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SARS-CoV-2 and COVID-19 (10)

This is a continuation of the topic SARS-CoV-2 and COVID-19 (9).

Pro and Con

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1margd
Jun 27, 5:36pm Top

No direct evidence that imbalance of gut bacteria is implicated in severity of COVID cases, but a thoughtful review.
Mentioned: the soluble fiber, inulin, which is available OTC as a cheap, tasteless powder that dissolves easily in one's coffee.

COVID-19: Could gut bacteria be involved?
Tim Newman | June 26, 2020

The authors of a recent paper ask what role gut bacteria might play in COVID-19. They outline strands of existing evidence and conclude that a link between the two is plausible, but that more research is necessary...

https://www.medicalnewstoday.com/articles/covid-19-could-gut-bacteria-be-involve...

--------------------------------------------------​

Debojyoti Dhara and Abhishek Mohantyb. 2020. Gut microbiota and Covid-19- possible link and implications (Review). Virus Research Volume 285, August 2020, 198018. https://doi.org/10.1016/j.virusres.2020.198018. https://www.sciencedirect.com/science/article/pii/S0168170220304603

Highlights

• Covid-19 disease show gastrointestinal symptoms in some patients hinting at a role of gut-lung axis.
• Gut microbiota diversity and its role in immunity highlighted.
• Possible role of gut microbiota in Covid-19 discussed.
• Implications of gut dysbiosis in Covid-19 analysed.
• Role of diet in strengthening the gut microbiota and in the context of Covid-19 discussed.
• Suggestions on therapy and prophylaxis based on gut microbiota in Covid-19.

2margd
Jun 28, 2:55am Top

Great overview worth the read:

How Exactly Do You Catch Covid-19? There Is a Growing Consensus
Daniela Hernandez, Sarah Toy, and Betsy McKay | June 16, 2020

...Being outside is generally safer, experts say, because viral particles dilute more quickly. But small and large droplets pose a risk even outdoors, when people are in close, prolonged contact, said Linsey Marr, a Virginia Tech environmental engineering professor who studies airborne transmission of viruses.

No one knows for sure how much virus it takes for someone to become infected, but recent studies offer some clues. In one small study published recently in the journal Nature, researchers were unable to culture live coronavirus if a patient’s throat swab or milliliter of sputum contained less than one million copies of viral RNA.

“Based on our experiment, I would assume that something above that number would be required for infectivity,” said Clemens Wendtner, one of the study’s lead authors and head of the department of infectious diseases and tropical medicine at München Klinik Schwabing, a teaching hospital at the Ludwig Maximilian University of Munich.

He and his colleagues found samples from contagious patients with virus levels up to 1,000 times that, which could help explain why the virus is so infectious in the right conditions: It may take much lower levels of virus than what’s found in a sick patient to infect someone else...

https://www.wsj.com/articles/how-exactly-do-you-catch-covid-19-there-is-a-growin...

3margd
Edited: Jun 28, 3:10am Top

Drug recently shown to reduce coronavirus death risk could run out, experts warn
Eli CahanJun. 21, 2020 , 6:25 PM

This week’s report that dexamethasone, a commonly used corticosteroid, reduces death rates of COVID-19 by up to one-third was greeted with enthusiasm around the globe.#

It also raised a question: Will there be enough of the medication? So far, doctors are not reporting problems getting dexamethasone for their patients. And as many news stories have pointed out, dexamethasone is off-patent, cheap, and relatively abundant.

But that doesn’t mean there won’t be shortages, says Stephen Schondelmeyer, director of the Pharmaceutical Research in Management and Economics Institute at the University of Minnesota, Twin Cities. “Even though this is an old drug that’s been around a long time, I think people saying that it’s commonly available … spoke too soon, without looking at the data,” he says. Since the trial findings came out, there has been “a degree of irrational exuberance,” about dexamethasone, Schondelmeyer says. “We are already seeing hoarding behaviors and lack of availability of the product because of it,” he adds.

...The situation could become especially dire for the injectable version of the drug, which some physicians say is the preferred formulation and is more complicated to produce than oral dexamethasone.

...Most of the drug is produced by two Indian companies, Wockhardt and Cadila Healthcare.

...The sickest patients are the ones most likely to benefit from the drug. In the study, dexamethasone reduced the death risk for patients on a ventilator by one-third, and for those requiring oxygen by one-fifth. Patients with milder disease did not benefit.

...The question is whether production of the intravenous form of dexamethasone can be ramped up quickly. Whereas oral dexamethasone is “relatively straightforward to make,” the intravenous form is harder to manufacture, says former FDA Commissioner Mark McClellan, because it needs to be done under sterile conditions to prevent microbes from reducing efficacy or sickening patients.

...Based on the study, the drug should only be used in severe cases, a small subset of the total number of COVID-19 patients. ...demand may increase because doctors will prescribe the drug for less severe cases as well...might accelerate shortages...

https://www.sciencemag.org/news/2020/06/corticosteroid-drug-recently-shown-reduc...

4margd
Jun 28, 3:41am Top

Down the line, it would be great if COVID mortality was equivalent to flu (which is not insignificant). Especially if longterm immunity ensues from mild case as a kid. Not particularly reassuring right now to naive and vulnerable populations, though...

For a limited time, US Red Cross, at least in my area, is offering antibody tests to blood donors.

U.S. CDC Coronavirus Data Bombshell Could Have a Huge Silver Lining
The Centers for Disease Control says there are likely ten times more coronavirus infections than official cases. Here's why that's good news.
W. E. Messamore @thehuli | June 27, 2020

This week the CDC said coronavirus has likely infected ten times more Americans than official case totals.

If accurate, that would mean it’s also ten times less deadly. Which would put its mortality rate in line with seasonal influenza.

Health and state authorities recommend wearing a mask, minimizing travel, and physical distancing to lower the risk of transmission.

According to the CDC, the coronavirus infection total in the US may be ten times higher than official tallies. The estimate is based on blood antibody testing. Experts at the Centers for Disease Control disclosed the estimate to reporters late Wednesday night.

If infections are as widespread as the CDC thinks, coronavirus is far less deadly than authorities have feared. It would have a mortality rate on par with seasonal influenza...

https://www.ccn.com/u-s-cdc-coronavirus-data-bombshell-could-have-a-huge-silver-...

5margd
Jun 28, 5:08am Top

Laurie Garrett | 11 hours ago, 4 tweets, 3 min read

The current surge in #COVID19 cases in the USA is the largest day-on-day increase America, or any other country, has experienced since the #coronavirus crisis started in Wuhan in December.
https://pbs.twimg.com/media/EbjOB8CWAAAqqkJ.png

2/
"There were 45,255 additional #COVID19 cases reported across the nation on Friday, bringing the total to more than 2.46 million cases. As of Fri, the U.S.′ 7-day average of new cases increased more than 41% compared with a week ago."
We're back to log scale, >early April.
https://pbs.twimg.com/media/EbjQguhXQAEIZoc.jpg

3/
Today the US #COVID19 total is more than double the next largest toll, Brazil. Combined, US + Brazil + Russia + India = 4,911,950 cases, out of a world total of 9,882,496: nearly half of the world's #pandemic .
https://pbs.twimg.com/media/EbjSupnWoAAMcL0.jpg

4/
World distribution of the #COVID19 #pandemic is clearly skewed to the USA, Brazil, Russia and India. Each of these countries' governments have failed to wrestle with the virus, while most of Europe, China, SE Asia, Canada & the Asia Pacific govts have found working strategies.

https://threadreaderapp.com/thread/1277003440464498688.html

6lriley
Edited: Jun 28, 7:06am Top

#5--we have no national strategy to deal with the virus. That should have been the POTUS's job to coordinate but from the beginning he's taken no responsibility for anything and left it up to state's and territorial governor's and mayor's to sort out and so we have a multiplicity of ways to wing a Covid-19 response by layman many of whom prioritize the economic/business side over the health and safety side of the pandemic.

Florida has a raging wildfire right now and I hate to say but it is going to have to burn out and it's probably going to take months. They are looking at the same scenario (maybe even worse)that NYC was looking at in the middle of the March. They are at the beginning and there is some denial of facts by their governor and many of their citizens (the anti-vaaxer's--the won't wear masker's, all kinds of religious zealots and right wing bullshitters). Texas, Arizona and California might all be joining Florida and with another 6 + months of Donald don't expect much help from the federal govt.--and Donald will be golfing while the country burns.

7bnielsen
Jun 29, 4:18am Top

There's an interesting difference between Norway and Denmark as regards testing of people without symptoms. Denmark test a lot and Norway very few. The Norwegian argument is that the tests will provide a large number of false positives even if the test is 99.99% good. The Danish authorities claim that they don't see false positives when they test a sample of the people who test positive.

8margd
Jun 29, 6:16am Top

CanSino's COVID-19 vaccine candidate approved for military use in China
Reuters | June 29, 2020

...The shot also won approval for human testing in Canada

...The Phase 1 and 2 clinical trials of the CanSino’s vaccine candidate showed it has the potential to prevent diseases caused by the coronavirus, which has killed half a million people globally, but its commercial success cannot be guaranteed, the company said...

https://www.reuters.com/article/us-health-coronavirus-china-vaccine/cansinos-cov...

9margd
Jun 29, 1:47pm Top

Gilead sets price of coronavirus drug remdesivir at $3,120 as Trump administration secures supply for 500,000 patients
Yasmeen Abutaleb, Hannah Denham and Christopher Rowland | June 29, 2020

Gilead Sciences, the maker of the first covid-19 treatment found to have worked in clinical trials, remdesivir, said Monday it will charge U.S. hospitals $3,120 for the typical patient with private insurance.

Soon after the announcement, the Trump administration said it had secured nearly all of the company’s supply of the drug for use in U.S. hospitals through September, with a contract for 500,000 treatment courses, which it will make available to hospitals at Gilead’s price.

Other developed countries will pay 25 percent less than the United States, a discount Gilead said reflects a need to make the drug as widely available as possible throughout the world.

The company has licensed generic manufacturers to produce the drug for developing countries which will receive the treatment “at a substantially lower cost,” the company said...

...a clinical trial had shown that hospitalized patients with advanced covid-19 who received the experimental drug recovered faster than similar patients who received a placebo.

https://www.washingtonpost.com/business/2020/06/29/gilead-sciences-remdesivir-co...

10cindydavid4
Jun 29, 2:12pm Top

From a dr in phx I have no link but am copying and pasting, sorry its so long

This week I was one of the COVID doctors in the hospital. Before I went on service, I had planned to share my experiences when I got home after my last shift. That didn't happen because I was mentally and emotionally exhausted after being at the hospital for 15+ hours.

I am going to try to break things down so that the general public can understand, because I want everyone, not just my fellow healthcare workers, to be as scared as I am.

This is going to be long, but hopefully will be worth the read for someone.

For references purposes, I am a Hospitalist, which is sort of like your primary care doctor when you're in the hospital. We manage your chronic medical conditions and most of your acute issues in the hospital and consult specialists when we need additional help with complex decision making or a specialized procedure to be performed. We are also the primary point of contact for your nurse on most issues.

I live in Arizona, the current COVID-19 hot spot. Arizona never really closed. Any level of closure that we obtained was the result of petitions with thousands of signatures from physicians. Despite pretty much being able to do anything you wanted to do except get your hair/nails done or eat out at a restaurant (carry out stayed open), people protested the state being closed. The state reopened immediately when criteria were put out to guide how and when states should reopen. To be clear, Arizona did not meet a single criteria for reopening. In addition, masks were not mandated. Governor Ducey avoided mandating masks and made it the responsibility of city Mayors to make any mandates. Mandatory masks were just implemented a few days ago.

As you have almost certainly seen in the news, the rapid reopening without mandated masks has been catastrophic. In a couple of weeks we have gone from a few hundred cases per day to around 3,500 cases per day. A few weeks ago, I was working at the COVID-free hospital designated to be the primary elective surgery campus within the network. The past few days, our recently reopened COVID Unit has been near or completely full. I shared the patient's on the unit with one other hospitalist.

Before I went on service this week, I read anything and everything I could to prepare myself to be the COVID doc. I was up to date on all of the latest recommendations. I was a little nervous, but felt like I was armed with the information that would allow me to help my patients.

I quickly learned that there is no possible way to prepare for how to treat a COVID patient. There is no rhyme, reason, or pattern. There is no possible way to predict what will happen with your patient.

In my sign out to the doc taking over for me today, I prefaced the individual patient sign outs with, "one slightly improving, one with less oxygen requirements but possible new liver failure developing, everyone else getting worse."

I have never seen anything like this. None of us have. We have no idea what we are doing. We are sharing evidence from small studies that could help and utilizing treatments that we think and hope are helpful. Of course, we also thought hydroxychloroquine was helpful a couple of months ago. So, we're hopefully helping people, maybe hurting them, and trying our best. We are flipping people on their stomachs while wide awake on a machine pushing oxygen into their lungs to try and help; this is called the prone position, and it works, but you're stuck in that position for as long as we can keep you there. The longer the better. Anyone on supplemental oxygen is receiving dexamethasone based on the European study that came out last week. We were using Remdesivir, but a patient I admitted two days ago is the last one that will receive it from our current stockpile. Convalescent plasma from patients that had COVID, recovered, and donated plasma is being administered, but studies suggest that antibody concentration diminishes by up to 90% within 2-3 months, so who knows if that's even doing anything.

I realized in the past two days that oxygen saturation numbers that you see on the machines are completely worthless in many COVID patients. So, the one thing we thought we knew, that COVID causes profound hypoxia, was true, but it's actually much worse than we thought. In order to figure out if you are hypoxic (low blood oxygen levels), a needle is stuck into an artery in your wrist as often as is needed. It hurts. A lot. I will have a needle stuck into your artery as often as I need to. I'm sorry, I know it hurts, but it's for your own good.

In any other time, most of my patients would already be intubated on a ventilator. We are managing so many critically ill patients on regular hospital floors. If we sent everyone to the ICU that would normally be there based on their current status and put them all on ventilators, all resources would be depleted in a day.

The patients I cared for the past few days were the most miserable, uncomfortable, terrified patients I have seen in the past four years. I sat with them while they cried because they are scared that they will get worse and get intubated and die without ever seeing their loved ones again. I can't comfort them by saying they'll get better soon, because I don't know that they will. All I can tell them is that we're doing everything we can and I really hope they improve. I held a patients hand while she cried and screamed, "oh my god, I'm going to die, aren't I? I'm dying" when I told her we couldn't give her more oxygen without intubating her and putting her on life support. I then tried to comfort her children over the phone after I informed them they were not allowed to come in to the hospital to be with her. They asked if someone could be there to comfort her if she is going to die.

Many of my patients were young. Many have no underlying conditions that predispose them to a bad outcome, yet are one bad blood oxygen reading away from needing to be intubated.

COVID does not care who you are.

I am scared and you should be, too.

All of that is to send the following message:

Please, please, stay home if you can. If you need to go out, WEAR A MASK! Do not touch your face. Wash your hands and sanitize often. I can't promise you won't end up in the hospital with COVID even if you do all of these things, but I promise it's the best shot you've got.

P.S. THANK YOU to all the amazing RNs, RTs, PCTs, Pharmacists, Pharmacy techs, lab techs, physical & occupational therapists, social workers, case managers, environmental service workers, and everyone else that makes it possible to care for these patients in the best way we know how. You don't get enough credit. You all are the real MVPs.

______________________________________

ADDENDUM: To be clear, COVID-19 is caused by a virus. This is a PUBLIC HEALTH CRISIS. It is not, never has been, and never will be a political issue. Politics have played a huge role in getting us into this mess, and it's time to cut them out. COVID doesn't discriminate, and it definitely doesn't care who you're going to vote for. When you see/hear/read anything related to COVID-19, pay attention to who is posting the information. If it is not coming from a medical professional, question your source.

______________________________________

ADDENDUM-2: I am so incredibly shocked at how widely this has been shared. Thank you all! Please continue to share! Since people are reading this, I would like to use this platform to ask you to PLEASE talk with your loved ones about your wishes. If you have an advance directive, please bring it with you if you are unfortunately in need of hospitalization. If you do not have an advance directive, it's time to get one. If we do not know what you would like to be done, we assume that the answer is everything. If your loved one or listed MPOA is unaware of your wishes, they will likely also err on the side of doing everything. Help them to make those very difficult decisions by making your wishes known. Do not wait until you are in the hospital, because it may be too late. Please look up what it means to be "full code" vs "DNR/DNI." Know what you would want done to you.

https://www.facebook.com/brandon.bikowski?__tn__=%2CdC-R-R&eid=ARAlvlEihYySB...

11margd
Edited: Jun 29, 4:53pm Top

>10 cindydavid4: Sounds like NYC not long ago. I hope somehow Arizona dodges NYC's hell.
However, it may not be...

Grim reality is that our most difficult weeks are in front of us
Image ( https://twitter.com/PeterHotez/status/1277592928555278337/photo/1 )
- Prof Peter Hotez MD PhD @PeterHotez | 9:21 AM · Jun 29, 2020
_______________________________________________

Daniel Stadlbauer et al. 2020. Seroconversion of a city: Longitudinal monitoring of SARS-CoV-2 seroprevalence in New York City. MedRxiv. Jun 29. 2020. doi: https://doi.org/10.1101/2020.06.28.20142190 . https://www.medrxiv.org/content/10.1101/2020.06.28.20142190v1

This article is a preprint and has not been certified by peer review

Abstract
By conducting a retrospective, cross-sectional analysis of SARS-CoV-2 seroprevalence in a sentinel group (enriched for SARS-CoV-2 infections) and a screening group (representative of the general population) using >5 margd:,000 plasma samples from patients at Mount Sinai Hospital in New York City (NYC), we identified seropositive samples as early as in the week ending February 23, 2020. A stark increase in seropositivity in the sentinel group started the week ending March 22 and in the screening group in the week ending March 29. By the week ending April 19, the seroprevalence in the screening group reached 19.3%, which is well below the estimated 67% needed to achieve community immunity to SARS-CoV-2. These data potentially suggest an earlier than previously documented introduction of SARS-CoV-2 into the NYC metropolitan area...

12lriley
Jun 29, 5:17pm Top

#10--sorry to say but a lot of those who end up in the hospital are there because they decided to be idiots and they're endangering those whose job it is to save them. People have had time to figure this out--they've had New York City and the Northeast as an example. Wearing masks and social distancing saves lives--not only your own. When I'm out in public I wear a mask and I'm cognizant of where exactly people are around me and I decided to wear a mask even before Gov. Cuomo mandated it---not because I like the thing but because I don't want to get this virus and I don't want to be part of the problem.

Political actors like Gov. Ducey of Arizona have abdicated their responsibility and deserve to be recalled. It's the same with Trump--his ineptitude is going to lead to more agony and more deaths. We have 130,000 or so dead already since March and we have 6+ more months until he's replaced. We could have 400--500,000 dead by then.

13cindydavid4
Jun 29, 10:21pm Top

interesting development today: Ducey apparenly is bowing to all the blowback he's getting and decided to close all gyms, bars, theatres and water parks, plus no more buying innertubes to go down the salt river. Hes even sorta admitting that he opened up too soon. Now he wants everyone to follow the rules. We'll see how that goes.

14kiparsky
Jun 30, 12:07am Top

>12 lriley: sorry to say but a lot of those who end up in the hospital are there because they decided to be idiots

While it may be technically true to say that "a lot" of people who are hospitalized with COVID-19 are there as a result of their own actions, depending on how you quantify "a lot", it is probably not a very helpful way to characterize the situation.

Presumably you're imagining a scenario where a person goes to an event or location where they are in close proximity to a lot of other people for an extended period of time, without wearing any protective equipment, and while at that event they are exposed to a quantity of SARS-CoV-2 particles sufficient to cause an infection.

It's a nice simplistic scenario, and useful for yelling at the idiots on the other side, which obviously is something I enjoy very much, and it's likely that it is happening. However, it does not seem to be the rule, even in the current outbreaks. Analysis from the Northeast (particularly Boston, where I am, and New York) show that the populations most at risk are residents of old-folks' homes, "essential workers", and people of color, with the latter two classes overlapping to a great degree.

