s coronavirus pandemic—days after the validity of the declaration came under question due to a number of apparently fake names among its expert signatories, including “Dr. Johnny Bananas.” According to The New York Times, on a call convened Monday by the White House, two anonymous administration officials cited the petition, titled The Great Barrington Declaration, which argues that COVID-19 should be allowed to spread through the population. The declaration’s website claims the petition has been signed by more than 15,000 scientists, but, last week, Sky News found dozens of fake names on the list of medical signatories, including Dr. I.P. Freely, Dr. Person Fakename, and Dr. Johnny Bananas.
https://www.thedailybeast.com/white-house-cites-herd-immunity-petition-signed-by...
_________________________________________
The John Snow Memorandum
Dr. Angela Rasmussen (virologist) @angie_rasmussen | 6:31 PM Oct 14, 2020:
Proud to be a signatory of the #JohnSnowMemorandum.
This statement, out now in @TheLancet, is the scientific consensus on the COVID-19 pandemic directly refutes
the Great Barrington Declaration proposal of "focused protection" as a route to herd immunity.
http://johnsnowmemo.com
And here is a link to the piece in @TheLancet
Scientific consensus on the COVID-19 pandemic: we need to act now (Correspondence)
https://thelancet.com/lancet/article/s0140-6736(20)32153-x
https://marlin-prod.literatumonline.com/pb-assets/Lancet/pdfs/S014067362032153X....
This is named after the epidemiologist who stopped a cholera epidemic by taking the handle off the pump.
84John5918
Ending Covid-19 via herd immunity is 'a dangerous fallacy' (Guardian)
The concept of ending the Covid pandemic through herd immunity is “a dangerous fallacy unsupported by scientific evidence”, say 80 researchers in a warning letter published by a leading medical journal.
The international signatories of the open letter in the Lancet say the interest in herd immunity comes from “widespread demoralisation and diminishing trust” as a result of restrictions being reimposed in many countries because of surging infections in a second wave.
The suggestion that the way out is by protecting the vulnerable and allowing the virus to transmit among those less at risk is flawed, they say...
The concept of ending the Covid pandemic through herd immunity is “a dangerous fallacy unsupported by scientific evidence”, say 80 researchers in a warning letter published by a leading medical journal.
The international signatories of the open letter in the Lancet say the interest in herd immunity comes from “widespread demoralisation and diminishing trust” as a result of restrictions being reimposed in many countries because of surging infections in a second wave.
The suggestion that the way out is by protecting the vulnerable and allowing the virus to transmit among those less at risk is flawed, they say...
85margd
#83 and 84, contd.
Proposal to hasten herd immunity to the coronavirus grabs White House attention but appalls top scientists
Joel Achenbach | Oct. 14, 2020
Maverick scientists who call for allowing the coronavirus to spread freely at “natural” rates among healthy young people while keeping most aspects of the economy up and running have found an audience inside the White House and at least one state capitol.
The scientists met last week with Health and Human Services Secretary Alex Azar and Scott Atlas, a neuroradiologist who has emerged as an influential adviser to President Trump on the pandemic.
When asked for comment, HHS referred a reporter to Azar’s subsequent Twitter statement about the meeting: “We heard strong reinforcement of the Trump Administration’s strategy of aggressively protecting the vulnerable while opening schools and the workplace.”
A senior administration official told reporters in a background briefing call Monday that the proposed strategy — which has been denounced by other infectious-disease experts and called “fringe” and “dangerous” by National Institutes of Health Director Francis Collins — supports what has been Trump’s policy for months.
...The three scientists pushing the strategy, which they call Focused Protection, have distinguished academic appointments. Martin Kulldorff is an epidemiologist at Harvard University. Sunetra Gupta is an epidemiologist at the University of Oxford. Jay Bhattacharya is a physician and health economist at Stanford Medical School.
They have codified their argument in the form of a document posted online that called itself the Great Barrington Declaration, named after the town in Massachusetts where it was unveiled on Oct. 4 in a ceremony at a libertarian think tank.
...The online document claims that thousands of doctors and scientists have signed it, as well as hundreds of thousands of people in the general public. Britain’s Sky News reported last week that some of the names are transparently fake, such as “Dr. Johnny Bananas” and “Dr. Person Fakename.”
...the Focused Protection idea already has found a purchase in Florida: Kulldorff, Gupta and Bhattacharya participated in a virtual roundtable discussion with Florida Gov. Ron DeSantis (R) in late September.
...Critics of Focused Protection say the idea is impractical, unethical and potentially deadly. There is no way, they say, to segregate society neatly by levels of vulnerability. Many vulnerable people live in multigenerational households. And although it is true that younger people are unlikely to die of covid-19, they can still become sick, potentially with chronic lung damage or other long-duration symptoms known as “long covid.”
https://www.washingtonpost.com/health/covid-herd-immunity/2020/10/10/3910251c-0a...
Proposal to hasten herd immunity to the coronavirus grabs White House attention but appalls top scientists
Joel Achenbach | Oct. 14, 2020
Maverick scientists who call for allowing the coronavirus to spread freely at “natural” rates among healthy young people while keeping most aspects of the economy up and running have found an audience inside the White House and at least one state capitol.
The scientists met last week with Health and Human Services Secretary Alex Azar and Scott Atlas, a neuroradiologist who has emerged as an influential adviser to President Trump on the pandemic.
When asked for comment, HHS referred a reporter to Azar’s subsequent Twitter statement about the meeting: “We heard strong reinforcement of the Trump Administration’s strategy of aggressively protecting the vulnerable while opening schools and the workplace.”
A senior administration official told reporters in a background briefing call Monday that the proposed strategy — which has been denounced by other infectious-disease experts and called “fringe” and “dangerous” by National Institutes of Health Director Francis Collins — supports what has been Trump’s policy for months.
...The three scientists pushing the strategy, which they call Focused Protection, have distinguished academic appointments. Martin Kulldorff is an epidemiologist at Harvard University. Sunetra Gupta is an epidemiologist at the University of Oxford. Jay Bhattacharya is a physician and health economist at Stanford Medical School.
They have codified their argument in the form of a document posted online that called itself the Great Barrington Declaration, named after the town in Massachusetts where it was unveiled on Oct. 4 in a ceremony at a libertarian think tank.
...The online document claims that thousands of doctors and scientists have signed it, as well as hundreds of thousands of people in the general public. Britain’s Sky News reported last week that some of the names are transparently fake, such as “Dr. Johnny Bananas” and “Dr. Person Fakename.”
...the Focused Protection idea already has found a purchase in Florida: Kulldorff, Gupta and Bhattacharya participated in a virtual roundtable discussion with Florida Gov. Ron DeSantis (R) in late September.
...Critics of Focused Protection say the idea is impractical, unethical and potentially deadly. There is no way, they say, to segregate society neatly by levels of vulnerability. Many vulnerable people live in multigenerational households. And although it is true that younger people are unlikely to die of covid-19, they can still become sick, potentially with chronic lung damage or other long-duration symptoms known as “long covid.”
https://www.washingtonpost.com/health/covid-herd-immunity/2020/10/10/3910251c-0a...
86John5918
And >69 John5918:, not that the current US administration would listen to WHO.
87margd
Did Lockdowns Lower Premature Births? A New Study Adds Evidence
Elizabeth Preston | Oct. 15, 2020
Dutch researchers say the “impact was real,” adding to hopes that doctors will learn more about factors contributing to preterm birth.
...With their large data set, the researchers compared early births in windows one to four months before and after the lockdown. Looking at the same windows in earlier years let them account for any other trends, such as seasonal changes in premature birth. No matter which windows they used, the researchers saw that premature births had dropped after March 9, when the government in the Netherlands began warning the public to take more hygiene measures and to stay home if they had symptoms or possible exposures to the virus. Within the next week, schools and workplaces began to close down.
...The Dutch study even hinted that the drop in preterm births was limited to wealthier neighborhoods, although the result wasn’t statistically significant....
https://www.nytimes.com/2020/10/15/health/covid-premature-births-lockdown.html
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Jasper V Been et al. 2020. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. The Lancet Public Health (October 13, 2020) DOI:https://doi.org/10.1016/S2468-2667(20)30223-1
Summary
Background
Preterm birth is the leading cause of child mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that numbers of preterm births greatly reduced following implementation of policy measures aimed at mitigating the effects of the COVID-19 pandemic. We aimed to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on March 9, March 15, and March 23, 2020, on the incidence of preterm birth.
Methods
We used a national quasi-experimental difference-in-regression-discontinuity approach. We used data from the neonatal dried blood spot screening programme (2010–20) cross-validated against national perinatal registry data. Stratified analyses were done according to gestational age subgroups, and sensitivity analyses were done to assess robustness of the findings. We explored potential effect modification by neighbourhood socioeconomic status, sex, and small-for-gestational-age status.
Findings
Data on 1 599 547 singleton neonates were available, including 56 720 births that occurred after implementation of COVID-19 mitigation measures on March 9, 2020. Consistent reductions in the incidence of preterm birth were seen across various time windows surrounding March 9 (± 2 months (n=531 823) odds ratio (OR) 0·77, 95% CI 0·66–0·91, p=0·0026; ± 3 months (n=796 531) OR 0·85, 0·73–0·98, p=0·028; ± 4 months (n=1 066 872) OR 0·84, 0·73–0·97, p=0·023). Decreases in incidence observed following the March 15 measures were of smaller magnitude, but not statistically significant. No changes were observed after March 23. Reductions in the incidence of preterm births after March 9 were consistent across gestational age strata and robust in sensitivity analyses. They appeared confined to neighbourhoods of high socioeconomic status, but effect modification was not statistically significant.
Interpretation
In this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a substantial reduction in the incidence of preterm births in the following months, in agreement with preliminary observations elsewhere. Integration of comparable data from across the globe is needed to further substantiate these findings and start exploring underlying mechanisms.
Elizabeth Preston | Oct. 15, 2020
Dutch researchers say the “impact was real,” adding to hopes that doctors will learn more about factors contributing to preterm birth.
...With their large data set, the researchers compared early births in windows one to four months before and after the lockdown. Looking at the same windows in earlier years let them account for any other trends, such as seasonal changes in premature birth. No matter which windows they used, the researchers saw that premature births had dropped after March 9, when the government in the Netherlands began warning the public to take more hygiene measures and to stay home if they had symptoms or possible exposures to the virus. Within the next week, schools and workplaces began to close down.
...The Dutch study even hinted that the drop in preterm births was limited to wealthier neighborhoods, although the result wasn’t statistically significant....
https://www.nytimes.com/2020/10/15/health/covid-premature-births-lockdown.html
--------------------------------------------------------
Jasper V Been et al. 2020. Impact of COVID-19 mitigation measures on the incidence of preterm birth: a national quasi-experimental study. The Lancet Public Health (October 13, 2020) DOI:https://doi.org/10.1016/S2468-2667(20)30223-1
Summary
Background
Preterm birth is the leading cause of child mortality globally, with many survivors experiencing long-term adverse consequences. Preliminary evidence suggests that numbers of preterm births greatly reduced following implementation of policy measures aimed at mitigating the effects of the COVID-19 pandemic. We aimed to study the impact of the COVID-19 mitigation measures implemented in the Netherlands in a stepwise fashion on March 9, March 15, and March 23, 2020, on the incidence of preterm birth.
Methods
We used a national quasi-experimental difference-in-regression-discontinuity approach. We used data from the neonatal dried blood spot screening programme (2010–20) cross-validated against national perinatal registry data. Stratified analyses were done according to gestational age subgroups, and sensitivity analyses were done to assess robustness of the findings. We explored potential effect modification by neighbourhood socioeconomic status, sex, and small-for-gestational-age status.
Findings
Data on 1 599 547 singleton neonates were available, including 56 720 births that occurred after implementation of COVID-19 mitigation measures on March 9, 2020. Consistent reductions in the incidence of preterm birth were seen across various time windows surrounding March 9 (± 2 months (n=531 823) odds ratio (OR) 0·77, 95% CI 0·66–0·91, p=0·0026; ± 3 months (n=796 531) OR 0·85, 0·73–0·98, p=0·028; ± 4 months (n=1 066 872) OR 0·84, 0·73–0·97, p=0·023). Decreases in incidence observed following the March 15 measures were of smaller magnitude, but not statistically significant. No changes were observed after March 23. Reductions in the incidence of preterm births after March 9 were consistent across gestational age strata and robust in sensitivity analyses. They appeared confined to neighbourhoods of high socioeconomic status, but effect modification was not statistically significant.
Interpretation
In this national quasi-experimental study, initial implementation of COVID-19 mitigation measures was associated with a substantial reduction in the incidence of preterm births in the following months, in agreement with preliminary observations elsewhere. Integration of comparable data from across the globe is needed to further substantiate these findings and start exploring underlying mechanisms.
88margd
Covid-19 Outbreaks Led to Dangerous Delay in Cancer Diagnoses
‘Cancer doesn’t take a pause’ but amid the pandemic, many Americans avoided oncology screenings and other potentially lifesaving procedures
Anna Wilde Mathews and Mike Cherney | Oct. 15, 2020
...“There’s really almost no way that doesn’t turn into increased mortality,” with the full effects likely to play out over a decade, said Norman E. “Ned” Sharpless, director of the National Cancer Institute. Missed screenings and other pandemic-related impacts on care could result in about 10,000 additional deaths from breast and colon cancer alone over the next 10 years, the NCI projected earlier this year. Dr. Sharpless said the estimate now appears low.
Cancer-care provider 21st Century Oncology, which has 300 locations around the U.S., said about 18% of its newly diagnosed breast-cancer patients this year through August had an advanced stage of the disease, compared with 12% in all of 2019. From 2015 to 2019, the share of its breast-cancer cases detected at an advanced stage was between 11% and 12.5%. The provider has also seen a higher proportion of its lung-cancer patients arriving with a more advanced stage of the disease this year.
...The early data on cancer underscore concerns that the negative health impact of the coronavirus extends well beyond the direct effects of Covid-19. This year, deaths tied to a range of medical conditions—from Alzheimer’s disease to heart attacks—have exceeded those of previous years in what physicians and researchers say reflects stress from the pandemic and deferred medical care...
https://www.wsj.com/articles/covid-19-outbreaks-led-to-dangerous-delay-in-cancer...
‘Cancer doesn’t take a pause’ but amid the pandemic, many Americans avoided oncology screenings and other potentially lifesaving procedures
Anna Wilde Mathews and Mike Cherney | Oct. 15, 2020
...“There’s really almost no way that doesn’t turn into increased mortality,” with the full effects likely to play out over a decade, said Norman E. “Ned” Sharpless, director of the National Cancer Institute. Missed screenings and other pandemic-related impacts on care could result in about 10,000 additional deaths from breast and colon cancer alone over the next 10 years, the NCI projected earlier this year. Dr. Sharpless said the estimate now appears low.
Cancer-care provider 21st Century Oncology, which has 300 locations around the U.S., said about 18% of its newly diagnosed breast-cancer patients this year through August had an advanced stage of the disease, compared with 12% in all of 2019. From 2015 to 2019, the share of its breast-cancer cases detected at an advanced stage was between 11% and 12.5%. The provider has also seen a higher proportion of its lung-cancer patients arriving with a more advanced stage of the disease this year.
...The early data on cancer underscore concerns that the negative health impact of the coronavirus extends well beyond the direct effects of Covid-19. This year, deaths tied to a range of medical conditions—from Alzheimer’s disease to heart attacks—have exceeded those of previous years in what physicians and researchers say reflects stress from the pandemic and deferred medical care...
https://www.wsj.com/articles/covid-19-outbreaks-led-to-dangerous-delay-in-cancer...
89margd
Our recent work examining therapeutic benefit of convalescant plasma treatment of SARSCoV2 in African Green Monkeys supports early treatment of COVID19 using donors with high neutralizing antibody titers
- Bob Cross @RobertWCross1 | 9:02 AM · Oct 15, 2020
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Robert Cross et al. 2020. Use of convalescent serum reduces severity of COVID-19 in nonhuman primates. BioRxiv (Oct 14, 2020) doi: https://doi.org/10.1101/2020.10.14.340091 https://www.biorxiv.org/content/10.1101/2020.10.14.340091v1
This article is a preprint and has not been certified by peer review
Abstract
Passive transfer of convalescent plasma or serum is a time-honored strategy for treating infectious diseases. Human convalescent plasma containing antibodies against SARS-CoV-2 is currently being used to treat COVID-19 patients. However, most patients have been treated outside of randomized clinical trials making it difficult to determine the efficacy of this approach. Here, we assessed the efficacy of convalescent sera in a newly developed African green monkey model of COVID-19. Groups of SARS-CoV-2-infected animals were treated with pooled convalescent sera containing either high or low to moderate anti-SARS-CoV-2 neutralizing antibody titers. Differences in viral load and disease pathology were minimal between monkeys that received the lower titer convalescent sera and untreated controls. However, and importantly, lower levels of SARS-CoV-2 in respiratory compartments, reduced gross and histopathological lesion severity in the lungs, and reductions in several parameters associated with coagulation and inflammatory processes were observed in monkeys that received convalescent sera versus untreated controls. Our data support human studies suggesting that convalescent plasma therapy is an effective strategy if donors with high level of antibodies against SARS-CoV-2 are employed and if recipients are at an early stage of disease.
- Bob Cross @RobertWCross1 | 9:02 AM · Oct 15, 2020
-------------------------------------------------------
Robert Cross et al. 2020. Use of convalescent serum reduces severity of COVID-19 in nonhuman primates. BioRxiv (Oct 14, 2020) doi: https://doi.org/10.1101/2020.10.14.340091 https://www.biorxiv.org/content/10.1101/2020.10.14.340091v1
This article is a preprint and has not been certified by peer review
Abstract
Passive transfer of convalescent plasma or serum is a time-honored strategy for treating infectious diseases. Human convalescent plasma containing antibodies against SARS-CoV-2 is currently being used to treat COVID-19 patients. However, most patients have been treated outside of randomized clinical trials making it difficult to determine the efficacy of this approach. Here, we assessed the efficacy of convalescent sera in a newly developed African green monkey model of COVID-19. Groups of SARS-CoV-2-infected animals were treated with pooled convalescent sera containing either high or low to moderate anti-SARS-CoV-2 neutralizing antibody titers. Differences in viral load and disease pathology were minimal between monkeys that received the lower titer convalescent sera and untreated controls. However, and importantly, lower levels of SARS-CoV-2 in respiratory compartments, reduced gross and histopathological lesion severity in the lungs, and reductions in several parameters associated with coagulation and inflammatory processes were observed in monkeys that received convalescent sera versus untreated controls. Our data support human studies suggesting that convalescent plasma therapy is an effective strategy if donors with high level of antibodies against SARS-CoV-2 are employed and if recipients are at an early stage of disease.
90margd
See map of US cases March 16-Oct 13. Yikes! (Winter is coming...)
U.S. Virus Cases Climb Toward a Third Peak
Lauren Leatherby | Oct. 15, 2020
https://www.nytimes.com/interactive/2020/10/15/us/coronavirus-cases-us-surge.htm...
U.S. Virus Cases Climb Toward a Third Peak
Lauren Leatherby | Oct. 15, 2020
https://www.nytimes.com/interactive/2020/10/15/us/coronavirus-cases-us-surge.htm...
91margd
THE SWISS CHEESE RESPIRATORY VIRUS PANDEMIC DEFENCE (Version 2)
The new version as promised (ver2).
It adds vaccines (at the end because gen1 won't simply fix everything) & tracing has been combined with the fast & sensitive testing slice.
I've combined hand & surface cleaning.
Constructive feedback welcome.
Image ( https://twitter.com/MackayIM/status/1316716840232448000 )
Version 2 also adds a slice for isolation & quarantine. The new Government Comms (includes education) & support slice reflect how essential these are to all of these interventions (especially if you're going into Iso & your livelihood is at risk) succeeding
I haven't added a "lockdown" slice although I don't see any other way to put the brakes on widespread & exponential rises in cases & hospitalizations without acknowledging that no intervention will lead to more deaths than lockdowns (unless there are studies that show otherwise?)
I'm not addressing the basics in this. For example, a good diet & exercise apply to everyday life &, I think it's fair to say, every disease whether acute, chronic, pandemic or non-communicable. Similarly, I'm not adding a "leadership" or "pre-existing immunity" slice.
- ɪᴀɴ ᴍ. ᴍᴀᴄᴋᴀʏ, ᴘʜᴅ @MackayIM | 8:25 AM · Oct 15, 2020
The new version as promised (ver2).
It adds vaccines (at the end because gen1 won't simply fix everything) & tracing has been combined with the fast & sensitive testing slice.
I've combined hand & surface cleaning.
Constructive feedback welcome.
Image ( https://twitter.com/MackayIM/status/1316716840232448000 )
Version 2 also adds a slice for isolation & quarantine. The new Government Comms (includes education) & support slice reflect how essential these are to all of these interventions (especially if you're going into Iso & your livelihood is at risk) succeeding
I haven't added a "lockdown" slice although I don't see any other way to put the brakes on widespread & exponential rises in cases & hospitalizations without acknowledging that no intervention will lead to more deaths than lockdowns (unless there are studies that show otherwise?)
I'm not addressing the basics in this. For example, a good diet & exercise apply to everyday life &, I think it's fair to say, every disease whether acute, chronic, pandemic or non-communicable. Similarly, I'm not adding a "leadership" or "pre-existing immunity" slice.
- ɪᴀɴ ᴍ. ᴍᴀᴄᴋᴀʏ, ᴘʜᴅ @MackayIM | 8:25 AM · Oct 15, 2020
92margd
Czechs to build field hospitals as COVID-19 cases soar
Reuters | 15 October 2020
PRAGUE, Oct 15 (Reuters) - The Czech Republic will start building capacity for COVID-19 patients outside of hospitals, government officials said on Thursday, as the country battles the fastest rate of infections in Europe.
Interior Minister Jan Hamacek told CTK news agency the army would start building an area for 500 hospital beds at a fairground in Prague from Saturday.
Both military and healthcare personnel will staff the makeshift hospital, Hamacek told Czech television.
COVID-19 infections have nearly doubled in October alone to a total so far of 139,290 in a country with a population of 10.7 million. The Health Ministry reported 9,544 new COVID-19 cases on Wednesday, its highest one-day tally so far.
Prime Minister Andrej Babis told reporters it was necessary to start building extra capacity and that the state would purchase 4,000 beds from hospital and nursing bed maker LINET.
"We don't have time, the outlook is not good. These numbers are catastrophic," Babis said.
The number of hospitalisations has risen 161% in October to 2,678, with 518 patientes in intensive care. Deaths have climbed to 1,172, up 75% this month.
The fast rise in cases has put strain on hospitals, which are converting general wards into COVID-19 units and cancelling non-urgent procedures to cope. The number hospitalised is six times the peak seen during the first wave of the virus.
(Reporting by Jason Hovet and Michael Kahn; Editing by Richard Pullin, Alex Richardson and Gareth Jones)
https://news.trust.org/item/20201015070150-nq7hg
Reuters | 15 October 2020
PRAGUE, Oct 15 (Reuters) - The Czech Republic will start building capacity for COVID-19 patients outside of hospitals, government officials said on Thursday, as the country battles the fastest rate of infections in Europe.
Interior Minister Jan Hamacek told CTK news agency the army would start building an area for 500 hospital beds at a fairground in Prague from Saturday.
Both military and healthcare personnel will staff the makeshift hospital, Hamacek told Czech television.
COVID-19 infections have nearly doubled in October alone to a total so far of 139,290 in a country with a population of 10.7 million. The Health Ministry reported 9,544 new COVID-19 cases on Wednesday, its highest one-day tally so far.
Prime Minister Andrej Babis told reporters it was necessary to start building extra capacity and that the state would purchase 4,000 beds from hospital and nursing bed maker LINET.
"We don't have time, the outlook is not good. These numbers are catastrophic," Babis said.
The number of hospitalisations has risen 161% in October to 2,678, with 518 patientes in intensive care. Deaths have climbed to 1,172, up 75% this month.
The fast rise in cases has put strain on hospitals, which are converting general wards into COVID-19 units and cancelling non-urgent procedures to cope. The number hospitalised is six times the peak seen during the first wave of the virus.
(Reporting by Jason Hovet and Michael Kahn; Editing by Richard Pullin, Alex Richardson and Gareth Jones)
https://news.trust.org/item/20201015070150-nq7hg
93margd
COVID-19: What role does vitamin D play?
Yella Hewings-Martinm | October 14, 2020
Studies investigating the role of vitamin D in preventing or treating COVID-19 have drawn conflicting conclusions. But should a lack of evidence stop us from topping up our vitamin D levels as the Northern Hemisphere heads toward winter?...
https://www.medicalnewstoday.com/articles/covid-19-what-role-does-vitamin-d-play
Yella Hewings-Martinm | October 14, 2020
Studies investigating the role of vitamin D in preventing or treating COVID-19 have drawn conflicting conclusions. But should a lack of evidence stop us from topping up our vitamin D levels as the Northern Hemisphere heads toward winter?...
https://www.medicalnewstoday.com/articles/covid-19-what-role-does-vitamin-d-play
94margd
Influenza drug (favipiravir) shows promise against SARS-CoV-2
James Kingsland on October 14, 2020
Researchers have found that high doses of a drug called favipiravir strongly inhibit SARS-CoV-2 in hamsters. Favipiravir also prevented infection in healthy animals that had exposure to an infected cage mate.
It takes many years to develop a potent antiviral drug from scratch for a particular viral infection. Throughout the pandemic of COVID-19 — the disease that SARS-CoV-2 causes — researchers and clinicians have, therefore, had to focus on repurposing existing drugs.
...Virologists at the Rega Institute for Medical Research in Leuven, Belgium, have now developed a model of COVID-19 in Syrian hamsters, which they hope will provide more reliable information before the results of clinical trials become available.
They have already used their animal model to test different doses of favipiravir, an antiviral drug that has had approval in Japan since 2014 to treat pandemic influenza infections.
...The researchers found that while low doses of the drug gave poor results against SARS-CoV-2, high doses were effective.
The team has also used the (hamster) model to confirm that hydroxychloroquine (while effective in cell culture) is ineffective (in animal model).
...favipiravir significantly reduced the number of viable virus particles present in (exposed) hamsters’ lungs, with higher doses leading to a more significant reduction.
Of the eight animals that received the highest dose, for example, six had no viable virus remaining in their lungs following the treatment.
Damage to their lungs was also less than that in the untreated animals, and there were no signs of adverse effects.
Similarly, high doses of favipiravir prevented healthy hamsters from becoming infected...
In fact, none of the animals in the favipiravir group had viable virus particles in their lungs after exposure to an infected cage mate, which suggests that the drug could work as a prophylactic.
...Clinical trials of favipiravir are underway. However, a small earlier trial suggested that while the drug was effective for people with mild symptoms, it did not appear to work for more severely ill people with hypertension, diabetes, or both.
...scientists do not know whether the drug penetrates lung tissue in humans as effectively as it does in these animals.
...while this study suggested that short-term use of the drug is safe, a previous review concluded that safety concerns remain about its long-term use...
https://www.medicalnewstoday.com/articles/influenza-drug-shows-promise-against-s...
-----------------------------------------------------------------
Suzanne J. F. Kaptein et al. 2020. Favipiravir at high doses has potent antiviral activity in SARS-CoV-2−infected hamsters, whereas hydroxychloroquine lacks activity (Research Article) PNAS first published October 9, 2020; https://doi.org/10.1073/pnas.2014441117 https://www.pnas.org/content/early/2020/10/08/2014441117
Significance
The previous lack of consensus around the use of hydroxychloroquine for COVID-19 patients underlines the need to thoroughly assess the in vivo efficacy of drugs against SARS-CoV-2. Small animal infection models, such as the hamster model, have a pivotal place herein. We here show in vivo preclinical results with favipiravir which indicate that antiviral efficacy against SARS-CoV-2 might only be achieved with a very high dose. Hydroxychloroquine, on the other hand, completely lacks antiviral activity, thus providing no scientific basis for its further use in COVID-19 patients. With this study on two key antiviral candidates, we establish the baseline for SARS-CoV-2 antiviral treatment, which will allow us to identify superior antiviral candidates in the near future.
