Coronavirus Tidbits #71 8/4/20

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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.

News 

Half of low-income communities have no ICU beds

A new Penn Medicine study sheds light on yet another reason why the coronavirus pandemic is disproportionately killing the poor [read POC]: Residents in low-income neighborhoods lack access to intensive care unit (ICU) beds.

Approximately half of communities with the lowest median household incomes (less than $35,000) have zero ICU beds per ten thousand residents age fifty or older, compared with just 3 percent of communities with household incomes of at least $90,000.

https://www.eurekalert.org/pub_releases/2020-08/uops-hol080320.php and

https://www.statnews.com/2020/08/03/covid19-icu-bed-disparities/

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How to fix the #Covid19 dumpster fire in the U.S.

Good suggestions from #PublicHealth experts via @HelenBranswell

We know what to do to get the epidemic under control (not gone, but more manageable) in 8 weeks. There is no political will or leadership….

First step: The stark case (of 2 hairdressers whose clients did not become infected), described on Tuesday in Morbidity and Mortality Weekly Report, adds to the near-universal scientific consensus that, more than any of single action short of everyone entering solitary confinement, face coverings can prevent the transmission of the coronavirus that causes Covid-19.

https://statnews.com/2020/07/14/fix-covid-19-dumpster-fire-us/…

What to do with used PPE?

Plastic from used personal protective equipment (PPE) can, and should, be transformed into renewable liquid fuels – according to a new study, published in the peer-reviewed Taylor & Francis journal Biofuels.

https://www.eurekalert.org/pub_releases/2020-08/tfg-dpc073120.php

Diagnostics:

still an incredible, negligent lack of testing.

Drugs:

Convalescent Plasma Rx?

The antibodies in plasma can be concentrated and delivered to patients through a type of drug called immune globulin, or IG, which can be given through either an IV drip or a shot. IG shots have for decades been used to prevent an array of diseases; the IG shot that prevents hepatitis A was first licensed in 1944. They are available to treat patients who have recently been exposed to hepatitis B, tetanus, varicella and rabies.

Yet for the coronavirus, manufacturers are only developing an intravenous solution of IG…

Advocates for the immunity shots say businesses are reluctant to invest in a product that could soon be replaced by a vaccine, so the government should offer financial incentives to offset that risk…

“They charge a fortune off of intravenous drugs in the hospital. They don’t want to devote the manufacturing plant to something that won’t make oodles of money,” said one infectious disease expert, who has advocated for coronavirus IG shots but asked not to be publicly identified.

Researchers also said industry executives have little incentive to produce the immunity shots for the coronavirus, given the possibility that a longer-lasting vaccine could replace it within a year.

The antibody injections, for now, do not appear to be a high priority for the government or the industry.

[Why not? she asked innocently…]

https://www.latimes.com/science/story/2020-07-10/injection-prevent-coronavirus-feds-manufacturers-fail-to-act

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Vaccine prospects that have made it to phase three (efficacy) and beyond

—including a quick primer on how they work and where they stand.

How mRNA vaccines work: https://www.nationalgeographic.com/science/2020/05/moderna-coronavirus-vaccine-how-it-works-cvd/

Moderna: relies on injecting snippets of a virus’s genetic material, in this case mRNA, into human cells. They create viral proteins that mimic the coronavirus, training the immune system to recognize its presence. This technology has never been licensed for any disease.

Pfizer: BNT162b2 another mRNA vaccine:

Preliminary results of phase one/two data show the vaccine produces antibodies and T-cell responses specific to the SARS-CoV-2 protein.

Oxford-AstraZeneca

a viral vector vaccine, hoping to trigger a strong immune response. So far, it has increased antibodies and responses from T-cells—with only minor side effects such as fatigue and headache.

The others are mostly Chinese, w more limited data.

https://www.nationalgeographic.com/science/health-and-human-body/human-diseases/coronavirus-vaccine-tracker-how-they-work-latest-developments-cvd/

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Anthony Fauci Wary of Russian and Chinese Coronavirus Vaccines Being Rushed Into Phase III Trials

But the Gamaleya vaccine was tested on only 38 people in Phase I and II combined as per Elena Smolyarchuk, Chief Researcher of Sechenov University Center for Clinical Research

https://www.ibtimes.sg/anthony-fauci-wary-russian-chinese-coronavirus-vaccines-being-rushed-into-phase-iii-trials-49375

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

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

Devices:

Opinion: A national mandatory order to wear a mask would keep people from becoming ‘walking weapons’

Masks are not primarily about self-protection. They are about protecting others. Wearing an appropriate mask in an indoor public setting, even when social distancing can be maintained, is a crucial means of reducing transmission of virus-bearing droplets or aerosols from individuals who are infected to those who are not…. a national mask order reduces the stigma of wearing a mask by making it clear that we are all looking after each others’ health. [Alien concept, it would appear, in our current narcissistic climate] https://www.statnews.com/2020/07/15/national-mandatory-mask-order-prevent-walking-weapons/? ~ ~ ~ Power of masks:

Epidemiology/Infection control:

How to Lie with Statistics:

COVID-19 Hospital Data System That Bypasses CDC to report only to HHS Plagued By Delays, Inaccuracies

https://www.npr.org/sections/health-shots/2020/07/31/897429054/covid-19-hospital-data-system-that-bypasses-cdc-plagued-by-delays-inaccuracies?