What I'm seeing so far from Arizona and Texas (the two places where I've seen reporting lately) suggests that, while we're seeing the cases skew younger, we're not significantly breaking from those trends, so it's probably a little more complicated than your simplistic picture.

While I completely agree that people who fail to follow basic protective measures are idiots and dangerous to those around them, I don't think it's helpful to suggest that people who contracted COVID-19 probably brought it on themselves. They probably did not. Most likely, they contracted the virus in a care facility, or while working to keep things running for you and me. And most likely, they had very little say about the conditions under which they contracted it.

Now, if you point me to someone who contracted COVID-19 after a rousing game of lick-the-lamppost with a few hundred of their best friends, or something of that nature, sure. Idiot got what idiot asked for. But even then, idiot is probably now pretty well aware of the cause and effect, and yelling at them about it isn't really going to help much, so in that case, maybe a bit of compassion is in order. At least until you figure out whether they've learned something from the whole business and maybe even came away a bit smarter. People do sometimes learn from their mistakes.

15cindydavid4
Jun 30, 5:47am Top

>14 kiparsky: Yes, this. Well said . While it makes us feel good and superior for blaming the victim, it doesn't do much to help them. I cringe hearing stories of Covid deniers catching it, even dying from it. What is needed is indeed some compassion, and use the stories to educate others of the dangers.

16margd
Edited: Jun 30, 7:10am Top

Randy Rainbow says COVER YOUR FREAKIN' FACE! :D
https://www.youtube.com/watch?v=6kOesPt7iBY :D
___________________________________________

Hopefully, we will face only COVID and regular flu next fall & winter...
(This particular virus combines bits from North America and Europe as well as Asia--from pigs, birds, (humans?))

China researchers discover new swine flu with 'pandemic potential'
Jessie Yeung | June 30, 2020

...the virus does not pose an immediate global health threat.

The disease, which researchers called the G4 virus, is genetically descended from the H1N1 swine flu that caused a pandemic in 2009.

...G4 can infect humans by binding to our cells and receptors, and it can replicate quickly inside our airway cells. And though G4 holds H1N1 genes, people who have received seasonal flu vaccines won't have any immunity.

G4 already appears to have infected humans in China. In Hebei and Shandong provinces, both places with high pig numbers, more than 10% of swine workers on pig farms and 4.4% of the general population tested positive in a survey from 2016 to 2018.

There is no evidence yet that G4 could spread from person to person -- perhaps the most promising sign so far, said Carl Bergstrom, a professor of biology at the University of Washington...

https://www.cnn.com/2020/06/30/asia/china-swine-flu-pandemic-intl-hnk-scli-scn/i...

--------------------------------------------------​

Honglei Sun et al. 2020. Prevalent Eurasian avian-like H1N1 swine influenza virus with 2009 pandemic viral genes facilitating human infection. PNAS first published June 29, 2020 https://doi.org/10.1073/pnas.1921186117 https://www.pnas.org/content/early/2020/06/23/1921186117

Significance
Pigs are intermediate hosts for the generation of pandemic influenza virus. Thus, systematic surveillance of influenza viruses in pigs is a key measure for prewarning the emergence of the next pandemic influenza. Here, we identified a reassortant EA H1N1 virus possessing pdm/09 and TR-derived internal genes, termed as G4 genotype, which has become predominant in swine populations since 2016. Similar to pdm/09 virus, G4 viruses have all the essential hallmarks of a candidate pandemic virus. Of concern is that swine workers show elevated seroprevalence for G4 virus. Controlling the prevailing G4 EA H1N1 viruses in pigs and close monitoring in human populations, especially the workers in swine industry, should be urgently implemented.

Abstract
Pigs are considered as important hosts or “mixing vessels” for the generation of pandemic influenza viruses. Systematic surveillance of influenza viruses in pigs is essential for early warning and preparedness for the next potential pandemic. Here, we report on an influenza virus surveillance of pigs from 2011 to 2018 in China, and identify a recently emerged genotype 4 (G4) reassortant Eurasian avian-like (EA) H1N1 virus, which bears 2009 pandemic (pdm/09) and triple-reassortant (TR)-derived internal genes and has been predominant in swine populations since 2016. Similar to pdm/09 virus, G4 viruses bind to human-type receptors, produce much higher progeny virus in human airway epithelial cells, and show efficient infectivity and aerosol transmission in ferrets. Moreover, low antigenic cross-reactivity of human influenza vaccine strains with G4 reassortant EA H1N1 virus indicates that preexisting population immunity does not provide protection against G4 viruses. Further serological surveillance among occupational exposure population showed that 10.4% (35/338) of swine workers were positive for G4 EA H1N1 virus, especially for participants 18 y to 35 y old, who had 20.5% (9/44) seropositive rates, indicating that the predominant G4 EA H1N1 virus has acquired increased human infectivity. Such infectivity greatly enhances the opportunity for virus adaptation in humans and raises concerns for the possible generation of pandemic viruses.

17John5918
Jun 30, 9:29am Top

Chinese coronavirus vaccine approved for military use (Bangkok Post)

China's military has approved a coronavirus vaccine for use within its ranks that has been developed by its research unit and a biotech firm...

18davidgn
Jun 30, 1:32pm Top

>17 John5918: Well, that's one sort of clinical trial...

19margd
Jun 30, 3:29pm Top

The vaccine is also approved (for testing?) in Canada--I assume only Montreal has sufficient infection rate?
Re the Chinese guines pigs--er, soldiers--Lord knows the US has foisted some meds and vaccines and chems on OUR troops that we might not on our civilians.

The name "CanSino Biologics" made me think it might be a joint Chinese-Canadian venture. Perhaps, never mind the Huawei dustup, Canada remembered the 3M PPE fight seizures by US and figgered best to look to China (among others) for a foreign-produced vaccine for backup to one they are working on domestically?

20lriley
Edited: Jun 30, 3:38pm Top

#14--we may just see this situation differently---your having the rosier view.

So wearing a mask in public is getting parsed on the right as a way to insinuate control over the population and as an assault on people's religious convictions. There's been a steady drumbeat of misinformation from the right that the virus isn't all that real and that the 130,000 claimed coronavirus deaths aren't all from Covid--that a lot of this has been made up and the effects of those dead or ill from the virus is secondary to the damage done to the economy. The mask wearers (that includes I and I assume you) are sheep being led around by their noses (baah-baah) by the fake media, democratic politicos (many of whom I despise by the way), George Soros, etc. One big huge conspiracy to derail the Trump administration after the impeachment failed....and very sadly I'm not sure there is a way to get through to some of these people convinced by that kind of messaging but to have them actually experience the virus for themselves and unfortunately that doctor in Arizona and the people double shifting around him for the next probable several weeks anyway are going to have to risk their own lives and sanity to save some of them. Truly when people choose (Live free or die!) to not take precautions they're only feeding the pandemic's fire and only going to prolong the human and the economic agony but still so many are choosing exactly to do that freedumb thing.

If people would take the time to look they would see that other countries are getting back to some kind of normalcy....maybe not all the way but even so. They might also see that at least some other countries not only did more to protect their populations but also to protect their economies as well. In the United States we did neither and we're arguably in a worse place now than we were in March, April and May and we still don't have any real coordinated national response to the pandemic and are not likely to until January at the earliest and because of all that irrationality is on the loose.

Meanwhile Donald Trump's golfing again. I guess he's gone back to normal.

21cindydavid4
Jun 30, 4:17pm Top

>20 lriley: and very sadly I'm not sure there is a way to get through to some of these people convinced by that kind of messaging but to have them actually experience the virus for themselves and unfortunately that doctor in Arizona and the people double shifting around him for the next probable several weeks anyway are going to have to risk their own lives and sanity to save some of them. Truly when people choose (Live free or die!) to not take precautions they're only feeding the pandemic's fire and only going to prolong the human and the economic agony but still so many are choosing exactly to do that freedumb thing.

Freedumb? typo or new word? Im stealing it, whichever :)

Another dr talked about spending so much time and energy getting people to do the right thing. But then he realized people are gonna do what they are gonna do. Yu can only reach so many. So he is focusing time and energy on fixing the conseqence of those decisions. Theres not much else thay can do

On CNN, somewhere in Fla there was a huge meeting with the city, with these people calling all this the devils work, and that the city speakers were all going to be arrested for mass murder. You can't fix stupid. Wonder tho if we can just put all those folk in the same room for a while.........

22cindydavid4
Edited: Jun 30, 5:09pm Top

BTW was reminded of a quote from one of my fav authors, and think it pertains here

On every act the balance of the whole depends. The winds and seas, the powers of water and earth and light, all that these do, and all that the beasts and green things do, is well done, and rightly done. All these act within the Equilibrium. From the hurricane and the great whale's sounding to the fall of a dry leaf and the gnat's flight, all they do is done within the balance of the whole.

But we, insofar as we have power over the world and over one another, we must learn to do what the leaf and the whale and the wind do of their own nature. We must learn to keep the balance. Having intelligence, we must not act in ignorance. Having choice, we must not act without responsibility.”
― Ursula K. Le Guin, The Farthest Shore

23lriley
Edited: Jun 30, 5:21pm Top

#21--certainly not a typo.

Between Florida, Texas, Arizona and California---the biggest hotspots right now---somewhere around 25,000 new cases today. Just saying--when numbers are coming in like that--taking Italy, Spain, Britain, NYS as previous examples that means many many more are out there in those states that will be coming for treatment tomorrow and the day after, and the day after that etc. I think the medicos are getting savvier and savvier about how to save lives but the risks are also you run out of space, equipment and supplies and you're running those doctors, nurses and assistants right into the ground to the point that some of them will get the virus too and some of them will break physically or psychologically before all is said and done.

Don't disturb Trump at the links though--he needs a break from all the hard stuff he has to do as world leader. He really is a fucking shitbird.

24cindydavid4
Jun 30, 6:03pm Top

>23 lriley: oh I am so glad!

seen elsewhere: It took 'clickit or ticket' to get people to wear their seatbelt, maybe mask it or casket might work?

25kiparsky
Jun 30, 7:19pm Top

>24 cindydavid4: I love the rhyme, but it seems to me that if we're honest, the point of wearing a mask is not self-protection, it's minimizing community transmission.

And that's a really hard sell.

26cindydavid4
Jun 30, 7:24pm Top

i know, but it just might make people think. maybe....

27John5918
Jun 30, 11:46pm Top

>25 kiparsky: minimizing community transmission. And that's a really hard sell.

Particularly in a country where one of the dominant narratives is the primacy of individuality at all costs.

28margd
Jul 1, 3:21am Top

>24 cindydavid4: 'Mask it or casket'--I like it.

Another: ‘It’s a lot easier to wear a mask than a ventilator’?
https://www.msnbc.com/deadline-white-house/watch/cdc-adviser-it-s-a-lot-easier-t...

__________________________________________________​

The effect of Black Lives Matter protests on coronavirus cases, explained
German Lopez | Jun 26, 2020

Here are six reasons the protests may not have led to a big spike in coronavirus cases — and what we can learn from that.

1) The protests were mostly outdoors
2) Protesters wore masks, washed their hands, and took other precautions
3) The protesters were relatively young
4) The protesters made up a small portion of the overall population
5) The protests pushed other people to stay home
6) There’s an element of chance

https://www.vox.com/2020/6/26/21300636/coronavirus-pandemic-black-lives-matter-p...

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Young people doing what young people do: as kids head back to university, outbreak at a Michigan bar may have lessons in what NOT to do. Too many people indoors, even if at 50% capacity. The Governor observed that loud music means people have to raise their voices to be heard. Photos I saw of lines outside showed few masks and little social distancing. Amazing in a university town how far patrons travelled (12 = 1 counties)! An indication of how quickly, without contact-tracing and quarantine, a state can move to community transmission?

Coronavirus outbreak linked to East Lansing bar tops 100, officials take emergency action
Justine Lofton | Jun 30, 2020; Posted Jun 30, 2020

Positive COVID-19 coronavirus cases traced to an East Lansing bar have climbed to 107 a week after health officials warned the public about possible exposure (Tuesday, June 23).

The outbreak has prompted the Ingham County Health Department to issue an emergency order to reduce restaurant capacity to 50% or no more than 75 people, whichever is fewer. (Gov. Gretchen Whitmer’s executive order allowed restaurants and bars to open at 50% capacity but did not impose a limit on the number of patrons.)

...Harper’s was following safety procedures related to employees, capacity and table spacing when inspected by the health department after cases were linked to it. The bar voluntarily closed to enhance safety, including modifications to its HVAC system.

...Of the 107 people infected with the virus, 95 are primary cases, meaning they visited Harper’s during the exposure period, the health department said. The remaining 12 are secondary cases, which means they were in contact with someone who visited the bar during the exposure period.

Fifty-nine of the 95 primary cases are in Ingham County residents, the health department said. The others have residency in Clinton, Oakland, Wayne, St. Clair, Macomb, Eaton, Shiawassee, Livingston, Kalamazoo, Ottawa, Berrien and Calhoun counties.

All the people with cases linked to Harper’s are between 16 and 28 years old, the health department said. None of them have been hospitalized. Most have mild symptoms. Twenty-eight are asymptomatic, which means they don’t have symptoms but are contagious. At least 40 percent are Michigan State University (MSU) students or recent graduates...

https://www.mlive.com/news/2020/06/coronavirus-outbreak-linked-to-east-lansing-b...

29margd
Jul 1, 3:33am Top

Researchers Identify N95 Respirator Decontamination Method Using a Microwave
American Society for Microbiology | June 30, 2020

Due to the rapid spread of COVID-19, there is an increasing shortage of personal protective equipment (PPE) crucial to protecting health care workers from infection. N95 respirators are recommended by the CDC as the ideal protection method from COVID-19 and, although traditionally single-use, PPE shortages have necessitated the need for reuse. New research published recently in mBio an open-access journal of the American Society for Microbiology, describes an effective, standardized method of decontamination for hospitals and health care centers facing N95 respirator shortages.

The researchers, from Beth Israel Deaconess Medical Center, Harvard University and Massachusetts General Hospital, have detailed a reproducible decontamination approach that all health care workers would be able to utilize. “We identified an effective method of N95 decontamination by microwave-generated steam utilizing universally accessible materials. Our method resulted in almost complete sterilization after only 3 min of treatment and did not appear to affect the integrity of N95 filtration or fit with repeated treatment,” the researchers write.

Reference: “Microwave-Generated Steam Decontamination of N95 Respirators Utilizing Universally Accessible Materials” by Katelyn E. Zulauf, Alex B. Green, Alex N. Nguyen Ba, Tanush Jagdish, Dvir Reif, Robert Seeley, Alana Dale and James E. Kirby, 25 June 2020, mBio. DOI: 10.1128/mBio.00997-20 https://mbio.asm.org/content/11/3/e00997-20

https://scitechdaily.com/researchers-identify-n95-respirator-decontamination-met...

30margd
Jul 1, 3:42am Top

Inovio's stock falls (margd: from huge run-up) as it discloses early-stage data for its COVID-19 vaccine candidate
Jaimy Lee | June 30, 2020

Shares of Inovio Pharmaceuticals Inc. INO, -14.95% tumbled 10.8% in premarket trading on Tuesday after the company said its COVID-19 vaccine candidate was considered safe and well-tolerated in all 40 of the participants in a Phase 1 clinical trial. However, the company did not disclose data about the participants' antibody response, though it said 94% of 36 trial participants showed "overall immunological response rates based on preliminary data assessing humoral (binding and neutralizing) and T cell immune responses." (Three trial participants tested positive for COVID-19 and one left the study for non-clinical reasons.) There were some adverse events, though none were serious, that primarily consisted of redness on the skin where the experimental vaccine was administered. Inovio also said it has added older participants to the early-stage trial; the original 40 are between the ages of 18 and 50 years old. It also plans to start a Phase 2/3 study this summer. Inovio is one of a handful of companies in the U.S. studying whether their experimental vaccines can prevent infection with the coronavirus. Shares of Inovio have soared 860.3% year-to-date. The S&P 500 SPX, +1.54% declined 5.5% since the start of the year.

https://www.marketwatch.com/story/inovios-stock-falls-as-it-discloses-early-stag...

31margd
Jul 1, 3:50am Top

Taking A Trip To Visit Grandparents Or Older Relatives? Tips To Reduce The Risk
Allison Aubrey, Jane Greenhalgh | June 24, 2020

Assess the risk
Plan ahead, by two weeks
If you can, make it a road trip
Think twice before you fly
Should you get tested?
Where should you stay?
Limit activities when you get there
Consider staying home

https://www.npr.org/sections/health-shots/2020/06/24/880962631/taking-a-trip-to-...

32margd
Jul 1, 4:32am Top

Why a Pediatric Group Is Pushing to Reopen Schools This Fall
Dana Goldstein | June 30, 2020

The American Academy of Pediatrics has a reputation as conservative and cautious, which is what you would expect from an organization devoted to protecting children’s health. But this week, the academy made a splash with advice about reopening schools that appears to be somewhat at odds with what administrators are hearing from some federal and state health officials.

The Centers for Disease Control and Prevention, for example, have advised that remote learning is the safest option. But the academy’s guidelines strongly recommend that students be “physically present in school” as much as possible, and emphasize that there are major health, social and educational risks to keeping children at home...

https://www.nytimes.com/2020/06/30/us/coronavirus-schools-reopening-guidelines-a...

__________________________________________________​

*American Academy of Pediatrics
COVID-19 Planning Considerations: Guidance for School Re-entry
Critical Updates on COVID-19 / Clinical Guidance / COVID-19 Planning Considerations: Guidance for School Re-entry

...Any school re-entry policies should consider the following key principles:

School policies must be flexible and nimble in responding to new information, and administrators must be willing to refine approaches when specific policies are not working.

It is critically important to develop strategies that can be revised and adapted depending on the level of viral transmission in the school and throughout the community and done with close communication with state and/or local public health authorities and recognizing the differences between school districts, including urban, suburban, and rural districts.

Policies should be practical, feasible, and appropriate for child and adolescent's developmental stage.

Special considerations and accommodations to account for the diversity of youth should be made, especially for our vulnerable populations, including those who are medically fragile, live in poverty, have developmental challenges, or have special health care needs or disabilities, with the goal of safe return to school.

No child or adolescents should be excluded from school unless required in order to adhere to local public health mandates or because of unique medical needs. Pediatricians, families, and schools should partner together to collaboratively identify and develop accommodations, when needed.

School policies should be guided by supporting the overall health and well-being of all children, adolescents, their families, and their communities. These policies should be consistently communicated in languages other than English, if needed, based on the languages spoken in the community, to avoid marginalization of parents/guardians who are of limited English proficiency or do not speak English at all.

With the above principles in mind, the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school...

https://services.aap.org/en/pages/2019-novel-coronavirus-covid-19-infections/cli...

33margd
Jul 1, 4:59am Top

YAY! "Finding Reveals Achilles’ Heel Easily Targeted with Existing Drugs"

COVID-19 Relies on Cell’s ‘Master Regulators’ for Survival

...In a study published June 28, 2020, in Cell,* the researchers found that when SARS-CoV-2 infects cells, it assumes control over a family of enzymes known as kinases. Under normal circumstances, kinases serve as master regulators of metabolism, growth, movement, repair and other important cellular functions. Kinases work by attaching tiny chemical tags to proteins through a process known as phosphorylation. Once attached, these tags act as switches that turn proteins on or off, which keeps the complex machinery of the cell running smoothly.

When a cell is commandeered by SARS-CoV-2, however, these same kinases behave in ways that disrupt normal cell function and transform the host cell into a virus factory. Cell division comes to a halt, inflammation pathways are activated, and the cell even begins to produce tentacle-like structures known as filopodia, which protrude from the cell’s surface and may serve as molecular highways that help the virus spread rapidly to neighboring cells.