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly spread around the globe after its emergence in Wuhan in December 2019. With no specific therapeutic and prophylactic options available, the virus has infected millions of people of which more than half a million succumbed to the viral disease, COVID-19. The urgent need for an effective treatment together with a lack of small animal infection models has led to clinical trials using repurposed drugs without preclinical evidence of their in vivo efficacy. We established an infection model in Syrian hamsters to evaluate the efficacy of small molecules on both infection and transmission. Treatment of SARS-CoV-2−infected hamsters with a low dose of favipiravir or hydroxychloroquine with(out) azithromycin resulted in, respectively, a mild or no reduction in virus levels. However, high doses of favipiravir significantly reduced infectious virus titers in the lungs and markedly improved lung histopathology. Moreover, a high dose of favipiravir decreased virus transmission by direct contact, whereas hydroxychloroquine failed as prophylaxis. Pharmacokinetic modeling of hydroxychloroquine suggested that the total lung exposure to the drug did not cause the failure. Our data on hydroxychloroquine (together with previous reports in macaques and ferrets) thus provide no scientific basis for the use of this drug in COVID-19 patients. In contrast, the results with favipiravir demonstrate that an antiviral drug at nontoxic doses exhibits a marked protective effect against SARS-CoV-2 in a small animal model. Clinical studies are required to assess whether a similar antiviral effect is achievable in humans without toxic effects.
James Kingsland on October 14, 2020
Researchers have found that high doses of a drug called favipiravir strongly inhibit SARS-CoV-2 in hamsters. Favipiravir also prevented infection in healthy animals that had exposure to an infected cage mate.
It takes many years to develop a potent antiviral drug from scratch for a particular viral infection. Throughout the pandemic of COVID-19 — the disease that SARS-CoV-2 causes — researchers and clinicians have, therefore, had to focus on repurposing existing drugs.
...Virologists at the Rega Institute for Medical Research in Leuven, Belgium, have now developed a model of COVID-19 in Syrian hamsters, which they hope will provide more reliable information before the results of clinical trials become available.
They have already used their animal model to test different doses of favipiravir, an antiviral drug that has had approval in Japan since 2014 to treat pandemic influenza infections.
...The researchers found that while low doses of the drug gave poor results against SARS-CoV-2, high doses were effective.
The team has also used the (hamster) model to confirm that hydroxychloroquine (while effective in cell culture) is ineffective (in animal model).
...favipiravir significantly reduced the number of viable virus particles present in (exposed) hamsters’ lungs, with higher doses leading to a more significant reduction.
Of the eight animals that received the highest dose, for example, six had no viable virus remaining in their lungs following the treatment.
Damage to their lungs was also less than that in the untreated animals, and there were no signs of adverse effects.
Similarly, high doses of favipiravir prevented healthy hamsters from becoming infected...
In fact, none of the animals in the favipiravir group had viable virus particles in their lungs after exposure to an infected cage mate, which suggests that the drug could work as a prophylactic.
...Clinical trials of favipiravir are underway. However, a small earlier trial suggested that while the drug was effective for people with mild symptoms, it did not appear to work for more severely ill people with hypertension, diabetes, or both.
...scientists do not know whether the drug penetrates lung tissue in humans as effectively as it does in these animals.
...while this study suggested that short-term use of the drug is safe, a previous review concluded that safety concerns remain about its long-term use...
https://www.medicalnewstoday.com/articles/influenza-drug-shows-promise-against-s...
-----------------------------------------------------------------
Suzanne J. F. Kaptein et al. 2020. Favipiravir at high doses has potent antiviral activity in SARS-CoV-2−infected hamsters, whereas hydroxychloroquine lacks activity (Research Article) PNAS first published October 9, 2020; https://doi.org/10.1073/pnas.2014441117 https://www.pnas.org/content/early/2020/10/08/2014441117
Significance
The previous lack of consensus around the use of hydroxychloroquine for COVID-19 patients underlines the need to thoroughly assess the in vivo efficacy of drugs against SARS-CoV-2. Small animal infection models, such as the hamster model, have a pivotal place herein. We here show in vivo preclinical results with favipiravir which indicate that antiviral efficacy against SARS-CoV-2 might only be achieved with a very high dose. Hydroxychloroquine, on the other hand, completely lacks antiviral activity, thus providing no scientific basis for its further use in COVID-19 patients. With this study on two key antiviral candidates, we establish the baseline for SARS-CoV-2 antiviral treatment, which will allow us to identify superior antiviral candidates in the near future.
Abstract
Severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) rapidly spread around the globe after its emergence in Wuhan in December 2019. With no specific therapeutic and prophylactic options available, the virus has infected millions of people of which more than half a million succumbed to the viral disease, COVID-19. The urgent need for an effective treatment together with a lack of small animal infection models has led to clinical trials using repurposed drugs without preclinical evidence of their in vivo efficacy. We established an infection model in Syrian hamsters to evaluate the efficacy of small molecules on both infection and transmission. Treatment of SARS-CoV-2−infected hamsters with a low dose of favipiravir or hydroxychloroquine with(out) azithromycin resulted in, respectively, a mild or no reduction in virus levels. However, high doses of favipiravir significantly reduced infectious virus titers in the lungs and markedly improved lung histopathology. Moreover, a high dose of favipiravir decreased virus transmission by direct contact, whereas hydroxychloroquine failed as prophylaxis. Pharmacokinetic modeling of hydroxychloroquine suggested that the total lung exposure to the drug did not cause the failure. Our data on hydroxychloroquine (together with previous reports in macaques and ferrets) thus provide no scientific basis for the use of this drug in COVID-19 patients. In contrast, the results with favipiravir demonstrate that an antiviral drug at nontoxic doses exhibits a marked protective effect against SARS-CoV-2 in a small animal model. Clinical studies are required to assess whether a similar antiviral effect is achievable in humans without toxic effects.
95margd
(I'm having difficulty linking to report--might be too soon--but will add citation below once available.)
______________________________________________________
>62 margd:, contd. Here's that Dept of Defense paper on COVID exposure on planes, with link to some twitter discussion led by engineering prof from Vermont (for context):
(citation)
https://ustranscom.mil/cmd/docs/TRANSCOM%20Report%20Final.pdf
-----------------------------------------------------------------------
Linsey Marr (engineering prof VT) @linseymarr | 2:23 PM · Oct 15, 2020:
https://twitter.com/linseymarr/status/1316806801715798016
Report of the DoD study on airplanes now available.
https://ustranscom.mil/cmd/docs/TRANSCOM%20Report%20Final.pdf
They say it would take 54 hours sitting next to an index case to be infected by aerosols. This assumes breathing and no turning of head. I say risk could be 10x higher with talking, but still low. /1
Image ( https://twitter.com/linseymarr/status/1316806801715798016/photo/1 )
Need to be careful with mask-off periods while eating and drinking...don't talk.
Boarding and deplaning, crowding in jetbridge and gate area, other parts of travel are probably riskier.
Planes have very high ventilation rate (32-35 ACH) and excellent filtration. /2
Michael Otsuka @MikeOtsuka · 12h
Thanks for this. Do you happen to have any thoughts on how easy to reconcile with (Australian case report)
..."A total of 64 passengers on the flight had or later experienced an illness compatible with #COVID19 and were tested by PCR" Genomics tracks many passengers to a cruise. March 5 hr domestic flight in Australia ("rare")
https://wwwnc.cdc.gov/eid/article/26/12/20-3910_article
Linsey Marr @linseymarr · 12h
Mask use was rare on the flight.
Flight was long enough that talking could have explained transmission.
I think airlines were not running the best ventilation during boarding and deplaning back then.
Lucre Snooker@LucreSnooker | 2:25 PM · Oct 15, 2020:
i was suppressed by the low figure they used for virions per minute. a study of exhaled breath condensate estimated (millions) copies per hr emitted by people early in disease course...
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1283/5898624
Linsey Marr @linseymarr · 12h:
Yes, they assumed 4000 infectious virions/hour. The literature and my own analyses of measurements in hospitals suggest an emission rate of 1,000,000 RNA copies/hr. It's unlikely that 1 RNA copy = 1 infectious virus, could be more like 100-10,000 RNA copies...
Taulant Muka, PD, MD, MPH, PhD @muka_taulant | 2:34 PM · Oct 15, 2020:
Would u reccomend "stay silent" sign as potential effective measure, even substituting mask use in certain conditions?!
David Ridley @RidleyDM · 12h:
I wouldn't *substitute* it for mask use, but it seems like an excellent idea. The Tokyo metro has been exhorting people to do just this--and it seems to be working...
Pete Trefonas @p3voices | 2:55 PM · Oct 15, 2020
I am more concerned when the pilot turns off the indoor ventilation systems while the jet sits on the runway.
Many times, I have been in jets with no air circulation, sometimes for hours, waiting on a runway. Saves fuel, you know!
Paula Olsiewski @polsiewski | 4:59 PM · Oct 15, 2020:
Nice work studying wide body jets- 767's & 777's.
However, most domestic air travel is on 737's and smaller regional jets -
are similar results expected or will they study those planes next?
Heather Poole @Heather_Poole | 8:41 PM · Oct 15, 2020:
Fumes / fume events seem to be a problem on airplanes with IAE engines (737 / A321T).
If the ventilation can filter particles in the air, would it also filter out the jet fuel fume / oil leak smell?
Linsey Marr @linseymarr · 6h
Particles are removed by HEPA filters.
You need a different type of control device (e.g., activated carbon) to remove the fumes.
Renee M @twindependent | 2:29 PM · Oct 15, 2020:
We all know no one ever turns their head on an airplane.
Lois Patterson @loisrp | 2:24 AM · Oct 16, 2020:
How about plane restroom use, particularly as one study suggested that
the infection occurred when a passenger took off her mask briefly in the plane restroom?
'Neighbourhood buffers' are political negligence @ianwrob · 13h
If 10x that makes it 5.4 hours? ... add an error bar to that and likely more like 2.5-7.5 hours?
______________________________________________________
>62 margd:, contd. Here's that Dept of Defense paper on COVID exposure on planes, with link to some twitter discussion led by engineering prof from Vermont (for context):
(citation)
https://ustranscom.mil/cmd/docs/TRANSCOM%20Report%20Final.pdf
-----------------------------------------------------------------------
Linsey Marr (engineering prof VT) @linseymarr | 2:23 PM · Oct 15, 2020:
https://twitter.com/linseymarr/status/1316806801715798016
Report of the DoD study on airplanes now available.
https://ustranscom.mil/cmd/docs/TRANSCOM%20Report%20Final.pdf
They say it would take 54 hours sitting next to an index case to be infected by aerosols. This assumes breathing and no turning of head. I say risk could be 10x higher with talking, but still low. /1
Image ( https://twitter.com/linseymarr/status/1316806801715798016/photo/1 )
Need to be careful with mask-off periods while eating and drinking...don't talk.
Boarding and deplaning, crowding in jetbridge and gate area, other parts of travel are probably riskier.
Planes have very high ventilation rate (32-35 ACH) and excellent filtration. /2
Michael Otsuka @MikeOtsuka · 12h
Thanks for this. Do you happen to have any thoughts on how easy to reconcile with (Australian case report)
..."A total of 64 passengers on the flight had or later experienced an illness compatible with #COVID19 and were tested by PCR" Genomics tracks many passengers to a cruise. March 5 hr domestic flight in Australia ("rare")
https://wwwnc.cdc.gov/eid/article/26/12/20-3910_article
Linsey Marr @linseymarr · 12h
Mask use was rare on the flight.
Flight was long enough that talking could have explained transmission.
I think airlines were not running the best ventilation during boarding and deplaning back then.
Lucre Snooker@LucreSnooker | 2:25 PM · Oct 15, 2020:
i was suppressed by the low figure they used for virions per minute. a study of exhaled breath condensate estimated (millions) copies per hr emitted by people early in disease course...
https://academic.oup.com/cid/advance-article/doi/10.1093/cid/ciaa1283/5898624
Linsey Marr @linseymarr · 12h:
Yes, they assumed 4000 infectious virions/hour. The literature and my own analyses of measurements in hospitals suggest an emission rate of 1,000,000 RNA copies/hr. It's unlikely that 1 RNA copy = 1 infectious virus, could be more like 100-10,000 RNA copies...
Taulant Muka, PD, MD, MPH, PhD @muka_taulant | 2:34 PM · Oct 15, 2020:
Would u reccomend "stay silent" sign as potential effective measure, even substituting mask use in certain conditions?!
David Ridley @RidleyDM · 12h:
I wouldn't *substitute* it for mask use, but it seems like an excellent idea. The Tokyo metro has been exhorting people to do just this--and it seems to be working...
Pete Trefonas @p3voices | 2:55 PM · Oct 15, 2020
I am more concerned when the pilot turns off the indoor ventilation systems while the jet sits on the runway.
Many times, I have been in jets with no air circulation, sometimes for hours, waiting on a runway. Saves fuel, you know!
Paula Olsiewski @polsiewski | 4:59 PM · Oct 15, 2020:
Nice work studying wide body jets- 767's & 777's.
However, most domestic air travel is on 737's and smaller regional jets -
are similar results expected or will they study those planes next?
Heather Poole @Heather_Poole | 8:41 PM · Oct 15, 2020:
Fumes / fume events seem to be a problem on airplanes with IAE engines (737 / A321T).
If the ventilation can filter particles in the air, would it also filter out the jet fuel fume / oil leak smell?
Linsey Marr @linseymarr · 6h
Particles are removed by HEPA filters.
You need a different type of control device (e.g., activated carbon) to remove the fumes.
Renee M @twindependent | 2:29 PM · Oct 15, 2020:
We all know no one ever turns their head on an airplane.
Lois Patterson @loisrp | 2:24 AM · Oct 16, 2020:
How about plane restroom use, particularly as one study suggested that
the infection occurred when a passenger took off her mask briefly in the plane restroom?
'Neighbourhood buffers' are political negligence @ianwrob · 13h
If 10x that makes it 5.4 hours? ... add an error bar to that and likely more like 2.5-7.5 hours?
96margd
Kai Kupferschmidt et al. 2020. Remdesivir and interferon fall flat in WHO’s megastudy of COVID-19 treatments. Science (Oct. 16, 2020) doi:10.1126/science.abf1946 https://www.sciencemag.org/news/2020/10/remdesivir-and-interferon-fall-flat-who-...
...(None of Hydroxychloroquine, Remdesivir, Interferon, Lopinavir (each v placebo))...lowered mortality or delayed the moment patients needed ventilation to help them breathe.
...Remdesivir, which attacks a specific enzyme in several RNA viruses and was previously tested against Ebola, was initially seen as a promising candidate. In a U.S. trial with more than 1000 COVID-19 patients published last week, those who received remdesivir had a shorter recovery time than patients in the control group, but there was no significant difference in mortality. Two smaller trials found few significant benefits. Remdesivir received an Emergency Use Authorization from the U.S. Food and Drug Administration (FDA) in May for severe COVID-19 patients that was later expanded to include all patients.
But the Solidarity trial suggests the drug does little in severe cases. Of 2743 hospitalized patients who received the drug, 11.0% died, versus 11.2% in a control group of roughly the same size. The difference is so small it could have arisen by chance.
When the authors pooled Solidarity’s data with those from the three other trials, they found a slight reduction in mortality that wasn’t statistically significant either.
...Solidarity’s “most disappointing results,” however, are those for interferon-beta, says (Eric) Topol. Mortality among the 2050 people who received that drug (either alone or in combination with lopinavir/ritonavir) was 11.9%, versus 10.5% in the control group. Prior studies have suggested that interferon can only help if given early, however, and not once patients have been hospitalized...
...The silver lining may be that the trial itself, unprecedented in several ways, succeeded. Set up in a short time in March as the pandemic engulfed the world, it used a simple protocol that allowed doctors in overstretched hospitals anywhere to randomize their patients to whatever study drug was available or to standard care.
...As early as next week Solidarity participants could start receiving acalabrutinib, a cancer drug that inhibits an enzyme that plays an important role in the human immune system. The hope is to soon include targeted therapies such as monoclonal antibodies as well because they are more likely to be successful than repurposed drugs.
------------------------------------------------------------------
WHO Solidarity Trial Consortium et al. 2020. Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results. MedRxiv doi: https://doi.org/10.1101/2020.10.15.20209817 https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1
This article is a preprint and has not been certified by peer review (planned publication in NEJM)
Abstract
BACKGROUND
WHO expert groups recommended mortality trials in hospitalized COVID-19 of four re-purposed antiviral drugs.
METHODS
Study drugs were Remdesivir, Hydroxychloroquine, Lopinavir (fixed-dose combination with Ritonavir) and Interferon-β1a (mainly subcutaneous; initially with Lopinavir, later not). COVID-19 inpatients were randomized equally between whichever study drugs were locally available and open control...
RESULTS
...No study drug definitely reduced mortality (in unventilated patients or any other subgroup of entry characteristics), initiation of ventilation or hospitalisation duration.
CONCLUSIONS
These Remdesivir, Hydroxychloroquine, Lopinavir and Interferon regimens appeared to have little or no effect on hospitalized COVID-19, as indicated by overall mortality, initiation of ventilation and duration of hospital stay. The mortality findings contain most of the randomized evidence on Remdesivir and Interferon, and are consistent with meta-analyses of mortality in all major trials.
_______________________________________________
Twitter discussion: https://twitter.com/EricTopol/status/1316877188596002817
...(None of Hydroxychloroquine, Remdesivir, Interferon, Lopinavir (each v placebo))...lowered mortality or delayed the moment patients needed ventilation to help them breathe.
...Remdesivir, which attacks a specific enzyme in several RNA viruses and was previously tested against Ebola, was initially seen as a promising candidate. In a U.S. trial with more than 1000 COVID-19 patients published last week, those who received remdesivir had a shorter recovery time than patients in the control group, but there was no significant difference in mortality. Two smaller trials found few significant benefits. Remdesivir received an Emergency Use Authorization from the U.S. Food and Drug Administration (FDA) in May for severe COVID-19 patients that was later expanded to include all patients.
But the Solidarity trial suggests the drug does little in severe cases. Of 2743 hospitalized patients who received the drug, 11.0% died, versus 11.2% in a control group of roughly the same size. The difference is so small it could have arisen by chance.
When the authors pooled Solidarity’s data with those from the three other trials, they found a slight reduction in mortality that wasn’t statistically significant either.
...Solidarity’s “most disappointing results,” however, are those for interferon-beta, says (Eric) Topol. Mortality among the 2050 people who received that drug (either alone or in combination with lopinavir/ritonavir) was 11.9%, versus 10.5% in the control group. Prior studies have suggested that interferon can only help if given early, however, and not once patients have been hospitalized...
...The silver lining may be that the trial itself, unprecedented in several ways, succeeded. Set up in a short time in March as the pandemic engulfed the world, it used a simple protocol that allowed doctors in overstretched hospitals anywhere to randomize their patients to whatever study drug was available or to standard care.
...As early as next week Solidarity participants could start receiving acalabrutinib, a cancer drug that inhibits an enzyme that plays an important role in the human immune system. The hope is to soon include targeted therapies such as monoclonal antibodies as well because they are more likely to be successful than repurposed drugs.
------------------------------------------------------------------
WHO Solidarity Trial Consortium et al. 2020. Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results. MedRxiv doi: https://doi.org/10.1101/2020.10.15.20209817 https://www.medrxiv.org/content/10.1101/2020.10.15.20209817v1
This article is a preprint and has not been certified by peer review (planned publication in NEJM)
Abstract
BACKGROUND
WHO expert groups recommended mortality trials in hospitalized COVID-19 of four re-purposed antiviral drugs.
METHODS
Study drugs were Remdesivir, Hydroxychloroquine, Lopinavir (fixed-dose combination with Ritonavir) and Interferon-β1a (mainly subcutaneous; initially with Lopinavir, later not). COVID-19 inpatients were randomized equally between whichever study drugs were locally available and open control...
RESULTS
...No study drug definitely reduced mortality (in unventilated patients or any other subgroup of entry characteristics), initiation of ventilation or hospitalisation duration.
CONCLUSIONS
These Remdesivir, Hydroxychloroquine, Lopinavir and Interferon regimens appeared to have little or no effect on hospitalized COVID-19, as indicated by overall mortality, initiation of ventilation and duration of hospital stay. The mortality findings contain most of the randomized evidence on Remdesivir and Interferon, and are consistent with meta-analyses of mortality in all major trials.
_______________________________________________
Twitter discussion: https://twitter.com/EricTopol/status/1316877188596002817
97margd
Sinovac coronavirus vaccine offered by Chinese city for emergency use costs $60
Reuters•October 16, 2020
BEIJING (Reuters) - A Chinese city is offering Sinovac Biotech's experimental COVID-19 vaccine to essential workers and other high-risk groups as part of a national programme for about $60.
The eastern city of Jiaxin's center for disease control and prevention (CDC) said in a statement on WeChat that two doses of the vaccine candidate, called CoronaVac, will cost 200 yuan ($29.75) per dose and that vaccinations for key groups including medical professionals have begun.
...Bio Farma, a state-owned firm in Indonesia which has reached a deal for at least 40 million doses from Sinovac, said this week the vaccine will cost around 200,000 rupiah ($13.60) per dose when it becomes available in the southeast Asian country.
China has said that while reasonable profits for companies are permitted, COVID-19 vaccines should be priced close to cost...
https://news.yahoo.com/sinovac-coronavirus-vaccine-offered-chinese-064827335.htm...
Reuters•October 16, 2020
BEIJING (Reuters) - A Chinese city is offering Sinovac Biotech's experimental COVID-19 vaccine to essential workers and other high-risk groups as part of a national programme for about $60.
The eastern city of Jiaxin's center for disease control and prevention (CDC) said in a statement on WeChat that two doses of the vaccine candidate, called CoronaVac, will cost 200 yuan ($29.75) per dose and that vaccinations for key groups including medical professionals have begun.
...Bio Farma, a state-owned firm in Indonesia which has reached a deal for at least 40 million doses from Sinovac, said this week the vaccine will cost around 200,000 rupiah ($13.60) per dose when it becomes available in the southeast Asian country.
China has said that while reasonable profits for companies are permitted, COVID-19 vaccines should be priced close to cost...
https://news.yahoo.com/sinovac-coronavirus-vaccine-offered-chinese-064827335.htm...
98margd
Pfizer won't seek coronavirus vaccine authorization until after election
ZACHARY BRENNAN | 10/16/2020
...Pfizer CEO Albert Bourla said Friday that the company may know whether its vaccine is effective by the end of October, but won't have the safety data the FDA wants at least until the end of November. Amid rising concerns about political pressure on the agency, the FDA released guidance on emergency authorizations that requires vaccine developers to provide two months of safety data on half of the trial participants following the final dose of the vaccine.
"Let me be clear, assuming positive data, Pfizer will apply for Emergency Authorization Use in the U.S. soon after the safety milestone is achieved in the third week of November," Bourla wrote in an open letter.
Moderna, the other company with a vaccine in a late-stage trial with more than 20,000 enrolled, has also said it won't be ready to file for an emergency authorization before the election. Other vaccines could be ready for FDA review late this year or early 2021, but not by Nov. 3...
https://www.politico.com/news/2020/10/16/pfizer-coronavirus-vaccine-authorizatio...
ZACHARY BRENNAN | 10/16/2020
...Pfizer CEO Albert Bourla said Friday that the company may know whether its vaccine is effective by the end of October, but won't have the safety data the FDA wants at least until the end of November. Amid rising concerns about political pressure on the agency, the FDA released guidance on emergency authorizations that requires vaccine developers to provide two months of safety data on half of the trial participants following the final dose of the vaccine.
"Let me be clear, assuming positive data, Pfizer will apply for Emergency Authorization Use in the U.S. soon after the safety milestone is achieved in the third week of November," Bourla wrote in an open letter.
Moderna, the other company with a vaccine in a late-stage trial with more than 20,000 enrolled, has also said it won't be ready to file for an emergency authorization before the election. Other vaccines could be ready for FDA review late this year or early 2021, but not by Nov. 3...
https://www.politico.com/news/2020/10/16/pfizer-coronavirus-vaccine-authorizatio...
99margd
>71 lriley: and #72
Medieval Europeans didn’t understand how the plague spread. Their response wasn’t so different from ours now.
Chico Harlan and Stefano Pitrelli | Oct. 15, 2020
...in both cases, the first instinct was to close borders to try to keep the disease at bay. When that didn’t work, officials called for strict rules — but only some people paid attention. All the while, there was a proliferation of conspiracy theories. Many tried to blame the disease on outsiders or minorities — in medieval Europe, often Jews.
... Some in Florence shut themselves inside their homes and lived in isolation, according to a detailed account from 14th-century writer and poet Giovanni Boccaccio. Others ventured out in public, armed with herbs and spices intended to purify the air — a medieval version of HVAC filters and masks. Still others were cavalier about the disease and went about their lives socializing, drinking heavily, “satisfying their appetites by any means available,” Boccaccio wrote.
Nobody was safe, and isolation scarcely worked as a safeguard in a dense city. But the people who gathered in groups courted greater risk. Marchionne di Coppo Stefani, a wealthy Florentine, wrote of daring dinner parties in which a host would gather 10 friends, with plans to reconvene again the next night.
At the next dinner, Stefani said, sometimes “two or three were missing.”
Worst of all, in an obvious parallel to the present, many faced their last moments cut off from everybody else, according to accounts from the time. During the plague, these lonely deaths were not the result of public health protocols but the product of sheer terror. People, after the onset of symptoms, were a mortal danger to those around them. So in some cases, family members abandoned sick loved ones, even children. Their deaths were noticed only when neighbors smelled the rotting corpses.
People were panicked. It was unclear how the disease spread — but there was no doubt that proximity to others was a risk. Animals — oxen, dogs, pigs — were dying, as well. People wondered whether it was retribution from God. They prayed and disavowed sin. They obsessed about the air and used scents and fires to ward off perceived deadly vapors. They were mostly guessing; scientists wouldn’t know what actually caused the plague — how the bacteria was spread by rats and fleas — until 500 years later.
...plague pits were dug all over the city and that all the usual customs for grieving together and mourning collapsed.
At a time when people were trying to avoid the disease with trial-and-error strategies, only one thing seemed to work: If the plague arrived in your city, drop everything, flee the crowds and take refuge in the countryside...
https://www.washingtonpost.com/world/europe/coronavirus-plague-europe/2020/10/14...
Medieval Europeans didn’t understand how the plague spread. Their response wasn’t so different from ours now.
Chico Harlan and Stefano Pitrelli | Oct. 15, 2020
...in both cases, the first instinct was to close borders to try to keep the disease at bay. When that didn’t work, officials called for strict rules — but only some people paid attention. All the while, there was a proliferation of conspiracy theories. Many tried to blame the disease on outsiders or minorities — in medieval Europe, often Jews.
... Some in Florence shut themselves inside their homes and lived in isolation, according to a detailed account from 14th-century writer and poet Giovanni Boccaccio. Others ventured out in public, armed with herbs and spices intended to purify the air — a medieval version of HVAC filters and masks. Still others were cavalier about the disease and went about their lives socializing, drinking heavily, “satisfying their appetites by any means available,” Boccaccio wrote.
Nobody was safe, and isolation scarcely worked as a safeguard in a dense city. But the people who gathered in groups courted greater risk. Marchionne di Coppo Stefani, a wealthy Florentine, wrote of daring dinner parties in which a host would gather 10 friends, with plans to reconvene again the next night.
At the next dinner, Stefani said, sometimes “two or three were missing.”
Worst of all, in an obvious parallel to the present, many faced their last moments cut off from everybody else, according to accounts from the time. During the plague, these lonely deaths were not the result of public health protocols but the product of sheer terror. People, after the onset of symptoms, were a mortal danger to those around them. So in some cases, family members abandoned sick loved ones, even children. Their deaths were noticed only when neighbors smelled the rotting corpses.
People were panicked. It was unclear how the disease spread — but there was no doubt that proximity to others was a risk. Animals — oxen, dogs, pigs — were dying, as well. People wondered whether it was retribution from God. They prayed and disavowed sin. They obsessed about the air and used scents and fires to ward off perceived deadly vapors. They were mostly guessing; scientists wouldn’t know what actually caused the plague — how the bacteria was spread by rats and fleas — until 500 years later.
