Coronavirus Tidbits #77 8/27/20

Announcements:

First, there is now a Resources Page here for the most commonly asked questions I'm getting.

Happy to continue to answer your questions/concerns as best I can, so don't be shy about that.

NEW post on Forbes:

Mouthwashes Are A Cheap Tool In The Fight Against Coronavirus

http://www.forbes.com/sites/judystone/2020/08/27/mouthwashes-are-a-cheap-tool-in-the-fight-against-coronavirus/

News 

ALERT: Multiple alarms for decisions at the FDA and CDC

@CDCgov⁩ now says people exposed to COVID-19 do not need to get tested.

-They also said people who travel into the country or interstate from high prevalence areas should not be quarantined.

One hypothesis is that he is trying to depress the case numbers to look good...but cases will inevitably spike, as will hospitalizations and deaths.

Andy Slavitt has a more likely explanation: Make an enemy of the scientists? They're not supporting him anyway. This isn't fascism. Its dangerous populism. He's not running on the death toll. He couldn't compete. He's running on the stock market & the American way of life. Yes 5 million people have been infected & know it... For everyone else, these are just restrictions from his point of view. If I don't feel sick, why should I have to do anything?

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"It truly makes no sense," Dr. Leana Wen, a former Baltimore health commissioner, said. "The CDC itself estimates that 40 percent of people with coronavirus are asymptomatic. And if we are unable to identify asymptomatic individuals, we cannot stop this pandemic."

"We should be dramatically ramping up our testing capacity, not limiting the people who should be getting tests," she said.

Dr. Ashish Jha, director of the Harvard Global Health Institute, suggested the guidance was "dangerous."

"If we're not testing these people, they will infect others, and the viral transmission and outbreak will only get worse over time," he said.

Fauci was undergoing surgery when the decision was made

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The other appalling decision is the FDA's turnabout on giving an EUA for convalescent plasma...this is establishing the precedent of railroading through an experimental Covid-19 vaccine before the election. Good showmanship. Never mind that scientists don't support this and many, many people will refuse the vaccine...If we don't get a good vaccine and broad uptake by the public, it will be useless.

[Also note that a new FDA spokesperson appeared this weekend - Emily Miller. She is a former OANN (far right wing One America News Network) reporter and gun rights advocate with zero scientific or medical background. How did she get this job?

https://www.latimes.com/business/story/2020-08-24/trump-fda-attack-commissioner-stephen-hahn-silent

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First evidence of reinfection...but don't panic!

Read more here: https://www.statnews.com/2020/08/24/first-covid-19-reinfection-documented-in-hong-kong-researchers-say/

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Review on coronavirus

Starting with how the virus was identified; the molecular details of its mechanism of infection; how it transmits between people; and the many ways in which it affects the human body.

https://www.nature.com/articles/d41586-020-02414-1

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Rural Hospitals Are Sinking Under COVID-19 Financial Pressures

https://www.npr.org/sections/health-shots/2020/08/22/904455215/rural-hospitals-are-sinking-under-covid-19-financial-pressures

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Fascinating study of spread from Biogen conference:

likely led to 20,000 COVID-19 cases in Boston area

included 122 who lived in homeless shelters

https://www.bostonglobe.com/2020/08/25/business/biogen-conference-likely-led-20000-covid-19-cases-boston-area-researchers-say/

Diagnostics:

still an incredible, negligent lack of accurate, adequate testing.

New pooled testing strategy from Israel

called P-Best, for Pooling-Based Efficient SARS-CoV-2 Testing

In one typical iteration, the Israeli team took samples of 384 people and divided them into 48 pools, so that each person’s sample wound up in a unique set of six pools.

Each of the 48 pools was then tested. If one person was positive for the virus, then each of the six pools containing that sample should test positive — resulting in a unique combination of positive pools revealing the identity of the person (or people) carrying the virus.

Like all types of pooled testing, the usefulness of this method drops as a community’s “positivity rate” — the proportion of tests that come back positive — climbs. But when positivity rates are lower, the Israeli method is dramatically more efficient than others. At an infection rate of 1 percent, the new method is eight times as efficient as individual testing

https://www.nytimes.com/2020/08/21/health/fast-coronavirus-testing-israel.html

https://advances.sciencemag.org/content/early/2020/08/20/sciadv.abc5961

Drugs:

Convalescent Plasma, the "Deep State," and Covid vaccines

FDA did not grant approval (appropriately so) for Rx with convalescent plasma.

Trump throws a hissy about the "Deep State."

FDA backtracks over the weekend and grants an EUA (emergency use authorization).

This is bad move: Will make it harder to do any real study with RCT (randomized, controlled, clinical trial).

Some suspect that Trump's pressuring the FDA to approve an EUA prematurely is a practice run for his ramming through a Covid vaccine hastily, before it has been adequately assessed, so he can claim his Operation Warp Speed will have delivered a vaccine before election day. Not that we are cynical...but...

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Andy Slavitt: "icymi, Trump announced a breakthrough treatment for COVID! . . . that has been around for 100 years. And is only marginally beneficial. And is already available. And his announcement could make less available. And hurts the effort for better therapies...