...49 kinases exhibited abnormal activity in infected cells. In particular, the researchers found that a well-studied kinase network known as the p38/MAPK pathway, which is known to trigger the production of inflammation-inducing cytokines, was significantly more active...But perhaps most surprising was the international team’s finding that SARS-CoV-2 activated a kinase called CK2, which in turn appeared to stimulate the production of filopodia, tiny tentacle-like protuberances that extend out from the cell’s surface.

...After identifying the kinases that SARS-CoV-2 depends on for survival, the scientists compiled a list of existing drugs known to target many of these kinases. If these drugs could successfully interfere with kinase activity in infected cells, they might be able to stop the virus in its tracks.

The scientists tested 68 such compounds and found that those that interfered with the activity of the CK2, p38/MAPK and CDK pathways exhibited potent antiviral activity without being toxic to cells, suggesting that a combination “cocktail” of these drugs could prove to be an effective way to treat COVID-19...

--------------------------------------------------​

* Mehdi Bouhaddou et al. 2020. The Global Phosphorylation Landscape of SARS-CoV-2 Infection. Cell. Published:June 28, 2020 DOI:https://doi.org/10.1016/j.cell.2020.06.034 . https://www.cell.com/cell/fulltext/S0092-8674(20)30811-4

34margd
Jul 1, 5:45am Top

A National Mask Mandate Could Save The U.S. Economy $1 Trillion, Goldman Sachs Says
Sarah Hansen | Jun 30, 2020

...Goldman’s analysts found that wearing face coverings has a significant impact on coronavirus outcomes, and they suggest that a federal mask mandate would “meaningfully” increase mask usage across the country, especially in states like Florida and Texas, where masks are not currently required.

The researchers estimate that a national mandate would increase the portion of people wearing masks by 15%, and cut the daily growth of new cases by between 0.6% and 1%.

Reducing the spread of the virus through mask-wearing, the analysts found, could be a substitute for strict lockdown measures that would otherwise shave 5%—or $1 trillion—off the U.S. GDP...

https://www.forbes.com/sites/sarahhansen/2020/06/30/a-national-mask-mandate-coul...

35cindydavid4
Edited: Jul 1, 11:01am Top

>32 margd: Policies should be practical, feasible, and appropriate for child and adolescent's developmental stage.

Ya think?! We had three year olds with special needs expected to attend to a zoom lesson.

With the above principles in mind, the AAP strongly advocates that all policy considerations for the coming school year should start with a goal of having students physically present in school...

Every educator I know wants nothing more than to be back in thei classroom with the kids, teaching.Parents of course want this as well. Its a important goal to have for the emotional wellbeing and academic development for our kids. I like this statement, its flexible and looks at the many issues to be considered. but Two things that are missing -

First there is no mention of how the people teaching and caring for students will be protected, many of these same are in the risk age. How will school staff and visitors be protected at the school, what procedures are in place for substitutes, and what happens to staff who do not feel comfortable being at school, can they stay home and still receive salary.

Second, where is the money coming from to make sure all specifications for health (santizing, cleaning) to be met. Will teachers be required to do this? Where is the money to pay others to do so? This is a biggie, esp in my state that has one of the lowest salaries in the country, has a teacher shortage, and often expect teachers to pay for things like kleenex.

These questions must be answered in order for this goal of back to normal is acheived. And I am not optimistic they will be.



36margd
Jul 1, 12:23pm Top

Would Zinc Lozenges Help with COVID-19? (6:02)
Michael Greger, MD
https://nutritionfacts.org/video/would-zinc-lozenges-help-with-covid-19/

margd: a sign of zinc deficiency is white spots on one's nails.

37margd
Jul 1, 5:01pm Top

Paul Krugman @paulkrugman | 1:28 PM · Jul 1, 2020:

Another thought on Arizona's numbers: AZ, with 7 million people,
is reporting as many new cases per day as the European Union, with 446 million.

38John5918
Edited: Jul 2, 12:10am Top

We can't play dead, Kenya is ready for travel (Star)

Travel restrictions will soon be lifted following the launch of the Tourism and Travel, Health and Safety Protocols. Interior CS Fred Matiang'i on Wednesday said the country is now safe for travel resumption. "Kenya is ready for travel. Kenyans should know that"...

Matiang'i said the country will continue to provide security for both locals and foreign travelers to curb the risk of accelerated infections. "It's now a reality that the virus could become endemic and we must all be prepared to live with it and resume normalcy under the prevailing circumstances as global efforts to find a vaccine continues... We can't sit back, play dead and wait for some magic so we can begin to live normally. There is no country that is an example of what we ought to be doing. Therefore we have to learn for ourselves," he said.

His sentiments were echoed by Health Cs Mutahi Kagwe who said Kenyans need to learn to live with the virus...


Coronavirus in Africa: Why is there a surge in South Africa? (BBC)

Coronavirus cases are rising across Africa and, in South Africa, the biggest provincial hotspot looks to be shifting – with the country’s economic hub now under threat... Gauteng...

39margd
Jul 2, 4:58am Top

Harvard Global Health Institute
The Path to Zero: Key Metrics For COVID Suppression – Pandemics Explained

How severe is the pandemic where you live?
Browse our COVID Risk Levels Dashboard (interactive map of US)

https://globalepidemics.org/key-metrics-for-covid-suppression/

40John5918
Jul 2, 9:42am Top

Africa waited for solutions to past health crises: will it be different for COVID-19? (The Conversation)

As a public health specialist and infectious diseases epidemiologist, I am very happy and impressed to see such massive research activity to relieve human suffering from this baffling disease. But then, as an African, I ask myself, when will these treatments or vaccines be available for Africans on African soil? Will the “break-neck speed”, “affordability” and “equity” work for the benefit of Africa?

It is true that African countries are making their own efforts to fight the pandemic... But the history of pandemic or epidemic diseases is not encouraging. It shows that treatments and vaccines have been accessible to African countries only after the loss of millions of lives and typically years – sometimes decades – after developed nations have benefited from them. This is mainly because the treatments and vaccines for most diseases are produced in Western countries and are too expensive for African countries. This largely remains in place as the chief barrier to accessibility of treatments and vaccines...

41amysisson
Edited: Jul 2, 11:50am Top

This is sick (no pun intended). The organizers of such parties should be charged with reckless endangerment, if nothing else.

Young people are throwing coronavirus parties with a payout when one gets infected, official says

https://www.cnn.com/2020/07/02/us/alabama-coronavirus-parties-trnd/index.html

42John5918
Edited: Jul 2, 12:59pm Top

Africa’s scientists set out their COVID-19 research priorities (The Conversation)

In April 2020, about two months after the African continent recorded its first case of COVID-19, the African Academy of Sciences undertook an extensive survey of its members. This allowed hundreds of scientists in African countries to identify COVID-19 related research priorities across a range of disciplines. The Conversation Africa’s Natasha Joseph asked Dr Moses Alobo, who is heading the Academy’s COVID-19 response efforts, to explain the survey’s findings and how they can be applied...

From Crisis to Opportunity: Covid-19 and Innovation in Africa (African Leadership Centre)

- The neo-colonial habit of looking outward to the Global North for ideas and solutions may prove to be more devastating for the African populace than the COVID-19 pandemic itself.
- Given the existing resource and infrastructural opportunities and constraints in Africa, AU member states must collaborate to harness indigenous innovations across the continent.
- Leading innovation is not business as usual. It is not déjà vu. The leader’s role is to unleash individual innovative talents and harness all those diverse talents to yield a useful and cohesive result.
- The role of the African States, RECs, and AU in facilitating the emergence and nurturing of talents and the exchange of ideas will be crucial in the process of co-creating sustainable solutions and innovations.

Out of necessity, Africans - like many other people across the world - have responded to the COVID-19 crisis in innovative ways...

43margd
Jul 3, 8:16am Top

Why Surviving the Virus Might Come Down to Which Hospital Admits You

In New York City’s poor neighborhoods, some patients have languished in understaffed hospitals, with substandard equipment. It was a different story in Manhattan’s private medical centers.

Brian M. Rosenthal, Joseph Goldstein, Sharon Otterman and Sheri Fink | July 1, 2020

...At the peak of the pandemic in April, the data suggests, patients at some community hospitals were three times more likely to die as patients at medical centers in the wealthiest parts of the city.

Underfunded hospitals in the neighborhoods hit the hardest often had lower staffing, worse equipment and less access to drug trials and advanced treatments at the height of the crisis than the private, well-financed academic medical centers in wealthy parts of Manhattan, according to interviews with workers at all 47 of the city’s general hospitals.

...Inequality did not arrive with the virus; the divide between the haves and the have-nots has long been a part of the web of hospitals in the city.

Manhattan is home to several of the world’s most prestigious medical centers, a constellation of academic institutions that attract wealthy residents with private health insurance. The other boroughs are served by a patchwork of satellite campuses, city-run public hospitals and independent facilities, all of which treat more residents on Medicaid or Medicare, or without insurance.

The pandemic exposed and amplified the inequities, especially during the peak, according to doctors, nurses and other workers.

Overall, more than 17,500 people have been confirmed to have died in New York City of Covid-19, the illness caused by the coronavirus. More than 11,500 lived in ZIP codes with median household incomes below the city median, according to city data.

Deaths have slowed, but with the possibility of a second surge looming, doctors are examining the disparities...

https://www.nytimes.com/2020/07/01/nyregion/Coronavirus-hospitals.html

44margd
Jul 3, 8:47am Top

"A hypothesis-free profiling of ACE2 suggests tongue keratinocytes, olfactory epithelial cells, airway club cells and respiratory ciliated cells as potential reservoirs of the SARS-CoV-2 receptor. We find the gut as the putative hotspot of COVID-19, where a maturation correlated transcriptional signature is shared in small intestine enterocytes among coronavirus receptors(ACE2, DPP4, ANPEP)."

Watch: It’s not just the lungs: The Covid-19 virus attacks like no other ‘respiratory’ infection
Sharon Begley | June 26, 2020

...Venky Soundararajan had a hunch that the extent of ACE2 distribution throughout the body was lying in plain sight. The co-founder and chief scientific officer of nference, which uses artificial intelligence to mine existing knowledge, he and his colleagues turned their system into a hunt for ACE2 knowledge. Combing 100 million biomedical documents from published papers to genomic and other -omics databases, they uncovered multiple tissues and cell types with ACE2 receptors, they reported last month in the journal eLife.

...That study, using health records of 77,167 people tested for Covid-19, showed how the assumption that infection would first and foremost cause respiratory symptoms was misplaced. In the week before they were diagnosed, Covid-19 patients were 27 times more likely than people who tested negative for the virus to have lost their sense of smell. They were only 2.6 times more likely to have fever or chills, 2.2 times more likely to have trouble breathing or to be coughing, and twice as likely to have muscle aches. For months, government guidelines kept people not experiencing such typical signs of a respiratory infection from getting tested.

Faced with a disease the world had never seen before, physicians are learning as they go. By following the trail of ACE2 receptors, they are more and more prepared to look for, and treat, consequences of SARS-CoV-2 infection well beyond the obvious:

Gut: The coronavirus infects cells that line the inside of the large and small intestine, called gut enterocytes. That likely accounts for the diarrhea, nausea, and abdominal pain that about one-third of Covid-19 patients experience...

Kidney: The cells lining the tubules that filter out toxic compounds from the blood are rife with ACE2 receptors....New York City hospital reported that 78% of those in intensive care developed acute kidney injury.

Smell: ...41% had lost their sense of taste or smell, or both...Perhaps the highest levels of ACE2 receptors are expressed in cells in the nasal epithelium...high levels of the ACE2 gene in tongue cells called keratinocytes, which contribute to the sense of taste.

...ACE2 levels in the olfactory epithelium of the upper airways...are 200 to 700 times higher than in the lower airways might explain the virus’s high transmissibility.

Lungs: ...The lungs’ type II alveolar cells — among other jobs, they release a compound that allows the lungs to pass oxygen to the blood and take carbon dioxide from it — are studded with ACE2 receptors. Once infected with the coronavirus, they become dysfunctional or die, and are so swarmed by immune cells that this inflammatory response can explode into the acute respiratory distress syndrome (ARDS) that strikes many patients with severe Covid-19...

There is new evidence that the virus also attacks platelet-producing cells, called megakaryocytes, in the lungs...extensive clotting in the veins and other small blood vessels of patients’ hearts, kidneys, liver, and lungs. (Pathologist Amy Rapkiewicz of NYU Winthrop Hospital)suspects that the platelets produced by infected megakaryocytes travel through the bloodstream to multiple organs, damaging their vasculature and producing potentially fatal clots. “You see that and you say, wow, this is not just a ‘respiratory’ virus,”

Pancreas: ...higher expression of the gene for ACE2 in the pancreas than in the lungs...Chinese researchers also found blood markers for pancreas damage in Covid-19 patients, including in about 17% of those with severe disease.

Heart: ...arrhythmia (including atrial fibrillation), heart injury, and even heart failure and pulmonary embolism might reflect the fact that ACE2 receptors are highly expressed in cells along the inside walls of capillaries. When these “vascular endothelial” cells become infected, the resulting damage can cause clots...which in turn can cause Covid toe, strokes, and ischemic bowel (too little blood flow to the gut)...7% to 31% of Covid-19 patients experience some sort of cardiac injury.

Gallbladder: Specialized cells in this organ, too, have high levels of ACE2 receptors...can cause digestive symptoms.

With the number of Covid-19 patients closing in on 10 million, physicians fervently hope the virus has no more surprises in store. But they’re not counting on it....

https://www.statnews.com/2020/06/26/from-nose-to-toe-covid19-virus-attacks-like-...

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AJ Venkatakrishnan et al. 2020. Knowledge synthesis of 100 million biomedical documents augments the deep expression profiling of coronavirus receptors. eLife 2020;9:e58040. March 28, 2020. doi: 10.7554/eLife.5804 https://elifesciences.org/articles/58040

Abstract
The COVID-19 pandemic demands assimilation of all biomedical knowledge to decode mechanisms of pathogenesis. Despite the recent renaissance in neural networks, a platform for the real-time synthesis of the exponentially growing biomedical literature and deep omics insights is unavailable. Here, we present the nferX platform for dynamic inference from 45 quadrillion+ possible conceptual associations from unstructured text and triangulation with insights from Single Cell RNA-sequencing, bulk RNAseq and proteomics from diverse tissue types. A hypothesis-free profiling of ACE2 suggests tongue keratinocytes, olfactory epithelial cells, airway club cells and respiratory ciliated cells as potential reservoirs of the SARS-CoV-2 receptor. We find the gut as the putative hotspot of COVID-19, where a maturation correlated transcriptional signature is shared in small intestine enterocytes among coronavirus receptors(ACE2, DPP4, ANPEP). A holistic data science platform triangulating insights from structured and unstructured data holds potential for accelerating the generation of impactful biological insights and hypotheses.


45margd
Jul 3, 9:29am Top

Monkeys infected with novel coronavirus developed short-term immunity
July 3, 2020

...Scientists from Peking Union Medical College performed an experiment on rhesus macaques, often used because of their similarities to humans, to find out if they have a short-term immunity to the virus.

Six rhesus macaques were infected in their trachea with a dose of the SARS-CoV-2 virus. They developed mild to moderate symptoms, and took about two weeks to recover.

Twenty-eight days after the first infection, four of the six monkeys received another dose of virus, but this time, despite a brief rise in temperature, they showed no sign of reinfection, the study authors wrote.

By taking frequent samples the researchers discovered that the peak viral load was reached three days after the monkeys were infected.

The monkeys showed a stronger immune response after the first infection, producing more so-called neutralizing antibodies which may have protected them against short-term reinfection...More experiments are needed to see how long this immune defense remains...

https://medicalxpress.com/news/2020-07-monkeys-infected-coronavirus-short-term-i...

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Wei Deng et al. 2020. Primary exposure to SARS-CoV-2 protects against reinfection in rhesus macaques, Science (2 July 2020). DOI: 10.1126/science.abc5343

Abstract
Coronavirus disease 2019 (COVID-19), which is caused by infection with the severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), has become a global pandemic. It currently remains unclear whether convalescing patients have a risk of reinfection. We generated a rhesus macaque model of SARS-CoV-2 infection that was characterized by interstitial pneumonia and systemic viral dissemination mainly in the respiratory and gastrointestinal tracts. Rhesus macaques reinfected with the identical SARS-CoV-2 strain during the early recovery phase of the initial SARS-CoV-2 infection did not show detectable viral dissemination, clinical manifestations of viral disease, or histopathological changes. Comparing the humoral and cellular immunity between primary infection and rechallenge revealed notably enhanced neutralizing antibody and immune responses. Our results suggest that primary SARS-CoV-2 exposure protects against subsequent reinfection in rhesus macaques.

46margd
Jul 3, 3:01pm Top

Below on vitamin D just turned up in my news feed. It sounds familiar--maybe posted before peer review?

‘No evidence’ that vitamin D can prevent or treat COVID-19
James Kingsland | July 3, 2020

A review from health experts in the United Kingdom has found no evidence that vitamin D deficiency is an independent risk factor for COVID-19. However, the country’s National Health Service recommend taking a daily vitamin D supplement to compensate for any lack of sunlight exposure during lockdown.

...In a preprint review, The Royal Society, in London, has called for more research into the possibility that vitamin D deficiency predisposes people to COVID-19.

The review cites several lines of evidence to suggest that people with the deficiency may be more susceptible to the disease:

“Vitamin D deficiency is associated with an increased risk of both respiratory viral infections and inflammatory conditions. Vitamin D has an important regulatory role in the human immune system, so a deficiency of vitamin D is likely to cause immune dysregulation, which may reduce the first line of our defense against COVID-19. It is therefore biologically plausible that vitamin D deficiency may contribute to susceptibility to COVID-19 infection. However, there is no direct causal link yet between vitamin D deficiency and increased susceptibility to COVID-19.”

The authors point out that vitamin D deficiency is more common among older people, those who are Black or of Asian origin, and those who have obesity. These groups of people are also known to have an increased risk of developing severe COVID-19.

Nonetheless, the scientists emphasize that “Correlations are not the same as causality.”

https://www.medicalnewstoday.com/articles/no-evidence-that-vitamin-d-can-prevent...

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COVID-19 rapid evidence summary: vitamin D for COVID-19
Evidence summary ES28 Published date: 29 June 2020
Advisory statement on likely place in therapy

There is no evidence to support taking vitamin D supplements to specifically prevent or treat COVID‑19. However, all people should continue to follow UK Government advice on daily vitamin D supplementation to maintain bone and muscle health during the COVID‑19 pandemic.

Rationale
To protect bone and muscle health, the UK Government advises that everyone needs vitamin D equivalent to an average daily intake of 10 micrograms (400 international units). They advise that all people should consider taking a daily supplement containing 10 micrograms vitamin D during autumn and winter months. They also advise that people whose skin has little to no exposure to sunlight and ethnic minority groups with dark skin, from African, Afro-Caribbean and South Asian backgrounds, should consider taking a vitamin D supplement all year round. This advice would also apply to people whose skin has little to no exposure to sunlight because they are indoors shielding or self-isolating. Therefore, UK Government advice during the COVID‑19 pandemic is that everyone should consider taking 10 micrograms of vitamin D a day because they might not be getting enough from sunlight if they're indoors most of the day. See also NICE guidance on Vitamin D: supplement use in specific population groups.

Following appropriate testing and clinical management, people with vitamin D deficiency may also be prescribed higher therapeutic doses of vitamin D.

https://www.nice.org.uk/advice/es28/chapter/Advisory-statement-on-likely-place-i...

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VITAMIN D AND COVID-19 (3 p)
The Royal Society • 18 JUNE 2020

This rapid review of the science of Vitamin D and COVID-19 from the Royal Society is provided to assist in the understanding of COVID-19.This paper is a pre-print and has not been subject to formal peer-review.

https://royalsociety.org/-/media/policy/projects/set-c/set-c-vitamin-d-and-covid...