...plague pits were dug all over the city and that all the usual customs for grieving together and mourning collapsed.
At a time when people were trying to avoid the disease with trial-and-error strategies, only one thing seemed to work: If the plague arrived in your city, drop everything, flee the crowds and take refuge in the countryside...
https://www.washingtonpost.com/world/europe/coronavirus-plague-europe/2020/10/14...
100margd
Yodel-Ay-Eee-OH-NO: Yodeling Concert Blamed as Superspreader in Rural Swiss Region
Sarah Rumpf | Oct 16th, 2020
https://www.mediaite.com/news/yodel-ay-eee-oh-no-yodeling-concert-blamed-as-supe...
Sarah Rumpf | Oct 16th, 2020
https://www.mediaite.com/news/yodel-ay-eee-oh-no-yodeling-concert-blamed-as-supe...
101margd
Putin Announces Approval Of A 2nd Unproven Coronavirus Vaccine
Scott Neuman | October 14, 2020
...Speaking during a televised news conference, (Russian President Vladimir Putin) said the new vaccine developed by Siberian biotech company Novosibirsk's Vektor State Virology and Biotechnology Center, a former Soviet-era bioweapons lab.
Large-scale studies, such as those required for vaccines developed in the U.S., are designed to assess not only if a vaccine works, but whether it is free from dangerous side effects that might only show up once millions of people are immunized.
EpiVacCorona, described as a "peptide-based shot," has yet to even begin (large-scale trials designed to assess if a vaccine worksand whether it is free from dangerous side effects) and its "registration" — a bureaucratic procedure undertaken by the Russian Health Ministry, which amounts to regulatory approval — is likely to be viewed as risky, at best.
Early trials of the latest vaccine on 100 volunteers were successful, Putin said. He also said that Deputy Prime Minister Tatyana Golikova and the head of Russia's consumer safety watchdog, Anna Popova, had both received the vaccine known as EpiVacCorona.
...Since the start of the coronavirus pandemic, more than 23,000 people have died in Russia from COVID-19 and it ranks fourth in the world for confirmed infections after the U.S., India and Brazil.
https://www.npr.org/sections/coronavirus-live-updates/2020/10/14/923785152/russi...
Scott Neuman | October 14, 2020
...Speaking during a televised news conference, (Russian President Vladimir Putin) said the new vaccine developed by Siberian biotech company Novosibirsk's Vektor State Virology and Biotechnology Center, a former Soviet-era bioweapons lab.
Large-scale studies, such as those required for vaccines developed in the U.S., are designed to assess not only if a vaccine works, but whether it is free from dangerous side effects that might only show up once millions of people are immunized.
EpiVacCorona, described as a "peptide-based shot," has yet to even begin (large-scale trials designed to assess if a vaccine worksand whether it is free from dangerous side effects) and its "registration" — a bureaucratic procedure undertaken by the Russian Health Ministry, which amounts to regulatory approval — is likely to be viewed as risky, at best.
Early trials of the latest vaccine on 100 volunteers were successful, Putin said. He also said that Deputy Prime Minister Tatyana Golikova and the head of Russia's consumer safety watchdog, Anna Popova, had both received the vaccine known as EpiVacCorona.
...Since the start of the coronavirus pandemic, more than 23,000 people have died in Russia from COVID-19 and it ranks fourth in the world for confirmed infections after the U.S., India and Brazil.
https://www.npr.org/sections/coronavirus-live-updates/2020/10/14/923785152/russi...
102margd
Cool. In this huge cooperative study, scientists identified proteins critical to infection by coronaviruses responsible for COVID-19, SARS, and MERS. They then combed medical billing information for COVID-19 patients using meds that targeted these proteins, finding some that appeared to have improved COVID-19 outcomes. Because the proteins were common to COVID-19, SARS, and MERS, this approach may predict therapeutics that may not only treat COVID-19, but any new coronavirus that jump species in future.
Scientists identify common vulnerabilities across SARS-CoV-2, SARS-CoV-1 and MERS coronaviruses
16 October 2020
In a study published online in Science, an international team of almost 200 researchers from 14 leading institutions in six countries, including France with the Institut Pasteur and CNRS, studied the three lethal coronaviruses SARS-CoV-2, SARS-CoV-1 and MERS-CoV in order to identify commonly hijacked cellular pathways and detect promising targets for broad coronavirus inhibition. In addition, using the molecular insights gained from this multidisciplinary, systematic study of coronaviruses, the group performed an analysis of medical records of approximately 740,000 patients with SARS-CoV-2 that altered clinical outcomes in these patients to uncover approved therapeutics with potential for rapid deployment. These results demonstrate how molecular information can be translated into real-world implications for the treatment of COVID-19, an approach that can ultimately be applied to other diseases in the future...
...Pathway Targets for Potential Clinically-Approved Therapeutics
... Armed with this knowledge, the group performed a retrospective analysis of medical billing data from approximately 740,000 people who tested positive for SARS-CoV-2 or were presumptively positive.
In the outpatient setting, SARS-CoV-2-positive, new users of indomethacin, a non-steroidal anti-inflammatory drug (NSAID) that targets PGES-2, were less likely than matched new users of celecoxib, an NSAID that does not target PGES-2, to require hospitalization or inpatient services.
In the inpatient setting, again leveraging the medical billing data, the group compared the effectiveness of typical antipsychotics, namely haloperidol, which have activity against sigma receptor 1, versus atypical antipsychotics, which do not. Half as many new users of typical antipsychotics compared to new users of atypical antipsychotics progressed to the point of requiring mechanical ventilation. Typical antipsychotics can have significant adverse effects, but other sigma receptor 1-targeting drugs exist and more still are in development.
"It is critical to note that the number of patients taking each of these compounds represent small, non-interventional studies," commented Nevan Krogan, Ph.D., director of the Quantitative Biosciences Institute (QBI) at the School of Pharmacy at UC San Francisco, senior investigator at Gladstone Institutes, and lead investigator of the study. "They are nonetheless powerful examples of how molecular insight can rapidly generate clinical hypotheses and help prioritize candidates for prospective clinical trials or future drug development. A careful analysis of the relative benefits and risks of these therapeutics should be undertaken before considering prospective studies or interventions."
"These analyses demonstrate how biological and molecular information are translated into real-world implications for the treatment of COVID-19 and other viral diseases," said Pedro Beltrao, Ph.D., group leader at EMBL's European Bioinformatics Institute. "After more than a century of relatively harmless coronaviruses, in the last 20 years we have had three coronaviruses which have been deadly. By looking across the species, we have the capability to predict pan-coronavirus therapeutics that may be effective in treating the current pandemic, which we believe will also offer therapeutic promise for a future coronavirus as well."
https://www.worldpharmanews.com/research/5431-scientists-identify-common-vulnera...
---------------------------------------------------------------------
David E. Gordon et al. 2020. Comparative host-coronavirus protein interaction networks reveal pan-viral disease mechanisms. Science 15 Oct 2020: eabe9403. DOI: 10.1126/science.abe9403 https://science.sciencemag.org/content/early/2020/10/14/science.abe9403
Abstract
The COVID-19 (Coronavirus disease-2019) pandemic, caused by the SARS-CoV-2 coronavirus, is a significant threat to public health and the global economy. SARS-CoV-2 is closely related to the more lethal but less transmissible coronaviruses SARS-CoV-1 and MERS-CoV. Here, we have carried out comparative viral-human protein-protein interaction and viral protein localization analysis for all three viruses. Subsequent functional genetic screening identified host factors that functionally impinge on coronavirus proliferation, including Tom70, a mitochondrial chaperone protein that interacts with both SARS-CoV-1 and SARS-CoV-2 Orf9b, an interaction we structurally characterized using cryo-EM. Combining genetically-validated host factors with both COVID-19 patient genetic data and medical billing records identified important molecular mechanisms and potential drug treatments that merit further molecular and clinical study.
Scientists identify common vulnerabilities across SARS-CoV-2, SARS-CoV-1 and MERS coronaviruses
16 October 2020
In a study published online in Science, an international team of almost 200 researchers from 14 leading institutions in six countries, including France with the Institut Pasteur and CNRS, studied the three lethal coronaviruses SARS-CoV-2, SARS-CoV-1 and MERS-CoV in order to identify commonly hijacked cellular pathways and detect promising targets for broad coronavirus inhibition. In addition, using the molecular insights gained from this multidisciplinary, systematic study of coronaviruses, the group performed an analysis of medical records of approximately 740,000 patients with SARS-CoV-2 that altered clinical outcomes in these patients to uncover approved therapeutics with potential for rapid deployment. These results demonstrate how molecular information can be translated into real-world implications for the treatment of COVID-19, an approach that can ultimately be applied to other diseases in the future...
...Pathway Targets for Potential Clinically-Approved Therapeutics
... Armed with this knowledge, the group performed a retrospective analysis of medical billing data from approximately 740,000 people who tested positive for SARS-CoV-2 or were presumptively positive.
In the outpatient setting, SARS-CoV-2-positive, new users of indomethacin, a non-steroidal anti-inflammatory drug (NSAID) that targets PGES-2, were less likely than matched new users of celecoxib, an NSAID that does not target PGES-2, to require hospitalization or inpatient services.
In the inpatient setting, again leveraging the medical billing data, the group compared the effectiveness of typical antipsychotics, namely haloperidol, which have activity against sigma receptor 1, versus atypical antipsychotics, which do not. Half as many new users of typical antipsychotics compared to new users of atypical antipsychotics progressed to the point of requiring mechanical ventilation. Typical antipsychotics can have significant adverse effects, but other sigma receptor 1-targeting drugs exist and more still are in development.
"It is critical to note that the number of patients taking each of these compounds represent small, non-interventional studies," commented Nevan Krogan, Ph.D., director of the Quantitative Biosciences Institute (QBI) at the School of Pharmacy at UC San Francisco, senior investigator at Gladstone Institutes, and lead investigator of the study. "They are nonetheless powerful examples of how molecular insight can rapidly generate clinical hypotheses and help prioritize candidates for prospective clinical trials or future drug development. A careful analysis of the relative benefits and risks of these therapeutics should be undertaken before considering prospective studies or interventions."
"These analyses demonstrate how biological and molecular information are translated into real-world implications for the treatment of COVID-19 and other viral diseases," said Pedro Beltrao, Ph.D., group leader at EMBL's European Bioinformatics Institute. "After more than a century of relatively harmless coronaviruses, in the last 20 years we have had three coronaviruses which have been deadly. By looking across the species, we have the capability to predict pan-coronavirus therapeutics that may be effective in treating the current pandemic, which we believe will also offer therapeutic promise for a future coronavirus as well."
https://www.worldpharmanews.com/research/5431-scientists-identify-common-vulnera...
---------------------------------------------------------------------
David E. Gordon et al. 2020. Comparative host-coronavirus protein interaction networks reveal pan-viral disease mechanisms. Science 15 Oct 2020: eabe9403. DOI: 10.1126/science.abe9403 https://science.sciencemag.org/content/early/2020/10/14/science.abe9403
Abstract
The COVID-19 (Coronavirus disease-2019) pandemic, caused by the SARS-CoV-2 coronavirus, is a significant threat to public health and the global economy. SARS-CoV-2 is closely related to the more lethal but less transmissible coronaviruses SARS-CoV-1 and MERS-CoV. Here, we have carried out comparative viral-human protein-protein interaction and viral protein localization analysis for all three viruses. Subsequent functional genetic screening identified host factors that functionally impinge on coronavirus proliferation, including Tom70, a mitochondrial chaperone protein that interacts with both SARS-CoV-1 and SARS-CoV-2 Orf9b, an interaction we structurally characterized using cryo-EM. Combining genetically-validated host factors with both COVID-19 patient genetic data and medical billing records identified important molecular mechanisms and potential drug treatments that merit further molecular and clinical study.
103margd
Republican Judges Are Quietly Upending Public Health Laws
A catastrophic sequence of decisions has blocked states from responding to the pandemic.
John Fabian Witt* | Oct. 15, 2020
...For centuries, American constitutional law granted state governments broad public health powers. “Salus populi suprema lex,” the old saying went: The health of the people is the supreme law. Such authority went back to the beginning of the Republic. In the famous 1824 case of Gibbons v. Ogden, Chief Justice John Marshall defended the “acknowledged power of a State to provide for the health of its citizens.” States, he explained, were empowered to enact “inspection laws, quarantine laws” and “health laws of every description.”
...The basic outlines of this approach remained in place for more than two centuries. Today, however, the tradition of salus populi is in collapse. In state and federal courts alike, Republican-appointed and Republican-elected judges are upsetting the long-established consensus.
...Michigan Supreme Court struck down the state’s 75-year-old emergency powers law ...
...federal district judge in Pennsylvania...struck down the state’s business closure rules and its limits on gatherings....
...Wisconsin Supreme Court overturned their state’s common-sense emergency Covid-19 rules...
The U.S. Supreme Court threatens to get into the action, too...four conservative justices (Clarence Thomas, Samuel Alito, Neil Gorsuch and Brett Kavanaugh) dissented...California...Nevada...(restrictions on gatherings worship)
Next month, the court is scheduled to hear arguments on a startling and widely criticized decision from the U.S. Court of Appeals for the Fifth Circuit in Texas last year that offers yet another opportunity to strike down the Affordable Care Act...
All of this is a sharp departure from a long history of judicial solicitude toward state powers during epidemics...Now a new generation of judges, propelled by partisan energies, look to deprive states of the power to fight for the sick and dying in a pandemic in which the victims are disproportionately Black and brown...
https://www.nytimes.com/2020/10/15/opinion/coronavirus-health-courts.html
* Mr. Witt is a law professor at Yale and the author of the forthcoming “American Contagions: Epidemics and the Law From Smallpox to Covid-19.”
A catastrophic sequence of decisions has blocked states from responding to the pandemic.
John Fabian Witt* | Oct. 15, 2020
...For centuries, American constitutional law granted state governments broad public health powers. “Salus populi suprema lex,” the old saying went: The health of the people is the supreme law. Such authority went back to the beginning of the Republic. In the famous 1824 case of Gibbons v. Ogden, Chief Justice John Marshall defended the “acknowledged power of a State to provide for the health of its citizens.” States, he explained, were empowered to enact “inspection laws, quarantine laws” and “health laws of every description.”
...The basic outlines of this approach remained in place for more than two centuries. Today, however, the tradition of salus populi is in collapse. In state and federal courts alike, Republican-appointed and Republican-elected judges are upsetting the long-established consensus.
...Michigan Supreme Court struck down the state’s 75-year-old emergency powers law ...
...federal district judge in Pennsylvania...struck down the state’s business closure rules and its limits on gatherings....
...Wisconsin Supreme Court overturned their state’s common-sense emergency Covid-19 rules...
The U.S. Supreme Court threatens to get into the action, too...four conservative justices (Clarence Thomas, Samuel Alito, Neil Gorsuch and Brett Kavanaugh) dissented...California...Nevada...(restrictions on gatherings worship)
Next month, the court is scheduled to hear arguments on a startling and widely criticized decision from the U.S. Court of Appeals for the Fifth Circuit in Texas last year that offers yet another opportunity to strike down the Affordable Care Act...
All of this is a sharp departure from a long history of judicial solicitude toward state powers during epidemics...Now a new generation of judges, propelled by partisan energies, look to deprive states of the power to fight for the sick and dying in a pandemic in which the victims are disproportionately Black and brown...
https://www.nytimes.com/2020/10/15/opinion/coronavirus-health-courts.html
* Mr. Witt is a law professor at Yale and the author of the forthcoming “American Contagions: Epidemics and the Law From Smallpox to Covid-19.”
104margd
Already facing a third wave of COVID cases, states are challenged to equitably, safely, and efficiently distribute vaccine, when available. Good problem to have, but from news reports it looks like distribution will vary highly from state to state...
Facing Many Unknowns, States Rush To Plan Distribution Of COVID-19 Vaccines
Selena Simmons-Duffin and Pien Huang | October 16, 2020
Heard on Morning Edition
...public health officers across the country are rushing to finish up the first draft of plans for how to distribute a coronavirus vaccine if and when it is authorized, and they're grappling with a host of unknowns as they try to design a system for getting the vaccine out to everyone who wants it....
Planning fast with changing expectations...
Overcoming logistical hurdles...
Finding the money to execute plans...
https://www.npr.org/sections/health-shots/2020/10/16/924247360/facing-many-unkno...
Facing Many Unknowns, States Rush To Plan Distribution Of COVID-19 Vaccines
Selena Simmons-Duffin and Pien Huang | October 16, 2020
Heard on Morning Edition
...public health officers across the country are rushing to finish up the first draft of plans for how to distribute a coronavirus vaccine if and when it is authorized, and they're grappling with a host of unknowns as they try to design a system for getting the vaccine out to everyone who wants it....
Planning fast with changing expectations...
Overcoming logistical hurdles...
Finding the money to execute plans...
https://www.npr.org/sections/health-shots/2020/10/16/924247360/facing-many-unkno...
105margd
The Dublin-Boston score can now accurately predict how severe the infection will be on day seven after measuring the patient’s blood for the first four days.
Prof. Gerry McElvaney and Prof. Ger Curley | Oct 16, 2020
...The blood test works by measuring the levels of two molecules that send messages to the body’s immune system and control inflammation. One of these molecules, interleukin (IL)-6, is pro-inflammatory, and a different one, called IL-10, is anti-inflammatory. The levels of both are altered in severe Covid-19 patients.
Based on the changes in the ratio of these two molecules over time (4 days), the researchers developed a point system where each 1-point increase was associated with a 5.6 times increased odds for a more severe outcome.
“The Dublin-Boston score is easily calculated and can be applied to all hospitalised Covid-19 patients,” said RCSI Professor of Medicine Gerry McElvaney, the study’s senior author and a consultant in Beaumont Hospital.
“More informed prognosis could help determine when to escalate or de-escalate care, a key component of the efficient allocation of resources during the current pandemic. The score may also have a role in evaluating whether new therapies designed to decrease inflammation in Covid-19 actually provide benefit.”...
https://scitechdaily.com/new-blood-test-accurately-predicts-which-covid-19-patie...
----------------------------------------------------------------
J McElvaney et al. 2020. A linear prognostic score based on the ratio of interleukin-6 to interleukin-10 predicts outcomes in COVID-19. EBioMedicine. (8 October 2020) DOI: 10.1016/j.ebiom.2020.103026
Abstract
Background
Prognostic tools are required to guide clinical decision-making in COVID-19.
Methods
We studied the relationship between the ratio of interleukin (IL)-6 to IL-10 and clinical outcome in 80 patients hospitalized for COVID-19, and created a simple 5-point linear score predictor of clinical outcome, the Dublin-Boston score. Clinical outcome was analysed as a three-level ordinal variable (“Improved”, “Unchanged”, or “Declined”). For both IL-6:IL-10 ratio and IL-6 alone, we associated clinical outcome with a) baseline biomarker levels, b) change in biomarker level from day 0 to day 2, c) change in biomarker from day 0 to day 4, and d) slope of biomarker change throughout the study. The associations between ordinal clinical outcome and each of the different predictors were performed with proportional odds logistic regression. Associations were run both “unadjusted” and adjusted for age and sex. Nested cross-validation was used to identify the model for incorporation into the Dublin-Boston score.
Findings
The 4-day change in IL-6:IL-10 ratio was chosen to derive the Dublin-Boston score. Each 1 point increase in the score was associated with a 5.6 times increased odds for a more severe outcome (OR 5.62, 95% CI -3.22–9.81, P = 1.2 × 10−9). Both the Dublin-Boston score and the 4-day change in IL-6:IL-10 significantly outperformed IL-6 alone in predicting clinical outcome at day 7.
Interpretation
The Dublin-Boston score is easily calculated and can be applied to a spectrum of hospitalized COVID-19 patients. More informed prognosis could help determine when to escalate care, institute or remove mechanical ventilation, or drive considerations for therapies.
Prof. Gerry McElvaney and Prof. Ger Curley | Oct 16, 2020
...The blood test works by measuring the levels of two molecules that send messages to the body’s immune system and control inflammation. One of these molecules, interleukin (IL)-6, is pro-inflammatory, and a different one, called IL-10, is anti-inflammatory. The levels of both are altered in severe Covid-19 patients.
Based on the changes in the ratio of these two molecules over time (4 days), the researchers developed a point system where each 1-point increase was associated with a 5.6 times increased odds for a more severe outcome.
“The Dublin-Boston score is easily calculated and can be applied to all hospitalised Covid-19 patients,” said RCSI Professor of Medicine Gerry McElvaney, the study’s senior author and a consultant in Beaumont Hospital.
“More informed prognosis could help determine when to escalate or de-escalate care, a key component of the efficient allocation of resources during the current pandemic. The score may also have a role in evaluating whether new therapies designed to decrease inflammation in Covid-19 actually provide benefit.”...
https://scitechdaily.com/new-blood-test-accurately-predicts-which-covid-19-patie...
----------------------------------------------------------------
J McElvaney et al. 2020. A linear prognostic score based on the ratio of interleukin-6 to interleukin-10 predicts outcomes in COVID-19. EBioMedicine. (8 October 2020) DOI: 10.1016/j.ebiom.2020.103026
Abstract
Background
Prognostic tools are required to guide clinical decision-making in COVID-19.
Methods
We studied the relationship between the ratio of interleukin (IL)-6 to IL-10 and clinical outcome in 80 patients hospitalized for COVID-19, and created a simple 5-point linear score predictor of clinical outcome, the Dublin-Boston score. Clinical outcome was analysed as a three-level ordinal variable (“Improved”, “Unchanged”, or “Declined”). For both IL-6:IL-10 ratio and IL-6 alone, we associated clinical outcome with a) baseline biomarker levels, b) change in biomarker level from day 0 to day 2, c) change in biomarker from day 0 to day 4, and d) slope of biomarker change throughout the study. The associations between ordinal clinical outcome and each of the different predictors were performed with proportional odds logistic regression. Associations were run both “unadjusted” and adjusted for age and sex. Nested cross-validation was used to identify the model for incorporation into the Dublin-Boston score.
Findings
The 4-day change in IL-6:IL-10 ratio was chosen to derive the Dublin-Boston score. Each 1 point increase in the score was associated with a 5.6 times increased odds for a more severe outcome (OR 5.62, 95% CI -3.22–9.81, P = 1.2 × 10−9). Both the Dublin-Boston score and the 4-day change in IL-6:IL-10 significantly outperformed IL-6 alone in predicting clinical outcome at day 7.
Interpretation
The Dublin-Boston score is easily calculated and can be applied to a spectrum of hospitalized COVID-19 patients. More informed prognosis could help determine when to escalate care, institute or remove mechanical ventilation, or drive considerations for therapies.
106margd
We Just Got More Evidence Your Blood Type May Change COVID-19 Risk And Severity
AYLIN WOODWARD | 16 OCTOBER 2020
...Both new studies came out Wednesday in the journal Blood Advances. One looked at 95 critically ill COVID-19 patients at hospitals in Vancouver, Canada, between February and April.
They found that patients with Type O or B blood spent, on average, 4.5 fewer days in the intensive-care unit than those with Type A or AB blood. The latter group stayed, on average, 13.5 days in the ICU. The researchers did not see any link between blood type and the length of each patient's total hospital stay, however.
They did, however, find that only 61 percent of the patients with Type O or B blood required a ventilator, compared to 84 percent of patients with Type A or AB.
Patients with Type A or AB, meanwhile, were also more likely to need dialysis, a procedure that helps the kidneys filter toxins from the blood.
"Patients in these two blood groups may have an increased risk of organ dysfunction or failure due to COVID-19 than people with blood types O or B," the study authors concluded.
A June study found a similar link: Patients in Italy and Spain with Type O blood had a 50 percent reduced risk of severe coronavirus infection (meaning they needed intubation or supplemental oxygen) compared to patients with other blood types.
The second new study found that people with Type O blood may be at a lower risk of getting the coronavirus in the first place relative to people with other blood types.
The team examined nearly half a million people in the Netherlands who were tested for COVID-19 between late February and late July. Of the roughly 4,600 people who tested positive and reported their blood type, 38.4 percent had Type O blood.
That's lower than the prevalence of Type O in a population of 2.2 million Danish people, 41.7 percent, so the researchers determined that people with Type O blood had disproportionately avoided infection...
https://www.sciencealert.com/study-gives-more-evidence-that-blood-type-may-chang...
--------------------------------------------------------
Ryan L. Hoiland et al. 2020. The association of ABO blood group with indices of disease severity and multiorgan dysfunction in COVID-19. Blood Adv (Oct 14, 2020) 4 (20): 4981–4989.
https://doi.org/10.1182/bloodadvances.2020002623 https://ashpublications.org/bloodadvances/article/4/20/4981/464437
Key Points
COVID-19 patients with blood group A or AB are at increased risk for requiring mechanical ventilation vs those with blood group O or B.
COVID-19 patients with blood group A or AB appear to exhibit a greater disease severity than patients with blood group O or B.
Abstract
Studies on severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) suggest a protective effect of anti-A antibodies against viral cell entry that may hold relevance for SARS-CoV-2 infection. Therefore, we aimed to determine whether ABO blood groups are associated with different severities of COVID-19. We conducted a multicenter retrospective analysis and nested prospective observational substudy of critically ill patients with COVID-19. We collected data pertaining to age, sex, comorbidities, dates of symptom onset, hospital admission, intensive care unit (ICU) admission, mechanical ventilation, continuous renal replacement therapy (CRRT), standard laboratory parameters, and serum inflammatory cytokines. National (N = 398 671; P = .38) and provincial (n = 62 246; P = .60) ABO blood group distributions did not differ from our cohort (n = 95). A higher proportion of COVID-19 patients with blood group A or AB required mechanical ventilation (P = .02) and CRRT (P = .004) and had a longer ICU stay (P = .03) compared with patients with blood group O or B. Blood group A or AB also had an increased probability of requiring mechanical ventilation and CRRT after adjusting for age, sex, and presence of ≥1 comorbidity. Inflammatory cytokines did not differ between patients with blood group A or AB (n = 11) vs O or B (n = 14; P more than .10 for all cytokines). Collectively, our data indicate that critically ill COVID-19 patients with blood group A or AB are at increased risk for requiring mechanical ventilation, CRRT, and prolonged ICU admission compared with patients with blood group O or B. Further work is needed to understand the underlying mechanisms.
--------------------------------------------------------
Mike Bogetofte Barnkob et al. 2020. Reduced prevalence of SARS-CoV-2 infection in ABO blood group O. Blood Adv (2020) 4 (20): 4990–4993. https://doi.org/10.1182/bloodadvances.2020002657 https://ashpublications.org/bloodadvances/article/4/20/4990/463793
Abstract
Identification of risk factors for contracting and developing serious illness following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of paramount interest. Here, we performed a retrospective cohort analysis of all Danish individuals tested for SARS-CoV-2 between 27 February 2020 and 30 July 2020, with a known ABO and RhD blood group, to determine the influence of common blood groups on virus susceptibility. Distribution of blood groups was compared with data from nontested individuals. Participants (29% of whom were male) included 473 654 individuals tested for SARS-CoV-2 using real-time polymerase chain reaction (7422 positive and 466 232 negative) and 2 204 742 nontested individuals, accounting for ∼38% of the total Danish population. Hospitalization and death from COVID-19, age, cardiovascular comorbidities, and job status were also collected for confirmed infected cases. ABO blood groups varied significantly between patients and the reference group, with only 38.41% (95% confidence interval CI, 37.30-39.50) of the patients belonging to blood group O compared with 41.70% (95% CI, 41.60-41.80) in the controls, corresponding to a relative risk of 0.87 (95% CI, 0.83-0.91) for acquiring COVID-19. This study identifies ABO blood group as a risk factor for SARS-CoV-2 infection but not for hospitalization or death from COVID-19.
AYLIN WOODWARD | 16 OCTOBER 2020
...Both new studies came out Wednesday in the journal Blood Advances. One looked at 95 critically ill COVID-19 patients at hospitals in Vancouver, Canada, between February and April.
