Coronavirus Tidbits #63 7/2/20

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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.

On Tues, July 7, I’ll be speaking about my book, Resilience, and family’s story for the Camden, Maine library, via Zoom.

Email jpierce@librarycamden.org to request a link to attend.

More info at https://www.librarycamden.org/event/on-zoom-resilience-one-familys-story-of-hope-and-triumph-over-evil/

News 

Fauci says US ‘going in wrong direction,’ could reach 100,000 new cases per day

The U.S. is “going in the wrong direction” with the coronavirus surging badly enough that Dr. Anthony Fauci told senators Tuesday some regions are putting the entire country at risk.

AP news: https://tucson.com/news/national/virus-review-fauci-says-us-going-in-wrong-direction-could-reach-100-000-new-cases/article_6b1df35b-71bb-5b1b-95ed-af271b2ae339.html

“We have to understand if we have 100,000 cases a day, we will have a crisis in intensive care units around the country,” Fauci said, warning that many hospitals still don’t have adequate supplies of protective equipment, and more health workers will die if the outbreak spirals further out of control.

The Centers for Disease Control and Prevention estimates that 88,000 health workers in the U.S. have been infected with Covid-19 and 481 have died.

https://www.statnews.com/2020/06/30/u-s-could-see-100000-new-covid-19-cases-per-day-fauci-says/

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“60% of all #covid19 cases so far have been reported just in the past month”, says @drtedros at regular @WHO presser on #covid19. “For the past week, the number of new cases has exceeded 160,000 on every single day.”

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Bill Hanage @Harvard SPH

“I would optimistically estimate that the final number will be closer to 1 million, if we are lucky.”

How can I put this? Someone you know is likely to die from this (I can already think of multiple examples). Going forward, how do we stop more of that happening? Easy. Stop transmission. Stop blowing on the embers. It’s epidemiology, not rocket science 11/end”

https://twitter.com/BillHanage/status/1278155779619651584?s=20

White House just calls these “embers that need to be put out”.

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Swine flu strain with human pandemic potential increasingly found in pigs in China

When multiple strains of influenza viruses infect the same pig, they can easily swap genes, a process known as “reassortment.” The new study, published today in the Proceedings of the National Academy of Sciences, focuses on an influenza virus dubbed G4. The virus is a unique blend of three lineages: one similar to strains found in European and Asian birds, the H1N1 strain that caused the 2009 pandemic, and a North American H1N1 that has genes from avian, human, and pig influenza viruses.

The G4 variant is especially concerning because its core is an avian influenza virus—to which humans have no immunity—with bits of mammalian strains mixed in. “From the data presented, it appears that this is a swine influenza virus that is poised to emerge in humans,” says Edward Holmes,

https://www.sciencemag.org/news/2020/06/swine-flu-strain-human-pandemic-potential-increasingly-found-pigs-china

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Coronavirus autopsies: A story of 38 brains, 87 lungs and 42 hearts

“Covid-19 and dengue sound really different, but the cells (platelets) that are involved are similar.”

…consistent across several studies, is confirmation the virus appears to attack the lungs the most ferociously. They also found the pathogen in parts of the brain, kidneys, liver, gastrointestinal tract and spleen and in the endothelial cells that line blood vessels, as some had previously suspected. Researchers also found widespread clotting in many organs.

But the brain and heart yielded surprises.

“It’s about what we are not seeing,” said Mary Fowkes…But there was very little inflammation (in the brain or heart)

Another unexpected finding, pathologists said, is that oxygen deprivation of the brain and the formation of blood clots may start early in the disease process.

Most recently, a study out this month in the Lancet’s eClinicalMedicine, found abnormal clotting in the heart, kidney and liver, as well as the lungs of seven patients, leading the authors to suggest this may be a major cause of the multiple-organ failure in covid-19 patients.

nothing that looked like myocarditis.

NYU Langone’s Rapkiewicz, who studied seven hearts, was struck by the abundance of a rare cell called megakaryocytes in the heart. Megakaryocytes, which produce platelets that control clotting, typically exist only in the bone marrow and lungs. When she went back to the lung samples from the coronavirus patients, she discovered those cells were too plentiful there, too.

(in brains) There were only small pockets of inflammation. But there were large swaths of damage due to oxygen deprivation…the findings underscore the importance of getting people on supplementary oxygen quickly to prevent irreversible damage.

…(not) a lot of virus or inflammation. However, the group noted in a paper that the widespread presence of tiny clots was “striking.”

…the autopsies suggest anti-platelet medications, in addition to blood thinners, may be helpful to stem the effects of covid-19.

https://www.washingtonpost.com/health/2020/07/01/coronavirus-autopsies-findings/

 

Diagnostics:

still an incredible, negligent lack of testing…and now

U.S. coronavirus testing could fail again, as surging demand creates new backlogs and delays.

Quest said that orders for COVID-19 testing had grown by 50 percent in three weeks=> 3-5 days to get report x in hosp pt or HCW.

…if you don’t get results back in a day or so, outbreaks really can’t be stopped without isolating and quarantining all contacts preemptively.”

The hardest-hit new areas do not have enough machines to process samples, leading to a growing backlog of tests, lab directors told us. Some are also running out of the chemical reagent that must react with a testing specimen.

…Only in the past two weeks has the U.S. succeeded in testing more than 500,000 people a day, which the Harvard Global Health Institute once said would be a good goal for mid-May. The institute said today that the U.S. must test at least 1.2 million people a day to control the outbreak and at least 4.3 million people a day to eliminate it.

…And at a rally on June 20, President Donald Trump said he told members of his staff to “slow down the testing, please,” because he did not like the growing number of confirmed coronavirus infections.

https://www.theatlantic.com/science/archive/2020/06/us-coronavirus-testing-could-fail-again/613675/

Drugs:

Remdesivir:

Pharma giant Gilead announced they’ll charge $2500 for Remdesivir, a COVID-19 treatment. (I’ve since seen $3400)

US taxpayers invested $70 million developing Remdesivir.

The cost of making it is $10. This isn’t healthcare. It’s extortion.

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America First! US claims entire world supply of Remdesivir for itself. 

This will come back to bite us. Guaranteed. As well as being unethical and…

https://www.theguardian.com/us-news/2020/jun/30/us-buys-up-world-stock-of-key-covid-19-drug

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Vaccine development:

@WHO says 17 vaccines are in human trials around the world at this point: 7 in China, 4 in the US, 2 in the UK* & 1 each in Russia, South Korea, Australia & Germany. *the Oxford-AstraZeneca partnership in the UK is testing 3 vaccines. https://www.who.int/publications/m/item/draft-landscape-of-covid-19-candidate-vaccines

Devices:

Epidemiology/Infection control:

Warning that COVID-19 could jump back to animal populations

in this human-to-mink-and-back transmission

https://healthydebate.ca/2020/06/topic/covid-19-animal-populations

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Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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Video shows workers removing social distancing signs before Trump Tulsa rally: report http://hill.cm/A9qGRC7

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Feel good du jour:

Comic relief:

Perspective/Poem

“Economic growth accompanied by worsening social outcomes is not success, it is failure” Jacinda Ardern

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From Antique Sugar store in Phoenix.

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Bits of beauty:

 

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