47margd
Edited: Jul 3, 4:06pm Top

Researchers report nearly 300 cases of inflammatory syndrome tied to Covid-19 in kids
Helen Branswell | June 29, 2020

...(Two) studies, published in the New England Journal of Medicine, describe children who develop severe inflammation affecting multiple organ systems after having had Covid-19, sometimes between two and four weeks after the infection. The majority of the children were previously healthy.

In one of the studies, led by researchers at Boston Children’s Hospital, 80% of the children who developed the condition required intensive care, 20% required mechanical ventilation, and four children, or 2%, died. In the second study, from researchers from New York state, a similar percentage of 99 children who developed the syndrome required ICU care and two children died. In both studies, many of the children developed cardiovascular and clotting problems and many had gastrointestinal symptoms. A high proportion also had skin rashes.

...On the whole, children appear to contract SARS-CoV-2 less often than adults and have a milder course of disease when they do.

...The nearly 300 cases identified in these two studies share some similarities with KD (Kawasaki’s disease, an inflammatory condition that can attack the heart...generally seen in children under the age of 5), but there are also differences...The average age of children in the larger study was 8; 42% of the children in the New York cohort were aged 6 to 12...While KD disproportionately affects children of Asian descent, MIS-C cases in the New York cohort were of all racial and ethnic backgrounds...

The New York group estimated that the majority of MIS-C cases occurred about one month after the peak of Covid-19 cases in the state. They estimated that between March 1 and May 10, two of every 100,000 people under the 21 years of age who had laboratory-confirmed SARS-CoV-2 virus developed MIS-C in the state. The infection rate in people under the age of 21 years was 322 in 100,000 over that period...

https://www.statnews.com/2020/06/29/nejm-inflammation-children-covid19-misc/

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Leora R. Feldstein et al. 2020. Multisystem Inflammatory Syndrome in U.S. Children and Adolescents. NEJM June 29, 2020
DOI: 10.1056/NEJMoa2021680 https://www.nejm.org/doi/full/10.1056/NEJMoa2021680

Abstract
Background
Methods

Results
We report on 186 patients with MIS-C in 26 states. The median age was 8.3 years, 115 patients (62%) were male, 135 (73%) had previously been healthy, 131 (70%) were positive for SARS-CoV-2 by RT-PCR or antibody testing, and 164 (88%) were hospitalized after April 16, 2020. Organ-system involvement included the gastrointestinal system in 171 patients (92%), cardiovascular in 149 (80%), hematologic in 142 (76%), mucocutaneous in 137 (74%), and respiratory in 131 (70%). The median duration of hospitalization was 7 days (interquartile range, 4 to 10); 148 patients (80%) received intensive care, 37 (20%) received mechanical ventilation, 90 (48%) received vasoactive support, and 4 (2%) died. Coronary-artery aneurysms (z scores ≥2.5) were documented in 15 patients (8%), and Kawasaki’s disease–like features were documented in 74 (40%). Most patients (171 92%) had elevations in at least four biomarkers indicating inflammation. The use of immunomodulating therapies was common: intravenous immune globulin was used in 144 (77%), glucocorticoids in 91 (49%), and interleukin-6 or 1RA inhibitors in 38 (20%).

Conclusions
Multisystem inflammatory syndrome in children associated with SARS-CoV-2 led to serious and life-threatening illness in previously healthy children and adolescents.

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Elizabeth M. Dufort et al. 2020. Multisystem Inflammatory Syndrome in Children in New York State. NEJM June 29, 2020
DOI: 10.1056/NEJMoa2021756 https://www.nejm.org/doi/full/10.1056/NEJMoa2021756

Abstract
Background
Methods

Results
As of May 10, 2020, a total of 191 potential cases were reported to the NYSDOH. Of 95 patients with confirmed MIS-C (laboratory-confirmed acute or recent severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection) and 4 with suspected MIS-C (met clinical and epidemiologic criteria), 53 (54%) were male; 31 of 78 (40%) were black, and 31 of 85 (36%) were Hispanic. A total of 31 patients (31%) were 0 to 5 years of age, 42 (42%) were 6 to 12 years of age, and 26 (26%) were 13 to 20 years of age. All presented with subjective fever or chills; 97% had tachycardia, 80% had gastrointestinal symptoms, 60% had rash, 56% had conjunctival injection, and 27% had mucosal changes. Elevated levels of C-reactive protein, d-dimer, and troponin were found in 100%, 91%, and 71% of the patients, respectively; 62% received vasopressor support, 53% had evidence of myocarditis, 80% were admitted to an intensive care unit, and 2 died. The median length of hospital stay was 6 days.

Conclusions
The emergence of multisystem inflammatory syndrome in children in New York State coincided with widespread SARS-CoV-2 transmission; this hyperinflammatory syndrome with dermatologic, mucocutaneous, and gastrointestinal manifestations was associated with cardiac dysfunction.

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Michael Levin. 2020. Childhood Multisystem Inflammatory Syndrome — A New Challenge in the Pandemic (EDITORIAL) NEJM
June 29, 2020 DOI: 10.1056/NEJMe2023158 https://www.nejm.org/doi/full/10.1056/NEJMe2023158

...Overall, a consistent clinical picture is emerging. MIS-C occurs 2 to 4 weeks after infection with SARS-CoV-2. The disorder is uncommon (2 in 100,000 persons less than 21 years of age) as compared with SARS-CoV-2 infection diagnosed in persons younger than 21 years of age over the same period (322 in 100,000). Most patients with MIS-C have antibodies against SARS-CoV-2, and virus is detected in a smaller proportion. A relatively high proportion of cases have occurred among black, Hispanic, or South Asian persons.

Critical illness leading to intensive care develops in some patients, with prominent cardiac involvement and coronary-artery aneurysms in 10 to 20%. Elevated levels of troponin and B-type natriuretic peptide are common in severely affected patients, particularly those with cardiac dysfunction, and most have elevations in levels of C-reactive protein, ferritin, lactate dehydrogenase, and d-dimers, as well as in neutrophil counts. Anemia, lymphopenia, hypoalbuminemia, and abnormal coagulation indexes are also common. Most patients have recovered with intensive care support and after treatment with a range of immunomodulatory agents (including intravenous immune globulin, glucocorticoids, anti–tumor necrosis factor, and interleukin-1 or 6 inhibitors). A small percentage of patients have received extracorporeal membrane oxygenation support, and 2 to 4% have died.

Direct comparison of the clinical and laboratory features of MIS-C with those of Kawasaki’s disease suggests that the new disorder is distinct from the latter. Patients with MIS-C are older and have more intense inflammation and greater myocardial injury than patients with Kawasaki’s disease, and racial and ethnic predominance differs between the conditions.

There is concern that children meeting current diagnostic criteria for MIS-C are the “tip of the iceberg,” and a bigger problem may be lurking below the waterline....

Clinicians face difficult management issues as they see such a wide spectrum of patients....

Elucidating the mechanism of this new entity may have importance for understanding Covid-19 far beyond the patients who have had MIS-C to date, who are relatively few in number as compared with those who have had SARS-CoV-2 infection. Because MIS-C generally occurs late after SARS-CoV-2 infection, after antibody has developed, aberrant cellular or humoral adaptive immune responses may be involved. There is evidence that antibodies may enhance the severity of SARS-CoV-1 infection by triggering inflammation or mediating organ damage.9 Furthermore, genetic studies hint that children carrying variants in genes that regulate T- and B-cell responses or the clearance of immune complexes are at higher risk for Kawasaki’s disease.10 One might speculate that the clinical similarity between Kawasaki’s disease and MIS-C implies a related underlying genetic architecture, supporting the hypothesis that the new disorder arises from aberrant T- or B-cell responses to SARS-CoV-2. Given such hypotheses, might an understanding of MIS-C illuminate the elusive pathogenesis of Kawasaki’s disease? Furthermore, would it have implications for the development of a safe vaccine against SARS-CoV-2, and could it provide an understanding of the late hyperinflammatory syndrome that occurs in some adults with Covid-19 and that has features similar to those of MIS-C?

48margd
Edited: Jul 4, 6:47am Top

Hydroxychloroquine is effective in treating COVID-19, says Henry Ford Health System study
Andrew Mullin | Jul 03, 2020

...Henry Ford (Health System) published the peer-reviewed study on July 1, using a large-scale perspective analysis of (hydroxychloroquine) patients from March 10 to May 2. The study looked over 2,500 hospitalized patients from the Henry Ford’s six hospitals...

The study concluded that treatment with hydroxychloroquine significantly reduces the death rate of COVID-19 patients...of those treated with hydroxychloroquine alone, 13% of them died, compared to the 26.4% who died and were were not treated with the drug. There was an overall 18.1% in-hospital mortality rate and patients were over the age of 18, with a median age of 64.

Many of the fatalities involved people with underlying health diseases...included chronic kidney and lung disease. Mortality of hospitalized patients ranged between 10% and 30% worldwide.

The study also considered treatment using azithromycin. It found that 20.1% patients treated with both azithromycin and hydroxychloroquine died and 22.4% of those treated only with azithromycin died — compared a death rate of 26.4% for those not treated with either drug, according to the Henry Ford health article.

...Randomized, controlled trials would still be required to confirm hydroxychloroquine’s effectiveness in treating COVID-19...

https://www.mlive.com/news/2020/07/hydroxychloroquine-is-effective-in-treating-c...

__________________________________________________

Samia Arshad et al. 2020. Treatment with Hydroxychloroquine, Azithromycin, and Combination in Patients Hospitalized with COVID-19. International Journal of Infectious Diseases. Open Access Published:July 01, 2020 DOI:https://doi.org/10.1016/j.ijid.2020.06.099 https://www.ijidonline.com/article/S1201-9712(20)30534-8/fulltext

Highlights

• As of May27, 2020 there are over 1,678,843 confirmed cases of COVID-19 claiming more than 100,000 lives in the Unites States. Currently there is no known effective therapy or vaccine.
• According to a protocol-based treatment algorithm, among hospitalized patients, use of hydroxychloroquine alone and in combination with azithromycin was associated with a significant reduction in-hospital mortality compared to not receiving hydroxychloroquine.
• -Findings of this observational study provide crucial data on experience with hydroxychloroquine therapy, providing necessary interim guidance for COVID-19 therapeutic practice.

Abstract
Significance
Objective

Design
Multi-center retrospective observational study

Setting

Participants
Consecutive patients hospitalized with a COVID-related admission in the health system from March 10,2020 to May 2,2020 were included. Only the first admission was included for patients with multiple admissions. All patients evaluated were 18 years of age and older and were treated as inpatients for at least 48 hours unless expired within 24 hours.

Exposure
Receipt of hydroxychloroquine alone, hydroxychloroquine in combination with azithromycin, azithromycin alone, or neither.

Main Outcome
The primary outcome was in-hospital mortality.

Results
Of 2,541 patients, with a median total hospitalization time of 6 days (IQR: 4-10 days), median age was 64 years (IQR:53-76 years), 51% male, 56% African American, with median time to follow-up of 28.5 days (IQR:3-53). Overall in-hospital mortality was 18.1% (95% CI:16.6%-19.7%); by treatment: hydroxychloroquine + azithromycin, 157/783 (20.1% (95% CI: 17.3%-23.0%)), hydroxychloroquine alone, 162/1202 (13.5% (95% CI: 11.6%-15.5%)), azithromycin alone, 33/147 (22.4% (95% CI: 16.0%-30.1%)), and neither drug, 108/409 (26.4% (95% CI: 22.2%-31.0%))​. Primary cause of mortality was respiratory failure (88%); no patient had documented torsades de pointes. From Cox regression modeling, predictors of mortality were age>65 years (HR:2.6 (95% CI:1.9-3.3)), white race (HR:1.7 (95% CI:1.4-2.1)), CKD (HR:1.7 (95%CI:1.4-2.1)), reduced O2 saturation level on admission (HR:1.5 (95%CI:1.1-2.1), and ventilator use during admission (HR: 2.2 95%CI:1.4-3.3).

Hydroxychloroquine provided a 66% hazard ratio reduction, and hydroxychloroquine + azithromycin 71% compared to neither treatment (p 

49margd
Jul 4, 7:15am Top

The pandemic is giving people vivid, unusual dreams. Here’s why.
Rebecca Renner | April 15, 2020

...people around the world—including more than 600 featured in just one study—who say they are experiencing a new phenomenon: coronavirus pandemic dreams.

Science has long suggested that dream content and emotions are connected to wellbeing while we’re awake. Bizarre dreams laden with symbolism allow some dreamers to overcome intense memories or everyday psychological stressors within the safety of their subconscious. Nightmares, on the other hand, can be warning signs of anxieties that we might not otherwise perceive in our waking lives.

With hundreds of millions of people sheltering at home during the coronavirus pandemic, some dream experts believe that withdrawal from our usual environments and daily stimuli has left dreamers with a dearth of “inspiration,” forcing our subconscious minds to draw more heavily on themes from our past.

...According to an ongoing study the Lyon Neuroscience Research Center in France initiated in March, the coronavirus pandemic has caused a 35 percent increase in dream recall among participants, with respondents reporting 15 percent more negative dreams than usual. A different study promoted by Associazione Italiana di Medicina del Sonno (the Italian Association of Sleep Medicine) is analyzing the dreams of Italians confined during the outbreak. Many of the subjects are experiencing nightmares and parasomnias in line with symptoms of post-traumatic stress disorder.

...Results from (Luigi De Gennaro, a professor of physiological psychology at the University of Rome who is working on the Italian coronavirus study)’s ongoing research and other work such as the Lyon study suggest that people closer to the pandemic threat—health-care workers, those living in epicenters, and those with affected family members—are more likely to experience outbreak-influenced dreams.

...For those experiencing coronavirus nightmares, there is growing evidence that so-called “dream mastery techniques” can alleviate their suffering.

When (Deirdre Barrett, assistant professor of psychology at Harvard University, who studies dreams from the survivors of traumatic events) works with patients on “scripting” their own dreams, she often asks how they want the nightmare to be different. After a patient figures out their dream’s new direction, they can write it down and rehearse it before bed. These scripts range from more mundane solutions, like fighting off attackers, to more “dreamlike” scenarios, such as shrinking the attacker down to the size of an ant...

https://www.nationalgeographic.com/science/2020/04/coronavirus-pandemic-is-givin...

50margd
Edited: Jul 4, 8:30am Top

Coronavirus in the U.S.: Where cases are growing and declining
July 3, 2020

https://www.nationalgeographic.com/science/2020/05/graphic-tracking-coronavirus-...

51lriley
Jul 4, 12:32pm Top

Florida reporting 11,458 new cases today but only 18 deaths. The second time in the last 3 days that state has gone over the 10,000 mark.

52John5918
Jul 5, 12:28pm Top

London Underground: What TfL says you should do if you spot someone on the Tube not wearing a face mask (My London)

Face masks have been compulsory on public transport since mid June - a move made to reduce the spread of Covid-19. By covering your face, you will not be protecting yourself from catching coronavirus, but rather the people around you. So, by wearing face masks, we are playing our part and helping to keep each other safe...

53margd
Edited: Jul 5, 5:31pm Top

Miles Beckett
Jul 2nd 2020, 10 tweets, 3 min read

The trillion dollar question. Why are COVID cases increasing while deaths are decreasing? The answer is simple. It's called Simpson's paradox and it's the result of incorrectly pooling data and arriving at a false conclusion. A thread 1/9 #COVID19 #ThursdayThoughts

...8/9 The truth is simple, and horrifying. We are about to have dozens of NYCs around the country. The next 8 weeks are going to brutal, no matter what we do. ICUs overflowing, ventilators rationed, hundreds of thousands of deaths...

https://threadreaderapp.com/thread/1278750652160634880.html

54lriley
Jul 5, 7:02pm Top

#53--Hopefully it is not as bad as Mr. Beckett thinks it might become. I was reading a little about Miami-Dade yesterday and they seem to be on the cusp of overwhelming their hospital system. Deaths do lag cases though. Florida also seems to fuck around with their statistics. Texas currently has the most hospitalizations--again Florida hasn't been giving out numbers.

For New York it was a long long climb up the mountain. In April close to 17,000 New Yorkers died. It can happen fast. Cuomo wasn't perfect--he made a mistake with the nursing homes but he worked to get everyone on board here and we flattened the curve and then pushed it down. We haven't had over 1000 new cases in a day since June 6. When I started keeping track of hospitalizations in the state they were 17,671 on April 18--I'm sure they were higher than that but now we're at 832. I'm not really a fan of Cuomo's but I appreciate the effort he put into this battle. This should have never been a state by state response. If we had a functioning federal govt. there would have been some kind of national response but Trump criminally abdicated his role and much of the death and misery from this should be laid directly in front of his door.

55margd
Jul 6, 8:00am Top

239 Experts With One Big Claim: The Coronavirus Is Airborne
Apoorva Mandavilli | July 4, 2020

The coronavirus is finding new victims worldwide, in bars and restaurants, offices, markets and casinos, giving rise to frightening clusters of infection that increasingly confirm what many scientists have been saying for months: The virus lingers in the air indoors, infecting those nearby.

If airborne transmission is a significant factor in the pandemic, especially in crowded spaces with poor ventilation, the consequences for containment will be significant. Masks may be needed indoors, even in socially-distant settings. Health care workers may need N95 masks that filter out even the smallest respiratory droplets as they care for coronavirus patients.

Ventilation systems in schools, nursing homes, residences and businesses may need to minimize recirculating air and add powerful new filters. Ultraviolet lights may be needed to kill viral particles floating in tiny droplets indoors.

The World Health Organization has long held that the coronavirus is spread primarily by large respiratory droplets that, once expelled by infected people in coughs and sneezes, fall quickly to the floor.

But in an open letter to the W.H.O., 239 scientists in 32 countries have outlined the evidence showing that smaller particles can infect people, and are calling for the agency to revise its recommendations. The researchers plan to publish their letter in a scientific journal next week. (Clinical Infectious Diseases, according to CNBC)

Even in its latest update on the coronavirus, released June 29, the W.H.O. said airborne transmission of the virus is possible only after medical procedures that produce aerosols, or droplets smaller than 5 microns. (A micron is equal to one millionth of a meter.)...

https://www.nytimes.com/2020/07/04/health/239-experts-with-one-big-claim-the-cor...

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Modes of transmission of virus causing COVID-19: implications for IPC precaution recommendations
Scientific brief
29 March 2020

The Scientific brief on Modes of transmission of the virus causing COVID-19: implications for IPC precaution recommendations is currently being updated. At this time, the PDF cannot be downloaded.

https://www.who.int/news-room/commentaries/detail/modes-of-transmission-of-virus...

56margd
Jul 6, 8:39am Top

Below, suggestions that SARS-CoV-2 found around the world, even before Wuhan outbreak, are interesting, but not yet conclusive. Could be false positive or related DNA fragment or a true bit of evidence that virus was sloshing around the world well before it found an opportunity to spark a pandemic (like HIV?)--interesting to see where studies lead.

Coronavirus traces found in March 2019 sewage sample, Spanish study shows
Nathan Allen, Inti Landauro | June 26, 2020

MADRID (Reuters) - Spanish virologists have found traces of the novel coronavirus in a sample of Barcelona waste water collected in (12) March 2019, nine months before the COVID-19 disease was identified in China, the University of Barcelona said on

The discovery of virus genome presence so early in Spain, if confirmed, would imply the disease may have appeared much earlier than the scientific community thought.

...“The levels of SARS-CoV-2 were low but were positive,” research leader Albert Bosch was quoted as saying by the university.

The research has been submitted for a peer review.