They found that patients with Type O or B blood spent, on average, 4.5 fewer days in the intensive-care unit than those with Type A or AB blood. The latter group stayed, on average, 13.5 days in the ICU. The researchers did not see any link between blood type and the length of each patient's total hospital stay, however.
They did, however, find that only 61 percent of the patients with Type O or B blood required a ventilator, compared to 84 percent of patients with Type A or AB.
Patients with Type A or AB, meanwhile, were also more likely to need dialysis, a procedure that helps the kidneys filter toxins from the blood.
"Patients in these two blood groups may have an increased risk of organ dysfunction or failure due to COVID-19 than people with blood types O or B," the study authors concluded.
A June study found a similar link: Patients in Italy and Spain with Type O blood had a 50 percent reduced risk of severe coronavirus infection (meaning they needed intubation or supplemental oxygen) compared to patients with other blood types.
The second new study found that people with Type O blood may be at a lower risk of getting the coronavirus in the first place relative to people with other blood types.
The team examined nearly half a million people in the Netherlands who were tested for COVID-19 between late February and late July. Of the roughly 4,600 people who tested positive and reported their blood type, 38.4 percent had Type O blood.
That's lower than the prevalence of Type O in a population of 2.2 million Danish people, 41.7 percent, so the researchers determined that people with Type O blood had disproportionately avoided infection...
https://www.sciencealert.com/study-gives-more-evidence-that-blood-type-may-chang...
--------------------------------------------------------
Ryan L. Hoiland et al. 2020. The association of ABO blood group with indices of disease severity and multiorgan dysfunction in COVID-19. Blood Adv (Oct 14, 2020) 4 (20): 4981–4989.
https://doi.org/10.1182/bloodadvances.2020002623 https://ashpublications.org/bloodadvances/article/4/20/4981/464437
Key Points
COVID-19 patients with blood group A or AB are at increased risk for requiring mechanical ventilation vs those with blood group O or B.
COVID-19 patients with blood group A or AB appear to exhibit a greater disease severity than patients with blood group O or B.
Abstract
Studies on severe acute respiratory syndrome coronavirus 1 (SARS-CoV-1) suggest a protective effect of anti-A antibodies against viral cell entry that may hold relevance for SARS-CoV-2 infection. Therefore, we aimed to determine whether ABO blood groups are associated with different severities of COVID-19. We conducted a multicenter retrospective analysis and nested prospective observational substudy of critically ill patients with COVID-19. We collected data pertaining to age, sex, comorbidities, dates of symptom onset, hospital admission, intensive care unit (ICU) admission, mechanical ventilation, continuous renal replacement therapy (CRRT), standard laboratory parameters, and serum inflammatory cytokines. National (N = 398 671; P = .38) and provincial (n = 62 246; P = .60) ABO blood group distributions did not differ from our cohort (n = 95). A higher proportion of COVID-19 patients with blood group A or AB required mechanical ventilation (P = .02) and CRRT (P = .004) and had a longer ICU stay (P = .03) compared with patients with blood group O or B. Blood group A or AB also had an increased probability of requiring mechanical ventilation and CRRT after adjusting for age, sex, and presence of ≥1 comorbidity. Inflammatory cytokines did not differ between patients with blood group A or AB (n = 11) vs O or B (n = 14; P more than .10 for all cytokines). Collectively, our data indicate that critically ill COVID-19 patients with blood group A or AB are at increased risk for requiring mechanical ventilation, CRRT, and prolonged ICU admission compared with patients with blood group O or B. Further work is needed to understand the underlying mechanisms.
--------------------------------------------------------
Mike Bogetofte Barnkob et al. 2020. Reduced prevalence of SARS-CoV-2 infection in ABO blood group O. Blood Adv (2020) 4 (20): 4990–4993. https://doi.org/10.1182/bloodadvances.2020002657 https://ashpublications.org/bloodadvances/article/4/20/4990/463793
Abstract
Identification of risk factors for contracting and developing serious illness following infection with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) is of paramount interest. Here, we performed a retrospective cohort analysis of all Danish individuals tested for SARS-CoV-2 between 27 February 2020 and 30 July 2020, with a known ABO and RhD blood group, to determine the influence of common blood groups on virus susceptibility. Distribution of blood groups was compared with data from nontested individuals. Participants (29% of whom were male) included 473 654 individuals tested for SARS-CoV-2 using real-time polymerase chain reaction (7422 positive and 466 232 negative) and 2 204 742 nontested individuals, accounting for ∼38% of the total Danish population. Hospitalization and death from COVID-19, age, cardiovascular comorbidities, and job status were also collected for confirmed infected cases. ABO blood groups varied significantly between patients and the reference group, with only 38.41% (95% confidence interval CI, 37.30-39.50) of the patients belonging to blood group O compared with 41.70% (95% CI, 41.60-41.80) in the controls, corresponding to a relative risk of 0.87 (95% CI, 0.83-0.91) for acquiring COVID-19. This study identifies ABO blood group as a risk factor for SARS-CoV-2 infection but not for hospitalization or death from COVID-19.
107margd
Both J&J and Astrazeneca have paused their vaccine trials. (Astrazeneca has resumed in some countries.) Both are based on adenoviruses--human in J&J and chimp in Astrazeneca. Article below discusses some of the immune problems that have arisen in previous such vaccines but not in others. One reason for using chimp adenovirus was hope that humans not yet exposed to it would not mount an immune response. As mentioned above, at least one of Russia's vaccines and at least one of China's are based on adenovirus--hopefully, one way or another they, too are looking for problems. May be nothing, but important to do the studies...
Ailments in Covid-19 trials raise questions about vaccine method
Bloomberg | Oct 17, 2020
https://www.deccanherald.com/international/world-news-politics/ailments-in-covid...
Ailments in Covid-19 trials raise questions about vaccine method
Bloomberg | Oct 17, 2020
https://www.deccanherald.com/international/world-news-politics/ailments-in-covid...
108margd
More Than 1,000 Current and Former CDC Officers Criticize U.S. Covid-19 Response
An open letter calls for the federal agency to play a more central role in addressing the pandemic
Oct. 16, 2020 8:01 pm ET
More than 1,000 current and former officers of an elite disease-fighting program at the U.S. Centers for Disease Control and Prevention have signed an open letter*expressing dismay at the nation’s public-health response to the Covid-19 pandemic and calling for the federal agency to play a more central role.
“The absence of national leadership on Covid-19 is unprecedented and dangerous,” said the letter, signed by current and former officers of the CDC’s Epidemic Intelligence Service of outbreak investigators. “CDC should be at the forefront of a successful response to this global public health emergency.”
Signers included two former CDC directors: Jeffrey Koplan, who led the agency under Presidents Bill Clinton and George W. Bush, and Tom Frieden, who served under President Barack Obama.
All of the signatories were writing to “express our concern about the ominous politicization and silencing of the nation’s health protection agency” during the current pandemic, said their letter, which was published Friday in the Epidemiology Monitor, a newsletter for epidemiologists...
https://www.wsj.com/articles/more-than-1-000-current-and-former-cdc-officers-con...
* pages 12-18 at https://issuu.com/theepidemiologymonitor/docs/final-october-2020-the-epidemiolog...
An open letter calls for the federal agency to play a more central role in addressing the pandemic
Oct. 16, 2020 8:01 pm ET
More than 1,000 current and former officers of an elite disease-fighting program at the U.S. Centers for Disease Control and Prevention have signed an open letter*expressing dismay at the nation’s public-health response to the Covid-19 pandemic and calling for the federal agency to play a more central role.
“The absence of national leadership on Covid-19 is unprecedented and dangerous,” said the letter, signed by current and former officers of the CDC’s Epidemic Intelligence Service of outbreak investigators. “CDC should be at the forefront of a successful response to this global public health emergency.”
Signers included two former CDC directors: Jeffrey Koplan, who led the agency under Presidents Bill Clinton and George W. Bush, and Tom Frieden, who served under President Barack Obama.
All of the signatories were writing to “express our concern about the ominous politicization and silencing of the nation’s health protection agency” during the current pandemic, said their letter, which was published Friday in the Epidemiology Monitor, a newsletter for epidemiologists...
https://www.wsj.com/articles/more-than-1-000-current-and-former-cdc-officers-con...
* pages 12-18 at https://issuu.com/theepidemiologymonitor/docs/final-october-2020-the-epidemiolog...
109John5918
World caught in ‘syndemic’ of chronic diseases and COVID: Report (Al Jazeera)
The world is caught in a perfect storm of rising rates of chronic disease, persistent infectious diseases, and public health failures that have fuelled deaths during the COVID-19 pandemic, according to a major global study of human health.
The emergence and overlap of the coronavirus pandemic with a continued global rise in chronic conditions such as obesity and diabetes – with added environmental risks such as air pollution – have exacerbated the coronavirus death toll, it said... Published in The Lancet medical journal...
The world is caught in a perfect storm of rising rates of chronic disease, persistent infectious diseases, and public health failures that have fuelled deaths during the COVID-19 pandemic, according to a major global study of human health.
The emergence and overlap of the coronavirus pandemic with a continued global rise in chronic conditions such as obesity and diabetes – with added environmental risks such as air pollution – have exacerbated the coronavirus death toll, it said... Published in The Lancet medical journal...
110margd
Remembering PPE, testing, fingers crossed that feds are successful this time...
Feds planning now to get coronavirus shots to nursing homes
Associated Press | Oct 17, 2020
...The distribution program is contingent on the Food and Drug Administration authorizing a vaccine, which does not appear to be imminent. While one nursing home industry group endorsed the administration’s effort, another one (non-profits) was guarded in its reaction.
Under the voluntary program, trained staff from CVS and Walgreens would deliver the vaccines to each nursing home and administer shots. Assisted-living facilities and residential group homes can also participate. Nursing home staffers can be vaccinated, too, if they have not already received their shots. Needles, syringes and other necessary equipment will be included.
...The nation has 15,000-16,000 nursing homes, according to the Centers for Disease Control and Prevention. There may be another 20,000-45,000 assisted living facilities and similar kinds of settings for elderly and disabled people.
People in nursing homes and other long-term care facilities account for less than 1% of the U.S. population, but they represent about 40% of the deaths from COVID-19, with more than 83,600 fatalities logged by the COVID Tracking Project.
The Trump administration’s initial attempts to promote coronavirus testing in nursing homes and to ensure sufficient supplies of protective gear were hampered by missteps and led to widespread complaints from nursing home operators and advocates for older people. The vaccine program seems designed to get ahead of problems at a time when President Donald Trump is battling to hang on to support from older voters in his reelection campaign.
Earlier this month, the National Academies of Sciences, Engineering and Medicine recommended that the initial, limited doses of vaccine should go to first responders and high-risk health care workers. Those next in line should include older residents of nursing homes, the National Academies said, noting that who gets the shots will depend on age guidelines determined by the data on vaccine safety and efficacy.HHS is asking nursing homes to sign up for the program, but the allocation of vaccines will be done through state and territorial governments.
...Nursing homes and long-term care facilities will not be charged. CVS and Walgreens will be reimbursed at standard Medicare rates for administering the shots, officials said.
The use of retail chain pharmacies has prompted some concerns, because nursing homes typically deal with specialized pharmacies and not the big drugstores catering to consumers...the plan would accommodate nursing homes that want to continue to work with specialized pharmacies...
https://fox8.com/news/coronavirus/feds-planning-now-to-get-coronavirus-shots-to-...
Feds planning now to get coronavirus shots to nursing homes
Associated Press | Oct 17, 2020
...The distribution program is contingent on the Food and Drug Administration authorizing a vaccine, which does not appear to be imminent. While one nursing home industry group endorsed the administration’s effort, another one (non-profits) was guarded in its reaction.
Under the voluntary program, trained staff from CVS and Walgreens would deliver the vaccines to each nursing home and administer shots. Assisted-living facilities and residential group homes can also participate. Nursing home staffers can be vaccinated, too, if they have not already received their shots. Needles, syringes and other necessary equipment will be included.
...The nation has 15,000-16,000 nursing homes, according to the Centers for Disease Control and Prevention. There may be another 20,000-45,000 assisted living facilities and similar kinds of settings for elderly and disabled people.
People in nursing homes and other long-term care facilities account for less than 1% of the U.S. population, but they represent about 40% of the deaths from COVID-19, with more than 83,600 fatalities logged by the COVID Tracking Project.
The Trump administration’s initial attempts to promote coronavirus testing in nursing homes and to ensure sufficient supplies of protective gear were hampered by missteps and led to widespread complaints from nursing home operators and advocates for older people. The vaccine program seems designed to get ahead of problems at a time when President Donald Trump is battling to hang on to support from older voters in his reelection campaign.
Earlier this month, the National Academies of Sciences, Engineering and Medicine recommended that the initial, limited doses of vaccine should go to first responders and high-risk health care workers. Those next in line should include older residents of nursing homes, the National Academies said, noting that who gets the shots will depend on age guidelines determined by the data on vaccine safety and efficacy.HHS is asking nursing homes to sign up for the program, but the allocation of vaccines will be done through state and territorial governments.
...Nursing homes and long-term care facilities will not be charged. CVS and Walgreens will be reimbursed at standard Medicare rates for administering the shots, officials said.
The use of retail chain pharmacies has prompted some concerns, because nursing homes typically deal with specialized pharmacies and not the big drugstores catering to consumers...the plan would accommodate nursing homes that want to continue to work with specialized pharmacies...
https://fox8.com/news/coronavirus/feds-planning-now-to-get-coronavirus-shots-to-...
111margd
How the Sturgis Motorcycle Rally may have spread coronavirus across the Upper Midwest
Within weeks of the gathering that drew nearly half a million bikers, the Dakotas, along with Wyoming, Minnesota and Montana, were leading the nation in new coronavirus infections per capita.
Brittany Shammas and Lena H. Sun | Oct. 17, 2020
...Within weeks of the gathering, the Dakotas, along with Wyoming, Minnesota and Montana, were leading the nation in new coronavirus infections per capita. The surge was especially pronounced in North and South Dakota, where cases and hospitalization rates continued their juggernaut rise into October. Experts say they will never be able to determine how many of those cases originated at the 10-day rally, given the failure of state and local health officials to identify and monitor attendees returning home, or to trace chains of transmission after people got sick. Some, however, believe the nearly 500,000-person gathering played a role in the outbreak now consuming the Upper Midwest.
...The Aug. 7-16 gathering has drawn intense interest from scientists and health officials, and will likely be studied for years to come because of its singularity. It’s not just that Sturgis went on after the pandemic sidelined most everything else. It also drew people from across the country, all of them converging on one region, packing the small city’s Main Street and the bars and restaurants along it. And in contrast with participants in the Black Lives Matter protests this summer, many Sturgis attendees spent time clustered indoors at bars, restaurants and tattoo parlors, where experts say the virus is most likely to spread, especially among those without masks.
Attendees came from every state, with just under half hailing from the Great Plains and substantial numbers journeying from as far as California, Illinois and Arizona...
...On average, the analysis found, attendees spent less time at home than others before and after the event, and traveled twice the daily distance of non-rally goers, underscoring concerns about the potential for virus transmission.
That was true even in states where officials asked Sturgis attendees to quarantine after returning home, including Minnesota, New York and New Jersey.
...South Dakota, which had the most attendees, saw coronavirus cases surge within weeks of the rally’s Aug. 16 close, with the seven-day rolling average going from 84 on Aug. 6 to 214 on Aug. 27. The numbers remained elevated into October: The first day of the month, the seven-day rolling average was 434. The state is second in the nation in cases per capita behind North Dakota, with numbers high enough for the Harvard Global Health Institute to recommend stay-at-home orders.
https://www.washingtonpost.com/health/2020/10/17/sturgis-rally-spread/
Within weeks of the gathering that drew nearly half a million bikers, the Dakotas, along with Wyoming, Minnesota and Montana, were leading the nation in new coronavirus infections per capita.
Brittany Shammas and Lena H. Sun | Oct. 17, 2020
...Within weeks of the gathering, the Dakotas, along with Wyoming, Minnesota and Montana, were leading the nation in new coronavirus infections per capita. The surge was especially pronounced in North and South Dakota, where cases and hospitalization rates continued their juggernaut rise into October. Experts say they will never be able to determine how many of those cases originated at the 10-day rally, given the failure of state and local health officials to identify and monitor attendees returning home, or to trace chains of transmission after people got sick. Some, however, believe the nearly 500,000-person gathering played a role in the outbreak now consuming the Upper Midwest.
...The Aug. 7-16 gathering has drawn intense interest from scientists and health officials, and will likely be studied for years to come because of its singularity. It’s not just that Sturgis went on after the pandemic sidelined most everything else. It also drew people from across the country, all of them converging on one region, packing the small city’s Main Street and the bars and restaurants along it. And in contrast with participants in the Black Lives Matter protests this summer, many Sturgis attendees spent time clustered indoors at bars, restaurants and tattoo parlors, where experts say the virus is most likely to spread, especially among those without masks.
Attendees came from every state, with just under half hailing from the Great Plains and substantial numbers journeying from as far as California, Illinois and Arizona...
...On average, the analysis found, attendees spent less time at home than others before and after the event, and traveled twice the daily distance of non-rally goers, underscoring concerns about the potential for virus transmission.
That was true even in states where officials asked Sturgis attendees to quarantine after returning home, including Minnesota, New York and New Jersey.
...South Dakota, which had the most attendees, saw coronavirus cases surge within weeks of the rally’s Aug. 16 close, with the seven-day rolling average going from 84 on Aug. 6 to 214 on Aug. 27. The numbers remained elevated into October: The first day of the month, the seven-day rolling average was 434. The state is second in the nation in cases per capita behind North Dakota, with numbers high enough for the Harvard Global Health Institute to recommend stay-at-home orders.
https://www.washingtonpost.com/health/2020/10/17/sturgis-rally-spread/
112margd
STRAWBERRIES! :)
Cassandra Willyard. 2020. How anti-ageing drugs could boost COVID vaccines in older people. Nature 586, 352-354 (14 October 2020) Nature 586, 352-354 (2020) doi: https://doi.org/10.1038/d41586-020-02856-7 https://www.nature.com/articles/d41586-020-02856-7
COVID-19 poses the greatest threat to older people, but vaccines often don’t work well in this group. Scientists hope drugs that rejuvenate the immune system will help.
....In its phase I study of 40 people aged 56 and over, Moderna in Cambridge, Massachusetts, reported that its candidate mRNA-1273 elicited similar antibody levels as those elicited in a younger age group1. The Chinese biotech Sinovac in Beijing, which trialled its CoronaVac candidate in a phase I/II study that included 421 adults between 60 and 89 years of age, announced in a press release on 9 September that it seems to work as well in older adults as it does in younger ones. However, a phase I study by international pharma company Pfizer and BioNTech in Mainz, Germany, showed that their vaccine BNT162b2 provokes an immune response that is about half as strong in older adults as it is in younger ones2. The older adults still produced more antibodies in response to the vaccine than people of a similar age who had had COVID-19, but it’s not known how these levels translate into protection from the virus.
...researchers might be able to find ways to tweak the shot itself to elicit a stronger response. Some influenza vaccines, for instance, include immune-boosting ingredients or higher doses of the viral antigen. But some scientists say there is a better option. They are developing and testing drugs that could improve how older adults respond to vaccines and might also help them fight viruses more effectively in the first place. Rather than working with the limitations of the ageing immune system, they are planning to rejuvenate it.
...One promising class of anti-ageing drug acts on pathways involved in cell growth. These drugs inhibit a protein known as mTOR...
...RTB101 is similar to an already approved mTOR inhibitor, the immune-suppressing drug rapamycin. ..
...The type 2 diabetes drug metformin also dampens down mTOR’s activity, albeit indirectly.
...the anti-inflammatory drug losmapimod, which is being developed as a therapy for muscular dystrophy, might help boost immunity.
...Another class of drug, called senolytics, helps to purge the body of cells that have stopped dividing but won’t die.
...a senolytic called fisetin, which is found in strawberries and sold as a health supplement...
...Kirkland says he can envisage giving one of these anti-ageing drugs as a primer before vaccination. “...
...A team led by vaccinologist Ofer Levy at Boston Children’s Hospital in Massachusetts is working on a COVID-19 vaccine specifically for older adults, using an in-vitro screening system to identify the best adjuvants.
...an immune-boosting medication could be used with any vaccine...
Cassandra Willyard. 2020. How anti-ageing drugs could boost COVID vaccines in older people. Nature 586, 352-354 (14 October 2020) Nature 586, 352-354 (2020) doi: https://doi.org/10.1038/d41586-020-02856-7 https://www.nature.com/articles/d41586-020-02856-7
COVID-19 poses the greatest threat to older people, but vaccines often don’t work well in this group. Scientists hope drugs that rejuvenate the immune system will help.
....In its phase I study of 40 people aged 56 and over, Moderna in Cambridge, Massachusetts, reported that its candidate mRNA-1273 elicited similar antibody levels as those elicited in a younger age group1. The Chinese biotech Sinovac in Beijing, which trialled its CoronaVac candidate in a phase I/II study that included 421 adults between 60 and 89 years of age, announced in a press release on 9 September that it seems to work as well in older adults as it does in younger ones. However, a phase I study by international pharma company Pfizer and BioNTech in Mainz, Germany, showed that their vaccine BNT162b2 provokes an immune response that is about half as strong in older adults as it is in younger ones2. The older adults still produced more antibodies in response to the vaccine than people of a similar age who had had COVID-19, but it’s not known how these levels translate into protection from the virus.
...researchers might be able to find ways to tweak the shot itself to elicit a stronger response. Some influenza vaccines, for instance, include immune-boosting ingredients or higher doses of the viral antigen. But some scientists say there is a better option. They are developing and testing drugs that could improve how older adults respond to vaccines and might also help them fight viruses more effectively in the first place. Rather than working with the limitations of the ageing immune system, they are planning to rejuvenate it.
...One promising class of anti-ageing drug acts on pathways involved in cell growth. These drugs inhibit a protein known as mTOR...
...RTB101 is similar to an already approved mTOR inhibitor, the immune-suppressing drug rapamycin. ..
...The type 2 diabetes drug metformin also dampens down mTOR’s activity, albeit indirectly.
...the anti-inflammatory drug losmapimod, which is being developed as a therapy for muscular dystrophy, might help boost immunity.
...Another class of drug, called senolytics, helps to purge the body of cells that have stopped dividing but won’t die.
...a senolytic called fisetin, which is found in strawberries and sold as a health supplement...
...Kirkland says he can envisage giving one of these anti-ageing drugs as a primer before vaccination. “...
...A team led by vaccinologist Ofer Levy at Boston Children’s Hospital in Massachusetts is working on a COVID-19 vaccine specifically for older adults, using an in-vitro screening system to identify the best adjuvants.
...an immune-boosting medication could be used with any vaccine...
113margd
Pfizer begins manufacturing COVID-19 vaccines ahead of expected approval
Times of Israel staff and Agencies | 10/19/2020
US pharmaceutical giant Pfizer has begun manufacturing hundreds of thousands of doses of its COVID-19 vaccine...
(video showing a manufacturing plant in Puurs, Belgium with thousands of doses of the vaccine coming off the production line, 2:27).
Pfizer said last week it expects to file for emergency use authorization for its COVID-19 vaccine in late November, around two weeks after the November 3 US presidential election...after safety data is available in the third week of November.
The company has said it hopes to make 100 million doses available this year and a massive 1,3 billion available in 2021. Each recipient will need two doses.
...In July the US announced it will pay Pfizer nearly $2 billion for a December delivery of 100 million doses of a COVID-19 vaccine the pharmaceutical company is developing. The US could buy another 500 million doses under the agreement.
...The Pfizer announcement last week means the United States could have two vaccines ready by the end of the year, with Massachusetts biotech firm Moderna aiming for November 25 to seek authorization.
...Pfizer and Modern, both funded by the US government, launched Phase 3 of their clinical trials at the end of July, and both have started production of doses.
https://www.timesofisrael.com/pfizer-begins-manufacturing-covid-19-vaccines-ahea...
Times of Israel staff and Agencies | 10/19/2020
US pharmaceutical giant Pfizer has begun manufacturing hundreds of thousands of doses of its COVID-19 vaccine...
(video showing a manufacturing plant in Puurs, Belgium with thousands of doses of the vaccine coming off the production line, 2:27).
Pfizer said last week it expects to file for emergency use authorization for its COVID-19 vaccine in late November, around two weeks after the November 3 US presidential election...after safety data is available in the third week of November.
The company has said it hopes to make 100 million doses available this year and a massive 1,3 billion available in 2021. Each recipient will need two doses.
...In July the US announced it will pay Pfizer nearly $2 billion for a December delivery of 100 million doses of a COVID-19 vaccine the pharmaceutical company is developing. The US could buy another 500 million doses under the agreement.
...The Pfizer announcement last week means the United States could have two vaccines ready by the end of the year, with Massachusetts biotech firm Moderna aiming for November 25 to seek authorization.
...Pfizer and Modern, both funded by the US government, launched Phase 3 of their clinical trials at the end of July, and both have started production of doses.
https://www.timesofisrael.com/pfizer-begins-manufacturing-covid-19-vaccines-ahea...
114margd
Laurence Tribe tribelaw | 5:14 AM · Oct 19, 2020:
18 U.S.C. § 1112 defines “the commission…without due caution and circumspection, of a lawful act which might produce death” as “involuntarily manslaughter,” a felony punishable by 8 years in federal prison.
Donald Trump commits that crime every time he holds one of his rallies.
-----------------------------------------------------
18 U.S.C. § 1112 defines “the commission…without due caution and circumspection, of a lawful act which might produce death” as “involuntarily manslaughter,” a felony punishable by 8 years in federal prison.
Donald Trump commits that crime every time he holds one of his rallies.
-----------------------------------------------------
115margd
SARS-CoV-2 antibodies may provide immunity for at least 5–7 months
James Kingsland | October 16, 2020
...The scientists have also tracked how long immunity to the virus lasted among those who initially tested positive.
This showed that levels of immunity were strongest among those who experienced the most severe infections. However, the strength of immunity did not appear to vary according to age or sex.
In addition, their research revealed that after an initial decline, levels of immunity stabilized and persisted for at least 5–7 months of the follow-up.
...Other studies have suggested that immunity is short lived, in particular, among those with mild infections.
The authors of the new study believe that these studies made the mistake of extrapolating long-term immunity from the early falls they saw in neutralizing antibodies.
They write that in a typical viral infection, there is an initial wave of short-lived antibody-producing immune cells, which then quickly decline in number. However, what follows is the creation of a smaller number of longer lived antibody-producing cells, which can last for years.
...two limitations of their study. Firstly, they say there is a possibility that some individuals who had contracted the virus lost their immunity before they took the antibody test and, therefore, tested negative.
Secondly, the maximum follow-up was 226 days after the onset of the disease. There remains a possibility that antibody levels may decline sharply thereafter.
https://www.medicalnewstoday.com/articles/sars-cov-2-antibodies-may-provide-immu...
-----------------------------------------------------------------
Tyler J. Ripperger et al. 2020. Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low Prevalence Communities and Reveal Durable Humoral Immunity. Immunity. Published:October 13, 2020DOI:https://doi.org/10.1016/j.immuni.2020.10.004 https://www.cell.com/immunity/fulltext/S1074-7613(20)30445-3
Highlights
• Using independent SARS-CoV-2 antigens improves specificity of serological assays
• Neutralizing and spike-specific antibody production persists for at least 5-7 months
• Nucleocapsid antibodies frequently become undetectable by 5-7 months
• Antibody production is higher in severe disease relative to mild cases
Summary
We conducted a serological study to define correlates of immunity against SARS-CoV-2. Relative to mild COVID-19 cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against nucleocapsid (N) and the receptor binding domain (RBD) of spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months post-onset, whereas α-N titers diminished. Testing of 5882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
James Kingsland | October 16, 2020
...The scientists have also tracked how long immunity to the virus lasted among those who initially tested positive.
This showed that levels of immunity were strongest among those who experienced the most severe infections. However, the strength of immunity did not appear to vary according to age or sex.
In addition, their research revealed that after an initial decline, levels of immunity stabilized and persisted for at least 5–7 months of the follow-up.
