Coronavirus Tidbits #57 6-13-20
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News Diagnostics Drugs Devices Epidemiology/Infection control Tips Politics Feel good du jour Comic relief Perspective/Poem Bits of beauty
Announcements:
First, there is now a Resources Page here for the most commonly asked questions I’m getting.
Tidbits will likely be a bit shorter and a little less frequent for the next little bit. I have been immersed in it and I need to spend a little more time on self-care, which for me means seeing the spring flowers emerge and digging in the dirt.
Happy to continue to answer your questions/concerns as best I can, so don’t be shy about that.
News
States across the south and west (eg CA, AZ, TX, FL, SC, NC) hit record high new cases and rising hospitalizations.
Japan gave out masks to 50 million households.
— Eric Topol (@EricTopol) June 12, 2020
Toronto now mandates masks in public and is giving out 1 million.
But in the US, people revolt against masks and give death threatshttps://t.co/vRguybiF6S @LukeMMoney
Any wonder why we are failing? pic.twitter.com/k54Wg72l4q
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Despite rising number of cases, Trump schedules rallies in Tulsa–on Juneteenth–and in Jacksonville on Axe Handle Saturday
both thumbing his nose at Blacks and at epidemiologists/public health officials.
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https://twitter.com/chrishendel/status/1271505827363520514?s=20
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Fired scientist Rebekah Jones builds new coronavirus dashboard to rival Florida’s Dept. of Health
Rebekah Jones has created FloridaCOVIDAction.com, which asserts that the state’s widely read public-facing dashboard under reports how many people have tested positive for the pathogen. Jones was fired May 18 after refusing to “manipulate” COVID-19 data to justify reopening,
Diagnostics:
still an incredible, negligent lack of testing.
Playing games – Allegany County edition
I sent a nastygram to our ACHD and Gov. Hogan because of the disingenuous info they send. I received an email from their Medical Response reserve, and then saw this: 
First, why do you need volunteers to sew gowns here in Allegany County if we have such a low number of cases that we are not worthy of the state providing test kits. (Of course, w/o testing, who would know?) I know we have a low absolute # of cases, but it is high on a per capita basis. Who are the gowns going to? Nursing homes? EMTs? Health system? Families w Covid + patients? Are we lacking masks, too, in the county? Second, I looked to see where (indigent) patients might get tested in Allegany County. I called MDExpress in LaVale, the designated Covid testing site in Allegany County listed on the internet that does not require an MD’s order. I was told that: a) They charge $275 for an initial visit for testing and $250 for f/u b) Their website says you have to be symptomatic; she indicated that is no longer true c) You have to have legally accepted identification (Driver’s license, Soc Sec, or birth certificate) — some patients might lack these. d) turnaround is 2-3 days and through LabCorps e) nearest free testing is Hagerstown. So am I understanding correctly that if you are poor, unemployed, don’t have a car or the gas money, you are screwed and can merrily go infect anyone because neither the ACHD nor State will provide you with testing? Please let me know if I am missing anything in this.
Drugs:
Clinicians Urged to Use CURE ID to Report COVID-19 Cases
At long last, this project CURE ID, the FDA/NCATS Drug Repurposing database, is finally getting a boost. (Proud Mama moment disclaimer, as Heather is project lead)
https://www.medscape.com/viewarticle/932169
Here is this week’s webinar, explaining the app:
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Bottlenecks? Glass vials for COVID-19 vaccine may be in short supply
Devices:
Epidemiology/Infection control:
This is not a 2nd wave. We are still in the first, yet every state has reopened to some degree, and most are expected to continue to reopen, even as infection rates in many parts show a troubling rise.
Unofficial U.S. tally as of 8:00 a.m. ET Friday: 113,820 deaths and 2,023,347 cases. That’s up by about 5% and 9%, respectively, since a week ago at the same time.
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More evidence that MASKS work
Important results: Remember the 2 MO hairstylists who saw 140 clients over 8 days while infected with COVID but everyone had worn masks? Contact tracers found ZERO secondary infections.
https://www.cnn.com/2020/06/11/us/missouri-hairstylists-coronavirus-clients-trnd/index.html
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And this analysis of studies with >10K total patients found that surgical masks and extra thick (12-16 layer) cotton masks not only prevent transmission, they also protect the wearer more than recognized before, reducing likelihood of infection >80%. Eye protection also was associated with less infection
https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext
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Yet the revolt against masks–in the name of free-dumb–grows
including death threats against public health officials. In Ohio, Amy Acton, MD, MPH — reviled by anti-lockdown activists — resigned as the state’s health director on Thursday. (ABC News)
Armed men threatening violence against a public official and sitting outside her home with assault weapons should cover at least a few crimes. This is white privilege and it’s sickening.