Dr Joan Ramon Villalbi of the Spanish Society for Public Health and Sanitary Administration told Reuters it was still early to draw definitive conclusions. “When it’s just one result, you always want more data, more studies, more samples to confirm it and rule out a laboratory error or a methodological problem”...

https://www.reuters.com/article/us-health-coronavirus-spain-science-idUSKBN23X2H...
__________________________________________

It looks like COVID-19 did not start in China after all - Italy, Spain had it much earlier
Eamonn Sheridan | 5 Jul 2020

...coronavirus may have lain dormant across the world rather than starting in China

there is growing evidence the virus was elsewhere before it emerged in Asia
Spanish virologists say they found traces of COVID-19 in samples of waste water collected in March 2019 (this is 9 months ahead of the Wuhan outbreak)
Italian scientists have also found evidence of the virus in sewage samples in Milan and Turin, from mid-December 2019
Traces have also been found in Brazil from November 2019

https://www.reuters.com/article/us-health-coronavirus-spain-science-idUSKBN23X2H...
___________________________________________

Falkland Islands coronavirus case offers shock clue to where pandemic originated
THE coronavirus pandemic may not have started in China, according to an Oxford scientist.
Dylan Donnelly | Mon, Jul 6, 2020

Dr Tom Jefferson, senior associate tutor at the Centre for Evidence-Based Medicine (CEBM) at Oxford, believes that COVID-19 may have emerged due to environmental conditions. Dr Jefferson believes that viruses often lay dormant around the globe, and emerge and vanish depending on the conditions for viral spread.

..."I think the virus was already here, here meaning everywhere...We may be seeing a dormant virus that has been activated by environmental conditions...There was a case in the Falkland Islands in early February....Now where did that come from? There was a cruise ship that went from South Georgia to Buenos Aires, and the passengers were screened and then on day eight, when they started sailing towards the Weddell Sea, they got the first case...Was it in prepared food that was defrosted and activated?“

Jefferson added: "Strange things like this happened with Spanish Flu. “In 1918 around 30 per cent of the population of Western Samoa died of Spanish Flu, and they hadn’t had any communication with the outside world...The explanation for this could only be that these agents don’t come or go anywhere. They are always here and something ignites them, maybe human density or environmental conditions, and this is what we should be looking for."

...Both Dr Jefferson and Professor Car Henegehan...calling for an in-depth investigation into how the virus spreads through meatpacking and food plants, as well as shared toilet facilities, which they believe could uncover major insight into new transmission routes.

Dr Jefferson said: "We’re doing a living review, extracting environmental conditions, the ecology of these viruses which has been grossly understudied...There is quite a lot of evidence that huge amounts of the virus in sewage all over the place, and an increasing amount of evidence there is faecal transmission...There is a high concentration where sewage is four degrees, which is the ideal temperature for it to be stabled and presumably activated...And meatpacking plants are often at four degrees...These meat packing clusters and isolated outbreaks don’t fit with respiratory theory, they fit with people who haven’t washed their hands properly...These outbreaks need to be investigated properly with people on the ground one by one.”...

https://www.express.co.uk/news/world/1305533/Falkland-Islands-coronavirus-case-c...

57margd
Jul 6, 11:02am Top

Marina Pollán et al. 2020. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. The Lancet. July 06, 2020 DOI:https://doi.org/10.1016/S0140-6736(20)31483-5 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31483-5/fulltext

Summary

...In conclusion, our study provides nationwide and regional estimates of SARS-CoV-2 dissemination in Spain, showing remarkable differences between higher and lower prevalence areas. One in three infections seems to be asymptomatic, while a substantial number of symptomatic cases remained untested. Despite the high impact of COVID-19 in Spain, prevalence estimates remain low and are clearly insufficient to provide herd immunity. This cannot be achieved without accepting the collateral damage of many deaths in the susceptible population and overburdening of health systems. In this situation, social distance measures and efforts to identify and isolate new cases and their contacts are imperative for future epidemic control.

58margd
Jul 6, 11:12am Top

The Fullest Look Yet at the Racial Inequity of Coronavirus
Richard A. Oppel Jr., Robert Gebeloff, K.K. Rebecca Lai, Will Wright and Mitch Smith | July 5, 2020

Black and Latino people in the U.S. are 3 times as likely to contract the coronavirus than their white neighbors — and nearly twice as likely to die, according to new data we obtained by suing the CDC

...The data also showed several pockets of disparity involving Native American people. In much of Arizona and in several other counties, they were far more likely to become infected than white people. For people who are Asian, the disparities were generally not as large, though they were 1.3 times as likely as their white neighbors to become infected.

... The higher rate in deaths from the virus among Black and Latino people has been explained, in part, by a higher prevalence of underlying health problems, including diabetes and obesity. But the new C.D.C. data reveals a significant imbalance in the number of virus cases, not just deaths — a fact that scientists say underscores inequities unrelated to other health issues.

The focus on comorbidities “makes me angry, because this really is about who still has to leave their home to work, who has to leave a crowded apartment, get on crowded transport, and go to a crowded workplace, and we just haven’t acknowledged that those of us who have the privilege of continuing to work from our homes aren’t facing those risks,” said Dr. Mary Bassett, the Director of the FXB Center for Health and Human Rights at Harvard University.

Dr. Bassett, a former New York City health commissioner, said there is no question that underlying health problems — often caused by factors that people cannot control, such as lack of access to healthy food options and health care — play a major role in Covid-19 deaths.

But she also said a big determinant of who dies is who gets sick in the first place, and that infections have been far more prevalent among people who can’t work from home. “Many of us also have problems with obesity and diabetes, but we’re not getting exposed, so we’re not getting sick,” she said...

https://www.nytimes.com/interactive/2020/07/05/us/coronavirus-latinos-african-am...

59margd
Edited: Jul 6, 11:24am Top

COVID-19 in Indian Country
Coronavirus updates
Indian Health Service (Department of Health and Human Services) | June 30, 2020

...Overall, nearly 7.3 percent of IHS coronavirus tests have returned positive through June 28, according to the data. But the rate is far higher in the Phoenix Area, where almost 19.3 percent are positive.

Closely following is Navajo Area, which serves the largest reservation in the United States. But even with 18.7 percent tests returning positive, the rate has steadily dropped in the last several days.

The Nashville Area, which covers a wide area of Indian Country, including the South and Northeastern parts of the U.S., also continues to show a high positive rate of 11.4 percent.

On the other end of the spectrum, aggressive efforts in the Alaska Area are turning up very few cases. Out of 45,743 tests administered in Alaska, only 0.25 have returned positive, the data shows.

The Alaska Area also outnumbers every other area in terms of tests administered. It has surpassed the Navajo Area as well as the Oklahoma City Area...

(See map at bottom of post)
https://www.indianz.com/covid19/?p=6771

__________________________________________________​

Robert Reich @RBReich | 12:35 PM · Jul 5, 2020:

The death rate from Covid-19 in Navajo nation is now higher than any single state.
We should all be outraged by the suffering and neglect continually inflicted on Native peoples.

60cindydavid4
Jul 6, 12:06pm Top

better late then never, looks like guv ducey is listening and acting: https://www.12news.com/article/news/health/coronavirus/ducey-pushes-back-school-...

61alco261
Edited: Jul 6, 12:26pm Top

12:20 PM - I see by the covid tracking site we just rolled over 130,000 dead - Donald must be so proud. >60 cindydavid4: per the article you cited - in one week the death toll went from 1588 to 1809 - that's more than one death every hour - way to go Ducey.

62margd
Edited: Jul 6, 1:17pm Top

On the up side: on July 5,
Kingston, Ontario had no new cases,
a Toronto hospital had no COVID patients in its ICU,
Michigan had no deaths.
_______________________________________________

How Safe Are Outdoor Gatherings?
Tara Parker-Pope | July 3, 2020

With the virus raging in many parts of the country, new restrictions have left many wondering about the safety of a backyard barbecue or picnic.

...Your risk of catching the virus is much lower outdoors than indoors. If you want to spend time with friends, taking the party outside will reduce your risk of contracting Covid-19....

...If you socialize outdoors, it’s important to keep the guest list small. Socializing with just one additional household is safer than mixing multiple households. Make sure that the rate of Covid-19 in your community is low and falling. It’s safest to socialize when the test positivity rate is at 5 percent or lower — a level that reduces your chances of inviting an infected person to the party.

...Recent clusters of cases have been linked to home gatherings that appear to have broken those rules....

But adding to the confusion about outdoor gatherings is the fact that the continuing protests over police brutality and the killing of George Floyd in Minneapolis have not been associated with spikes in cases. The reason the protests haven’t caused a surge may be because protesters were often moving, lowering the risk of spending extended time with an infected person. Many marchers were also wearing masks.

...If you attend a social event and find yourself in close conversation with someone from outside your household, even outdoors, wear a mask. Keep music levels low so people don’t have to shout. (Loud speaking expels more droplets than a quiet voice.) Don’t share food or serving utensils.

...Limiting the number of partygoers not only lowers your risk of running into someone who has the virus, but small numbers also make it easier to keep track of just a few people and maintain physical distance, said Dr. Asaf Bitton, executive director of Ariadne Labs at Brigham and Women’s Hospital and the Harvard T.H. Chan School of Public Health...when a group gets larger, even outdoors, it can affect our overall spatial awareness, including proprioception — which is knowing where our body is in space without relying on visual cues. Add in alcohol, and our ability to keep our distance falls short.

...While it’s easy to keep your distance from strangers, it’s tougher to stay six feet from people you know...

https://www.nytimes.com/2020/07/03/well/live/coronavirus-spread-outdoors-party.h...

--------------------------------------------------​

Hiroshi Nishiura et al. 2020. Closed environments facilitate secondary transmission of coronavirus disease 2019 (COVID-19). MedRxiv April 16, 2020. doi: https://doi.org/10.1101/2020.02.28.20029272 https://www.medrxiv.org/content/10.1101/2020.02.28.20029272v2

This article is a preprint and has not been peer-reviewed

Abstract
...Results:...The odds that a primary case transmitted COVID-19 in a closed environment was 18.7 times greater compared to an open-air environment...

--------------------------------------------------​

Hua QIAN et al. 2020. Indoor transmission of SARS-CoV-2. MedRxiv. April 7, 2020. (22 p) https://doi.org/10.1101/2020.04.04.20053058 doi: https://www.medrxiv.org/content/10.1101/2020.04.04.20053058v1.full.pdf

Abstract
...Results:...Among the identified outbreaks, 53·8% involved three cases, 26·4% involved four cases, and only 1·6% involved ten or more cases. Home outbreaks were the dominant category (...79·9%), followed by transport (34·0%; note that many outbreaks involved more than one venue category). Most home outbreaks involved three to five cases. We identified only a single outbreak in an outdoor environment, which involved two cases.

Conclusions: All identified outbreaks of three or more cases occurred in an indoor environment, which confirms that sharing indoor space is a major SARS-CoV-2 infection risk.

63lriley
Jul 6, 2:30pm Top

#62--Congrats on Michigan. Hopefully your son has recovered with no issues too. Looking forward to the day NYS has no covid deaths. Sometimes we're in the low teens it seems--sometimes in single digits....so it may be a month or two. That said with cases skyrocketing all over the south, southwest and west it seems like we will probably get another wave. People move across borders--state borders anyway.

The NHL will also open training camps later this month. For the longest while speculation was that one of the two hub cities would be Las Vegas....but the NHL decided on safer and smarter and went with two Canadian locations---Toronto and Edmonton. There has been (going all the way back to March) until now 35 positive tests of NHL players---though only one is known--Toronto's Auston Matthews who is a huge star but who's hometown is Phoenix Arizona.

64margd
Edited: Jul 6, 3:10pm Top

Yep, son is fine. Had a brief, funny thing reappear in his lungs maybe a month ago but fine now.

Red Cross is testing a number of blood donors' antibodies here at least, so curious to see if anything surfaces. DH and my illness was so long ago that at first we weren't wanted as convalescent donors (antibodies diminish over time though one can still produce them in presence of virus), but we've since heard that our donation was now needed. I figure either study needs to nail down early cases or Red Cross really needs platelets, antibodies or no!

65margd
Edited: Jul 7, 8:45am Top

Donald J. Trump @realDonaldTrump | 2:40 PM · Jul 6, 2020:
SCHOOLS MUST OPEN IN THE FALL!!!
_______________________________

ABC 27 @abc27 | 6:13 PM · Jul 6, 2020:
#BREAKING: All of Florida's public K-12 schools are now required to reopen their campuses in August.

FL Education Commissioner requires all Florida school districts to reopen campuses in August
Posted at 6:11 PM, Jul 06, 2020 and last updated 7:01 PM, Jul 06, 2020

TALLAHASSEE, Fla. (WTXL) — Florida Education Commissioner Richard Corcoran has issued an executive order requiring all of Florida's public K-12 schools to reopen in August.

As part of the executive order issued Monday, school districts and charter school governing boards must open brick and mortar schools at least five days per week for all students in August...

https://www.wtxl.com/news/local-news/fl-education-commissioner-requires-all-flor...

________________________________

More than 7,000 Children in Florida Have Tested Positive for COVID-19
Giselle Balido | Last Updated July 2, 2020
https://couriernewsroom.com/2020/07/01/more-than-7000-children-in-florida-have-t...

________________________________

Richard W. Painter @RWPUSA | 10:26 PM · Jul 6, 2020:

Now @realDonaldTrump is using ICE and the immigration system to try to force colleges to offer in person classes and spread the COVID19.
Somebody should sue.
Awful.

Foreign Students Attending Schools That Operate Online-Only This Fall Will Be Barred From the U.S.
ICE is directing foreign students whose schools will operate online-only this fall to transfer institutions or leave the country – or face deportation proceedings.
Claire Hansen | July 6, 2020
https://www.usnews.com/news/national-news/articles/2020-07-06/foreign-students-a...

66John5918
Edited: Jul 7, 12:12am Top

Coronavirus: world treating symptoms, not cause of pandemics, says UN (Guardian)

The world is treating the health and economic symptoms of the coronavirus pandemic but not the environmental cause, according to the authors of a UN report. As a result, a steady stream of diseases can be expected to jump from animals to humans in coming years, they say.

The number of such “zoonotic” epidemics is rising, from Ebola to Sars to West Nile virus and Rift Valley fever, with the root cause being the destruction of nature by humans and the growing demand for meat, the report says.

Even before Covid-19, 2 million people died from zoonotic diseases every year, mostly in poorer countries. The coronavirus outbreak was highly predictable, the experts said. {Covid-19} may be the worst, but it is not the first,” said the UN environment chief, Inger Andersen....


Coronavirus: Fear over rise in animal-to-human diseases (BBC)

Zoonotic diseases - which jump from animals to humans - are increasing and will continue to do so without action to protect wildlife and preserve the environment, UN experts have warned.

They blame the rise in diseases such as Covid-19 on high demand for animal protein, unsustainable agricultural practices and climate change...

67margd
Jul 7, 9:03am Top

Oh my— In Florida, 43 hospital ICU’s in 21 counties have hit capacity and show zero ICU beds available,
including in Miami-Dade, Broward, Hillsborough and Orange Counties,
according to data released by the Agency for Health Care Administration (AHCA).

- Ana Cabrera (CNN) @AnaCabrera | 10:10 PM · Jul 6, 2020

68cindydavid4
Edited: Jul 7, 3:17pm Top

Many "zonies' head for the beaches of Puerto Peñasco,near the border with Mexico. And apprent do not care if their actions affect any of the natives there, so the community put up a wall of sorts (yes, the irony)

https://entertainment--news.com/2020/07/05/the-latest-mexican-town-residents-blo...

69margd
Jul 7, 3:47pm Top

This map shows why it would be 'terrifying' to open Canada-U.S. border
Sean Davidson | July 6, 2020 4:30PM EDT. Last Updated Tuesday, July 7, 2020 10:03AM EDT

...To date, there have been 2,796 COVID-19 cases per million people in Canada, while in the United States that number is much higher at 9,051 per million.

... Ontario Premier Doug Ford said in June that he believes reopening the borders too early could spark a second wave of COVID-19.

"I know it's inevitable … I just don't think we are ready right now," Ford said. "You see what's happening down in the states; you look at Florida, you look at Texas, Arizona, California. I don't want to be those states. I want to protect the people here in Ontario."

"Believe me, I love the Americans, make no mistake about it, but not when their COVID cases are just spiking right now and I’m just not in favour."...

https://toronto.ctvnews.ca/mobile/this-map-shows-why-it-would-be-terrifying-to-o...

70lriley
Edited: Jul 7, 6:21pm Top

#67--which means they're at the point in some hospitals of making decisions on who gets to live and who dies. It means doctors and hospital staffs are going to go through the wringer for a while and it means that all the assholes who continue to act as if they're impervious to getting seriously sick are just going to make the problem worse with their stupid behavior. I know in NYC they were sometimes splitting the respirators though it's not as effective that way. I don't know how Florida's hospital system works but Cuomo was forced to coordinate all the public's and private's statewide together so that all hospitals would be ready to take on excess ICU patients. It was kind of a temporary version of M4A.They had also set up the Javits Center as a temporary hospital and the Navy hospital ship came in but that wasn't for Covid patients and there were strict rules on who the hospital ship would take. The Navy did not want to take a chance bringing the virus on board with all the metal surface a ship of that size has. As far as I could tell it was basically there for decoration.

#69--Canada should wait until we really have our house in order. We're nowhere near that and without a vaccine I don't expect we will be until late February at the earliest. Without that vaccine there's no chance the Trump administration is going to get their act together.

71lriley
Jul 7, 6:39pm Top

One good thing that I can think of---there are no more fucking holidays for a while. The less reason for large masses of people to get together the better.

72margd
Jul 8, 8:20am Top

Search US map by county for daily new cases per 100,000 and risk level, i.e.,
green--on track for containment (fewer than 1/100,000): monitor
yellow--community spread (1-9 per 100,000): rigorous test & trace
orange--accelerated spread (10-24/100,000): stay-at-home and/or rigorous test & trace advised
red--tipping point (25+/100,000): stay-at-home order necessary

Key Metrics for COVID Suppression
Researchers and Public Health Experts unite to bring clarity to key metrics guiding coronavirus response

Harvard Global Health Institute, Harvard's Edmond J. Safra Center for Ethics, Rockefeller Foundation, CovidActNow, Covid-Local, CIDRAP and many others join forces, launch new COVID Risk Level map and COVID suppression guidance for policy makers and the public

Cambridge, July 1, 2020

https://globalepidemics.org/key-metrics-for-covid-suppression/

73margd
Edited: Jul 8, 9:41am Top

"...We estimate widespread community transmission of SARS-CoV-2 in February, 2020.

Modeling results indicate international travel as the key driver of the introduction of SARS-CoV-2 in the West and East Coast metropolitan areas that could have been seeded as early as late-December, 2019.

For most of the continental states the largest contribution of imported infections arrived through domestic travel flows..."

"...The model highlights that the geographical heterogenities in the observed spreading patterns are explained by the features of the air transportation network and population distributions. The results also indicate that the source of introduction of SARS-CoV-2 infections into the US changed substantially and rapidly through time. While early importations were from international sources, most introductions occurred during February and March 2020. Our results indicate that many states were seeded from domestic sources rather than international..."

margd: "Figure 3: Importation sources" in pdf is very cool graphic!

--------------------------------------------------​

Jessica T Davis et al. 2020. Estimating the establishment of local transmission and the cryptic phase of the COVID-19 pandemic in the USA. MedRxiv July 7, 2020. doi: https://doi.org/10.1101/2020.07.06.20140285 https://www.medrxiv.org/content/10.1101/2020.07.06.20140285v1.full.pdf 23 p

This article is a preprint and has not been certified by peer review

Abstract
We use a global metapopulation transmission model to study the establishment of sustained and undetected community transmission of the COVID-19 epidemic in the United States. The model is calibrated on international case importations from mainland China and takes into account travel restrictions to and from international destinations. We estimate widespread community transmission of SARS-CoV-2 in February, 2020. Modeling results indicate international travel as the key driver of the introduction of SARS-CoV-2 in the West and East Coast metropolitan areas that could have been seeded as early as late-December, 2019. For most of the continental states the largest contribution of imported infections arrived through domestic travel flows...