...Other studies have suggested that immunity is short lived, in particular, among those with mild infections.
The authors of the new study believe that these studies made the mistake of extrapolating long-term immunity from the early falls they saw in neutralizing antibodies.
They write that in a typical viral infection, there is an initial wave of short-lived antibody-producing immune cells, which then quickly decline in number. However, what follows is the creation of a smaller number of longer lived antibody-producing cells, which can last for years.
...two limitations of their study. Firstly, they say there is a possibility that some individuals who had contracted the virus lost their immunity before they took the antibody test and, therefore, tested negative.
Secondly, the maximum follow-up was 226 days after the onset of the disease. There remains a possibility that antibody levels may decline sharply thereafter.
https://www.medicalnewstoday.com/articles/sars-cov-2-antibodies-may-provide-immu...
-----------------------------------------------------------------
Tyler J. Ripperger et al. 2020. Orthogonal SARS-CoV-2 Serological Assays Enable Surveillance of Low Prevalence Communities and Reveal Durable Humoral Immunity. Immunity. Published:October 13, 2020DOI:https://doi.org/10.1016/j.immuni.2020.10.004 https://www.cell.com/immunity/fulltext/S1074-7613(20)30445-3
Highlights
• Using independent SARS-CoV-2 antigens improves specificity of serological assays
• Neutralizing and spike-specific antibody production persists for at least 5-7 months
• Nucleocapsid antibodies frequently become undetectable by 5-7 months
• Antibody production is higher in severe disease relative to mild cases
Summary
We conducted a serological study to define correlates of immunity against SARS-CoV-2. Relative to mild COVID-19 cases, individuals with severe disease exhibited elevated virus-neutralizing titers and antibodies against nucleocapsid (N) and the receptor binding domain (RBD) of spike protein. Age and sex played lesser roles. All cases, including asymptomatic individuals, seroconverted by 2 weeks post-PCR confirmation. Spike RBD and S2 and neutralizing antibodies remained detectable through 5-7 months post-onset, whereas α-N titers diminished. Testing of 5882 members of the local community revealed only 1 sample with seroreactivity to both RBD and S2 that lacked neutralizing antibodies. This fidelity could not be achieved with either RBD or S2 alone. Thus, inclusion of multiple independent assays improved the accuracy of antibody tests in low seroprevalence communities and revealed differences in antibody kinetics depending on the antigen. We conclude that neutralizing antibodies are stably produced for at least 5-7 months after SARS-CoV-2 infection.
116margd
3 billion people could struggle to get a COVID-19 vaccine because the world doesn't have enough fridges to store it
insider@insider.com (Bill Bostock) | Oct 19, 2020
Three billion people may be denied a COVID-19 vaccine when it's here because a number of countries don't have sufficient cold storage facilities...
Most vaccines need to kept at between 2 and 8 degrees Celsius, but the vaccine candidates from Moderna and Pfizer need temperatures of minus 15 and minus 70 Celsius respectively.
Parts of Central Asia, India, southeast Asia, Latin America, and "all but a tiny corner of Africa" are most in need of cold storage facilities...
...Other parts of the vaccine supply chain, such as a shortage of glass vials, could also hamper a global inoculation drive.
...Sam Roscoe, a senior lecturer in operations management at the University of Sussex and a fellow at the UK Trade Policy Observatory..."The World Health Organization, UNICEF, and USAID will have an important role to play in ensuring the current lack of cold storage does not impede the vaccine being distributed around the world."
A September report from the German logistics giant DHL said that "temperature requirements are likely to be the main challenge" to a COVID-19 vaccine rollout.
...Anna Nagurney, professor of operations management at the University of Massachusetts Amherst, also said the supply chain is currently able to handle the production and rollout of around 6.4 billion flu vaccines a year — which is not enough for the entire world.
...UPS is constructing two "freezer farms" containing "600 deep-freezers that can each hold 48,000 vials of vaccine at temperatures as low as -80 Celsius," Bloomberg reported.
...Covax — which is run by the World Health Organization, Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations — aims to administer two billion doses to the world's poorest by 2022...plans to prioritize vaccines that can be stored at 2 to 8 degrees Celsius...
Experts also worry that other parts of the vaccine supply chain are not equipped to handle a global vaccination drive...glass vials...cargo planes ...
https://www.msn.com/en-us/health/medical/3-billion-people-could-struggle-to-get-...
insider@insider.com (Bill Bostock) | Oct 19, 2020
Three billion people may be denied a COVID-19 vaccine when it's here because a number of countries don't have sufficient cold storage facilities...
Most vaccines need to kept at between 2 and 8 degrees Celsius, but the vaccine candidates from Moderna and Pfizer need temperatures of minus 15 and minus 70 Celsius respectively.
Parts of Central Asia, India, southeast Asia, Latin America, and "all but a tiny corner of Africa" are most in need of cold storage facilities...
...Other parts of the vaccine supply chain, such as a shortage of glass vials, could also hamper a global inoculation drive.
...Sam Roscoe, a senior lecturer in operations management at the University of Sussex and a fellow at the UK Trade Policy Observatory..."The World Health Organization, UNICEF, and USAID will have an important role to play in ensuring the current lack of cold storage does not impede the vaccine being distributed around the world."
A September report from the German logistics giant DHL said that "temperature requirements are likely to be the main challenge" to a COVID-19 vaccine rollout.
...Anna Nagurney, professor of operations management at the University of Massachusetts Amherst, also said the supply chain is currently able to handle the production and rollout of around 6.4 billion flu vaccines a year — which is not enough for the entire world.
...UPS is constructing two "freezer farms" containing "600 deep-freezers that can each hold 48,000 vials of vaccine at temperatures as low as -80 Celsius," Bloomberg reported.
...Covax — which is run by the World Health Organization, Gavi, the Vaccine Alliance, and the Coalition for Epidemic Preparedness Innovations — aims to administer two billion doses to the world's poorest by 2022...plans to prioritize vaccines that can be stored at 2 to 8 degrees Celsius...
Experts also worry that other parts of the vaccine supply chain are not equipped to handle a global vaccination drive...glass vials...cargo planes ...
https://www.msn.com/en-us/health/medical/3-billion-people-could-struggle-to-get-...
117margd
Eric Topol @EricTopol | 11:01 AM · Oct 19, 2020:
In a new study of over 5400 individuals at skilled nursing facilities who were PCR covid positive,
40.6% were asymptomatic. And they were assessed 14 days after virus testing.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771816
Image ( https://twitter.com/EricTopol/status/1318205662652813312/photo/1 )
Image ( https://twitter.com/EricTopol/status/1318205662652813312/photo/2 )
---------------------------------------------------------------------------------
Elizabeth M. White et al. 2020. Asymptomatic and Presymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection Rates in a Multistate Sample of Skilled Nursing Facilities (Research Letter). JAMA Intern Med. Published online October 19, 2020. doi:10.1001/jamainternmed.2020.5664 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2771816
Asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be a major contributing factor in skilled nursing facility (SNF) outbreaks. However, limited knowledge exists regarding the prevalence of asymptomatic and presymptomatic infection in this setting. Although an estimated 40% to 45% of SARS-CoV-2 infections in the general population are asymptomatic at time of testing, a small number of US and international reports have documented higher asymptomatic rates in SNFs. We examined asymptomatic and presymptomatic infection rates in a large multistate sample of US SNFs, and examined variation in case counts by SARS-CoV-2 prevalence in the counties where SNFs are located.
In a new study of over 5400 individuals at skilled nursing facilities who were PCR covid positive,
40.6% were asymptomatic. And they were assessed 14 days after virus testing.
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2771816
Image ( https://twitter.com/EricTopol/status/1318205662652813312/photo/1 )
Image ( https://twitter.com/EricTopol/status/1318205662652813312/photo/2 )
---------------------------------------------------------------------------------
Elizabeth M. White et al. 2020. Asymptomatic and Presymptomatic Severe Acute Respiratory Syndrome Coronavirus 2 Infection Rates in a Multistate Sample of Skilled Nursing Facilities (Research Letter). JAMA Intern Med. Published online October 19, 2020. doi:10.1001/jamainternmed.2020.5664 https://jamanetwork.com/journals/jamainternalmedicine/article-abstract/2771816
Asymptomatic transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) may be a major contributing factor in skilled nursing facility (SNF) outbreaks. However, limited knowledge exists regarding the prevalence of asymptomatic and presymptomatic infection in this setting. Although an estimated 40% to 45% of SARS-CoV-2 infections in the general population are asymptomatic at time of testing, a small number of US and international reports have documented higher asymptomatic rates in SNFs. We examined asymptomatic and presymptomatic infection rates in a large multistate sample of US SNFs, and examined variation in case counts by SARS-CoV-2 prevalence in the counties where SNFs are located.
118margd
#58 in previous thread (13). Scott Atlas, contd.
Trump’s den of dissent: Inside the White House task force as coronavirus surges
Yasmeen Abutaleb, Philip Rucker, Josh Dawsey and Robert Costa | Oct. 19, 2020
...Discord on the coronavirus task force has worsened since the arrival in late summer of (neuroradiologist Scott) Atlas, whom colleagues said they regard as ill-informed, manipulative and at times dishonest. As the White House coronavirus response coordinator, Deborah Birx is tasked with collecting and analyzing infection data and compiling charts detailing upticks and other trends. But Atlas routinely has challenged Birx’s analysis and those of other doctors, including Anthony S. Fauci, Centers for Disease Control and Prevention Director Robert Redfield, and Food and Drug Administration Commissioner Stephen Hahn, with what the other doctors considered junk science, according to three senior administration officials.
...In one recent encounter, Pence...told (Atlas and Birx) to bring data bolstering their perspectives to the task force and to work out their disagreements themselves...
The result has been a U.S. response increasingly plagued by distrust, infighting and lethargy, just as experts predict coronavirus cases could surge this winter and deaths could reach 400,000 by year’s end.
...whispering optimism in the tempestuous president’s ear has been Atlas, who is said to be operating with the full confidence of Jared Kushner, Trump’s son-in-law and senior adviser overseeing key aspects of the pandemic response, and Hope Hicks, the president’s counselor and confidante...
...Most controversially, Atlas has pushed a baseless theory inside the task force that the U.S. population is close to herd immunity — the point at which enough people become immune to a disease either by becoming infected or getting vaccinated that its spread slows — despite a scientific consensus that the United States is nowhere close.
...Trump has used Atlas to back up his own rejection of medical expertise. At Thursday’s NBC News town hall, a Florida voter asked the president whether after contracting covid-19 he now believed in the importance of mask-wearing.
(Savannah) Guthrie challenged him by noting that all of his health officials were united in advocating masks...
“Scott Adkins,” Trump said, mispronouncing the doctor’s name. “If you look at Scott, Dr. Scott, he’s from — great guy — from Stanford, he will tell you.”
“He’s not an infectious-disease expert,” Guthrie said.
“Oh, I don’t know,” Trump replied. “Look, he’s an expert. He’s one of the experts of the world.”
https://twitter.com/costareports/status/1318140673820905473
___________________________________________________
Trump making fun of Biden for listening to the scientists. Calling for states to open. Scared yet?
0:57 ( https://twitter.com/deanofdublin/status/1318214327975833603 )
Trump’s den of dissent: Inside the White House task force as coronavirus surges
Yasmeen Abutaleb, Philip Rucker, Josh Dawsey and Robert Costa | Oct. 19, 2020
...Discord on the coronavirus task force has worsened since the arrival in late summer of (neuroradiologist Scott) Atlas, whom colleagues said they regard as ill-informed, manipulative and at times dishonest. As the White House coronavirus response coordinator, Deborah Birx is tasked with collecting and analyzing infection data and compiling charts detailing upticks and other trends. But Atlas routinely has challenged Birx’s analysis and those of other doctors, including Anthony S. Fauci, Centers for Disease Control and Prevention Director Robert Redfield, and Food and Drug Administration Commissioner Stephen Hahn, with what the other doctors considered junk science, according to three senior administration officials.
...In one recent encounter, Pence...told (Atlas and Birx) to bring data bolstering their perspectives to the task force and to work out their disagreements themselves...
The result has been a U.S. response increasingly plagued by distrust, infighting and lethargy, just as experts predict coronavirus cases could surge this winter and deaths could reach 400,000 by year’s end.
...whispering optimism in the tempestuous president’s ear has been Atlas, who is said to be operating with the full confidence of Jared Kushner, Trump’s son-in-law and senior adviser overseeing key aspects of the pandemic response, and Hope Hicks, the president’s counselor and confidante...
...Most controversially, Atlas has pushed a baseless theory inside the task force that the U.S. population is close to herd immunity — the point at which enough people become immune to a disease either by becoming infected or getting vaccinated that its spread slows — despite a scientific consensus that the United States is nowhere close.
...Trump has used Atlas to back up his own rejection of medical expertise. At Thursday’s NBC News town hall, a Florida voter asked the president whether after contracting covid-19 he now believed in the importance of mask-wearing.
(Savannah) Guthrie challenged him by noting that all of his health officials were united in advocating masks...
“Scott Adkins,” Trump said, mispronouncing the doctor’s name. “If you look at Scott, Dr. Scott, he’s from — great guy — from Stanford, he will tell you.”
“He’s not an infectious-disease expert,” Guthrie said.
“Oh, I don’t know,” Trump replied. “Look, he’s an expert. He’s one of the experts of the world.”
https://twitter.com/costareports/status/1318140673820905473
___________________________________________________
Trump making fun of Biden for listening to the scientists. Calling for states to open. Scared yet?
0:57 ( https://twitter.com/deanofdublin/status/1318214327975833603 )
119margd
Herd immunity...
Saad B. Omer et al. 2020. Herd Immunity and Implications for SARS-CoV-2 Control (Insight). JAMA. Published online October 19, 2020. doi:10.1001/jama.2020.20892 https://jamanetwork.com/journals/jama/fullarticle/2772167
...there is no example of a large-scale successful intentional infection-based herd immunity strategy.
...The population of the United States is about 330 million. Based on World Health Organization estimates of an infection fatality rate of 0.5%, about 198 million individuals in the United States are needed to be immune to reach a herd immunity threshold of approximately 60%, which would lead to several hundred thousand additional deaths. Assuming that less than 10% of the population has been infected so far, 10 with an infection-induced immunity lasting 2 to 3 years (duration unknown), infection-induced herd immunity is not realistic at this point to control the pandemic. SARS-CoV-2 vaccines will help to reach the herd immunity threshold, but the effectiveness of the vaccine(s) and the vaccine coverage are to be seen...
Saad B. Omer et al. 2020. Herd Immunity and Implications for SARS-CoV-2 Control (Insight). JAMA. Published online October 19, 2020. doi:10.1001/jama.2020.20892 https://jamanetwork.com/journals/jama/fullarticle/2772167
...there is no example of a large-scale successful intentional infection-based herd immunity strategy.
...The population of the United States is about 330 million. Based on World Health Organization estimates of an infection fatality rate of 0.5%, about 198 million individuals in the United States are needed to be immune to reach a herd immunity threshold of approximately 60%, which would lead to several hundred thousand additional deaths. Assuming that less than 10% of the population has been infected so far, 10 with an infection-induced immunity lasting 2 to 3 years (duration unknown), infection-induced herd immunity is not realistic at this point to control the pandemic. SARS-CoV-2 vaccines will help to reach the herd immunity threshold, but the effectiveness of the vaccine(s) and the vaccine coverage are to be seen...
120margd
CDC v. WH/Atlas?
U.S. CDC issues 'strong recommendation' for mask mandate on airplanes, trains
David Shepardson | 10/20/2020
The U.S. Centers for Disease Control and Prevention on Monday issued a “strong recommendation” that all passengers and employees on airplanes, trains, subways, buses, taxis and ride-share vehicles should wear masks to prevent the spread of COVID-19.
The interim guidance also calls for facial coverings at transportation hubs like airports and train stations.
...the White House in July opposed language in a bill before Congress that would have mandated all airline, train and public transit passengers and workers to wear masks...
https://ca.reuters.com/article/instant-article/idUSL1N2HA24V
U.S. CDC issues 'strong recommendation' for mask mandate on airplanes, trains
David Shepardson | 10/20/2020
The U.S. Centers for Disease Control and Prevention on Monday issued a “strong recommendation” that all passengers and employees on airplanes, trains, subways, buses, taxis and ride-share vehicles should wear masks to prevent the spread of COVID-19.
The interim guidance also calls for facial coverings at transportation hubs like airports and train stations.
...the White House in July opposed language in a bill before Congress that would have mandated all airline, train and public transit passengers and workers to wear masks...
https://ca.reuters.com/article/instant-article/idUSL1N2HA24V
121margd
Britain to infect healthy volunteers with coronavirus in vaccine challenge trials
William Booth and Carolyn Y. Johnson | Oct. 20, 2020
...people will be submitting themselves to a deadly virus with no surefire treatment.
...potential payoff is massive — that accelerating vaccine development by even three months could save hundreds of thousands of lives globally.
The British experiment is scheduled to begin in January. Volunteers will have a purified, laboratory-grown strain of the live virus blown into their noses, while quarantined in a 22-bed biosecure unit at the Royal Free Hospital in London, where they will undergo daily, even hourly, tests over two to three weeks.
...determine the minimal amount of virus necessary to cause an active, measurable infection in their upper respiratory system
...possible candidates include those vaccines that have proven themselves in large-scale Phase 3 trials, or they may be earlier in their development but potentially more effective
...Phase 3 trials will still be essential to show the vaccines are ready to be deployed in large populations. But the British government hopes challenge trials will help accelerate the study of vaccines in mid-stages of development...
...major advantage is “you get efficacy data so much sooner” than trials that rely on chance exposure (especially) If there is not much virus circulating in a population
...British human challenge model would be able to tell within 10 weeks how effective a coronavirus vaccine is
...If a clinical subject became seriously ill or died in the British challenge trials, the scientists, pharmaceutical companies and the government could be blamed and condemned as reckless. Public support for clinical trials and for new vaccines could also take a hit.
...38,000 people willing to volunteer...altruism...
...volunteers would be increasing their risk but not starting from zero — they would be exposed to a strain of the novel coronavirus already circulating widely in Britain, especially among young people.
...volunteers should be paid for their time
https://www.washingtonpost.com/world/europe/covid-challenge-trials-uk/2020/10/20...
___________________________________________________
ETA
Eric Topol @EricTopol 8:40 PM · Oct 21, 2020
Many will question the ethics of a vaccine challenge trial (intentionally infecting the virus)
https://nature.com/articles/d41586-020-02821-4
But that's nothing compared with the unethical, reckless strategy to achieve herd immunity without a vaccine
https://nature.com/articles/d41586-020-02948-4 ...
William Booth and Carolyn Y. Johnson | Oct. 20, 2020
...people will be submitting themselves to a deadly virus with no surefire treatment.
...potential payoff is massive — that accelerating vaccine development by even three months could save hundreds of thousands of lives globally.
The British experiment is scheduled to begin in January. Volunteers will have a purified, laboratory-grown strain of the live virus blown into their noses, while quarantined in a 22-bed biosecure unit at the Royal Free Hospital in London, where they will undergo daily, even hourly, tests over two to three weeks.
...determine the minimal amount of virus necessary to cause an active, measurable infection in their upper respiratory system
...possible candidates include those vaccines that have proven themselves in large-scale Phase 3 trials, or they may be earlier in their development but potentially more effective
...Phase 3 trials will still be essential to show the vaccines are ready to be deployed in large populations. But the British government hopes challenge trials will help accelerate the study of vaccines in mid-stages of development...
...major advantage is “you get efficacy data so much sooner” than trials that rely on chance exposure (especially) If there is not much virus circulating in a population
...British human challenge model would be able to tell within 10 weeks how effective a coronavirus vaccine is
...If a clinical subject became seriously ill or died in the British challenge trials, the scientists, pharmaceutical companies and the government could be blamed and condemned as reckless. Public support for clinical trials and for new vaccines could also take a hit.
...38,000 people willing to volunteer...altruism...
...volunteers would be increasing their risk but not starting from zero — they would be exposed to a strain of the novel coronavirus already circulating widely in Britain, especially among young people.
...volunteers should be paid for their time
https://www.washingtonpost.com/world/europe/covid-challenge-trials-uk/2020/10/20...
___________________________________________________
ETA
Eric Topol @EricTopol 8:40 PM · Oct 21, 2020
Many will question the ethics of a vaccine challenge trial (intentionally infecting the virus)
https://nature.com/articles/d41586-020-02821-4
But that's nothing compared with the unethical, reckless strategy to achieve herd immunity without a vaccine
https://nature.com/articles/d41586-020-02948-4 ...
122margd
Building on the caged hamster study, caged ferret study demonstrates that "SARS-CoV and SARS-CoV-2 can remain infectious while traveling through (more than one meter of) air." Granted one must be "at the right place at the right moment" to be infected.
Dr. Ali Nouri (Pres. FAS) @AliNouriPhD | 7:15 PM · Oct 19, 2020:
REPORT: SARS-COV-2 can remain infectious while traveling through air. Donor ferrets infected with SARS-COV-2 (or classic SARS) infected recipient ferrets over 1 meter away.
Diagram of cage set-up ( https://twitter.com/AliNouriPhD/status/1318330008755195904/photo/1 )
In addition to remaining infectious, there was robust viral replication after transmission via the air
Despite donor ferrets given a high viral dose and recipient animals that likely received a lower infectious dose
via the air, kinetics of virus shedding were similar in all animals, indicating a robust replication of both SARS-CoV-2 and SARS-CoV upon transmission via air 2/3
Should be noted that the experimental set-up included uni-directional airflow where recipients are "constantly at the
right place at the right moment, which may contribute to the relatively high efficiency of virus transmission via the air" 3/3
------------------------------------------------------------
Jasmin S Kutter et al. 2020. SARS-CoV and SARS-CoV-2 are transmitted through the air between ferrets over more than one meter distance. BioRxiv (Oct 19, 2020) doi: https://doi.org/10.1101/2020.10.19.345363 https://www.biorxiv.org/content/10.1101/2020.10.19.345363v1
This article is a preprint and has not been certified by peer review .
Abstract
SARS-CoV-2 emerged in late 2019 and caused a pandemic, whereas the closely related SARS-CoV was contained rapidly in 2003. Here, a newly developed experimental set-up was used to study transmission of SARS-CoV and SARS-CoV-2 through the air between ferrets over more than a meter distance. Both viruses caused a robust productive respiratory tract infection resulting in transmission of SARS-CoV-2 to two of four indirect recipient ferrets and SARS-CoV to all four. A control pandemic A/H1N1 influenza virus also transmitted efficiently. Serological assays confirmed all virus transmission events. Although the experiments did not discriminate between transmission via small aerosols, large droplets and fomites, these results demonstrate that SARS-CoV and SARS-CoV-2 can remain infectious while traveling through the air. Efficient virus transmission between ferrets is in agreement with frequent SARS-CoV-2 outbreaks in mink farms. Although the evidence for airborne virus transmission between humans under natural conditions is absent or weak for SARS-CoV and SARS-CoV-2, ferrets may represent a sensitive model to study interventions aimed at preventing virus transmission.
Dr. Ali Nouri (Pres. FAS) @AliNouriPhD | 7:15 PM · Oct 19, 2020:
REPORT: SARS-COV-2 can remain infectious while traveling through air. Donor ferrets infected with SARS-COV-2 (or classic SARS) infected recipient ferrets over 1 meter away.
Diagram of cage set-up ( https://twitter.com/AliNouriPhD/status/1318330008755195904/photo/1 )
In addition to remaining infectious, there was robust viral replication after transmission via the air
Despite donor ferrets given a high viral dose and recipient animals that likely received a lower infectious dose
via the air, kinetics of virus shedding were similar in all animals, indicating a robust replication of both SARS-CoV-2 and SARS-CoV upon transmission via air 2/3
Should be noted that the experimental set-up included uni-directional airflow where recipients are "constantly at the
right place at the right moment, which may contribute to the relatively high efficiency of virus transmission via the air" 3/3
------------------------------------------------------------
Jasmin S Kutter et al. 2020. SARS-CoV and SARS-CoV-2 are transmitted through the air between ferrets over more than one meter distance. BioRxiv (Oct 19, 2020) doi: https://doi.org/10.1101/2020.10.19.345363 https://www.biorxiv.org/content/10.1101/2020.10.19.345363v1
This article is a preprint and has not been certified by peer review .
Abstract
SARS-CoV-2 emerged in late 2019 and caused a pandemic, whereas the closely related SARS-CoV was contained rapidly in 2003. Here, a newly developed experimental set-up was used to study transmission of SARS-CoV and SARS-CoV-2 through the air between ferrets over more than a meter distance. Both viruses caused a robust productive respiratory tract infection resulting in transmission of SARS-CoV-2 to two of four indirect recipient ferrets and SARS-CoV to all four. A control pandemic A/H1N1 influenza virus also transmitted efficiently. Serological assays confirmed all virus transmission events. Although the experiments did not discriminate between transmission via small aerosols, large droplets and fomites, these results demonstrate that SARS-CoV and SARS-CoV-2 can remain infectious while traveling through the air. Efficient virus transmission between ferrets is in agreement with frequent SARS-CoV-2 outbreaks in mink farms. Although the evidence for airborne virus transmission between humans under natural conditions is absent or weak for SARS-CoV and SARS-CoV-2, ferrets may represent a sensitive model to study interventions aimed at preventing virus transmission.
123margd
"The distribution of viral loads, in the form of Cycle thresholds (Ct), from positive surveillance samples at a single point in time can provide accurate estimation of an epidemic's trajectory, subverting the need for repeated case count measurements which are frequently obscured by changes in testing capacity."
If only we knew the viral load
Joshua Gans | Oct 19, 2020
A new study shows that knowing the viral load of infected people can help chart the pandemic*
...The PCR test** that is most widely used gives an outcome as to whether someone is infected or not with SARS-CoV-2. But it also gives a strong indication as to the viral load of a person. This is because the PCR test operates in cycles. It starts with a sample from a person and extracts the genetic material. It then looks for the marker of the coronavirus. If it doesn’t find it, it replicates the genetic material and then, in that cycle, looks again for the viral marker. It keeps replicating the material each cycle at an exponential rate until either it finds the viral marker or it reaches 40 or so cycles in which case it stops and pronounces the person ‘negative.’ The number of cycles can be measured and is called the Ct score. The lower the Ct score, the more of the virus there is in the sample as it took ‘less time’ to find it.
...the Ct score is not kept...
...Think of it. We can get data that properly identifies the most significant population-level number, the reproduction number, for the coronavirus without widespread testing and right at the moment rather than waiting for a time series pattern to emerge.
In a world in which we have the most testing ever done on populations, it is extremely frustrating that the test results are crimped in ways that really harm our ability to see what is happening. This has to end. Governments need to act now to mandate the recording of Ct scores with every positive test result.
https://joshuagans.substack.com/p/if-only-we-knew-the-viral-load
** Polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies of a specific DNA sample, allowing scientists to take a very small sample of DNA and amplify it to a large enough amount to study in detail.
(Wikipedia)
--------------------------------------------------------------------
* James A. Hay...Michael J. Mina. 2020. Estimating epidemiologic dynamics from single cross-sectional viral load distributions. MedRxiv (Oct 13,2020) doi: https://doi.org/10.1101/2020.10.08.20204222 https://www.medrxiv.org/content/10.1101/2020.10.08.20204222v1
This article is a preprint and has not been peer-reviewed
Abstract
Virologic testing for SARS-CoV-2 has been central to the COVID-19 pandemic response, but interpreting changes in incidence and fraction of positive tests towards understanding the epidemic trajectory is confounded by changes in testing practices. Here, we show that the distribution of viral loads, in the form of Cycle thresholds (Ct), from positive surveillance samples at a single point in time can provide accurate estimation of an epidemic's trajectory, subverting the need for repeated case count measurements which are frequently obscured by changes in testing capacity. We identify a relationship between the population-level cross-sectional distribution of Ct values and the growth rate of the epidemic, demonstrating how the skewness and median of detectable Ct values change purely as a mathematical epidemiologic rule without any change in individual level viral load kinetics or testing. Although at the individual level measurement variation can complicate interpretation of Ct values for clinical use, we show that population-level properties reflect underlying epidemic dynamics. In support of these theoretical findings, we observe a strong relationship between the time-varying effective reproductive number, R(t), and the distribution of Cts among positive surveillance specimens, including median and skewness, measured in Massachusetts over time. We use the observed relationships to derive a novel method that allows accurate inference of epidemic growth rate using the distribution of Ct values observed at a single cross-section in time, which, unlike estimates based on case counts, is less susceptible to biases from delays in test results and from changing testing practices. Our findings suggest that instead of discarding individual Ct values from positive specimens, incorporation of viral loads into public health data streams offers a new approach for real-time resource allocation and assessment of outbreak mitigation strategies, even where repeat incidence data is not available. Ct values or similar viral load data should be regularly reported to public health officials by testing centers and incorporated into monitoring programs.
