Coronavirus Tidbits #68 7/23/20

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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.

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NEW Post at Forbes:

#BumpDay Highlights Coronavirus And Racial Disparities In Pregnancy

https://www.forbes.com/sites/judystone/2020/07/22/bumpday-highlights-coronavirus-and-racial-disparities-in-pregnancy/#7cee04ad74c4

News 

Feds brutally attack protestors in Portland, 

seemingly practicing for a run up to the election. Bets are on Chicago being next.

https://www.independent.co.uk/news/world/americas/portland-protests-trump-veteran-christopher-david-federal-officers-oregon-a9627466.html?amp=1

see also Ron Wyden’s statement and

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Fighting Pandemics Webinar

hosted by TB Alliance, was pretty interesting today–at least the parts with Betsy McKay interviewing Dr. Fauci and Dr. Soumya Swaminathan

https://vimeo.com/440719222

Diagnostics:

still an incredible, negligent lack of accurate testing and turnaround time of a week makes results of very limited value.

Very small study from Monash U looks interesting:

Rapid Gel Card Agglutination Assays – Blood test detects positive COVID-19 result in 20 minutes https://medicalxpress.com/news/2020-07-blood-positive-covid-result-minutes.html via @medical_xpress

Tiny Study details at https://pubs.acs.org/doi/10.1021/acssensors.0c01050

Drugs:

Oxford’s vaccine is a frontrunner

it will likely finish vaccinating subjects in its big 10,000-person efficacy trial before other candidates even start testing on that scale,

Administration has said a vaccine would need to be 50% more effective than a placebo to be approved and would need to show more evidence than blood tests indicating an immune response.

The vaccine is a so-called viral vector type based on years of research by Gilbert and Adrian Hill, the head of the Jenner Institute. Traditional vaccines are made with a weakened or inactivated form of the germ that causes infection to stimulate an immune response. Those vaccines aren’t easy to develop and produce quickly. The Oxford team has developed a technology that can speed up the process by using a harmless virus as a kind of Trojan horse to carry the genetic material of a pathogen into cells to generate an immune response. In the case of Covid-19, Gilbert has taken a chimpanzee adenovirus (a common cold virus) and inserted genetic material from the surface spike protein of the SARS-CoV-2 virus as a way of tricking the immune system to fight back. The chimp adenovirus platform stimulates both antibodies and high levels of killer T-cells, a type of white blood cell that helps the immune system destroy infection.

“We know the chimp adenovirus is safe in humans, and it’s been tested in humans with the MERS spike. Given the similarities, the only question with the Covid-19 vaccine is whether it’s going to be protective or not.”…Oxford had an advantage unusual for an academic institution: its own vaccine manufacturing facility.

But:  in tests for a vaccine against the first SARS virus, which caused an epidemic in Asia in 2002-03, some vaccinated animals became more severely ill after they were challenged with the virus than unvaccinated ones did. The phenomenon is known as antibody dependent enhancement, or ADE. Scientists around the world were worried that might happen again with a SARS-CoV-2 vaccine

AstraZeneca agreed to be responsible for worldwide distribution and manufacturing.

AstraZeneca announced a $1.2 billion deal with the U.S. Biomedical Advanced Research and Development Authority (Barda) to develop and produce 300 million doses, one of the largest deals the agency has announced. AstraZeneca will work with the National Institutes of Health to test it in 30,000 people in the U.S., scheduled to start in August. The company later struck a licensing deal with the Serum Institute of India to produce a billion doses for developing and middle-income countries.

re ADE: “Not only were the monkeys fine, but as a bonus we saw some protection.” They’d vaccinated six monkeys and then 28 days later exposed them to a massive dose of SARS-CoV-2 via multiple routes—eyes, mouth, nose, and trachea, to expose the lungs. It was much more than a person might encounter on public transportation or even in a Covid ward. After exposure, the animals showed no signs of pneumonia in their lungs.

recent research has shown that T-cells may play an important role in responses to SARS-CoV-2. But the only way to know the most effective levels, or titres, of antibodies and T-cells is to test the vaccine in people where the virus is circulating… “If we get a strong T-cell response, we don’t need such a high neutralizing antibody titre to achieve protection. The two arms of the immune response work together to give better protection.”

https://www.bloomberg.com/news/features/2020-07-15/oxford-s-covid-19-vaccine-is-the-coronavirus-front-runner

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AstraZeneca has said it will provide it’s vaccine at cost to developing countries during the pandemic–

but the rest of the world should brace itself.