Discussion
Our study characterizes the cryptic transmission phase during which SARS-CoV-2 spread largely undetected in the US. The results suggest that the first sustained local transmission chains took place as early as the end of January, and by the end of February the infection was spreading to many other national locations. This timeline is shifted several weeks ahead with respect to the detection of cases in surveillance data. This is consistent with the fact that in January and February no country had the capacity to do mass testing. Countries adopted a policy of testing symptomatic individuals with a travel history linked to China, thus, generally missing the cryptic transmission occurring domestically. We find that the order in which the virus initially progressed across states according to our model is highly correlated with the official record. The model highlights that the geographical heterogenities in the observed spreading patterns are explained by the features of the air transportation network and population distributions. The results also indicate that the source of introduction of SARS-CoV-2 infections into the US changed substantially and rapidly through time. While early importations were from international sources, most introductions occurred during February and March 2020. Our results indicate that many states were seeded from domestic sources rather than international. The presented results could be of potential interest in combination with sequencing data of SARS-CoV-2 genomes in order to reconstruct in greater detail the early epidemic history of the USCOVID-19 epidemic. The estimated SARS-Cov-2 importation pattern and the cryptic transmis-sion phase dynamic are of potential use when planning and modelling public health policies in the context of international travel.

74margd
Jul 8, 1:02pm Top

65, contd.

Harvard, MIT sue Trump administration over international student visas
They argue the administration's order was meant to pressure colleges to reopen.
Sophie Tatum and Jack Arnholz | July 8, 2020

Harvard University and the Massachusetts Institute of Technology (MIT) filed a lawsuit Wednesday challenging the Department of Homeland Security and U.S. Immigration and Customs Enforcement over a directive that would prevent international students from studying in the United States on F-1 or M-1 student visas in the fall if their school only offers online classes.

The institutions are seeking a temporary restraining order and an injunction preventing the government from enforcing the directive, arguing, in part, that the administration made the decision to bar international students to pressure institutions to reopen amid the coronavirus pandemic.

"The order came down without notice—its cruelty surpassed only by its recklessness. It appears that it was designed purposefully to place pressure on colleges and universities to open their on-campus classrooms for in-person instruction this fall, without regard to concerns for the health and safety of students, instructors, and others," Harvard President Larry Bacow said in a statement Wednesday...

https://abcnews.go.com/Politics/harvard-mit-sue-trump-administration-internation...

75margd
Jul 8, 1:29pm Top

Increase in delirium, rare brain inflammation and stroke linked to COVID-19
University College London | July 7, 2020

...The study provides a detailed account of neurological symptoms of 43 people (aged 16-85) treated at the National Hospital for Neurology and Neurosurgery, UCLH, who had either confirmed or suspected Covid-19.

The researchers identified 10 cases of transient encephalopathies (temporary brain dysfunction) with delirium, which corresponds with other studies finding evidence of delirium with agitation. There were also 12 cases of brain inflammation, eight cases of strokes, and eight others with nerve damage, mainly Guillain-Barré syndrome (which usually occurs after a respiratory or gastrointestinal infection).

Most (nine out of 12 cases) of those with brain inflammation conditions were diagnosed with acute disseminated encephalomyelitis (ADEM). ADEM is rare and typically seen in children and can be triggered by viral infections: the team in London normally sees about one adult patient with ADEM per month, but that increased to at least one per week during the study period, which the researchers say is a concerning increase.

The virus causing Covid-19, SARS-CoV-2, was not detected in the cerebrospinal brain fluid of any of the patients tested, suggesting the virus did not directly attack the brain to cause the neurological illness. Further research is needed to identify why patients were developing these complications.

In some patients, the researchers found evidence that the brain inflammation was likely caused by an immune response to the disease, suggesting that some neurological complications of Covid-19 might come from the immune response rather than the virus itself.

...This study also confirms the previously reported findings of a higher than expected number of patients with stroke which results from the excessive stickiness of the blood in COVID-19 patients...

https://medicalxpress.com/news/2020-07-delirium-rare-brain-inflammation-linked.h...

--------------------------------------------------​

Ross W Paterson et al. 2020. The emerging spectrum of COVID-19 neurology: clinical, radiological and laboratory findings. Brain, awaa240, 08 July 2020. https://doi.org/10.1093/brain/awaa240 . https://academic.oup.com/brain/article/doi/10.1093/brain/awaa240/5868408

Abstract
...Detailed clinical and paraclinical data were collected from cases where the diagnosis of COVID-19 was confirmed through RNA PCR, or where the diagnosis was probable/possible according to World Health Organization criteria. Of 43 patients, 29 were SARS-CoV-2 PCR positive and definite, eight probable and six possible.

Five major categories emerged:
(i) encephalopathies (n = 10) with delirium/psychosis and no distinct MRI or CSF abnormalities, and with 9/10 making a full or partial recovery with supportive care only;
(ii) inflammatory CNS syndromes (n = 12) including encephalitis (n = 2, para- or post-infectious), acute disseminated encephalomyelitis (n = 9), with haemorrhage in five, necrosis in one, and myelitis in two, and isolated myelitis (n = 1). Of these, 10 were treated with corticosteroids, and three of these patients also received intravenous immunoglobulin; one made a full recovery, 10 of 12 made a partial recovery, and one patient died;
(iii) ischaemic strokes (n = 8) associated with a pro-thrombotic state (four with pulmonary thromboembolism), one of whom died;
(iv) peripheral neurological disorders (n = 8), seven with Guillain-Barré syndrome, one with brachial plexopathy, six of eight making a partial and ongoing recovery; and
(v) five patients with miscellaneous central disorders who did not fit these categories. SARS-CoV-2 infection is associated with a wide spectrum of neurological syndromes affecting the whole neuraxis, including the cerebral vasculature and, in some cases, responding to immunotherapies.

The high incidence of acute disseminated encephalomyelitis, particularly with haemorrhagic change, is striking. This complication was not related to the severity of the respiratory COVID-19 disease. Early recognition, investigation and management of COVID-19-related neurological disease is challenging. Further clinical, neuroradiological, biomarker and neuropathological studies are essential to determine the underlying pathobiological mechanisms, which will guide treatment. Longitudinal follow-up studies will be necessary to ascertain the long-term neurological and neuropsychological consequences of this pandemic.

76lriley
Edited: Jul 8, 2:17pm Top

#67--it's at 56 ICU's in Florida that have reached capacity now with 35 more with 10% or less ICU bed availability.

Florida still is not out with official hospitalization numbers.

When this was happening in March and April and PPE and medical supplies were low there weren't really that many states greatly affected but there are a lot more states with the virus spiking now and still a shortage of PPE, machines and equipment and supplies only more states desperately needing help now. That problem really hasn't gone away.

77margd
Jul 8, 3:25pm Top

Volunteer for vaccine study: https://www.coronaviruspreventionnetwork.org/
Study locations: https://www.coronaviruspreventionnetwork.org/clinical-study-locations/

Volunteers can now sign up for large coronavirus vaccine studies
Carolyn Y. Johnson | July 8, 2020
https://www.washingtonpost.com/health/2020/07/08/volunteers-can-now-sign-up-larg...

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Even without a Covid-19 vaccine, there's reason for hope
Opinion by William Haseltine | Updated July 8, 2020

...One thing we do know is that some of the vaccines currently being tested in humans are already causing serious side effects. The side effects are likely a result of the powerful ingredients added to the vaccine to help inflame the body's immune system. These ingredients -- called adjuvants -- help vaccines work better, but if they can land the young and healthy patients in the clinical trial in the hospital because of high fevers and fainting, imagine what they might do to those already ill with secondary conditions or to those who are older. Indeed, the elderly may need repeated doses of the vaccine, given how resistance to some vaccinations becomes progressively more profound with time...

https://www.cnn.com/2020/07/08/opinions/covid-19-treatment-reason-for-hope-hasel...

78stellarexplorer
Jul 8, 10:49pm Top

Trump has demanded the CDC issue less demanding guidelines for school reopenings. What puzzles me is this: If you’re a top CDC official, and you put out a thoughtful comprehensive set of policies and recommendations on school reopenings, why would you go back and weaken it, going against your original medical judgment, because the President doesn’t like it? You’d think someone would have the guts to resign.

79cindydavid4
Jul 9, 12:32am Top

I am really wondering if Trump wants to kill people off, the ultimate voter suppression method
I have no other explanation for his response to this pandemic. And yeah, if I was Fucci I would have lefft a long time ago - but then I admire him, he wants to keep damage somewhat controlled. just not sure how much more he can do.

80stellarexplorer
Edited: Jul 9, 12:46am Top

>79 cindydavid4: Not much, it seems. And he can have his job back in 6 months. (6 months and hundreds of thousands of deaths later!)

81margd
Jul 9, 4:44am Top

Dentist's recommendation for improving fit of your surgical or cloth mask:

https://www.tiktok.com/@oliviacuidmd/video/6841373365500955909?source=h5_m

82margd
Edited: Jul 9, 7:15am Top

Republican Governor, Republican-majority state Legislature....

Outbreak at Mississippi Capitol: Number of infected lawmakers grows to 26
Giacomo Bologna | July 8, 2020

Gov. Tate Reeves is warning the public to get tested for coronavirus if they have been in contact with a state lawmaker.

The number of coronavirus cases linked to an outbreak at the Capitol has grown to 36, which includes 26 legislators, according to the state's top health official.

Many politicians flouted recommendations to wear a mask inside the Capitol in recent weeks. Now, about one in six of Mississippi state lawmakers have tested positive for the coronavirus...

https://www.clarionledger.com/story/news/politics/2020/07/08/mississippi-coronav...

83lriley
Jul 9, 5:51am Top

We set records again yesterday. Over 63,000 new cases. Arizona came in with it's usual 3500+, California did 11,700 or so, Texas 9,979 and Florida 9,989--Texas falling short of 10,000 new cases by 21 and Florida falling short of 10,000 new cases by 11. We know at least 56 Florida hospitals were at capacity for ICU beds with 35 very close yesterday so my guess is that number has risen in both cases. DeSantis is still in denial. Still thinks schools will be opening in September and ignores questions about the Republican National Convention in late August and by the way Senator Grassley has already made it clear he won't be there. In Texas now there is a mask order that came a few days after Lt. Gov. Dan Patrick said no such thing would ever happen.......and in Arizona Gov. Ducey seems to have finally fully realized he's in the middle of a battle to save lives over the economy---well maybe he's there--sometimes it's hard to tell.

84John5918
Jul 9, 7:32am Top

Countries can learn from Africa in handling future pandemics: UN report (Down to Earth)

The world can learn from Africa’s experience in handling zoonotic diseases — illnesses caused by germs that spread between animals and humans — in its fight against the novel coronavirus disease (COVID-19) and future pandemics, said a recent joint scientific assessment report.

In 2019, the continent reported 500 outbreaks of zoonotic diseases. Of this, Senegal accounted for nearly 57 per cent. The country reported over 280 outbreaks of Equine influenza or ‘horse flu’, that occurred as a result of strong winds and dust... The continent also experienced and responded to the most recent Ebola outbreak in the Democratic Republic of Congo, where its second-deadliest disease outbreak in the country’s eastern area was declared to be over June 25... “Ending this outbreak is a sign of hope for the region and the world: With solidarity, science, courage and commitment, even the most challenging epidemics can be controlled”...

Sectoral policy frameworks for dealing with the diseases in environment, agriculture and health is, so far, often inadequate... A One Health approach, however, that unites public health, veterinary and environmental expertise was suggested by the report as the optimal method for preventing and responding to zoonotic disease outbreaks. A number of African countries successfully managed deadly zoonotic outbreaks and have the potential to leverage this experience to tackle future outbreaks through this approach...

85margd
Jul 9, 9:36am Top

(Cdn) Trial hopes to give cancer patients an immunity boost
Steph Crosier | July 8, 2020. Last Updated: July 9, 2020

..The vaccine is called IMM-101 and was manufactured by Immodulon Therapeutics. O’Callaghan explained that the vaccine is similar to the Bacillus Calmette-Guerin (BCG) vaccine, which was first used in 1921 to combat tuberculosis. The difference is that the micro-bacteria in the BCG vaccine are alive, while the micro-bacteria in the IMM-101 are dead.

“It is the same micro-bacteria as the BCG vaccine, but it is safe for cancer patients because it’s been killed,” (Dr. Chris O’Callaghan, senior investigator with the Canadian Cancer Trials Group at Queen’s University) said. “In fact, the whole background to this product is that the company was developing it specifically with the intention of treating cancer patients to boost their immune responses against cancer. Well, if you boost the general immune response, you’re not only boosting it against cancer, you’re boosting it against other potential infections.”

O’Callaghan explained that even pre-pandemic, the majority of cancer patients receiving toxic chemotherapy, if not all, were being told to protect themselves from other illnesses. He said certain cancers and chemotherapy both suppress patients’ immune systems. Add COVID-19 into the mix, and the results can be disastrous.

Researchers hope the IMM-101 will bring a patient’s immune system to at least the same level as a healthy person’s. O’Callaghan said they hope this happens because this is what happens with the BCG vaccine. Researchers have found that those who received the vaccine for tuberculosis also contracted fewer respiratory infections...

https://www.thewhig.com/news/local-news/trial-hopes-to-give-cancer-patients-an-i...

86margd
Jul 9, 11:25am Top

Not so bad, since wealthy neighborhoods can more easily avoid exposure?

68% Have Antibodies in This Clinic. Can Neighborhood Beat a Next Wave?
Joseph Goldstein | July 9, 2020

At a clinic in Corona, a working-class neighborhood in Queens, more than 68 percent of people tested positive for antibodies to the new coronavirus. At another clinic in Jackson Heights, Queens, that number was 56 percent. But at a clinic in Cobble Hill, a mostly white and wealthy neighborhood in Brooklyn, only 13 percent of people tested positive for antibodies.

As it has swept through New York, the coronavirus has exposed stark inequalities in nearly every aspect of city life, from who has been most affected to how the health care system cared for those patients. Many lower-income neighborhoods, where Black and Latino residents make up a large part of the population, were hard hit, while many wealthy neighborhoods suffered much less.

But now, as the city braces for a possible second wave of the virus, some of those vulnerabilities may flip, with the affluent neighborhoods becoming most at risk of a surge...

https://www.nytimes.com/2020/07/09/nyregion/nyc-coronavirus-antibodies.html

87librorumamans
Edited: Jul 9, 12:30pm Top

It should be my right to drive my car with my eyes closed. Who am I hurting, really? — Robyn Urback in The Globe and Mail
. . . I am, frankly, fed-up with so-called experts telling me that I cannot drive on the highway with my eyes closed. It’s enough. Freedom should not be conditional on the fickle opinions of city planners, or occupational health and safety specialists, or my auto-insurance provider. It should be my right, as a free citizen, to close my eyes and daydream about picking up food from that taco place by my house as I merge into traffic on the 400-series highways. If you tasted their refried beans, I’m sure you would understand what I’m saying.

All of these people I see driving with their eyes open nowadays are but mere sheep, flocking mindlessly to the latest popular, virtue-signalling gesture. Or else they’re pitiful weaklings, living in a chronic state of fear about the world and the traffic around them. Who could live like that? . . .

88margd
Jul 9, 12:48pm Top

COVID-19: How do we explain 'happy' hypoxia?
Timothy Huzar on July 8, 2020

...The ongoing COVID-19 pandemic holds many mysteries. Among the more baffling has been the frequency of silent hypoxemia, or happy hypoxia, as it has been dubbed in the media.

Hypoxemia is defined as “a decrease in the partial pressure of oxygen in the blood.” As blood oxygen levels begin to reduce, a person may experience shortness of breath, also called dyspnea. If blood oxygen levels continue to fall, the organs may shut down, and the issue becomes life threatening.

...despite low blood oxygen levels (in COVID-19), some patients appear to be functioning without serious issues or even shortness of breath.

...The lead author of the study,* Dr. Martin J. Tobin — a professor of pulmonary and critical care medicine at the Loyola University Medical Center, in Maywood, IL — noted that “In some instances, the patient is comfortable and using a phone at a point when the physician is about to insert a breathing endotracheal tube and connect the patient to a mechanical ventilator, which, while potentially lifesaving, carries its own set of risks.”

...informal survey of 58 healthcare workers asking whether they had encountered cases of silent hypoxemia, or happy hypoxia. The team received 22 responses with useful data.

...many of the cases of silent hypoxemia could be explained through conventional respiratory science.

For example, a healthcare provider typically first measures oxygen levels with a pulse oximeter. Dr. Tobin points out that “while a pulse oximeter is remarkably accurate when oxygen readings are high, it markedly exaggerates the severity of low levels of oxygen when readings are low.”

Dr. Tobin also noted that the brain may not immediately recognize that blood oxygen levels have reduced, explaining, “As oxygen levels drop in patients with COVID-19, the brain does not respond until oxygen falls to very low levels — at which point, a patient typically becomes short of breath.”

In addition, more than half of the patients with silent hypoxemia also had low carbon dioxide levels, which Dr. Tobin and his co-authors believe could reduce the effect of low blood oxygen levels.

“It is also possible that the coronavirus is exerting a peculiar action on how the body senses low levels of oxygen,” said Dr. Tobin, speculating that this could be linked to the lack of smell that many COVID-19 patients experience.

...For Dr. Tobin, “This new information may help to avoid unnecessary endotracheal intubation and mechanical ventilation, which presents risks, when the ongoing and much anticipated second wave of COVID-19 fully emerges.”

https://www.medicalnewstoday.com/articles/covid-19-how-do-we-explain-happy-hypox...

--------------------------------------------------​

* Martin J. Tobin et al. 2020. Why COVID-19 Silent Hypoxemia is Baffling to Physicians. American Journal of Respiratory and Critical Care Medicine. Published Online: June 15, 2020. https://doi.org/10.1164/rccm.202006-2157CP https://www.atsjournals.org/doi/10.1164/rccm.202006-2157CP

Andrew M Luks and Erik R. Swenson. 2020. Pulse Oximetry for Monitoring Patients with COVID-19 at Home: Potential Pitfalls and Practical Guidance. Annals of the American Thoracic Society. Published Online: June 10, 2020. https://doi.org/10.1513/AnnalsATS.202005-418FR https://www.atsjournals.org/doi/abs/10.1513/AnnalsATS.202005-418FR

89lriley
Jul 9, 1:44pm Top

#86--one of the issues in NYC was the public and private hospitals. The publics are funded by the state govt. and the privates are for profit enterprises so they will have more money to work with, better more up to date equipment, more in reserve of everything. And most of the black and brown people in certain districts of New York are poorer---many uninsured and tend to end up in the publics which got overwhelmed because that's the way the system works and so more of them died and it's also why Cuomo kind of worked at merging the privates and publics to take the stress off the publics.

90Molly3028
Edited: Jul 9, 2:04pm Top

Opening school buildings in August/September

Under the best of conditions, schools are petri dishes of medical
concerns. Adding a pandemic to the mix will not bring about
good outcomes. Trump and his enablers letting things slide at
the outset has made the situation much worse than it should
have been. Bar openings/closings are small-scale warnings about
what we can expect to take place.

91margd
Jul 9, 3:43pm Top

Patients with autoimmune rheumatic disease might be more susceptible to COVID-19 infection than the general population.

Patients with rheumatic disease who were taking hydroxychloroquine had a lower risk of COVID-19 infection than patients taking other disease-modifying anti-rheumatic drugs

--------------------------------------------------​

Jixin Zhong et al. 2020. COVID-19 in patients with rheumatic disease in Hubei province, China: a multicentre retrospective observational study. The Lancet Rheumatology. Published:July 03, 2020 DOI:https://doi.org/10.1016/S2665-9913(20)30227-7
https://www.thelancet.com/journals/lanrhe/article/PIIS2665-9913(20)30227-7/fulltext

Summary
Background
Methods

Findings
Between March 20 and March 30, 2020, 6228 patients with autoimmune rheumatic diseases were included in the study. The overall rate of COVID-19 in patients with an autoimmune rheumatic disease in our study population was 0·43% (27 of 6228 patients). We identified 42 families in which COVID-19 was diagnosed between Dec 20, 2019, and March 20, 2020, in either patients with a rheumatic disease or in a family member residing at the same physical address during the outbreak. Within these 42 families, COVID-19 was diagnosed in 27 (63%) of 43 patients with a rheumatic disease and in 28 (34%) of 83 of their family members with no rheumatic disease (adjusted odds ratio (OR) 2·68 (95% CI 1·14–6·27); p=0·023). Patients with rheumatic disease who were taking hydroxychloroquine had a lower risk of COVID-19 infection than patients taking other disease-modifying anti-rheumatic drugs (OR 0·09 (95% CI 0·01–0·94); p=0·044). Additionally, the risk of COVID-19 was increased with age (adjusted OR 1·04 (95%CI 1·01–1·06); p=0·0081).