If only we knew the viral load
Joshua Gans | Oct 19, 2020
A new study shows that knowing the viral load of infected people can help chart the pandemic*
...The PCR test** that is most widely used gives an outcome as to whether someone is infected or not with SARS-CoV-2. But it also gives a strong indication as to the viral load of a person. This is because the PCR test operates in cycles. It starts with a sample from a person and extracts the genetic material. It then looks for the marker of the coronavirus. If it doesn’t find it, it replicates the genetic material and then, in that cycle, looks again for the viral marker. It keeps replicating the material each cycle at an exponential rate until either it finds the viral marker or it reaches 40 or so cycles in which case it stops and pronounces the person ‘negative.’ The number of cycles can be measured and is called the Ct score. The lower the Ct score, the more of the virus there is in the sample as it took ‘less time’ to find it.
...the Ct score is not kept...
...Think of it. We can get data that properly identifies the most significant population-level number, the reproduction number, for the coronavirus without widespread testing and right at the moment rather than waiting for a time series pattern to emerge.
In a world in which we have the most testing ever done on populations, it is extremely frustrating that the test results are crimped in ways that really harm our ability to see what is happening. This has to end. Governments need to act now to mandate the recording of Ct scores with every positive test result.
https://joshuagans.substack.com/p/if-only-we-knew-the-viral-load
** Polymerase chain reaction (PCR) is a method widely used to rapidly make millions to billions of copies of a specific DNA sample, allowing scientists to take a very small sample of DNA and amplify it to a large enough amount to study in detail.
(Wikipedia)
--------------------------------------------------------------------
* James A. Hay...Michael J. Mina. 2020. Estimating epidemiologic dynamics from single cross-sectional viral load distributions. MedRxiv (Oct 13,2020) doi: https://doi.org/10.1101/2020.10.08.20204222 https://www.medrxiv.org/content/10.1101/2020.10.08.20204222v1
This article is a preprint and has not been peer-reviewed
Abstract
Virologic testing for SARS-CoV-2 has been central to the COVID-19 pandemic response, but interpreting changes in incidence and fraction of positive tests towards understanding the epidemic trajectory is confounded by changes in testing practices. Here, we show that the distribution of viral loads, in the form of Cycle thresholds (Ct), from positive surveillance samples at a single point in time can provide accurate estimation of an epidemic's trajectory, subverting the need for repeated case count measurements which are frequently obscured by changes in testing capacity. We identify a relationship between the population-level cross-sectional distribution of Ct values and the growth rate of the epidemic, demonstrating how the skewness and median of detectable Ct values change purely as a mathematical epidemiologic rule without any change in individual level viral load kinetics or testing. Although at the individual level measurement variation can complicate interpretation of Ct values for clinical use, we show that population-level properties reflect underlying epidemic dynamics. In support of these theoretical findings, we observe a strong relationship between the time-varying effective reproductive number, R(t), and the distribution of Cts among positive surveillance specimens, including median and skewness, measured in Massachusetts over time. We use the observed relationships to derive a novel method that allows accurate inference of epidemic growth rate using the distribution of Ct values observed at a single cross-section in time, which, unlike estimates based on case counts, is less susceptible to biases from delays in test results and from changing testing practices. Our findings suggest that instead of discarding individual Ct values from positive specimens, incorporation of viral loads into public health data streams offers a new approach for real-time resource allocation and assessment of outbreak mitigation strategies, even where repeat incidence data is not available. Ct values or similar viral load data should be regularly reported to public health officials by testing centers and incorporated into monitoring programs.
124margd
UK study lumped South and East Asians (Indian, Pakistani, Bangladeshi, Chinese, any other Asian) in study below: "Although the numbers of Asian patients in our study was low and they were predominantly non-East Asian, these results are consistent with other recent reports and therefore likely to represent a genuine difference with other minority ethnic groups." Wouldn't South Asians have more genetic vulnerability than East Asians, given South Asians' Neanderthal immunity and Vitamin D metabolism genes? Not to mention diet differences?
Wikipedia: The 2011 United Kingdom census recorded 1,451,862 residents of Indian, 1,174,983 of Pakistani, 451,529 of Bangladeshi, 433,150 of Chinese, and 861,815 of "Other Asian" ethnicity, making a total Asian British population of 4,373,339 (6.9 per cent of the total population), excluding people of mixed ethnicity.
Mortality rates for Africans are less in UK than in US, sounds like? But higher than in Africa? Genetic? Environmental? Universal healthcare? Diet? Vitamin D status? ETA: There's a Kaiser Permanente study that likewise saw little difference in disease between US whites and blacks--but subjects all had the same HMO. I'll see if I can find it.
-----------------------------------------------------------
Rosita Zakeri et al. 2020. A case-control and cohort study to determine the relationship between ethnic background and severe COVID-19. E Cliical Medicine (October 09, 2020DOI:https://doi.org/10.1016/j.eclinm.2020.100574
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30318-7/fullt...
4. Discussion
People of Black and other minority ethnic background are reported to have a disproportionately high mortality from COVID-19 both in the US and the UK ... However, it is unclear to what extent this is a reflection of the higher proportion of minority ethnic groups in the areas (typically cities) most affected by the pandemic, higher prevalence of cardiovascular, metabolic and other comorbidities, greater socioeconomic deprivation, or other underlying factors. It is also not established whether ethnicity predominantly impacts on the risk of infection, progression of disease once infected, or survival after admission with severe COVID-19.
The current study makes several new findings. First, we employ a case-control study design to identify an approximately 3-fold higher risk of hospital admission with COVID-19 for Black and Mixed ethnicity individuals, but not Asians, as compared to White inner city residents in the same region. Part of the increased risk may relate to comorbidities and deprivation, but there remains a 2.2 to 2.7-fold higher admission risk after adjusting for these factors.
Secondly, we find marked inter-ethnic variation in demographics and comorbidities among admitted patients despite broadly similar clinical severity at presentation. Minority ethnic group patients are on average 10–15 years younger than White patients yet have a higher prevalence of comorbidities. Diabetes is especially prevalent in all non-white groups, consistent with previous community-based data..., while Black patients also have high rates of hypertension and CKD.
Thirdly, we find no association between Black or Mixed ethnicity and in-hospital outcome but an association with increased in-hospital mortality and ICU admission is found for Asian patients. The numbers of Asians in our study is small and they were predominantly non-East Asian, but the association with increased mortality is consistent with a recent UK ICU audit report... and preprint data... Overall, our results suggest that Black or Mixed ethnicity are associated with COVID-19 at a different stage in its natural history as compared to Asian ethnicity (i.e. progression to severe symptomatic disease requiring admission versus in-hospital death). Adjusting for cardiometabolic and vascular comorbidities attenuates part of the higher risk but additional ethnicity-related factors may play a large role.
Disproportionately higher admission of Black and Mixed ethnicity individuals compared to White people living in the same region may be driven either by an increased risk of infection, more aggressive early disease progression to the stage requiring admission, or both. An increased susceptibility to infection could occur for several reasons. It has been suggested that a higher prevalence of socioeconomic deprivation (e.g. with poor housing), cultural factors such as living in multi-generational households, and working in higher-risk occupations may increase susceptibility in minority ethnic groups ... Adjustment for deprivation as assessed by IMD quintile had only a modest effect in our study. However, it is recognised that the complexity of disadvantage related to socioeconomic factors may be incompletely captured by the IMD score and that such metrics may not be directly comparable across ethnic groups ... A recent UK primary care-based study on people who underwent testing for SARS-CoV2 found that the odds of a positive test were statistically significantly higher in Black compared to White individuals ... However, the number of Black individuals in this study was
Wikipedia: The 2011 United Kingdom census recorded 1,451,862 residents of Indian, 1,174,983 of Pakistani, 451,529 of Bangladeshi, 433,150 of Chinese, and 861,815 of "Other Asian" ethnicity, making a total Asian British population of 4,373,339 (6.9 per cent of the total population), excluding people of mixed ethnicity.
Mortality rates for Africans are less in UK than in US, sounds like? But higher than in Africa? Genetic? Environmental? Universal healthcare? Diet? Vitamin D status? ETA: There's a Kaiser Permanente study that likewise saw little difference in disease between US whites and blacks--but subjects all had the same HMO. I'll see if I can find it.
-----------------------------------------------------------
Rosita Zakeri et al. 2020. A case-control and cohort study to determine the relationship between ethnic background and severe COVID-19. E Cliical Medicine (October 09, 2020DOI:https://doi.org/10.1016/j.eclinm.2020.100574
https://www.thelancet.com/journals/eclinm/article/PIIS2589-5370(20)30318-7/fullt...
4. Discussion
People of Black and other minority ethnic background are reported to have a disproportionately high mortality from COVID-19 both in the US and the UK ... However, it is unclear to what extent this is a reflection of the higher proportion of minority ethnic groups in the areas (typically cities) most affected by the pandemic, higher prevalence of cardiovascular, metabolic and other comorbidities, greater socioeconomic deprivation, or other underlying factors. It is also not established whether ethnicity predominantly impacts on the risk of infection, progression of disease once infected, or survival after admission with severe COVID-19.
The current study makes several new findings. First, we employ a case-control study design to identify an approximately 3-fold higher risk of hospital admission with COVID-19 for Black and Mixed ethnicity individuals, but not Asians, as compared to White inner city residents in the same region. Part of the increased risk may relate to comorbidities and deprivation, but there remains a 2.2 to 2.7-fold higher admission risk after adjusting for these factors.
Secondly, we find marked inter-ethnic variation in demographics and comorbidities among admitted patients despite broadly similar clinical severity at presentation. Minority ethnic group patients are on average 10–15 years younger than White patients yet have a higher prevalence of comorbidities. Diabetes is especially prevalent in all non-white groups, consistent with previous community-based data..., while Black patients also have high rates of hypertension and CKD.
Thirdly, we find no association between Black or Mixed ethnicity and in-hospital outcome but an association with increased in-hospital mortality and ICU admission is found for Asian patients. The numbers of Asians in our study is small and they were predominantly non-East Asian, but the association with increased mortality is consistent with a recent UK ICU audit report... and preprint data... Overall, our results suggest that Black or Mixed ethnicity are associated with COVID-19 at a different stage in its natural history as compared to Asian ethnicity (i.e. progression to severe symptomatic disease requiring admission versus in-hospital death). Adjusting for cardiometabolic and vascular comorbidities attenuates part of the higher risk but additional ethnicity-related factors may play a large role.
Disproportionately higher admission of Black and Mixed ethnicity individuals compared to White people living in the same region may be driven either by an increased risk of infection, more aggressive early disease progression to the stage requiring admission, or both. An increased susceptibility to infection could occur for several reasons. It has been suggested that a higher prevalence of socioeconomic deprivation (e.g. with poor housing), cultural factors such as living in multi-generational households, and working in higher-risk occupations may increase susceptibility in minority ethnic groups ... Adjustment for deprivation as assessed by IMD quintile had only a modest effect in our study. However, it is recognised that the complexity of disadvantage related to socioeconomic factors may be incompletely captured by the IMD score and that such metrics may not be directly comparable across ethnic groups ... A recent UK primary care-based study on people who underwent testing for SARS-CoV2 found that the odds of a positive test were statistically significantly higher in Black compared to White individuals ... However, the number of Black individuals in this study was
125margd
Key to Preventing Covid-19 Indoors: Ventilation
Caitlin McCabe | Sept. 1, 2020
...Scientists say schools and businesses should focus on improving ventilation to help prevent Covid-19’s spread. Spaces such as a typical classroom should aim to have air replaced with clean air four to six times an hour, though recommendations can vary by room size and occupancy. That can be done by introducing more outdoor air and enhancing filtration.
Without air conditioning...
With air conditioning...
...About 41% of U.S. public-school districts need to update or replace their HVAC systems in at least half their schools, representing about 36,000 schools nationwide, according to a report published in June by the U.S. Government Accountability Office, a federal watchdog.
Repairs can be costly. Denver Public Schools plans to spend nearly $5 million before students return to improve HVAC systems across roughly 185 buildings, including upgrading filters, repairing broken parts and increasing the amount of outdoor air in the systems, it said...
https://www.wsj.com/articles/key-to-preventing-covid-19-indoors-ventilation-1159...
Caitlin McCabe | Sept. 1, 2020
...Scientists say schools and businesses should focus on improving ventilation to help prevent Covid-19’s spread. Spaces such as a typical classroom should aim to have air replaced with clean air four to six times an hour, though recommendations can vary by room size and occupancy. That can be done by introducing more outdoor air and enhancing filtration.
Without air conditioning...
With air conditioning...
...About 41% of U.S. public-school districts need to update or replace their HVAC systems in at least half their schools, representing about 36,000 schools nationwide, according to a report published in June by the U.S. Government Accountability Office, a federal watchdog.
Repairs can be costly. Denver Public Schools plans to spend nearly $5 million before students return to improve HVAC systems across roughly 185 buildings, including upgrading filters, repairing broken parts and increasing the amount of outdoor air in the systems, it said...
https://www.wsj.com/articles/key-to-preventing-covid-19-indoors-ventilation-1159...
126margd
CEPI expands global manufacturing network, reserving manufacturing capacity for more than 1 billion doses of COVID-19 vaccines
CEPI | 21 Oct 2020
CEPI* continues to expand the global manufacturing network for its COVID-19 vaccine portfolio through agreements to secure vaccine manufacturing capacity with Biofabri in Spain, and GC Pharma in the Republic of Korea. CEPI aims to reserve capacity for the production of drug product at multiple vaccine manufacturers around the world to support our goal to produce 2 billion doses of safe and effective vaccine by the end of 2021 for global distribution through COVAX**.
Under the terms of the agreements, both Biofabri and GC Pharma will reserve manufacturing capacity exclusively for the production of drug product of COVID-19 vaccines designated by CEPI. One or more CEPI-supported vaccine candidates will be manufactured at each facility, and it is anticipated that vaccines manufactured under these agreements would be procured and distributed through the COVAX Facility, a global initiative which will enable equitable access to COVID-19 vaccines for all participating countries.
The agreements with Biofabri and GC Pharma are the latest in a series of strategic investments that CEPI is making to accelerate the manufacture of COVID-19 vaccines at scale, in parallel to the clinical development of COVID-19 candidate vaccines. CEPI has already reserved capacity for manufacturing of drug substance, and has secured a supply of glass vials to hold up to 2 billion doses of vaccine. CEPI’s investments are designed to ensure that, once proven safe and effective, vaccines can be made available to those who need them most as quickly as possible...
https://cepi.net/news_cepi/cepi-expands-global-manufacturing-network-reserving-m...
* The Coalition for Epidemic Preparedness Innovations is a foundation that takes donations from public, private, philanthropic, and civil society organisations, to finance independent research projects to develop vaccines against emerging infectious diseases. (Wikipedia)
** COVAX-- Access to COVID-19 Tools (ACT) Accelerator, a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. (WHO)
CEPI | 21 Oct 2020
CEPI* continues to expand the global manufacturing network for its COVID-19 vaccine portfolio through agreements to secure vaccine manufacturing capacity with Biofabri in Spain, and GC Pharma in the Republic of Korea. CEPI aims to reserve capacity for the production of drug product at multiple vaccine manufacturers around the world to support our goal to produce 2 billion doses of safe and effective vaccine by the end of 2021 for global distribution through COVAX**.
Under the terms of the agreements, both Biofabri and GC Pharma will reserve manufacturing capacity exclusively for the production of drug product of COVID-19 vaccines designated by CEPI. One or more CEPI-supported vaccine candidates will be manufactured at each facility, and it is anticipated that vaccines manufactured under these agreements would be procured and distributed through the COVAX Facility, a global initiative which will enable equitable access to COVID-19 vaccines for all participating countries.
The agreements with Biofabri and GC Pharma are the latest in a series of strategic investments that CEPI is making to accelerate the manufacture of COVID-19 vaccines at scale, in parallel to the clinical development of COVID-19 candidate vaccines. CEPI has already reserved capacity for manufacturing of drug substance, and has secured a supply of glass vials to hold up to 2 billion doses of vaccine. CEPI’s investments are designed to ensure that, once proven safe and effective, vaccines can be made available to those who need them most as quickly as possible...
https://cepi.net/news_cepi/cepi-expands-global-manufacturing-network-reserving-m...
* The Coalition for Epidemic Preparedness Innovations is a foundation that takes donations from public, private, philanthropic, and civil society organisations, to finance independent research projects to develop vaccines against emerging infectious diseases. (Wikipedia)
** COVAX-- Access to COVID-19 Tools (ACT) Accelerator, a ground-breaking global collaboration to accelerate the development, production, and equitable access to COVID-19 tests, treatments, and vaccines. (WHO)
127margd
NY, NJ, CT advisory on interstate travel. Just in time for Thanksgiving... :(
October 20, 2020 Albany, NY
Statement From Governor Cuomo (NY), Governor Murphy (NJ) and Governor Lamont (CT) on COIVD-19 Travel Advisory List
Our states have worked together successfully in combating this pandemic since the beginning and we'll continue to do so. The travel advisory was designed to keep our respective states safe, with the understanding that we are a connected region, dependent on each other when it comes to commerce, education, and health care. We're urging all of our residents to avoid unnecessary or non-essential travel between states at this time, but will not subject residents of our states to a quarantine if coming from a neighboring state. New York, New Jersey, and Connecticut have among the lowest infection rates in the country because we have based our approaches to controlling the spread on science and data, and we will continue to do so.
https://www.governor.ny.gov/news/statement-governor-cuomo-governor-murphy-and-go...
_________________________________________________________
New York could replace traveler quarantine with targeted testing
Karen DeWitt (NYS Capitol Correspondent) | Oct 21, 2020
https://www.northcountrypublicradio.org/news/story/42535/20201021/new-york-could...
October 20, 2020 Albany, NY
Statement From Governor Cuomo (NY), Governor Murphy (NJ) and Governor Lamont (CT) on COIVD-19 Travel Advisory List
Our states have worked together successfully in combating this pandemic since the beginning and we'll continue to do so. The travel advisory was designed to keep our respective states safe, with the understanding that we are a connected region, dependent on each other when it comes to commerce, education, and health care. We're urging all of our residents to avoid unnecessary or non-essential travel between states at this time, but will not subject residents of our states to a quarantine if coming from a neighboring state. New York, New Jersey, and Connecticut have among the lowest infection rates in the country because we have based our approaches to controlling the spread on science and data, and we will continue to do so.
https://www.governor.ny.gov/news/statement-governor-cuomo-governor-murphy-and-go...
_________________________________________________________
New York could replace traveler quarantine with targeted testing
Karen DeWitt (NYS Capitol Correspondent) | Oct 21, 2020
https://www.northcountrypublicradio.org/news/story/42535/20201021/new-york-could...
128margd
I might have had 'Long Covid'--exercise intolerance and fatigue that lasted months. DH's symptoms gone in 2-3 weeks. He had higher fever than I did in those initial days--I thought that might have been a factor, but not mentioned below.
‘Long Covid’: These 5 factors make it more likely you’ll suffer long term from coronavirus
Holly Ellyatt | Oct 21 2020
...“Long Covid” ...1 in 20 people with Covid-19 are likely to suffer symptoms for at least eight weeks...
Risk factors
...long Covid affects around 10% of 18-49 year olds who become unwell with Covid-19, with the percentage of people affected rising to 22% for the over-70s.
Weight also plays a role, with it affecting people with a slightly higher average BMI (body mass index).
Women were much more likely to suffer from long Covid than men (14.5% compared with 9.5%), but only in the younger age group.
...people reporting a wide range of initial symptoms were more likely to develop long Covid, as were people with asthma, although there were no clear links to any other underlying health conditions.
...two main symptom groupings;
(1) dominated by respiratory symptoms such as a cough and shortness of breath, fatigue and headaches.
(2) “was clearly multi-system, affecting many parts of the body, including the brain, gut and heart,” King’s noted.
...while most people with Covid-19 reported being back to normal in 11 days or less, around one in seven (13.3%, 558 users) had Covid-19 symptoms lasting for at least four weeks, with around one in 20 (4.5%, 189 users) staying ill for eight weeks and one in 50 (2.3%, 95 users) suffering for longer than 12 weeks.
“These are conservative estimates, which, because of the strict definitions used, may underestimate the extent of Long-Covid”...
https://www.cnbc.com/2020/10/21/long-covid-these-factors-make-it-more-likely-you...
-------------------------------------------------------------
https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1
Carole H Sudre et al. 2020. Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App. MedRxiv (Oct 21, 2020) doi: https://doi.org/10.1101/2020.10.19.20214494 https://www.cnbc.com/2020/10/21/long-covid-these-factors-make-it-more-likely-you...
This article is a preprint and has not been certified by peer review
Abstract
Reports of "Long-COVID", are rising but little is known about prevalence, risk factors, or whether it is possible to predict a protracted course early in the disease. We analysed data from 4182 incident cases of COVID-19 who logged their symptoms prospectively in the COVID Symptom Study app. 558 (13.3%) had symptoms lasting >28 margd: days, 189 (4.5%) for >8 margd: weeks and 95 (2.3%) for more than 12 weeks. Long-COVID was characterised by symptoms of fatigue, headache, dyspnoea and anosmia and was more likely with increasing age, BMI and female sex. Experiencing more than five symptoms during the first week of illness was associated with Long-COVID, OR=3.53... Our model to predict long-COVID at 7 days, which gained a ROC-AUC of 76%, was replicated in an independent sample of 2472 antibody positive individuals. This model could be used to identify individuals for clinical trials to reduce long-term symptoms and target education and rehabilitation services.
‘Long Covid’: These 5 factors make it more likely you’ll suffer long term from coronavirus
Holly Ellyatt | Oct 21 2020
...“Long Covid” ...1 in 20 people with Covid-19 are likely to suffer symptoms for at least eight weeks...
Risk factors
...long Covid affects around 10% of 18-49 year olds who become unwell with Covid-19, with the percentage of people affected rising to 22% for the over-70s.
Weight also plays a role, with it affecting people with a slightly higher average BMI (body mass index).
Women were much more likely to suffer from long Covid than men (14.5% compared with 9.5%), but only in the younger age group.
...people reporting a wide range of initial symptoms were more likely to develop long Covid, as were people with asthma, although there were no clear links to any other underlying health conditions.
...two main symptom groupings;
(1) dominated by respiratory symptoms such as a cough and shortness of breath, fatigue and headaches.
(2) “was clearly multi-system, affecting many parts of the body, including the brain, gut and heart,” King’s noted.
...while most people with Covid-19 reported being back to normal in 11 days or less, around one in seven (13.3%, 558 users) had Covid-19 symptoms lasting for at least four weeks, with around one in 20 (4.5%, 189 users) staying ill for eight weeks and one in 50 (2.3%, 95 users) suffering for longer than 12 weeks.
“These are conservative estimates, which, because of the strict definitions used, may underestimate the extent of Long-Covid”...
https://www.cnbc.com/2020/10/21/long-covid-these-factors-make-it-more-likely-you...
-------------------------------------------------------------
https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1
Carole H Sudre et al. 2020. Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms collected by the Covid Symptoms Study App. MedRxiv (Oct 21, 2020) doi: https://doi.org/10.1101/2020.10.19.20214494 https://www.cnbc.com/2020/10/21/long-covid-these-factors-make-it-more-likely-you...
This article is a preprint and has not been certified by peer review
Abstract
Reports of "Long-COVID", are rising but little is known about prevalence, risk factors, or whether it is possible to predict a protracted course early in the disease. We analysed data from 4182 incident cases of COVID-19 who logged their symptoms prospectively in the COVID Symptom Study app. 558 (13.3%) had symptoms lasting >28 margd: days, 189 (4.5%) for >8 margd: weeks and 95 (2.3%) for more than 12 weeks. Long-COVID was characterised by symptoms of fatigue, headache, dyspnoea and anosmia and was more likely with increasing age, BMI and female sex. Experiencing more than five symptoms during the first week of illness was associated with Long-COVID, OR=3.53... Our model to predict long-COVID at 7 days, which gained a ROC-AUC of 76%, was replicated in an independent sample of 2472 antibody positive individuals. This model could be used to identify individuals for clinical trials to reduce long-term symptoms and target education and rehabilitation services.
129margd
:(
Coronavirus cases confirmed at 360+ schools across South Florida
David Selig | October 21, 2020
FORT LAUDERDALE, Fla. – More than 360 primary and secondary schools in South Florida have had confirmed COVID-19 cases among students or staff since early September.
Those numbers are reflected in the state’s latest report on coronavirus in schools, which was released Wednesday and can be seen in its entirety at the bottom of this page.
The latest data includes cases confirmed through Oct. 17. The cumulative totals include cases dating back to Sept. 6, which is earlier than many South Florida students returned to the classroom.
In total, 144 primary and secondary schools in Miami-Dade County have had confirmed cases, 102 schools in Broward, 106 in Palm Beach County and nine in Monroe...
https://www.local10.com/news/local/2020/10/21/coronavirus-cases-confirmed-at-360...
Coronavirus cases confirmed at 360+ schools across South Florida
David Selig | October 21, 2020
FORT LAUDERDALE, Fla. – More than 360 primary and secondary schools in South Florida have had confirmed COVID-19 cases among students or staff since early September.
Those numbers are reflected in the state’s latest report on coronavirus in schools, which was released Wednesday and can be seen in its entirety at the bottom of this page.
The latest data includes cases confirmed through Oct. 17. The cumulative totals include cases dating back to Sept. 6, which is earlier than many South Florida students returned to the classroom.
In total, 144 primary and secondary schools in Miami-Dade County have had confirmed cases, 102 schools in Broward, 106 in Palm Beach County and nine in Monroe...
https://www.local10.com/news/local/2020/10/21/coronavirus-cases-confirmed-at-360...
130margd
Studies Point To Big Drop In COVID-19 Death Rates
Geoff Brumfiel | October 20, 2020
Heard on All Things Considered
Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness.
The (March-August NYU) study, which was of a single health system, finds that mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance.
The death rate "is still higher than many infectious diseases, including the flu," (Leora Horwitz, a doctor who studies population health at New York University's Grossman School of Medicine and an author on one of the studies)) says. And those who recover can suffer complications for months or even longer. "It still has the potential to be very harmful in terms of long-term consequences for many people."
...death rates dropped for all groups, even older patients by 18 percentage points on average.
The research, an earlier version of which was shared online as a preprint in August, will appear next week in the Journal of Hospital Medicine.
...Bilal Mateen, a data science fellow at the Alan Turing Institute in the United Kingdom...conducted his own research of 21,000 hospitalized cases in England, which also found a similarly sharp drop in the death rate. The work, which will soon appear in the journal Critical Care Medicine and was released earlier in preprint, shows an unadjusted drop in death rates among hospitalized patients of around 20 percentage points since the worst days of the pandemic.
Mateen says drops are clear across ages, underlying conditions and racial groups. Although the paper does not provide adjusted mortality statistics, his rough estimates are comparable to those Horwitz and her team found in New York.
...Doctors have gotten better at quickly recognizing when COVID-19 patients are at risk of experiencing blood clots or debilitating "cytokine storms," where the body's immune system turns on itself, says Amesh Adalja, an infectious disease, critical care and emergency medicine physician who works at the Johns Hopkins Center for Health Security.
...Horwitz believes that mask-wearing may be helping by reducing the initial dose of virus a person receives, thereby lessening the overall severity of illness for many patients.