Trump said "mortality is reduced by 35%." Not at all true. A tiny fraction benefitted. When there are high levels of antibodies in the plasma, within 3 days of diagnosis, the patient wasn't on a ventilator & was under 80, they were 35% more likely to be alive after a month.

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Following the FDA's emergency use authorization for convalescent plasma late Sunday, the Infectious Diseases Society of America protested that "we lack the randomized controlled trial data we need to better understand its utility in COVID-19 treatment" and that "wider use" of plasma should await such data.

And the World Health Organization's chief scientist followed suit this morning, calling the supporting evidence "low quality." (Reuters)

And so did a bunch of individual U.S. scientists who took to Twitter to blast the FDA decision. (Newsweek)

Good critique: Convalescent Plasma: The Unanswered Questions

— "The data don't show anything useful"

https://www.medpagetoday.com/infectiousdisease/covid19/88264?

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Blood pressure medication with ACE inhibitors or ARBs improves COVID-19 survival rates

"Covid-19 patients with high blood pressure who were taking ACEi/ARB medications were 0.67 times less likely to have a critical or fatal outcome than those not taking these medications.

https://www.eurekalert.org/pub_releases/2020-08/uoea-bpm082020.php

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Expected prices of vaccine candidates:

Moderna                      $32-37

Pfizer                             19.50

AstraZeneca-Oxford       4

SinoPharm                    145

Serum Institute               13.20

https://gulfnews.com/world/revealed-prices-of-some-leading-covid-19-vaccine-candidates-1.1598192772387?slide=2

Devices:

Epidemiology/Infection control:

Mother transmitted COVID-19 to baby during pregnancy

The case, detailed in an article published last month in The Pediatric Infectious Disease Journal, adds to a growing body of evidence that the SARS-CoV-2 virus can be transmitted in utero. It also underscores the importance of limiting COVID-19 exposure for pregnant women. Both recovered.

https://www.eurekalert.org/pub_releases/2020-08/usmc-mtc082020.php

More on value of masks

A person sitting under an air conditioner infected 27 others with coronavirus at a Starbucks cafe in South Korea, but none of employees, who were wearing masks, got the virus.

https://m.chosun.com/svc/article.html?

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Study finds asymptomatic transmission of Covid-19 during a flight

1 woman/299 passengers became infected on this flight.

The findings showcase why masks are needed on flights and public transport.

https://www.zmescience.com/science/asymptomatic-transmission-of-covid-1924664/

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WHO Director-General Tedros Adhanom Ghebreyesus announced during a news conference that we likely have another year-plus to go.

https://www.yahoo.com/lifestyle/hopes-coronavirus-pandemic-over-less-162355603.html

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Fascinating read on the spread of Covid-19 across Maine from 1 wedding.

Now 2 people dead. Most of the infections were NOT in people who attended the wedding, but were in secondary or tertiary contacts. Now spread >100 miles, involving a nursing home and jail, among others.

https://www.cnn.com/2020/08/25/us/maine-wedding-outbreak-spreads-nursing-home-trnd/index.html

Tips, general reading for public:

StayAtHome

Wash your hands.

Rinse and repeat.

They survived life on a submarine and at the South Pole. Here’s their advice for staying sane this winter

Create minievents to look forward to. Learn something new. Don’t fall into 'Is it over yet?' syndrome.

Have/find a sense of mission. Keep busy, with something other than your job. Learn something new.

https://www.bostonglobe.com/2020/08/19/nation/they-survived-life-submarine-south-pole-heres-their-advice-staying-sane-this-winter/

What works for you???

Politics:

Trump's proposal to eliminate payroll taxes would deplete the Social Security Trust Fund by 2023, "with no ability to pay benefits thereafter." - Social Security Chief Actuary: ssa.gov/oact/solvency/

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PSA: Thread by Joshua Potash w useful tips/links for Protection during Protests

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The Carter Center, the democracy promotion organisation founded by Jimmy Carter, is to launch its first United States election initiative this year, citing an "erosion" of democracy in the country.

https://www.independent.co.uk/news/world/americas/us-election/carter-center-us-election-2020-donald-trump-democracy-a9683011.html

 

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https://twitter.com/AndrewFeinberg/status/1296873496493133825?s=20

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Trump’s Handpicked Postal Service Chair Has A Long History Of Voter Suppression

Robert Duncan chaired the RNC during the party’s unprecedented escalation of voter disenfranchisement efforts in swing states.

Also, WHY did DeJoy need to remove high-speed sorting machines and why NOW, ahead of a historic crush of mail-in ballots?

Dave Williams, the former USPS IG, testified last week that removing the sorting machines COSTS taxpayers money, not saves it.

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https://twitter.com/BillKristol/status/1298673811425034242?s=20

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https://twitter.com/amandalitman/status/1298034500157530112?s=20

Feel good du jour:

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Sweet story: Melanie and Tyler Tapajna couldn't have a wedding reception and had prepaid for the food, so...they not only donated the food to Laura's shelter for women and children, but served the meal themselves.

https://www.washingtonpost.com/lifestyle/2020/08/24/this-couple-had-extra-food-after-their-wedding-so-they-took-it-shelter-served-it/

Comic relief:

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Buster Keaton on Social Distancing

https://www.facebook.com/watch/?v=580295695929033

Perspective/Poem

Bits of beauty:

 

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