Interpretation
Patients with autoimmune rheumatic disease might be more susceptible to COVID-19 infection than the general population.

92margd
Jul 9, 3:51pm Top

Always best to be careful: one never knows effects down the road.

Study results suggest pregnant women may be able to transmit coronavirus to their babies
Lenny Bernstein | July 9, 2020

...Claudio Fenizia, an assistant professor of immunology at the University of Milan, who led the study...said the review of 31 pregnant women is preliminary and was plagued by factors that make it too early to draw conclusions for use in the care of pregnant women infected by the virus. But, he said, “our study should be considered a ringing bell to raise awareness that transmission is possible.” He urged further research in the area, which already is underway in some places.

The full study is not yet available. An abstract with results was released Thursday ahead of a one-day worldwide conference on covid-19 that will take place Friday. Previous reports on a small number of infected women in China reached similar conclusions.

Fenizia’s group looked at 31 women with the coronavirus in three Milan area hospitals in March and April. All were late in their pregnancies, leaving open the question of the virus’s impact on the early stages of gestation.

The virus itself was found in one woman’s vagina, one woman’s placenta, one woman’s umbilical cord blood and one woman’s breast milk, the results show. Nine had antibodies in umbilical cord blood and one showed them in breast milk.

Fenizia said the results suggest it may be important as the pandemic continues to monitor pregnant mothers and newborns for signs of inflammation, especially in light of the discovery of an alarming inflammatory syndrome linked to covid-19 that has affected hundreds of children in the United States.

At the moment, he said, there are no proven interventions for pregnant women infected by the coronavirus. Fenizia said prevention is the best approach.

https://www.washingtonpost.com/health/another-study-suggests-pregnant-women-can-...

93margd
Jul 9, 3:58pm Top

Cases of broken heart syndrome have ticked upwards since pandemic began, study finds
Kelsie Sandoval | July 9, 2020

The COVID-19 pandemic may be taking a toll on Americans’ heart health, even if they’re not infected with the virus: According to research published Thursday in JAMA Open Network, cases of broken heart syndrome are on the rise among people without the illness.

The condition, which is distinct from a heart attack, goes by several names, including stress cardiomyopathy or takotsubo syndrome. It occurs when a part of the heart becomes enlarged and is unable to pump blood effectively. Unlike a heart attack, which is caused by clogged arteries, broken heart syndrome is preceded by intense emotional or physical stress...

https://www.nbcnews.com/health/health-news/cases-broken-heart-syndrome-have-tick...

--------------------------------------------------​

Ahmad Jabri et al. 2020. Incidence of Stress Cardiomyopathy During the Coronavirus Disease 2019 Pandemic
JAMA Netw Open. July 9, 2020;3(7):e2014780. doi:10.1001/jamanetworkopen.2020.14780 https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768093

Key Points
Question Is psychological, social, and economic stress associated with coronavirus disease 2019 (COVID-19) associated with the incidence of stress cardiomyopathy?

Findings This cohort study included 1914 patients with acute coronary syndrome to compare patients presenting during the COVID-19 pandemic with patients presenting across 4 timelines prior to the pandemic and found a significantly increased incidence of 7.8% of stress cardiomyopathy during the COVID-19 pandemic, compared with prepandemic incidences that ranged from 1.5% to 1.8%.

Meaning These findings suggest that psychological, social, and economic stress related to the COVID-19 pandemic was associated with an increased incidence of stress cardiomyopathy.

94margd
Jul 9, 4:20pm Top

Timeline of US cases, with Trumpian commentary...

Image ( https://twitter.com/TBPInvictus/status/1281256803788107776/photo/1 )
- Invictus @TBPInvictus | 12:00 PM · Jul 9, 2020

95margd
Jul 9, 4:27pm Top

4 of the top 5 worst coronavirus epicenters in the WORLD are U.S. STATES.
Trump’s chaos has a deadly price.

0:43 ( https://twitter.com/CAPAction/status/1281266005382217728 )

- CAP Action @CAPAction | 12:36 PM · Jul 9, 2020

96cindydavid4
Jul 10, 4:13am Top

I am sooooo using this elsewhere!

97margd
Edited: Jul 10, 7:35am Top

What a Schrodinger virus SARS-CoV-2 is! An antibody test administered in course of my July 6 blood donation was negative. (Symptoms of my illness commenced February 13, low fever disappeared after a few days, at nine days much better, but it was months before my endurance on resumption of daily walks improved significantly.) While disappointing not to have COVID confirmed--and especially to be disqualified as a Convalescent Plasma Donor--some upside, I guess, in that I'm discouraged from assuming any immunity and thus encouraged to keep up defenses against the virus...

Research is coalescing around the idea that coronavirus antibodies may last just a few months
Aylin Woodward | 7/9/2020

We don't know how long coronavirus antibodies last.
Recent research from Spain suggests they may disappear in some patients in a matter of weeks.
( https://www.businessinsider.com/coronavirus-antibodies-study-herd-immunity-unach... )
Other studies suggest antibodies last a few months.
( https://www.businessinsider.com/coronavirus-antibodies-only-last-months-weaker-i... )
Here's what we do know so far about the life span of coronavirus antibodies and what it means for immunity and potential vaccines.

...How long do antibodies last?

With some diseases, like measles and hepatitis A, infection is a one-and-done deal. Once you get sick and recover, you're immune for life.

"For human coronaviruses, that's not the case," Florian Krammer, a vaccinologist at the Icahn School of Medicine at Mount Sinai, told Business Insider. "You can get repeatedly infected once your immunity goes down."

Increasingly, research is starting to coalesce around an unfortunate picture of COVID-19 immunity: People who develop antibodies might not keep them for very long...

https://www.businessinsider.com/coronavirus-antibodies-last-just-months-2020-7

--------------------------------------------------​
"Together, these data might indicate the risks of using COVID-19 ‘immunity passports’ and support the prolongation of public health interventions, including social distancing, hygiene, isolation of high-risk groups and widespread testing."

Quan-Xin Long et al. 2020. Clinical and immunological assessment of asymptomatic SARS-CoV-2 infections (Letter). Nature Medicine. (18 June 2020) https://www.nature.com/articles/s41591-020-0965-6

...Discussion
To date, the duration of SARS-CoV-2 RNA shedding has not been well characterized. In SARS-CoV, viral RNA was detectable in different specimens, including throat swabs, stool and urine, in more than 30% of patients for as long as 4 weeks after disease onset... In MERS-CoV infections, viral shedding in respiratory secretions persisted for at least 3 weeks... Recently, one study of 191 patients with COVID-19 reported that the median duration of viral shedding was 20 d in survivors (range, 8–37 d)... In another report, the duration of viral shedding in nasopharyngeal aspirates was prolonged up to at least 24 d after symptom onset in 18 patients infected with SARS-CoV-2 in Singapore... In this study, the median duration of viral shedding in 37 patients with mild symptoms was 14 d, which was shorter than in previous reports. In comparison to symptomatic patients, the asymptomatic group had a significantly longer duration of viral shedding, with a viral shedding time of 19 d. Several factors might contribute to the variation of duration of viral shedding in different studies, including the severity of disease, definition of duration of viral shedding and frequency of specimen collection. Notably, detection of viral RNA does not necessarily mean that infectious virus is present in respiratory specimens, and caution is required when applying virus shedding duration that was calculated based on RT–PCR to assess infection potential.

The strength and duration of immunity after infection are key issues for ‘shield immunity’...and for informing decisions on how and when to ease physical distancing restrictions... Previous studies have shown that circulating antibodies against SARS-CoV or MERS-CoV last for at least 1 year... Sustained IgG levels were maintained for more than 2 years after SARS-CoV infection... Antibody responses in individuals with laboratory-confirmed MERS-CoV infection lasted for at least 34 months after the outbreak... Recently, several studies characterizing adaptive immune responses to SARS-CoV-2 infection have reported that most COVID-19 convalescent individuals have detectable neutralizing antibodies, which correlate with the numbers of virus-specific T cells... In this study, we observed that IgG levels and neutralizing antibodies in a high proportion of individuals who recovered from SARS-CoV-2 infection start to decrease within 2–3 months after infection. In another analysis of the dynamics of neutralizing antibody titers in eight convalescent patients with COVID-19, four patients showed decreased neutralizing antibodies approximately 6–7 weeks after illness onset... One mathematical model also suggests a short duration of immunity after SARS-CoV-2 infection... Together, these data might indicate the risks of using COVID-19 ‘immunity passports’ and support the prolongation of public health interventions, including social distancing, hygiene, isolation of high-risk groups and widespread testing. Additional longitudinal serological studies profiling more symptomatic and asymptomatic individuals are urgently needed to determine the duration of antibody-mediated immunity. In addition, low levels of anti-viral IgG in asymptomatic patients, who might be more likely to become seronegative, further support the need for timely serosurvey to study the true infection rate.

--------------------------------------------------​
"These results emphasise the need for maintaining public health measures to avoid a new epidemic wave."

Marina Pollán et al. 2020. Prevalence of SARS-CoV-2 in Spain (ENE-COVID): a nationwide, population-based seroepidemiological study. The Lancet (July 06, 2020) DOI:https://doi.org/10.1016/S0140-6736(20)31483-5 https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31483-5/fulltext#figures

Summary
Interpretation
The majority of the Spanish population is seronegative to SARS-CoV-2 infection, even in hotspot areas. Most PCR-confirmed cases have detectable antibodies, but a substantial proportion of people with symptoms compatible with COVID-19 did not have a PCR test and at least a third of infections determined by serology were asymptomatic. These results emphasise the need for maintaining public health measures to avoid a new epidemic wave.

98margd
Jul 10, 9:12am Top

Contact tracing apps ‘fundamentally flawed’ for controlling COVID-19
Samantha Butler-Hassan | July 9, 2020

...David Skillicorn, a professor of computing at Queen’s University...says the core premise of equating a Bluetooth connection with a COVID-19 exposure is completely flawed....“The fact that you were close according to Bluetooth doesn’t mean that you were close according to COVID-19,” he said. “If you’re standing on the sidewalk and a car drives past with its window up, that Bluetooth exchange between mobile phones is going to count as a contact,” he said. “But there’s no way you got COVID-19 from the person in the car...“No body’s going to put themselves into 14 days of isolation based on notifications from an app like that”...

https://www.kingstonist.com/news/contact-tracing-apps-fundamentally-flawed-for-c...

99margd
Jul 10, 10:46am Top

Here, we report SARS-CoV-2 seroprevalence of >1 margd:,000 pregnant women in Philadelphia

9.7% Black and 10.4% Latina women seropositive
2.0% White and 0.9% Asian women seropositive

Racial/ethnicity differences in exposure likely driving differences in disease!

- Hensley Lab @SCOTTeHENSLEY | 10:19 AM · Jul 10, 2020

-------------------------------------------------
Dustin D. Flannery et al. 2020. SARS-CoV-2 Seroprevalence Among Parturient Women. medRxiv July 10, 2020.
doi: https://doi.org/10.1101/2020.07.08.20149179 https://www.medrxiv.org/content/10.1101/2020.07.08.20149179v1

Abstract
Limited data are available for pregnant women affected by SARS-CoV-2. Serological tests are critically important to determine exposure and immunity to SARS-CoV-2 within both individuals and populations. We completed SARS-CoV-2 serological testing of 1,293 parturient women at two centers in Philadelphia from April 4 to June 3, 2020. We tested 834 pre-pandemic samples collected in 2019 and 15 samples from COVID-19 recovered donors to validate our assay, which has a ~1% false positive rate. We found 80/1,293 (6.2%) of parturient women possessed IgG and/or IgM SARS-CoV-2-specific antibodies. We found race/ethnicity differences in seroprevalence rates, with higher rates in Black/non-Hispanic and Hispanic/Latino women. Of the 72 seropositive women who also received nasopharyngeal polymerase chain reaction testing during pregnancy, 46 (64%) were positive. Continued serologic surveillance among pregnant women may inform perinatal clinical practices and can potentially be used to estimate seroprevalence within the community.

100lriley
Jul 10, 5:27pm Top

Arizona went over 4000 new cases today for a roughly 7.2 million population. They've been a steady 3,000--to 3,500 for a while now. Meanwhile no numbers in yet from California but Texas had almost 10,000 new cases today and Florida was over 11,000 new cases and on any given day that 9-10-11,000 has pretty much par for the course. How long is this all going to be sustainable? Gov. Newsom of California has at least been putting the effort in for a while and his is the largest population. Florida OTOH is going to send kids to school and the Republican National Convention is coming too.

101cindydavid4
Jul 10, 9:16pm Top

any chance a space ship from anywhere wil come to earth, and solve our problems for us? asking for a friend

102clamairy
Jul 10, 10:13pm Top

103John5918
Jul 10, 11:33pm Top

The pandemic’s spread across Africa is being tempered by a young population, for now (Quartz)

Findings of Surgo Foundation from a new Africa COVID-19 Community Vulnerability Index (CCVI) posit that Africa’s relatively young population has been the best explanation for the low fatality rate in the continent with projected infection fatality rate (IFR) based on age and gender distribution relatively low in most regions of the continent—between 0.10% and 0.15% compared with 0.66% in the US which has an older population.

Many African countries, particularly in Sub Saharan Africa, have a median age of around 18. The index shows that North African countries and South Africa with a higher median age are more vulnerable when it comes to this factor but that is somewhat offset by positive factors such as better healthcare facilities...

104librorumamans
Jul 11, 12:32am Top

>101 cindydavid4:

Please enquire if there's room for one more person. (Also asking for a friend.)

105margd
Edited: Jul 11, 4:38am Top

>101 cindydavid4: Comet this month, anyway! (Not stopping for passengers, though...)

( https://www.space.com/comet-neowise-july-2020-night-sky-forecast.html )

106margd
Jul 11, 6:30am Top

Breaking on @MSNBC:

The U.S. has crossed more than 70,000 new coronavirus cases in a single day.
That is a record. A week ago, the record was about 50,000 cases in a single day.

- Kyle Griffin @kylegriffin | 19:50 PM · Jul 10, 2020

107cindydavid4
Edited: Jul 11, 9:41am Top

108cindydavid4
Jul 11, 9:40am Top

is that the one that just passed by us? we could have hitched a riide via Arthur Trent

109cindydavid4
Jul 11, 4:38pm Top

wow!

https://kjzz.org/content/1599587/poll-arizona-gov-ducey-has-worst-approval-ratin...

hes got two more years in office, wonder if he'll resign and wonder who'll run against him.

110lriley
Jul 11, 8:17pm Top

#109--Might be better to wonder if he can be recalled.

111cindydavid4
Jul 11, 10:11pm Top

interestingly, the far right anti mask folk were going to try just that when the gov was going to make them compulsive, Would be funny if both sides recalled him for different reasons!

112margd
Edited: Jul 12, 2:19pm Top

Florida shatters coronavirus records with almost 15,300 new cases
Ben Kesslen | July 12, 2020

Florida shattered previous records for any state's biggest single-day recording of new coronavirus cases on Sunday, announcing almost 15,300 new cases.

The state added 15,299 cases of COVID-19, the disease caused by coronavirus, to its constantly-rising total, outpacing New York's previous daily record by more than 3,000...

https://www.nbcnews.com/news/us-news/florida-shatters-coronavirus-records-almost...

____________________________________

Disney lawyers be on the case, you bet! Seriously, FL Governor DeSantis could well kill the Golden Goose? To say nothing of all those retirees...

Mike Madrid @madrid_mike | 12:31 PM · Jul 12, 2020 from Sacramento, CA
Who did this?

0:35 ( https://twitter.com/madrid_mike/status/1282351918619086848 )

_____________________________________

It could be years before Florida’s jobs recover from COVID-19
David Lyons | Jul 12, 2020

South Florida’s tourism-heavy economy is paying a price in jobs lost to COVID-19 — a toll so heavy that some executives don’t see a recovery until two years from now.

All three counties have lost a substantial number of jobs in hotels, restaurants and leisure-oriented businesses, but Broward County has taken the biggest hit, according to the most recent data available,

Unemployment reached 16% in Broward in May. Palm Beach County fared better at 14.1% and Miami-Dade at 11.3% — just a year after unemployment hovered around 3%.

Other tourism centers have suffered, too. Unemployment in Orange County — home to Disney World, Universal and other nationally prominent attractions — hit a sky-high 23.2% in May, the second-worst in the state. Only Osceola County, directly to the south, was hit harder, with 31.1% of the workforce unemployed.

With the coronavirus pandemic raging more than ever, many tourism-dependent businesses say they won’t be able to recall workers as quickly as they had hoped, and the economic damage is spotlighting South Florida’s need to develop other types of industries...

https://www.sun-sentinel.com/coronavirus/fl-ne-coronavirus-leisure-hospitality-s...

113margd
Jul 12, 4:14pm Top

Does UV light kill the new coronavirus?
Donavyn Coffey | 7/12/2020

...The short answer is yes. But it takes the right kind of UV in the right dosage, a complex operation that is best administered by trained professionals. In other words, many at-home UV-light devices claiming to kill SARS-CoV-2 likely aren't a safe bet.
ADVERTISING

UV radiation can be classified into three types based on wavelength: UVA, UVB and UVC. Nearly all the UV radiation that reaches Earth is UVA, because most of UVB and all of UVC light is absorbed by the ozone layer, according to the Centers for Disease Control and Prevention. And it's UVC, which has the shortest wavelength and the highest energy, that can act as a disinfectant.

...UVC at a specific wavelength, 254 nanometers, has been successfully used to inactivate H1N1 influenza and other coronaviruses, such as severe acute respiratory virus (SARS-CoV) and Middle Eastern Respiratory Syndrome (MERS-CoV), (Indermeet Kohli, a physicist who studies photomedicine in dermatology at Henry Ford Hospital in Detroit) said. A study published June 26 to the preprint database medRxiv from Kohli's colleagues awaiting peer review now confirms that UVC also eliminates SARS-CoV-2.

UVC-254 works because this wavelength causes lesions in DNA and RNA. Enough exposure to UVC-254 damages the DNA and RNA so that they can't replicate, effectively killing or inactivating a microorganism or virus.

"The data that backs up this technology, the ease of use, and the non-contact nature" of UVC make it a valuable tool amid the pandemic, Kohli said. But responsible, accurate use is critical. UVC's DNA-damaging capabilities make it extremely dangerous to human skin and eyes, Kohli said. She cautioned that UVC disinfection technologies should primarily be left to medical facilities and evaluated for safety and efficacy by teams with expertise in photomedicine and photobiology...

https://www.livescience.com/uv-light-kill-coronavirus.html

_____________________________________________

David M. Ozog et al. 2020. The Effect of Ultraviolet C Radiation Against SARS-CoV-2 Inoculated N95 Respirators. MedRXiv June 26, 2020. doi: https://doi.org/10.1101/2020.05.31.20118588 https://www.medrxiv.org/content/10.1101/2020.05.31.20118588v3

This article is a preprint and has not been peer-reviewed

Abstract

Since March 31st, 2020, during the height of the pandemic, we have decontaminated thousands of 3M 1860 respirators with Ultraviolet C (UVC) for our frontline workers. There is no published peer-reviewed data regarding the dose required to effectively disinfect SARS-CoV-2 on N95 filtering facepiece respirators (FFRs). Four different locations (facepiece and strap) on 5 different N95 FFR models (3M 1860, 8210, 8511, 9211; Moldex 1511) were inoculated with a 10 μL drop of SARS-CoV-2 viral stock (8 x 107 TCID50/mL). The outside-facing and wearer-facing surfaces of the respirators were each irradiated with a dose of 1.5 J/cm2 UVC (254 nm). Viable SARS-CoV-2 was quantified by a median tissue culture infectious dose assay (TCID50). UVC delivered using a dose of 1.5 J/cm2, to each side, was an effective method of decontamination for the facepieces of 3M 1860 and Moldex 1511, and for the straps of 3M 8210 and the Moldex 1511. This dose is an appropriate decontamination method to facilitate reuse of respirators for healthcare personnel when applied to certain models/materials. Increasing the dose may improve decontamination for the other models and straps; however, UVC radiation can degrade certain polymers in a dose dependent manner, and the effects may vary greatly between different models. Therefore, fit-testing of UVC decontaminated respirators must be performed each time a new model and/or dose is introduced into the healthcare system.