And Mateen says that his data strongly suggest that keeping hospitals below their maximum capacity also helps to increase survival rates. When cases surge and hospitals fill up, "staff are stretched, mistakes are made, it's no one's fault — it's that the system isn't built to operate near 100%," he says.
For these reasons, Horwitz and Mateen believe that masking and social distancing will continue to play a big role in keeping the mortality rate down, especially as the U.S. and U.K. move into the fall and winter months...
https://www.npr.org/sections/health-shots/2020/10/20/925441975/studies-point-to-...
Geoff Brumfiel | October 20, 2020
Heard on All Things Considered
Two new peer-reviewed studies are showing a sharp drop in mortality among hospitalized COVID-19 patients. The drop is seen in all groups, including older patients and those with underlying conditions, suggesting that physicians are getting better at helping patients survive their illness.
The (March-August NYU) study, which was of a single health system, finds that mortality has dropped among hospitalized patients by 18 percentage points since the pandemic began. Patients in the study had a 25.6% chance of dying at the start of the pandemic; they now have a 7.6% chance.
The death rate "is still higher than many infectious diseases, including the flu," (Leora Horwitz, a doctor who studies population health at New York University's Grossman School of Medicine and an author on one of the studies)) says. And those who recover can suffer complications for months or even longer. "It still has the potential to be very harmful in terms of long-term consequences for many people."
...death rates dropped for all groups, even older patients by 18 percentage points on average.
The research, an earlier version of which was shared online as a preprint in August, will appear next week in the Journal of Hospital Medicine.
...Bilal Mateen, a data science fellow at the Alan Turing Institute in the United Kingdom...conducted his own research of 21,000 hospitalized cases in England, which also found a similarly sharp drop in the death rate. The work, which will soon appear in the journal Critical Care Medicine and was released earlier in preprint, shows an unadjusted drop in death rates among hospitalized patients of around 20 percentage points since the worst days of the pandemic.
Mateen says drops are clear across ages, underlying conditions and racial groups. Although the paper does not provide adjusted mortality statistics, his rough estimates are comparable to those Horwitz and her team found in New York.
...Doctors have gotten better at quickly recognizing when COVID-19 patients are at risk of experiencing blood clots or debilitating "cytokine storms," where the body's immune system turns on itself, says Amesh Adalja, an infectious disease, critical care and emergency medicine physician who works at the Johns Hopkins Center for Health Security.
...Horwitz believes that mask-wearing may be helping by reducing the initial dose of virus a person receives, thereby lessening the overall severity of illness for many patients.
And Mateen says that his data strongly suggest that keeping hospitals below their maximum capacity also helps to increase survival rates. When cases surge and hospitals fill up, "staff are stretched, mistakes are made, it's no one's fault — it's that the system isn't built to operate near 100%," he says.
For these reasons, Horwitz and Mateen believe that masking and social distancing will continue to play a big role in keeping the mortality rate down, especially as the U.S. and U.K. move into the fall and winter months...
https://www.npr.org/sections/health-shots/2020/10/20/925441975/studies-point-to-...
131margd
BNO Newsroom @BNODesk | 2:47 PM · Oct 21, 2020:
A lot of misinformation is being shared about the death of a vaccine volunteer in Brazil. Here's what we know so far:
- Doctor, 28, died of COVID-19 complications
- He is reported to have received a placebo, not the vaccine
- Oxford University: No safety concerns, trial continues
---------------------------------------------------------------
Deceased AstraZeneca Trial Volunteer Didn’t Receive Vaccine
Timothy Annett and Walter Brandimarte | October 21, 2020
https://www.bloomberg.com/news/articles/2020-10-21/astrazeneca-dips-on-report-of...
A lot of misinformation is being shared about the death of a vaccine volunteer in Brazil. Here's what we know so far:
- Doctor, 28, died of COVID-19 complications
- He is reported to have received a placebo, not the vaccine
- Oxford University: No safety concerns, trial continues
---------------------------------------------------------------
Deceased AstraZeneca Trial Volunteer Didn’t Receive Vaccine
Timothy Annett and Walter Brandimarte | October 21, 2020
https://www.bloomberg.com/news/articles/2020-10-21/astrazeneca-dips-on-report-of...
132margd
Rachel Maddow MSNBC @maddow | 2:20 PM · Oct 21, 2020:
Step 1: Florida GOP governor falls under the spell of "herd immunity" flat-earther fringe doctors
https://sun-sentinel.com/opinion/commentary/fl-op-com-schultz-herd-immunity-desa...
Step 2: Governor drops all COVID restrictions in the state, blocks local communities from implementing their own
Step 3:
Florida considers not releasing daily COVID-19 case numbers to the public
Brian Entin and Nexstar Media Wire | Oct 20, 2020
...“There are discussions ongoing as to when the best time to scale back the report frequency. The reasoning behind it is because it requires 24 hour staffing. Information won’t change and quality of the data will remain paramount,” DeSantis’ press secretary Cody McCloud wrote in an email to NewsNation Tuesday....
https://www.wfla.com/community/health/coronavirus/florida-considers-not-releasin...
Step 1: Florida GOP governor falls under the spell of "herd immunity" flat-earther fringe doctors
https://sun-sentinel.com/opinion/commentary/fl-op-com-schultz-herd-immunity-desa...
Step 2: Governor drops all COVID restrictions in the state, blocks local communities from implementing their own
Step 3:
Florida considers not releasing daily COVID-19 case numbers to the public
Brian Entin and Nexstar Media Wire | Oct 20, 2020
...“There are discussions ongoing as to when the best time to scale back the report frequency. The reasoning behind it is because it requires 24 hour staffing. Information won’t change and quality of the data will remain paramount,” DeSantis’ press secretary Cody McCloud wrote in an email to NewsNation Tuesday....
https://www.wfla.com/community/health/coronavirus/florida-considers-not-releasin...
133margd
CDC expands definition of who is a ‘close contact’ of an individual with covid-19
Lena H. Sun | Oct. 21, 2020
The new guidance is likely to have the biggest impact on schools, workplaces and other group settings since more people are likely to be considered at risk.
..The CDC had previously defined a “close contact” as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. The updated guidance, which health departments rely on to conduct contact tracing, now defines a close contact as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period, according to a CDC statement Wednesday....
https://www.washingtonpost.com/health/2020/10/21/coronavirus-close-contact-cdc/
_________________________________________________
CDC: "close contact"
https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-pl...
_________________________________________________
Pringle JC, Leikauskas J, Ransom-Kelley S, et al. COVID-19 in a Correctional Facility Employee Following Multiple Brief Exposures to Persons with COVID-19 — Vermont, July–August 2020. MMWR Morb Mortal Wkly Rep. ePub: 21 October 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6943e1
Lena H. Sun | Oct. 21, 2020
The new guidance is likely to have the biggest impact on schools, workplaces and other group settings since more people are likely to be considered at risk.
..The CDC had previously defined a “close contact” as someone who spent at least 15 consecutive minutes within six feet of a confirmed coronavirus case. The updated guidance, which health departments rely on to conduct contact tracing, now defines a close contact as someone who was within six feet of an infected individual for a total of 15 minutes or more over a 24-hour period, according to a CDC statement Wednesday....
https://www.washingtonpost.com/health/2020/10/21/coronavirus-close-contact-cdc/
_________________________________________________
CDC: "close contact"
https://www.cdc.gov/coronavirus/2019-ncov/php/contact-tracing/contact-tracing-pl...
_________________________________________________
Pringle JC, Leikauskas J, Ransom-Kelley S, et al. COVID-19 in a Correctional Facility Employee Following Multiple Brief Exposures to Persons with COVID-19 — Vermont, July–August 2020. MMWR Morb Mortal Wkly Rep. ePub: 21 October 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6943e1
134margd
Original Antigenic Sin--a potential mechanism leaving some vulnerable to serious COVID?
Original Antigen Sin or OAS is a phenomena where a response to a new pathogen is distracted by previous immune memories to related known pathogens
This distraction can boost memory against the previous virus, at the expense of a diminished response to the new pathogen
6/ Michael Mina (Harvard epidemiologist) @michaelmina_lab | 1:57 AM · Oct 21, 2020
(entire thread at https://threadreaderapp.com/thread/1318789621074067456.html )
------------------------------------------------------------------
Brenda M. Westerhuis et al. 2020. Severe COVID-19 patients display a back boost of seasonal coronavirus-specific antibodies. MedRxiv (Oct 12, 2020) doi: https://doi.org/10.1101/2020.10.10.20210070 https://www.medrxiv.org/content/10.1101/2020.10.10.20210070v1
This article is a preprint and has not been peer-reviewed.
Abstract
Severe acquired respiratory syndrome coronavirus-2 (SARS-CoV-2) is the cause of coronavirus disease (COVID-19). In severe COVID-19 cases, higher antibody titers against seasonal coronaviruses have been observed than in mild cases. To investigate antibody cross-reactivity as potential explanation for severe disease, we determined the kinetics, breadth, magnitude and level of cross-reactivity of IgG against SARS-CoV-2 and seasonal CoV nucleocapsid and spike from 17 severe COVID-19 cases at the clonal level. Although patients mounted a mostly type-specific SARS-CoV-2 response, B-cell clones directed against seasonal CoV dominated and strongly increased over time. Seasonal CoV IgG responses that did not neutralize SARS-CoV-2 were boosted well beyond detectable cross-reactivity, particularly for HCoV-OC43 spike. These findings support a back-boost of poorly protective coronavirus-specific antibodies in severe COVID-19 patients that may negatively impact de novo SARS-CoV-2 immunity, reminiscent of original antigenic sin.
Original Antigen Sin or OAS is a phenomena where a response to a new pathogen is distracted by previous immune memories to related known pathogens
This distraction can boost memory against the previous virus, at the expense of a diminished response to the new pathogen
6/ Michael Mina (Harvard epidemiologist) @michaelmina_lab | 1:57 AM · Oct 21, 2020
(entire thread at https://threadreaderapp.com/thread/1318789621074067456.html )
------------------------------------------------------------------
Brenda M. Westerhuis et al. 2020. Severe COVID-19 patients display a back boost of seasonal coronavirus-specific antibodies. MedRxiv (Oct 12, 2020) doi: https://doi.org/10.1101/2020.10.10.20210070 https://www.medrxiv.org/content/10.1101/2020.10.10.20210070v1
This article is a preprint and has not been peer-reviewed.
Abstract
Severe acquired respiratory syndrome coronavirus-2 (SARS-CoV-2) is the cause of coronavirus disease (COVID-19). In severe COVID-19 cases, higher antibody titers against seasonal coronaviruses have been observed than in mild cases. To investigate antibody cross-reactivity as potential explanation for severe disease, we determined the kinetics, breadth, magnitude and level of cross-reactivity of IgG against SARS-CoV-2 and seasonal CoV nucleocapsid and spike from 17 severe COVID-19 cases at the clonal level. Although patients mounted a mostly type-specific SARS-CoV-2 response, B-cell clones directed against seasonal CoV dominated and strongly increased over time. Seasonal CoV IgG responses that did not neutralize SARS-CoV-2 were boosted well beyond detectable cross-reactivity, particularly for HCoV-OC43 spike. These findings support a back-boost of poorly protective coronavirus-specific antibodies in severe COVID-19 patients that may negatively impact de novo SARS-CoV-2 immunity, reminiscent of original antigenic sin.
135margd
The Coronavirus Has Claimed 2.5 Million Years of Potential Life in the U.S., Study Finds
Katherine J. Wu | Oct. 21, 2020
In less than a year, the coronavirus has killed more than 220,000 Americans. But even that staggering number downplays the true toll of the pandemic, according to a recent analysis.
Every death represents years of potential life lost, years that might otherwise have been filled with rich memories of family, friends, productivity and joy — trips to the grocery store, late night conversations on the phone, tearful firsts with a newborn baby.
“Think of everything that a person does in a year,” said Stephen Elledge, a geneticist at Harvard. “Who among us would not give anything to have one more year with a parent, a spouse, a son or daughter, a close friend?”...
https://www.nytimes.com/2020/10/21/health/coronavirus-statistics-deaths.html
----------------------------------------------------------------
Stephen J. Elledge. 2020. 2.5 Million Person-Years of Life Have Been Lost Due to COVID-19 in the United States. Med Rxiv (Oct 20, 2020) doi: https://doi.org/10.1101/2020.10.18.20214783 https://www.medrxiv.org/content/10.1101/2020.10.18.20214783v1
This article is a preprint and has not been certified by peer review.
Abstract
The COVID-19 pandemic, caused by tens of millions of SARS-CoV-2 infections world-wide, has resulted in considerable levels of mortality and morbidity. The United States has been hit particularly hard having 20 percent of the world's infections but only 4 percent of the world population. Unfortunately, significant levels of misunderstanding exist about the severity of the disease and its lethality. As COVID-19 disproportionally impacts elderly populations, the false impression that the impact on society of these deaths is minimal may be conveyed by some because elderly individuals are closer to a natural death. To assess the impact of COVID-19 in the US, I have performed calculations of person-years of life lost as a result of 194,000 premature deaths due to SARS-CoV-2 infection as of early October, 2020. By combining actuarial data on life expectancy and the distribution of COVID-19 associated deaths we estimate that over 2,500,000 person-years of life have been lost so far in the pandemic in the US alone, averaging over 13.25 years per person with differences noted between males and females. Importantly, nearly half of the potential years of life lost occur in non-elderly populations. Issues impacting refinement of these models and the additional morbidity caused by COVID-19 beyond lethality are discussed.
...
Discussion
...calculations reveal a profound loss of life as measured in person-years of almost 2.5 million person-years as of early October, 2020 in the United States. This corresponds to an average loss of life of 13.25 person-years per COVID-19 associated death.
...in this analysis 45% of the person-years lost are between the ages of 0 and 64 overall, and 50% of the person-years lost in men falls in that age range.
...(lack of appropriate statistical information on) the effect of comorbidities on life expectancy of COVID-19 deaths...must...be considered a potential source of error...(however) already factored into the longevity tables...
...relatively uniform rise in the fold increase in COVID-19 deaths per million people from decade to decade of the population...immune system decreases in efficiency with age... together with other aspects of organismal senescence may contribute to this steady increase in susceptibility to COVID-19 lethality with age.
...disability-adjusted life years..., quality-adjusted life-year ..., and disability-adjusted life expectancy...We did not undertake those analyses but note that...COVID-19 patients who recover from the infection suffer from a number of potential long-term conditions such as myocarditis, pericarditis, increased propensity for blood clotting and strokes, lung scarring, fatigue, and neurological symptoms like dizziness, loss of taste and smell, impaired consciousness and loss of mental acuity. The long-term ramifications of COVID-19 will become apparent in the fullness of time but it already clear that many survivors suffer from debilitation that may affect the quality of their remaining years of life.
...the estimates herein could be expanded to perhaps 600,000 direct and indirect COVID-19 deaths and many additional million person-years of life lost in the next few months in the United States alone. These losses are on the same scale as the 6.8 million person-years lost to cancer in 1984... Note that the COVID-19 death toll through April 2021 will represent a single year of mortality.
Converting the COVID-19 death toll from individual deaths to person-years lost distributed across age categories shines a light on the magnitude of the pandemic’s toll across the American population. The loss of 2.5 million person-years might be viewed as the direct cost of the pandemic. COVID-19 has wiped out millions of years of productive, active, and happy existence. One must also consider the indirect costs of these lost person-years in the form of emotional and economic tolls these absences impose on the families, friends and co-workers of those lost. Who among us would not cherish another 5 years together with a father, mother, son, daughter or close friend? The full impact of COVID-19 will emerge over time and it is certain to be enormous.
Katherine J. Wu | Oct. 21, 2020
In less than a year, the coronavirus has killed more than 220,000 Americans. But even that staggering number downplays the true toll of the pandemic, according to a recent analysis.
Every death represents years of potential life lost, years that might otherwise have been filled with rich memories of family, friends, productivity and joy — trips to the grocery store, late night conversations on the phone, tearful firsts with a newborn baby.
“Think of everything that a person does in a year,” said Stephen Elledge, a geneticist at Harvard. “Who among us would not give anything to have one more year with a parent, a spouse, a son or daughter, a close friend?”...
https://www.nytimes.com/2020/10/21/health/coronavirus-statistics-deaths.html
----------------------------------------------------------------
Stephen J. Elledge. 2020. 2.5 Million Person-Years of Life Have Been Lost Due to COVID-19 in the United States. Med Rxiv (Oct 20, 2020) doi: https://doi.org/10.1101/2020.10.18.20214783 https://www.medrxiv.org/content/10.1101/2020.10.18.20214783v1
This article is a preprint and has not been certified by peer review.
Abstract
The COVID-19 pandemic, caused by tens of millions of SARS-CoV-2 infections world-wide, has resulted in considerable levels of mortality and morbidity. The United States has been hit particularly hard having 20 percent of the world's infections but only 4 percent of the world population. Unfortunately, significant levels of misunderstanding exist about the severity of the disease and its lethality. As COVID-19 disproportionally impacts elderly populations, the false impression that the impact on society of these deaths is minimal may be conveyed by some because elderly individuals are closer to a natural death. To assess the impact of COVID-19 in the US, I have performed calculations of person-years of life lost as a result of 194,000 premature deaths due to SARS-CoV-2 infection as of early October, 2020. By combining actuarial data on life expectancy and the distribution of COVID-19 associated deaths we estimate that over 2,500,000 person-years of life have been lost so far in the pandemic in the US alone, averaging over 13.25 years per person with differences noted between males and females. Importantly, nearly half of the potential years of life lost occur in non-elderly populations. Issues impacting refinement of these models and the additional morbidity caused by COVID-19 beyond lethality are discussed.
...
Discussion
...calculations reveal a profound loss of life as measured in person-years of almost 2.5 million person-years as of early October, 2020 in the United States. This corresponds to an average loss of life of 13.25 person-years per COVID-19 associated death.
...in this analysis 45% of the person-years lost are between the ages of 0 and 64 overall, and 50% of the person-years lost in men falls in that age range.
...(lack of appropriate statistical information on) the effect of comorbidities on life expectancy of COVID-19 deaths...must...be considered a potential source of error...(however) already factored into the longevity tables...
...relatively uniform rise in the fold increase in COVID-19 deaths per million people from decade to decade of the population...immune system decreases in efficiency with age... together with other aspects of organismal senescence may contribute to this steady increase in susceptibility to COVID-19 lethality with age.
...disability-adjusted life years..., quality-adjusted life-year ..., and disability-adjusted life expectancy...We did not undertake those analyses but note that...COVID-19 patients who recover from the infection suffer from a number of potential long-term conditions such as myocarditis, pericarditis, increased propensity for blood clotting and strokes, lung scarring, fatigue, and neurological symptoms like dizziness, loss of taste and smell, impaired consciousness and loss of mental acuity. The long-term ramifications of COVID-19 will become apparent in the fullness of time but it already clear that many survivors suffer from debilitation that may affect the quality of their remaining years of life.
...the estimates herein could be expanded to perhaps 600,000 direct and indirect COVID-19 deaths and many additional million person-years of life lost in the next few months in the United States alone. These losses are on the same scale as the 6.8 million person-years lost to cancer in 1984... Note that the COVID-19 death toll through April 2021 will represent a single year of mortality.
Converting the COVID-19 death toll from individual deaths to person-years lost distributed across age categories shines a light on the magnitude of the pandemic’s toll across the American population. The loss of 2.5 million person-years might be viewed as the direct cost of the pandemic. COVID-19 has wiped out millions of years of productive, active, and happy existence. One must also consider the indirect costs of these lost person-years in the form of emotional and economic tolls these absences impose on the families, friends and co-workers of those lost. Who among us would not cherish another 5 years together with a father, mother, son, daughter or close friend? The full impact of COVID-19 will emerge over time and it is certain to be enormous.
136margd
CEO group to Michigan leaders: Stop suing over COVID-19 restrictions, unite to fight second wave
Chad Livengood | October 21, 2020
A coalition of 32 health care, labor, higher education and business executives called on Michigan political leaders Wednesday to cease litigation over public health orders aimed at mitigating spread of the coronavirus amid a resurgence that's starting to be felt in some hospitals across the state.
The open letter sent Wednesday to Gov. Gretchen Whitmer and her two counterparts in the Legislature — Senate Majority Leader Mike Shirkey and House Speaker Lee Chatfield — urges "collective action" to prevent additional deaths from COVID-19.
Signers of the letter include the top executives at Barton Malow, Dow Inc., DTE Energy Co., General Motors Co., Herman Miller, Lear Corp., Meijer Inc., Rocket Companies Inc., Steelcase, TCF Financial Corp. and the United Auto Workers.
The letter comes nearly three weeks after the Michigan Supreme Court upended Whitmer's management of the public health crisis, invalidating a law she used to issue broad executive orders without input from the Legislature.
The group of CEOs of major corporations, public universities and hospital systems effectively called for a legal cease fire, asking that public health and workplace safety orders issued by the Whitmer administration be allowed to stand without challenge in court or by legislation.
"On the cusp of a second wave, Michigan needs clearly defined mandatory standards which govern mask usage, workplace practices, public gatherings and certain social activities," the executives wrote. "The orders recently issued by the Michigan Department of Health and Human Services and (Michigan Occupational Safety and Health Administration) are sufficient to play this role. We should now focus on deploying them with discipline."
The call for keeping current state orders in place delivered to GOP legislative leaders one day after a group of House Republicans proposed letting counties loosen state-level COVID-19 restrictions when coronavirus cases have declined for at least 14 consecutive days.
The letter framed Michigan's ongoing battle with the pandemic as critical to the long-term health of the economy and education of 1.5 million school-aged children...
https://www.crainsdetroit.com/coronavirus/ceo-group-michigan-leaders-stop-suing-...
Chad Livengood | October 21, 2020
A coalition of 32 health care, labor, higher education and business executives called on Michigan political leaders Wednesday to cease litigation over public health orders aimed at mitigating spread of the coronavirus amid a resurgence that's starting to be felt in some hospitals across the state.
The open letter sent Wednesday to Gov. Gretchen Whitmer and her two counterparts in the Legislature — Senate Majority Leader Mike Shirkey and House Speaker Lee Chatfield — urges "collective action" to prevent additional deaths from COVID-19.
Signers of the letter include the top executives at Barton Malow, Dow Inc., DTE Energy Co., General Motors Co., Herman Miller, Lear Corp., Meijer Inc., Rocket Companies Inc., Steelcase, TCF Financial Corp. and the United Auto Workers.
The letter comes nearly three weeks after the Michigan Supreme Court upended Whitmer's management of the public health crisis, invalidating a law she used to issue broad executive orders without input from the Legislature.
The group of CEOs of major corporations, public universities and hospital systems effectively called for a legal cease fire, asking that public health and workplace safety orders issued by the Whitmer administration be allowed to stand without challenge in court or by legislation.
"On the cusp of a second wave, Michigan needs clearly defined mandatory standards which govern mask usage, workplace practices, public gatherings and certain social activities," the executives wrote. "The orders recently issued by the Michigan Department of Health and Human Services and (Michigan Occupational Safety and Health Administration) are sufficient to play this role. We should now focus on deploying them with discipline."
The call for keeping current state orders in place delivered to GOP legislative leaders one day after a group of House Republicans proposed letting counties loosen state-level COVID-19 restrictions when coronavirus cases have declined for at least 14 consecutive days.
The letter framed Michigan's ongoing battle with the pandemic as critical to the long-term health of the economy and education of 1.5 million school-aged children...
https://www.crainsdetroit.com/coronavirus/ceo-group-michigan-leaders-stop-suing-...
137bnielsen
Denmark is seeing a very rapid spread of Covid-19 in our mink farms. It is currently spreading faster that we can put down the animals and clean the farms. So far nobody has been able to detect how the virus spreads between farms.
https://www.thelocal.dk/20201014/why-denmark-is-culling-millions-of-minks-due-to...
My money is on birds, but that's just a guess.
https://www.thelocal.dk/20201014/why-denmark-is-culling-millions-of-minks-due-to...
My money is on birds, but that's just a guess.
138margd
>137 bnielsen: Maybe the fellow who delivers mink chow, or other supplies, is a carrier?
139margd
Gilead's remdesivir gets U.S. FDA approval for hospitalized COVID-19 patients
Deena Beasley | October 22, 2020
The U.S. Food and Drug Administration on Thursday approved Gilead Sciences Inc’s antiviral drug remdesivir for treating patients hospitalized with COVID-19, making it the first and only drug approved for the disease in the United States.
...The FDA’s formal approval comes just hours before the president’s final debate with Democratic rival Joe Biden ahead of the Nov. 3 presidential election.
Remdesivir has been available under an FDA emergency use authorization (EUA) since May, after a study led by the National Institutes of Health showed it reduced hospital stays by five days.
However, the World Health Organization (WHO) last week said its global trial of COVID-19 therapies (non-blinded) found that remdesivir did not have a substantial effect on patients’ length of hospital stay or chances of survival. That study has not been reviewed by outside experts.
...Remdesivir, which will be sold under the brand name Veklury, costs $3,120 for a five-day treatment course, or $2,340 for government purchasers such as the Department of Veterans Affairs. Shares of Gilead rose 4.3% in after hours trading to $63.30.
...Veklury has regulatory approvals or temporary authorizations in about 50 additional countries.
Also on Thursday, the FDA issued a new emergency use authorization for remdesivir to treat hospitalized pediatric patients under age 12 who weigh enough to receive an intravenous drug.
Gilead said it is still working to understand the full potential of remdesivir, in different settings and as part of combination therapy approaches. The company is also developing an inhaled version of the drug that might be used outside a hospital setting, if approved.
https://uk.reuters.com/article/us-health-coronavirus-gilead/gileads-remdesivir-g...
Deena Beasley | October 22, 2020
The U.S. Food and Drug Administration on Thursday approved Gilead Sciences Inc’s antiviral drug remdesivir for treating patients hospitalized with COVID-19, making it the first and only drug approved for the disease in the United States.
...The FDA’s formal approval comes just hours before the president’s final debate with Democratic rival Joe Biden ahead of the Nov. 3 presidential election.
Remdesivir has been available under an FDA emergency use authorization (EUA) since May, after a study led by the National Institutes of Health showed it reduced hospital stays by five days.
However, the World Health Organization (WHO) last week said its global trial of COVID-19 therapies (non-blinded) found that remdesivir did not have a substantial effect on patients’ length of hospital stay or chances of survival. That study has not been reviewed by outside experts.
...Remdesivir, which will be sold under the brand name Veklury, costs $3,120 for a five-day treatment course, or $2,340 for government purchasers such as the Department of Veterans Affairs. Shares of Gilead rose 4.3% in after hours trading to $63.30.
...Veklury has regulatory approvals or temporary authorizations in about 50 additional countries.
Also on Thursday, the FDA issued a new emergency use authorization for remdesivir to treat hospitalized pediatric patients under age 12 who weigh enough to receive an intravenous drug.
Gilead said it is still working to understand the full potential of remdesivir, in different settings and as part of combination therapy approaches. The company is also developing an inhaled version of the drug that might be used outside a hospital setting, if approved.
https://uk.reuters.com/article/us-health-coronavirus-gilead/gileads-remdesivir-g...
140SophieSpragg
Denne bruger er blevet fjernet som værende spam.
141margd
Bolster little kids' immune systems in just 28 days! (Not directly related to COVID.)
Daycares in Finland Built a 'Forest Floor', And It Changed Children's Immune Systems
CARLY CASSELLA | 22 OCTOBER 2020
Playing through the greenery and litter of a mini forest's undergrowth for just one month may be enough to change a child's immune system, according to a small new experiment.
When daycare workers in Finland rolled out a lawn, planted forest undergrowth such as dwarf heather and blueberries, and allowed children to care for crops in planter boxes, the diversity of microbes in the guts and on the skin of young kids appeared healthier in a very short space of time.
Compared to other city kids who play in standard urban daycares with yards of pavement, tile and gravel, 3-, 4-, and 5-year-olds at these greened-up daycare centres in Finland showed increased T-cells and other important immune markers in their blood within 28 days.
..."The results of this study support the biodiversity hypothesis and the concept that low biodiversity in the modern living environment may lead to an un-educated immune system and consequently increase the prevalence of immune-mediated diseases," the authors write.