— Ryan Marino (@RyanMarino) May 3, 2020
Let it be known that Dr. Acton is a goddamn hero btw. https://t.co/YjvRyqTmCp
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Here is a depressing example of Covidiocy:
More than 100 people showed up to this Orange County Board of Supervisors meeting to speak out against face mask regulations pic.twitter.com/qoxaOgESWg
— NowThis (@nowthisnews) June 11, 2020
Dr. Nichole Quick in Orange County, California, resigned due to similar threats over her mask recommendations.
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Asymptomatic or Pre-symptomatic spread
The WHO currently estimates that 16% of people with COVID-19 are asymptomatic and can transmit the coronavirus, while other data show that 40% of coronavirus transmission is due to carriers not displaying symptoms of the illness.
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The Washington Post reports that hospitalizations are on the rise in Texas, North and South Carolina, California, Oregon, Arkansas, Mississippi, Utah, and Arizona, and the spike of new, severe infections is linked to the reopening of states and Memorial Day weekend celebrations.
Despite the rise in cases, a new CNN poll shows that half of Americans are ready to return to their normal routines after 3 months of shutdowns, social distancing, and stay-at-home orders.
Forty-nine percent of all Americans, but 73% of Republicans, polled said they are ready to resume normal life. Only 23% of Democrats said the same.
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A Regimen for Reentry – by Atul Gawande
Worthwhile read: hygiene measures, screening, distancing, and masks–and a culture of caring about protecting others.
https://www.newyorker.com/science/medical-dispatch/amid-the-coronavirus-crisis-a-regimen-for-reentry
Tips, general reading for public:
StayAtHome
Wash your hands.
Rinse and repeat.
Politics:
NIH axed bat coronavirus grant
after pressure from Trump – a ‘horrible precedent’ and might break rules, critics say
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People generally don’t refer to the @SecretService as the “S.S.” https://t.co/2CpxczVfSM
— Andrew Feinberg (@AndrewFeinberg) June 11, 2020
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On the anniversary of the Pulse Nightclub massacre…
The Trump administration just finalized a rule that would remove nondiscrimination protections for LGBTQ people in health care and health insurance.
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Other countries responded quickly to slow the spread of coronavirus. We didn’t.
— CAP Action (@CAPAction) June 12, 2020
Other countries listened to experts. We didn't.
Other countries contained the virus and saved lives. We have nearly 114,000 deaths.
Other countries have competent leaders. We have Donald Trump. pic.twitter.com/zcd95dUEGy
Feel good du jour:
Teen Antonio Gwynn Jr. worked alone to clean Buffalo’s streets after unrest. People offered him a car and college tuition.
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The eyes of a chameleon. pic.twitter.com/b15P5u5S7L
— Earth's Beauty (@PhysicsAndAstr1) June 1, 2020
Comic relief:
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How to water pic.twitter.com/1wCzqAlvMq
— Sarah Cooper (@sarahcpr) June 13, 2020
Perspective
I love this. Bringing it all together.#COVID19 #BlackLivesMatter#GeorgeFloydProtests pic.twitter.com/YCWsDHH2yk
— Laurie Garrett (@Laurie_Garrett) June 8, 2020
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This white mother makes an EXCELLENT POINT. pic.twitter.com/FFUFMGiLiT
— Mohamad Safa (@mhdksafa) June 9, 2020
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“Every single one”
— Haitham Ahmed, MD, MPH (@haithamahmedmd) June 12, 2020
My patient works at a homeless shelter in Brooklyn. Tearfully she told me every resident there got COVID in April. Every single one.
More than 20 died.
No one had a funeral. No one called. No media reported about it.
Think about that. They just disappeared.
Bits of beauty:
One Comment
Sally Vaza
Over the past several weeks, people have died from seemingly different COVID-19 deaths, but I wondered if there is a link. First, I read about younger to middle-aged men getting better, it was thought, and then dying of heart failure or heart attack or stroke. Then, I heard about MIS-C infections, and thought there might be some vascular component to those. Finally, in JAMA a few weeks ago, there was mention of a small study done at Northwestern by a doctor on pregnant women. She determined that some of the women in this itty-bitty study that was ~two months long, were found to have placentas test positivve coronavirus in the blood vessels lining the placenta. When the babies were born, all were well, but the doctor cautioned about long-term effects possibly occurring later.
When pictured not as disparate events in different parts of the US and with different types of patients, but with some related mechanism that can insert the CV-19 in blood vessel linings.
CAVEAT EMPTOR: I know zero, zilch, nothing about all of this. However, that gave me the freedom at age 72 to imagine and make connections otherwise unimaginable. Please feel free to let me know that this is preposterous i