114cindydavid4
Edited: Jul 12, 6:23pm Top

gov of florida actually said there is no justification not to move forward to reopen? He and trump must be twins, both totally senile or at the very least illusional. I have elderly relatives that live in the state I know they are all staying in or masking. Pray they make it through this madness

115margd
Yesterday, 4:38am Top

:)

New York City Reaches Milestone With No Reported Virus Deaths
Yueqi Yang | July 12, 2020

New York City, once the epicenter of the nation’s coronavirus outbreak, has just reported its first day with zero confirmed or probable virus deaths since the pandemic hit New York State.

The milestone came Sunday in initial data from the New York City Department of Health and Mental Hygiene.

It marked the end of a four-month stretch since the city reported its first Covid-19 fatality on March 11. The confirmed daily death count hit its height on April 7 at 597. Another 216 people were reported likely to have died from the virus despite no positive laboratory tests that day...

https://www.bloomberg.com/news/articles/2020-07-12/new-york-city-reaches-milesto...

116margd
Yesterday, 6:04am Top

:(

My patient caught Covid-19 twice. So long to herd immunity hopes.
D. Clay Ackerly | Jul 12, 2020

Emerging cases of Covid-19 reinfection suggest herd immunity is wishful thinking.

...my patient’s experience serves as a warning sign on several fronts.

First, the trajectory of a moderate initial infection followed by a severe reinfection suggests that this novel coronavirus might share some tendencies of other viruses such as dengue fever, where you can suffer more severe illness each time you contract the disease.

Second, despite scientific hopes for either antibody-mediated or cellular immunity, the severity of my patient’s second bout with Covid-19 suggests that such responses may not be as robust as we hope.

Third, many people may let their guard down after being infected, because they believe they are either immune or incapable of contributing to community spread. As my patient’s case demonstrates, these assumptions risk both their own health and the health of those near them.
AD

Last, if reinfection is possible on such a short timeline, there are implications for the efficacy and durability of vaccines developed to fight the disease.

I am aware that my patient represents a sample size of one, but taken together with other emerging examples, outlier stories like his are a warning sign of a potential pattern. If my patient is not, in fact, an exception, but instead proves the rule, then many people could catch Covid-19 more than once, and with unpredictable severity.

With no certainty of personal immunity nor relief through herd immunity, the hard work of beating this pandemic together continues. Our efforts must go beyond simply waiting for effective treatments and vaccines. They must include continued prevention through the use of medically proven face masks, face shields, hand-washing, and physical distancing, as well as wide-scale testing, tracing, and isolation of new cases.

This is a novel disease: Learning curves are steep, and we must pay attention to the inconvenient truths as they arise. Natural herd immunity is almost certainly beyond our grasp. We cannot place our hopes on it.

D. Clay Ackerly, MD, MSc, is an internal medicine and primary care physician practicing in Washington, DC. He has served both as a faculty member of Harvard Medical School and as Assistant Chief Medical Officer at the Massachusetts General Hospital. He has also held positions in the government and private sector, including the White House, the Food and Drug Administration, and, most recently, as Chief Medical Officer of Privia Health. He can be reached at dclayackerly@gmail.com.

https://www.vox.com/2020/7/12/21321653/getting-covid-19-twice-reinfection-antibo...

117lriley
Yesterday, 6:47am Top

#116--I have had kind of the sense of this for a while--that if you do gain some immunity it is probably short term or not something you can depend on to last and I don't think everyone does get immunity. People who have had it should still take care.

Read this this morning on a Covid unit at the Tuscon Medical Center which is one of our front lines now:

https://www.news.yahoo.com/inside-arizona-hospital-battling-global-100028847.htm...

118margd
Yesterday, 9:31am Top

Preprint below prompted immunity discussion on Twitter beginning with

https://twitter.com/GordanLauc/status/1282549222890405888:

This is not a got news. The immunity to #SARSCoV2 seems to be quite short-term, in particular if symptoms were mild.
Image ( https://twitter.com/GordanLauc/status/1282549222890405888/photo/1 )
- Gordan Lauc @GordanLauc | 1:35 AM · Jul 13, 2020

__________________________________________________

Jeffrey Seow et al. 2020. Longitudinal evaluation and decline of antibody responses in SARS-CoV-2 infection. MedRxiv July 11, 2020 doi: https://doi.org/10.1101/2020.07.09.20148429 https://www.medrxiv.org/content/10.1101/2020.07.09.20148429v1

This article is a preprint and has not been certified by peer review

Abstract

Antibody (Ab) responses to SARS-CoV-2 can be detected in most infected individuals 10-15 days following the onset of COVID-19 symptoms. However, due to the recent emergence of this virus in the human population it is not yet known how long these Ab responses will be maintained or whether they will provide protection from re-infection. Using sequential serum samples collected up to 94 days post onset of symptoms (POS) from 65 RT-qPCR confirmed SARS-CoV-2-infected individuals, we show seroconversion in >95 margd:% of cases and neutralizing antibody (nAb) responses when sampled beyond 8 days POS. We demonstrate that the magnitude of the nAb response is dependent upon the disease severity, but this does not affect the kinetics of the nAb response. Declining nAb titres were observed during the follow up period. Whilst some individuals with high peak ID50 (>10 cindydavid4:,000) maintained titres >1 margd:,000 at >60 cindydavid4: days POS, some with lower peak ID50 had titres approaching baseline within the follow up period. A similar decline in nAb titres was also observed in a cohort of seropositive healthcare workers from Guy′s and St Thomas′ Hospitals. We suggest that this transient nAb response is a feature shared by both a SARS-CoV-2 infection that causes low disease severity and the circulating seasonal coronaviruses that are associated with common colds.

This study has important implications when considering widespread serological testing, Ab protection against re-infection with SARS-CoV-2 and the durability of vaccine protection.

119alco261
Yesterday, 12:12pm Top

>118 margd: I'll bite - what is "a got news"? As an aside - the lead data plot in that twitter feed gives a distinct impression of at least two groups of patients. I can see why some of the posters to that thread are having a hard time following the logic of the illustrated fit. I'd want to know more about the demographics of that sample before trying any kind of a univariate fit - as it appears has been done by the initial poster.

120margd
Yesterday, 12:56pm Top

>119 alco261: He's posting from Croatia, so I assume from that and context he means "not good news"?

Four+ months after my COVID symptoms commenced, I tested negative for antibodies so I'm much interested in what if any immunity I might have. Not "got", sounds like? :(

Paper is not yet reviewed, but based on Twitter response, sounds like it will provoke much discussion.

121stellarexplorer
Yesterday, 1:15pm Top

I have also heard more cases of this nature: had Covid, recovered, antibody positive, PCR negative. Months later returns sick, PCR positive again, antibody negative. See Daniel Griffin (he’s an infectious disease doc in NYC and has been great throughout) discussing on the latest TWIV podcast #638 dated July 12, 2020.
Importantly, he discusses why this is not evidence against an effective vaccine, even if it does suggest people should not be overconfident about the possibility of reinfection after initial illness.

122margd
Edited: Yesterday, 3:53pm Top

>121 stellarexplorer: Thanks--fingers crossed!

_____________________________________________

Andrew Cuomo @NYGovCuomo | 12:22 PM · Jul 13, 2020:
NY is issuing an emergency health order:

Out-of-state travelers from designated high-COVID states must provide their contact information upon arrival.

If you fail to provide it, you will receive a summons with a $2K fine.

We’re serious about enforcing quarantine.

______________________________________________

How Trump Is Helping Tycoons Exploit the Pandemic
Jane Mayer | July 13, 2020

The secretive titan (Ronald Cameron, Mountaire’s reclusive owner) behind one of America’s largest poultry companies (Mountaire), who is also one of the President’s top donors (nearly three million dollars in 2016), is ruthlessly leveraging the coronavirus crisis—and his vast fortune—to strip workers of protections.

...Democrats pushed for the agency to issue an emergency rule forcing businesses to comply with the Centers for Disease Control’s health guidelines for COVID-19, but the Labor Department refused.

Instead, on April 28th, forty-eight hours after Tyson Foods, the world’s second-largest meat company, ran a full-page ad in several newspapers warning that “the food supply chain is breaking,” Trump issued an executive order defining slaughterhouse workers as essential. The White House had appointed Cameron to an advisory board on the pandemic’s economic impact. The executive order commanded meat-processing facilities to “continue operations uninterrupted to the extent possible.” The Labor Department released an accompanying statement that all but indemnified companies for exposing workers to COVID-19. It assured employers in essential industries that the agency wouldn’t hold them responsible if they failed to follow the C.D.C.’s health guidelines, as long as they made a “good faith” effort.

Meat and poultry workers had to keep working and risk infection—or lose their jobs....

The prospect of food shortages understandably caused concern in the White House. Yet reports show that in April, as Tyson and other producers were warning that “millions of pounds of meat will disappear” from American stores if they had to shut down, exports of pork to China broke records—and Mountaire’s chicken exports were 3.4 per cent higher than they were a year earlier. The next month, the company’s exports were 10.9 per cent lower than in 2019, but its exports to China and Hong Kong grew by 23.1 per cent in April and by fourteen per cent in May, according to statistics provided by Christopher Rogers, an analyst with Panjiva, which tracks the food-supply chain. Tony Corbo, a lobbyist for Food and Water Watch, a progressive nonprofit advocacy group, said, “They were crying about shortages, and yet we’re still exporting meat. The shortage was phony.”

...Although Trump claims to be a defender of the working class, he has delighted wealthy donors—and their pressure groups, such as the Club for Growth—by reliably serving their agenda. (David Michaels, a professor of public health at George Washington University, who headed OSHA during the Obama Administration) told me, “Mountaire and others are taking advantage of the COVID-19 crisis to say, ‘We need more chickens.’ The Trump Administration is aiding and abetting this. They’re saying, ‘Produce more food,’ regardless of the cost to workers. If companies cared as much about their workers as they do about their chickens, we’d be a better country.”...

https://www.newyorker.com/magazine/2020/07/20/how-trump-is-helping-tycoons-explo...

123davidgn
Edited: Yesterday, 7:00pm Top

>116 margd:
Dour Cantabridgians.

What to do if COVID-19 is here to stay

We do not yet know whether individuals who recover from COVID-19 can be reinfected. If immunity wanes, the disease will become endemic, in sharp contrast to a model in which recovery confers permanent immunity. This column considers the possibility that immunity is indeed only temporary, and derives a stylised optimal containment policy to reduce the initial wave of contagion and then manage persistent infections. In practice, this means that partial lockdowns and social distancing measures may be the norm for years to come.

>
https://voxeu.org/article/what-do-if-covid-19-here-stay

125John5918
Today, 12:27am Top

Coronavirus: Nations heading in wrong direction with Covid-19, says WHO (BBC)

The coronavirus pandemic will get "worse and worse" if governments fail to take more decisive action, the World Health Organization (WHO) has warned. Director general Dr Tedros Adhanom Ghebreyesus said "too many countries {were} headed in the wrong direction". Cases were rising where proven measures were not adopted or followed...

"mixed messages from leaders" were undermining public trust in attempts to bring the pandemic under control. "The virus remains public enemy number one, but the actions of many governments and people do not reflect this," he said.

Dr Tedros said measures such as social distancing, hand washing, and wearing masks in appropriate situations needed to be taken seriously, warning that there would be "no return to the old normal for the foreseeable future... If the basics aren't followed, there is only one way this pandemic is going to go... It's going to get worse and worse and worse"...

126margd
Today, 6:57am Top

Again? Still? :(

America is running short on masks, gowns and gloves. Again.
William Wan | July 8, 2020

Health-care workers are scrambling for supplies and reusing equipment as the coronavirus pandemic surges

...Demand for protective equipment has soared, but unlike in March, when efforts focused on getting PPE for major hospitals — especially in New York, Detroit and Chicago — supplies now are desperately needed by primary care offices, nursing homes, prisons and psychiatric and disability facilities. As many states continue to reopen their economies, demand has also surged from the construction industry and other sectors. With soaring demand, prices have skyrocketed.

Some hospitals say much of the PPE they have acquired has been exorbitantly priced...

In a letter last week, the American Medical Association told the Federal Emergency Management Agency that doctor’s offices outside big systems — including those providing primary care, chemotherapy and minor surgeries — have struggled to reopen because they are unable to secure PPE. The association, which pleaded for transparency and a coordinated national strategy, said it is unclear “whether the central problem is in the availability of raw material, production backlogs, gaps in the distribution systems, or some combination of all three.”

In a second letter, the medical association urged the White House to invoke the Defense Production Act to compel manufacturers to increase supplies of N95 masks and gowns.

A Washington Post-Ipsos poll in May found two-thirds of front-line health-care workers were still experiencing insufficient supplies of face masks that filter out airborne particles. And more than 4 in 10 were seeing shortages of less protective surgical masks...

https://www.washingtonpost.com/health/2020/07/08/ppe-shortage-masks-gloves-gowns...

127margd
Today, 9:51am Top

‘Everyone is lying’: Trump undercuts public health officials in fresh attacks
QUINT FORGEY | 07/13/2020
https://www.politico.com/news/2020/07/13/trump-questions-public-health-experts-t...

--------------------------------------------------​

Gov Cuomo responds:
https://twitter.com/Alyssa_Milano/status/1282820814069329921

128lriley
Today, 11:05am Top

#126--trump invoked the defense production act months ago but really I don't think there's been much action. I think in its hubris his administration decided the pandemic was going to resolve itself and have never really pushed very hard. He and his administration are lazy--they don't dot their i's or cross their t's. They expect miracles to happen and then to take credit for them.

It's only to be expected that there are shortages now and that they're going to get worse. Whether people are dying in the same numbers or not the virus is deeper and more widespread in the country than it was in March/April. Hospitals will still use up their supplies and run out of equipment and PPE.

This guy and his administration has been flying blind since the beginning. He's not going to land--he's going to crash--we're going to crash because of him. He wants to open schools, he wants to open businesses....bars, restaurants, sports whatever despite all kinds of evidence that it's not safe and can only make things worse and as usual he's only really thinking about himself and staying in power.

129stellarexplorer
Today, 11:54am Top

Nothing new here, just reporting the demoralizing news that I am personally experiencing a new psychological wave: the growing conviction that immunity from Covid is likely to be short-lived and that this will extend the pandemic, make it harder to control, and who knows how long this goes on? A vaccine will come whenever: no one can really say. The spread that has been allowed in the US becomes an increasing disaster as the amount of virus around is astronomically higher, and without drastic measures (an ironclad shutdown?) this huge increase will haunt us for a very long time. I fear people have no idea how long this may go on. Hint: it may be far more than another year.

130margd
Today, 1:22pm Top

>129 stellarexplorer: I know--we are due for some good news, aren't we?
A small thing but it would be great as we move indoors next fall, this filter became widely available...

Innovative air filter could effectively kill SARS-CoV-2
Timothy Huzar on July 11, 2020

Researchers say that they have developed an air filter that can capture SARS-CoV-2, the new coronavirus, and instantly kill it.

...the nickel foam filter killed 99.8% of SARS-CoV-2 particles that passed through it.

The researchers heated the filter to 200ºC to achieve this. Previous research found that exposing the virus to 70ºC for 5 minutes deactivates it. At 200ºC, the filter can kill the virus immediately.

Usually, nickel foam has a low resistivity, which means it is difficult for it to achieve high temperatures. By folding the foam and using additional compartments connected with wires, the researchers were able to increase its resistivity and maintain the 200ºC temperature without needing external heating sources.

This is particularly important if the designers intend to insert the filters in air conditioning systems. By not requiring an external heating source, which could heat the air temperature, these filters become viable...

https://www.medicalnewstoday.com/articles/innovative-air-filter-could-effectivel...

--------------------------------------------------​

LuoYua et al. 2020. Catching and killing of airborne SARS-CoV-2 to control spread of COVID-19 by a heated air disinfection system. Materials Today Physics (Journal Pre-proof, 7 July 2020) https://doi.org/10.1016/j.mtphys.2020.100249 https://www.sciencedirect.com/science/article/pii/S2542529320300730?via%3Dihub

Highlights

• A heated air disinfection system was fabricated based on commercial Ni foams.
• The Ni-foam-based filters showed ∼100% ability for catching and killing of SARS-CoV-2.
• The air disinfection system is significant to control spread of COVID-19.

Abstract
Airborne transmission of severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) via air-conditioning systems poses a significant threat for the continued escalation of the current coronavirus disease (COVID-19) pandemic. Considering that SARS-CoV-2 cannot tolerate temperatures above 70 °C, here we designed and fabricated efficient filters based on heated nickel (Ni) foam to catch and kill SARS-CoV-2. Virus test results revealed that 99.8% of the aerosolized SARS-CoV-2 was caught and killed by a single pass through a novel Ni-foam-based filter when heated up to 200 °C. Additionally, the same filter was also used to catch and kill 99.9% of Bacillus anthracis, an airborne spore. This study paves the way for preventing transmission of SARS-CoV-2 and other highly infectious airborne agents in closed environments.

131margd
Today, 1:41pm Top

“While we are conducting the clinical trials, I don’t think it’s going to hurt anybody to have an MMR vaccine that would protect against the measles, mumps, and rubella with this potential added benefit of helping against COVID-19.”

– Dr. Paul Fidel

Paul L. Fidel Jr. and Mairi C. Noverr. 2020. Could an Unrelated Live Attenuated Vaccine Serve as a Preventive Measure To Dampen Septic Inflammation Associated with COVID-19 Infection? (Opinion/Hypothesis) mBio DOI: 10.1128/mBio.00907-20 https://mbio.asm.org/content/11/3/e00907-20

ABSTRACT

We propose the concept that administration of an unrelated live attenuated vaccine, such as MMR (measles, mumps, rubella), could serve as a preventive measure against the worst sequelae of coronavirus disease 2019 (COVID-19). There is mounting evidence that live attenuated vaccines provide nonspecific protection against lethal infections unrelated to the target pathogen of the vaccine by inducing “trained” nonspecific innate immune cells for improved host responses against subsequent infections. Mortality in COVID-19 cases is strongly associated with progressive lung inflammation and eventual sepsis. Vaccination with MMR in immunocompetent individuals has no contraindications and may be especially effective for health care workers who can easily be exposed to COVID-19. Following the lead of other countries conducting clinical trials with the live attenuated Mycobacterium bovis BCG (BCG) vaccine under a similar concept, a clinical trial with MMR in high-risk populations may provide a “low-risk–high-reward” preventive measure in saving lives during this unprecedented COVID-19 pandemic.

...According to the Centers for Disease Control (CDC), there are few contraindications against administration to adults of a live attenuated vaccine such as MMR if the recipient is immunocompetent and not pregnant and has not shown previous allergic responses to vaccination (https://www.cdc.gov/vaccines/vpd/mmr/hcp/recommendations.html). In fact, MMR vaccination is recommended in high-risk adults (i.e., health care workers) and people born before 1957 who did not receive the vaccine as a child. Adults who had received the MMR vaccine in childhood likely still possess antibody titers against the targeted viruses but not the shorter-lived trained innate leukocytes. Hence, at the very least, the MMR vaccine would provide added protection against measles, mumps, and rubella for older adults. But with the added induction of the trained innate cells, the MMR vaccination could provide protection against the worst sequelae of COVID-19...

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