...Among kids who got outside, playing in the dirt, the grass and among the trees, an increase in a microbe called gammaproteobacteria appeared to boost the skin's immune defence, as well as increase helpful immune secretions in the blood and reduce the content of interleukin-17A, which is connected to immune-transmitted diseases.
Research shows getting outside is also good for a child's eyesight, and being in nature as a kid is linked to better mental health. Some recent studies have even shown green spaces are linked to structural changes in the brains of children.
What's driving these incredible results is not yet clear. It could be linked to changes to the immune system, or something about breathing healthy air, soaking in the sun, exercising more or having greater peace of mind.
...Bonding with nature as a kid is also good for the future of our planet's ecosystems. Studies show kids who spend time outdoors are more likely to want to become environmentalists as adults, and in a rapidly changing world, that's more important than ever.
Just make sure everyone's up to date on their tetanus vaccinations, (Aki Sinkkonen, University of Helsinki) advises.
https://www.sciencealert.com/daycares-in-finland-built-a-backyard-forest-and-it-...
__________________________________________________________
Marja I. Roslund et al. 2020. Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children. Science Advances 14 Oct 2020: Vol. 6, no. 42, eaba2578. DOI: 10.1126/sciadv.aba2578 https://advances.sciencemag.org/content/6/42/eaba2578
Abstract
As the incidence of immune-mediated diseases has increased rapidly in developed societies, there is an unmet need for novel prophylactic practices to fight against these maladies. This study is the first human intervention trial in which urban environmental biodiversity was manipulated to examine its effects on the commensal microbiome and immunoregulation in children. We analyzed changes in the skin and gut microbiota and blood immune markers of children during a 28-day biodiversity intervention. Children in standard urban and nature-oriented daycare centers were analyzed for comparison. The intervention diversified both the environmental and skin Gammaproteobacterial communities, which, in turn, were associated with increases in plasma TGF-β1 levels and the proportion of regulatory T cells. The plasma IL-10:IL-17A ratio increased among intervention children during the trial. Our findings suggest that biodiversity intervention enhances immunoregulatory pathways and provide an incentive for future prophylactic approaches to reduce the risk of immune-mediated diseases in urban societies.
Daycares in Finland Built a 'Forest Floor', And It Changed Children's Immune Systems
CARLY CASSELLA | 22 OCTOBER 2020
Playing through the greenery and litter of a mini forest's undergrowth for just one month may be enough to change a child's immune system, according to a small new experiment.
When daycare workers in Finland rolled out a lawn, planted forest undergrowth such as dwarf heather and blueberries, and allowed children to care for crops in planter boxes, the diversity of microbes in the guts and on the skin of young kids appeared healthier in a very short space of time.
Compared to other city kids who play in standard urban daycares with yards of pavement, tile and gravel, 3-, 4-, and 5-year-olds at these greened-up daycare centres in Finland showed increased T-cells and other important immune markers in their blood within 28 days.
..."The results of this study support the biodiversity hypothesis and the concept that low biodiversity in the modern living environment may lead to an un-educated immune system and consequently increase the prevalence of immune-mediated diseases," the authors write.
...Among kids who got outside, playing in the dirt, the grass and among the trees, an increase in a microbe called gammaproteobacteria appeared to boost the skin's immune defence, as well as increase helpful immune secretions in the blood and reduce the content of interleukin-17A, which is connected to immune-transmitted diseases.
Research shows getting outside is also good for a child's eyesight, and being in nature as a kid is linked to better mental health. Some recent studies have even shown green spaces are linked to structural changes in the brains of children.
What's driving these incredible results is not yet clear. It could be linked to changes to the immune system, or something about breathing healthy air, soaking in the sun, exercising more or having greater peace of mind.
...Bonding with nature as a kid is also good for the future of our planet's ecosystems. Studies show kids who spend time outdoors are more likely to want to become environmentalists as adults, and in a rapidly changing world, that's more important than ever.
Just make sure everyone's up to date on their tetanus vaccinations, (Aki Sinkkonen, University of Helsinki) advises.
https://www.sciencealert.com/daycares-in-finland-built-a-backyard-forest-and-it-...
__________________________________________________________
Marja I. Roslund et al. 2020. Biodiversity intervention enhances immune regulation and health-associated commensal microbiota among daycare children. Science Advances 14 Oct 2020: Vol. 6, no. 42, eaba2578. DOI: 10.1126/sciadv.aba2578 https://advances.sciencemag.org/content/6/42/eaba2578
Abstract
As the incidence of immune-mediated diseases has increased rapidly in developed societies, there is an unmet need for novel prophylactic practices to fight against these maladies. This study is the first human intervention trial in which urban environmental biodiversity was manipulated to examine its effects on the commensal microbiome and immunoregulation in children. We analyzed changes in the skin and gut microbiota and blood immune markers of children during a 28-day biodiversity intervention. Children in standard urban and nature-oriented daycare centers were analyzed for comparison. The intervention diversified both the environmental and skin Gammaproteobacterial communities, which, in turn, were associated with increases in plasma TGF-β1 levels and the proportion of regulatory T cells. The plasma IL-10:IL-17A ratio increased among intervention children during the trial. Our findings suggest that biodiversity intervention enhances immunoregulatory pathways and provide an incentive for future prophylactic approaches to reduce the risk of immune-mediated diseases in urban societies.
142margd
SO amazing what science has learned about SARS-CoV-2 / COVID-19 in well under a year!
Below, a protein in human neural passages, where ACE2 isn't present, is doorway for the COVID-19 virus!
Apparently, Ebola, HIV-1 and highly virulent strains of avian influenza share COVID-19's ability to gain entry through neuropilin-1 protein.
Thank goodness, as I read in another article, the SARS virus, which is more lethal than cousin COVID-19, does NOT! (Let's keep it that way... :)
New understanding of the neuropilin-1 protein could speed COVID vaccine research
Rajesh Khanna and Aubin Moutal, The Conversation | October 23, 2020
...a protein called the neuropilin-1 receptor is an alternative doorway for SARS-CoV-2 to enter and infect human cells. This is a major breakthrough and a surprise, because scientists thought neuropilin-1 played roles in helping neurons make the correct connections and aiding the growth of blood vessels...neuropilin-1 is involved with pain signals and how, when the SARS-CoV-2 virus attaches to it, it blocks pain transmission and relieves pain. The new work shows that neuropilin-1 is an independent doorway for the COVID-19 virus to infect cells. This discovery provides insights that may reveal ways to block the virus.
...In experiments in the lab, the SARS-CoV-2 virus was able to infect fewer human cells that lacked neuropilin-1.
In cells with both the ACE2 and neuropilin-1 proteins, SARS-CoV-2 infection was greater compared to cells with either "doorway" alone.
...neuropilin-1 was present in the cells lining the human respiratory and nasal passages, while the ACE2 protein was not. This demonstrates that neuropilin-1 provides an independent doorway for the COVID-19 virus to infect the cells.
Moreover, cells lining the nasal passages from COVID-19 patients that were positive for neuropilin-1 were also positive for the Spike protein. These findings confirmed that Spike uses the neuropilin-1 protein to infect human cells in regions of the body where ACE2 isn't present.
...a potential new target—the neuropilin-1 receptor—for managing chronic pain.
These studies also have implications for the development of vaccines against the Spike protein. Perhaps the most important implication is that the neuropilin-1 binding region of Spike should be targeted for COVID-19 prevention. Because a number of other human viruses, including Ebola, HIV-1 and highly virulent strains of avian influenza, also share this signature sequence of Spike, neuropilin-1 may be a promiscuous mediator of viral entry.
But it appears that the tango is not over yet. More dance partners have emerged. PIKFyve kinase and CD147 – two proteins—have also been shown to bind Spike and facilitate viral entry. Whether these new partners take center stage or play second fiddle to ACE2 and neuropilin-1 remains to be seen.
https://medicalxpress.com/news/2020-10-neuropilin-protein-covid-vaccine.html
_______________________________________________________________
James L. Daly et al. 2020. Neuropilin-1 is a host factor for SARS-CoV-2 infection. Science 20 Oct 2020: eabd3072
DOI: 10.1126/science.abd3072 https://science.sciencemag.org/content/early/2020/10/19/science.abd3072
Ludovico Cantuti-Castelvetri et al. 2020. Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science 20 Oct 2020:
eabd2985 DOI: 10.1126/science.abd2985 https://science.sciencemag.org/content/early/2020/10/19/science.abd2985
Below, a protein in human neural passages, where ACE2 isn't present, is doorway for the COVID-19 virus!
Apparently, Ebola, HIV-1 and highly virulent strains of avian influenza share COVID-19's ability to gain entry through neuropilin-1 protein.
Thank goodness, as I read in another article, the SARS virus, which is more lethal than cousin COVID-19, does NOT! (Let's keep it that way... :)
New understanding of the neuropilin-1 protein could speed COVID vaccine research
Rajesh Khanna and Aubin Moutal, The Conversation | October 23, 2020
...a protein called the neuropilin-1 receptor is an alternative doorway for SARS-CoV-2 to enter and infect human cells. This is a major breakthrough and a surprise, because scientists thought neuropilin-1 played roles in helping neurons make the correct connections and aiding the growth of blood vessels...neuropilin-1 is involved with pain signals and how, when the SARS-CoV-2 virus attaches to it, it blocks pain transmission and relieves pain. The new work shows that neuropilin-1 is an independent doorway for the COVID-19 virus to infect cells. This discovery provides insights that may reveal ways to block the virus.
...In experiments in the lab, the SARS-CoV-2 virus was able to infect fewer human cells that lacked neuropilin-1.
In cells with both the ACE2 and neuropilin-1 proteins, SARS-CoV-2 infection was greater compared to cells with either "doorway" alone.
...neuropilin-1 was present in the cells lining the human respiratory and nasal passages, while the ACE2 protein was not. This demonstrates that neuropilin-1 provides an independent doorway for the COVID-19 virus to infect the cells.
Moreover, cells lining the nasal passages from COVID-19 patients that were positive for neuropilin-1 were also positive for the Spike protein. These findings confirmed that Spike uses the neuropilin-1 protein to infect human cells in regions of the body where ACE2 isn't present.
...a potential new target—the neuropilin-1 receptor—for managing chronic pain.
These studies also have implications for the development of vaccines against the Spike protein. Perhaps the most important implication is that the neuropilin-1 binding region of Spike should be targeted for COVID-19 prevention. Because a number of other human viruses, including Ebola, HIV-1 and highly virulent strains of avian influenza, also share this signature sequence of Spike, neuropilin-1 may be a promiscuous mediator of viral entry.
But it appears that the tango is not over yet. More dance partners have emerged. PIKFyve kinase and CD147 – two proteins—have also been shown to bind Spike and facilitate viral entry. Whether these new partners take center stage or play second fiddle to ACE2 and neuropilin-1 remains to be seen.
https://medicalxpress.com/news/2020-10-neuropilin-protein-covid-vaccine.html
_______________________________________________________________
James L. Daly et al. 2020. Neuropilin-1 is a host factor for SARS-CoV-2 infection. Science 20 Oct 2020: eabd3072
DOI: 10.1126/science.abd3072 https://science.sciencemag.org/content/early/2020/10/19/science.abd3072
Ludovico Cantuti-Castelvetri et al. 2020. Neuropilin-1 facilitates SARS-CoV-2 cell entry and infectivity. Science 20 Oct 2020:
eabd2985 DOI: 10.1126/science.abd2985 https://science.sciencemag.org/content/early/2020/10/19/science.abd2985
143margd
Bet we'd see the data if it supported WH approach to COVID-19...
Why Can’t We See All of the Government’s Virus Data?
Christopher J.L. Murray* | Oct. 23, 2020
The Trump administration has declined to release critical data to outside public health experts that would enable them to devise strategies against the virus that has killed 223,000 Americans and counting.
Federal agencies have told us that since March they have been compiling basic data for each county and city on Covid-19 cases, hospitalizations and deaths, the timing of social distancing mandates, testing, and other factors. This information can provide insights into how combinations of public health mandates — masks, social distancing and school closures, for instance — can keep the virus spread in check.
But the government, inexplicably, is not sharing all of its data. Researchers have asked federal officials many times for the missing information, but have been told it won’t be shared outside the government...
https://twitter.com/MorrisonCSIS/status/1319952514251456513
* Dr. Murray is the director of the Institute for Health Metrics and Evaluation and a professor of health metrics sciences at the University of Washington.
Why Can’t We See All of the Government’s Virus Data?
Christopher J.L. Murray* | Oct. 23, 2020
The Trump administration has declined to release critical data to outside public health experts that would enable them to devise strategies against the virus that has killed 223,000 Americans and counting.
Federal agencies have told us that since March they have been compiling basic data for each county and city on Covid-19 cases, hospitalizations and deaths, the timing of social distancing mandates, testing, and other factors. This information can provide insights into how combinations of public health mandates — masks, social distancing and school closures, for instance — can keep the virus spread in check.
But the government, inexplicably, is not sharing all of its data. Researchers have asked federal officials many times for the missing information, but have been told it won’t be shared outside the government...
https://twitter.com/MorrisonCSIS/status/1319952514251456513
* Dr. Murray is the director of the Institute for Health Metrics and Evaluation and a professor of health metrics sciences at the University of Washington.
144margd
...North Dakota has the highest mortality in the world. Higher than ANY country.
Daily COVID deaths per million for week ending Oct 19, 2020:
https://twitter.com/DrEricDing/status/1319475131098537984/photo/1
Daily COVID deaths per million for week ending Oct 19, 2020:
https://twitter.com/DrEricDing/status/1319475131098537984/photo/1
145margd
A start, but as Florian Krammer (virologist) tweeted, could use a zero or two more in the number...
----------------------------------------------------
CEPI @CEPIvaccines | 6:28 AM · Oct 23, 2020
We’re pleased to announce that the USA has joined @CEPIvaccines!
@USAID will provide US$20 million in financial support of CEPI
to advance our work to develop vaccines against emerging infectious diseases.
https://bit.ly/3kmMlRy
Image | https://twitter.com/CEPIvaccines/status/1319586487445442560/photo/1
USAID Global Health
----------------------------------------------------
CEPI @CEPIvaccines | 6:28 AM · Oct 23, 2020
We’re pleased to announce that the USA has joined @CEPIvaccines!
@USAID will provide US$20 million in financial support of CEPI
to advance our work to develop vaccines against emerging infectious diseases.
https://bit.ly/3kmMlRy
Image | https://twitter.com/CEPIvaccines/status/1319586487445442560/photo/1
USAID Global Health
146margd
Long-COVID was characterised by symptoms of fatigue, headache, dyspnoea* and anosmia** and was more likely with increasing age, BMI and female sex. Experiencing more than five symptoms during the first week of illness was associated with Long-COVID...
In the individuals with long duration (LC28), ongoing fever... and skipped meals were strong predictors of a subsequent hospital visit...
Carole H. Sudr et al. 2020. Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms 1collected by the Covid Symptoms Study App23e. MaedRxiv (Oct 21, 2020). doi: https://doi.org/10.1101/2020.10.19.20214494 https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1.full.pdf+html
This article is a preprint and has not been certified by peer review.
Abstract
Reports of "Long-COVID", are rising but little is known about prevalence, risk factors, or whether it is possible to predict a protracted course early in the disease. We analysed data from 4182 incident cases of COVID-19 who logged their symptoms prospectively in the COVID Symptom Study app. 558 (13.3%) had symptoms lasting more than 28 days, 189 (4.5%) for more than 8 weeks and 95 (2.3%) for more than 12 weeks. Long-COVID was characterised by symptoms of fatigue, headache, dyspnoea* and anosmia** and was more likely with increasing age, BMI and female sex. Experiencing more than five symptoms during the first week of illness was associated with Long-COVID, ... Our model to predict long-COVID at 7 days, which gained a ROC-AUC of 76%, was replicated in an independent sample of 2472 antibody positive individuals. This model could be used to identify individuals for clinical trials to reduce long-term symptoms and target education and rehabilitation services.
...We examined whether there were different types of symptomatology within Long-COVID. We found two main patterns: those reporting exclusively fatigue, headache and upper respiratory complaints (shortness of breath, sore throat, persistent cough and loss of smell) and those with multi-system complaints including ongoing fever and gastroenterological symptoms... In the individuals with long duration (LC28), ongoing fever... and skipped meals were strong predictors of a subsequent hospital visit...
* difficulty breathing
** loss of smell
In the individuals with long duration (LC28), ongoing fever... and skipped meals were strong predictors of a subsequent hospital visit...
Carole H. Sudr et al. 2020. Attributes and predictors of Long-COVID: analysis of COVID cases and their symptoms 1collected by the Covid Symptoms Study App23e. MaedRxiv (Oct 21, 2020). doi: https://doi.org/10.1101/2020.10.19.20214494 https://www.medrxiv.org/content/10.1101/2020.10.19.20214494v1.full.pdf+html
This article is a preprint and has not been certified by peer review.
Abstract
Reports of "Long-COVID", are rising but little is known about prevalence, risk factors, or whether it is possible to predict a protracted course early in the disease. We analysed data from 4182 incident cases of COVID-19 who logged their symptoms prospectively in the COVID Symptom Study app. 558 (13.3%) had symptoms lasting more than 28 days, 189 (4.5%) for more than 8 weeks and 95 (2.3%) for more than 12 weeks. Long-COVID was characterised by symptoms of fatigue, headache, dyspnoea* and anosmia** and was more likely with increasing age, BMI and female sex. Experiencing more than five symptoms during the first week of illness was associated with Long-COVID, ... Our model to predict long-COVID at 7 days, which gained a ROC-AUC of 76%, was replicated in an independent sample of 2472 antibody positive individuals. This model could be used to identify individuals for clinical trials to reduce long-term symptoms and target education and rehabilitation services.
...We examined whether there were different types of symptomatology within Long-COVID. We found two main patterns: those reporting exclusively fatigue, headache and upper respiratory complaints (shortness of breath, sore throat, persistent cough and loss of smell) and those with multi-system complaints including ongoing fever and gastroenterological symptoms... In the individuals with long duration (LC28), ongoing fever... and skipped meals were strong predictors of a subsequent hospital visit...
* difficulty breathing
** loss of smell
147John5918
If you're pinning your hopes on a Covid vaccine, here's a dose of realism (Guardian)
A targeted immunisation programme may offer some protection, but it will not deliver ‘life as normal’...
The false promise of herd immunity for COVID-19 (Nature)
Why proposals to largely let the virus run its course — embraced by Donald Trump’s administration and others — could bring “untold death and suffering”...
'Killer' cells in Ebola immunity study could help Covid research (Guardian)
Ebola survivors showing no antibodies found to still have lasting capacity to fight virus...
A targeted immunisation programme may offer some protection, but it will not deliver ‘life as normal’...
The false promise of herd immunity for COVID-19 (Nature)
Why proposals to largely let the virus run its course — embraced by Donald Trump’s administration and others — could bring “untold death and suffering”...
'Killer' cells in Ebola immunity study could help Covid research (Guardian)
Ebola survivors showing no antibodies found to still have lasting capacity to fight virus...
148margd
Marc Lipsitch and Natalie E. Dean. 2020. Understanding COVID-19 vaccine efficacy (Perspective). Science 21 Oct 2020:
eabe5938 DOI: 10.1126/science.abe5938 https://science.sciencemag.org/content/early/2020/10/21/science.abe5938
Abstract
Vaccine efficacy in high-risk groups and reduced viral shedding are important for protection
...Availability of a COVID-19 vaccine will initially be limited, and so several expert committees are exploring strategic prioritization plans. Health care workers are a common first-tier group..., which in turn preserves health care systems by protecting those who run them and need them. A next priority is to directly protect those who are at highest risk of death or hospitalization when infected: specifically, those over 65 and people with certain comorbid conditions. This strategy may be optimal for reducing mortality even if the vaccine is somewhat less effective in these groups... But if a vaccine offers little to no protection in high-risk groups yet is able to reduce infection or infectiousness in younger adults, an indirect strategy could be preferred as vaccine supplies become large enough... A worst-case scenario for an effective vaccine is one that reduces disease in younger adults but provides neither direct nor indirect protection to high-risk groups, leaving the most vulnerable at risk. Knowing these vaccine characteristics is important when evaluating the relative merits of other products. Fortunately, there are many vaccine candidates in development that use a mixture of innovative and existing technologies. Although vaccines may vary in their characteristics, having reliable evidence on direct and indirect protection can help plan how to use these vaccines in a coordinated way.
eabe5938 DOI: 10.1126/science.abe5938 https://science.sciencemag.org/content/early/2020/10/21/science.abe5938
Abstract
Vaccine efficacy in high-risk groups and reduced viral shedding are important for protection
...Availability of a COVID-19 vaccine will initially be limited, and so several expert committees are exploring strategic prioritization plans. Health care workers are a common first-tier group..., which in turn preserves health care systems by protecting those who run them and need them. A next priority is to directly protect those who are at highest risk of death or hospitalization when infected: specifically, those over 65 and people with certain comorbid conditions. This strategy may be optimal for reducing mortality even if the vaccine is somewhat less effective in these groups... But if a vaccine offers little to no protection in high-risk groups yet is able to reduce infection or infectiousness in younger adults, an indirect strategy could be preferred as vaccine supplies become large enough... A worst-case scenario for an effective vaccine is one that reduces disease in younger adults but provides neither direct nor indirect protection to high-risk groups, leaving the most vulnerable at risk. Knowing these vaccine characteristics is important when evaluating the relative merits of other products. Fortunately, there are many vaccine candidates in development that use a mixture of innovative and existing technologies. Although vaccines may vary in their characteristics, having reliable evidence on direct and indirect protection can help plan how to use these vaccines in a coordinated way.
149margd
Experts offer tips for navigating the holidays during the pandemic
Joel Achenbach | Oct. 25, 2020
...Do: Talk with family members and friends in advance to create a plan that everyone can abide by and be comfortable with. Be prepared to decline invitations. Think long term: The pandemic won’t last forever...
https://www.washingtonpost.com/health/covid-holiday-tips/2020/10/25/6792ba92-16b...
Joel Achenbach | Oct. 25, 2020
...Do: Talk with family members and friends in advance to create a plan that everyone can abide by and be comfortable with. Be prepared to decline invitations. Think long term: The pandemic won’t last forever...
https://www.washingtonpost.com/health/covid-holiday-tips/2020/10/25/6792ba92-16b...
150margd
COVID-19 Can Make Patients' Immune Systems Attack Their Own Bodies, Study Shows
MATTHEW WOODRUFF, THE CONVERSATION | 26 OCTOBER 2020
...in a newly released study awaiting peer-review, we describe the alarming finding that in the sickest patients with COVID-19, autoantibody production is common – a finding with large potential impact on both acute patient care and infection recovery.
Severe infection is linked with autoantibody production
...In this study, the Lowance Center group analyzed the medical charts of 52 patients in intensive care who were diagnosed with COVID-19. None of them had a history of autoimmune disorders. However, they were tested during infection for autoantibodies found in a variety of disorders.
The results are stark. More than half of the 52 patients tested positive for autoantibodies. In patients with the highest levels of c-reactive protein (a marker of inflammation) in the blood, more than two-thirds displayed evidence that their immune system was producing antibodies attacking their own tissue.
While these findings raise concerns, there are things that our data don't reveal. Although patients with severe disease clearly display autoantibody responses, the data don't tell us to what extent these autoantibodies contribute to the most severe symptoms of COVID-19.
... Maybe these self-targeted antibody responses do indeed contribute to disease severity, helping explain the delayed onset of severe symptoms in some patients that may correlate with antibody production.
This could be a reason that treatment with dexamethasone, an immunosuppressant often used to quell "flare-ups" of autoimmune disorders, might be effective in treating patients with only the most severe disease. It is also possible that these responses are not short-lived, outlasting the infection and contributing to ongoing symptoms now experienced by a growing number of "long-hauler" COVID-19 patients.
Most concerning, it is possible that these responses could self-perpetuate in some patients, resulting in the emergence of new, permanent autoimmune disorders.
My colleagues and I sincerely hope that...the emergence of autoantibodies in these patients is a red herring, a quirk of a viral immune response in some patients that will resolve on its own.
...the two most common antibodies that we find in these patients, antinuclear antibodies and rheumatoid factor, are detected by common tests used by rheumatologists.
Our study shows that by testing for just these two autoantibodies, and the inflammatory marker c-reactive protein, we may be able to identify patients more likely to be experiencing potentially dangerous immune responses that might benefit from more aggressive immune modulation.
Further, autoreactivity testing might help identify patients who might benefit from rheumotological follow-up to monitor recovery, and help us understand whether some cases of "long-hauler" COVID-19 might be related to persisting autoantibodies. If so, these patients might respond to the same immune-targeted therapies that have been successful in MIS-C where autoantibody production has now been documented.
Finally, by testing patients immediately following COVID-19 recovery, we can establish baselines and begin to track the possible emergence of new cases of autoimmunity following this terrible disease, and plan early rheumatological intervention if needed.
We now have the tools. It's time to start using them.
https://www.sciencealert.com/covid-19-triggers-an-immune-overaction-in-patients-...
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Matthew C. Woodruff et al. 2020. Broadly-targeted autoreactivity is common in severe SARS-CoV-2 Infection. MedRxiv (hOct 23, 2020) doi: https://doi.org/10.1101/2020.10.21.20216192 https://www.medrxiv.org/content/10.1101/2020.10.21.20216192v1
This article is a preprint and has not been certified by peer review.
Abstract
Severe SARS-CoV-2 infection is linked to the presence of autoantibodies against multiple targets, including phospholipids and type-I interferons. We recently identified activation of an autoimmune-prone B cell response pathway as correlate of severe COVID-19, raising the possibility of de novo autoreactive antibody production during the antiviral response. Here, we identify autoreactive antibodies as a common feature of severe COVID-19, identifying biomarkers of tolerance breaks that may indicate aggressive immunomodulation.
151Limelite
The Woodruff paper is very enlightening and leads to hope for additional knowledge emerging in the area of long term after effects with the added possibility of greater understanding how autoimmune inflammatory diseases like RA and lupus arise and what can be done to combat them.
To the paper's thesis, we can add at least one additional consideration -- what evidence is there that the SARS-COV-2 becomes (like herpes, etc.) dormant and sub-clinical in the body but "flares" under certain conditions or time periods, producing post-Covid symptoms.
The rise of literally new disease causing "organisms" can also be viewed as an opportunity to increase and improve medicine and science knowledge -- but with a price, of course. As has always been the history of Man's struggle vs. Nature.
To the paper's thesis, we can add at least one additional consideration -- what evidence is there that the SARS-COV-2 becomes (like herpes, etc.) dormant and sub-clinical in the body but "flares" under certain conditions or time periods, producing post-Covid symptoms.
The rise of literally new disease causing "organisms" can also be viewed as an opportunity to increase and improve medicine and science knowledge -- but with a price, of course. As has always been the history of Man's struggle vs. Nature.
152John5918
A Carte Blanche video about a South Sudanese doctor and his novel use of therapeutic bronchoscopies for critically-ill COVID-19 ventilator patients.
The Extraordinary Life of Emmanuel Taban
I've just reposted this in the new thread which mysteriously sprang up just as I was orginally posting.
The Extraordinary Life of Emmanuel Taban
Born in a tiny village in South Sudan, Emmanuel Taban was one of five siblings raised by a single mother. At 14 he was arrested by the Military for being a rebel-spy, incarcerated, tortured and sent off to Khartoum. He fled to Eritrea, where he was again imprisoned. Upon his release, he decided to walk nearly 3000km to an uncle in Nairobi, Kenya, but he wasn’t welcomed – so, inspired by the “made in South Africa” printing on a cola can, he travelled another 3000 km through East Africa on his own and eventually into South Africa. Carte Blanche celebrates a life of epic grit and imagination – of a young refugee who became a leading pulmonologist who is saving the lives of critically-ill COVID-19 ventilator patients with his novel use of therapeutic bronchoscopies.
I've just reposted this in the new thread which mysteriously sprang up just as I was orginally posting.
Denne tråd er fortsat i SARS-CoV-2 and COVID-19 (15).