How many patients in the U.S. are hospitalized with COVID-19? It’s not clear, as the state-level data havn’t been updated since July 23. (ProPublica)

See also

Last week >450,000 new #COVID19 cases were ID’ed nationwide, with surges in 42 States. “Numbers of #coronavirus-related hospitalizations in the U.S. went from 36,158 on Jul1 to 52,767 on Jul31. FEMA reports a sharp increase in the number of patients on ventilators.”

“37 states & Puerto Rico will probably see rising daily death tolls during the next 2 weeks compared with the previous two weeks, according to the latest ensemble forecast from the U of Mass at Amherst that combines more than 30 coronavirus models.”

33 States have #SARSCoV2 test positivity rates above 5%, the @WHO benchmark for govts deciding whether to reopen their economy. “Above 5 percent, stay closed. Of states with positivity rates below 5%, nine have seen those rates rise during the last 2 weeks.”

“The U.S. saw >1.9M new infectns in July; 42% of the >4.5M cases reported nationwide since the #pandemic began & > 2X the number documented in any other month.” At the start of July average death toll = 500/day. Last week, averaged >1,000 daily.

https://www.washingtonpost.com/health/coronavirus-threat-rises-across-us-we-just-have-to-assume-the-monster-is-everywhere/2020/08/01/cdb505e0-d1d8-11ea-8c55-61e7fa5e82ab_story.html

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Prolonged symptoms common even after mild Covid

a multistate telephone survey of symptomatic adults who had a positive outpatient test result for SARS-CoV-2 infection, found that 35% had not returned to their usual state of health even after 2-3 weeks from the day they tested positive. This included one in five people aged 18–34 years with no chronic medical conditions.

Lingering symptoms included:

  • fatigue (35%)
  • cough (43%)
  • shortness of breath (29%)
  • And loss of taste and smell, chest pain and confusion

…while symptoms, like vomiting, nausea, fever and chills, were likely to pass sooner.

https://www.msn.com/en-us/health/medical/1-in-3-covid-19-patients-have-these-symptoms-says-cdc/ar-BB17vcyI?ocid=msedgdhp

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A day after a top official in Gov. Bill Lee’s administration said Tennessee plans to withhold the number of COVID-19 cases in schools from the public, a spokesperson said the information will not even be collected by the state. https://tennessean.com/story/news/politics/2020/07/30/tennessee-will-not-collect-release-data-coronavirus-cases-schools-reopening/5534992002/… via @tennessean ~ ~ ~

Risk of Covid in a room?

Question  What is the estimated viral load released from an individual with coronavirus disease 2019 (COVID-19) by breathing and coughing, and what is the resulting concentration in a room?

Findings  In this mathematical modeling study, breathing and coughing by a simulated individual with COVID-19 were estimated to release large numbers of viruses in a poorly ventilated room with a coughing person. However, the estimated infectious risk posed by a person with typical viral load who breathes normally was low, and only few people with very high viral load posed an infection risk in a poorly ventilated closed environment.

Meaning  These results may partially explain the observed rates of transmission and suggest that there is a need for strict respiratory protection when people are in the same room with an individual with COVID-19.

https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768712?

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New studies in Europe and Asia suggest that riding public transportation is not a major source of transmission for the coronavirus, as long as riders wear masks and train cars or buses never become as intensely crowded as they did in pre-pandemic rush hours.

https://www.nytimes.com/2020/08/02/nyregion/nyc-subway-coronavirus-safety.html?smid=tw-share

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Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

Useful Risk Assessment tool for daily activities:

A unique, new online tool called COVID Can I Do It?, or CCIDI, empowers individuals to assess their risk of COVID-19 transmission while engaging in a selected activity at a specific location. Developed by a group of volunteer public health professionals and developers, the tool offers an accessible, user-friendly interface that relies on epidemiological data through COVID Exit Strategy, scientific literature, public health expert opinion, and crowding information from Google Maps.

I like the different scenarios offered and the explanations for how they came up with the assessment. Highly recommended.

https://covidcanidoit.com/US/

Politics:

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https://twitter.com/thejuicemedia/status/1288989754210557960?s=20

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https://twitter.com/scopedbylarry/status/1289725009229832194?s=20

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And Trump on John Lewis:

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Feel good du jour:

Farmers are destroying crops; this man rescued them for food banks.

George Ahearn co-founded EastWest Food Rescue after learning that Covid-19 was costing local farmers so much business that they were willing to destroy their crops.

His non-profit has since moved three million pounds of produce from farms in eastern Washington to the western part of the state for distribution to hundreds of food banks and meal programs. https://www.cnn.com/2020/08/01/us/washington-food-convoys-help-farmers-food-banks-trnd/index.html ~ ~ ~

https://twitter.com/AmyRetrieverDog/status/1290164868142661632?s=20

Comic relief:

Perspective/Poem

“You have to decide who you are and force the world to deal with you, not with its idea of you.” – James Baldwin

Bits of beauty:

 

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