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Interesting read:

Analysis: How A COVID-19 Vaccine Could Cost Americans Dearly

The United States is the only developed nation unable to balance cost, efficacy and social good in setting prices.

https://khn.org/news/analysis-how-a-covid-19-vaccine-could-cost-americans-dearly/

Devices:

Aerosol Filtration Efficiency of Common Fabrics Used in Respiratory Cloth Masks

https://pubs.acs.org/doi/10.1021/acsnano.0c03252

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MIT engineers designed an affordable, reusable face mask that’s as effective as an N95

https://cnbc.com/2020/07/21/mit-researchers-designed-reusable-n95-face-mask-for-healthcare-workers.html

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Epidemiology/Infection control:

On School reopening:

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Coronavirus Infections Much Higher Than Reported Cases in Parts of U.S., Study Shows

Data from antibody tests in 10 different cities and states indicate that many people with no symptoms may be spreading the virus. https://www.nytimes.com/2020/07/21/health/coronavirus-infections-us.html

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SARS-CoV-2 cannot be transmitted to people by mosquitoes: KSU study

The study, which was done at the BRI, a biosecurity level-3 facility, ultimately found that the virus is unable to replicate in three common and widely distributed species of mosquitoes — Aedes aegypti, Aedes albopictus and Culex quinquefasciatus — and therefore cannot be transmitted to humans.

http://outbreaknewstoday.com/sars-cov-2-cannot-be-transmitted-to-people-by-mosquitoes-ksu-study-61603/

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Coronavirus Disease 2019 Outbreak Likely Caused by Sewage Exposure in a Low-Income Community: Guangzhou, China

Our investigation has for the first time provided epidemiologic evidence that SARS-CoV-2 can be spread by sewage. This finding highlighted the importance of sewage management, especially in densely-populated places with poor hygiene and sanitation measures, such as urban slums and other low-income communities in developing countries.

https://papers.ssrn.com/sol3/papers.cfm?abstract_id=3618204

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Sailors Test Positive for COVID-19 after Sharing Firefighting Gear at San Diego Ship Fire

https://www.military.com/daily-news/2020/07/19/sailors-test-positive-covid-19-after-sharing-firefighting-gear-san-diego-ship-fire.html

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Former CDC chief: Most states fail to report data key to controlling the coronavirus pandemic

Not a single state reports on the turnaround time of diagnostic covid-19 tests.

Week-long waits for results hobble efforts to track real-time virus spread and make contact tracing almost irrelevant.

…if a state is reporting that only a small fraction of new covid-19 cases can be linked to prior cases, “things are not going well no matter what a national or local leader might say.”

The D.C. health department published that key metric for the first time Monday. It said the percentage of new coronavirus cases linked to already known cases is just 2.8 percent — meaning most people contracting the virus aren’t aware of who might have exposed them. The city’s goal is 60 percent.

https://www.washingtonpost.com/health/2020/07/21/coronavirus-states-data/ ~ ~ ~

MCAT Test-Takers Come Down With COVID-19

— Reports raise new concern about precautions at testing centers

https://www.medpagetoday.com/infectiousdisease/covid19/87663?

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Politics:

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https://twitter.com/jennycohn1/status/1285961344693399552?s=20

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Did Birx Shape White House’s Rosy View of Pandemic?

The Trump administration’s push to reopen the economy in mid-April allowed the COVID-19 pandemic to spin out of control, theNew York Times reports — and coronavirus task force coordinator Deborah Birx, MD, is partly to blame.

The administration was keen to shift responsibility for tackling COVID-19 to the states, and that transition was “at once a catastrophic policy blunder and an attempt to escape blame for a crisis that had engulfed the country — perhaps one of the greatest failures of presidential leadership in generations,” according to the Times.

https://www.medpagetoday.com/infectiousdisease/covid19/87689 ~ ~ ~

Confusion spreads over system to determine priority access to Covid-19 vaccines

A number of different groups vying for control.

https://www.statnews.com/2020/07/22/confusion-spreads-over-system-to-determine-priority-access-to-covid-19-vaccines/

Feel good du jour:

Comic relief:

Why has no one thought of opening a bar near a hospital and calling it PubMed?

There is (or, possibly, was) a bar near the big hospitals on the East Side of Manhattan called “The Recovery Room”…

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https://twitter.com/RandyRainbow/status/1285950574891073538?s=20

Perspective/Poem

From Ebola survivor and NYC ER doc Craig Spencer:

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From 4 year old Nadim:

Bits of beauty:

 

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