The typical ‘Monday News Dump’ happened today with a lot of sweeping new information regarding COVID-19. From new research, to old research getting removed, and from new numbers to Dr. Fauci making this bold statement:
Dr. Fauci explained at Monday’s briefing what he thought “getting back to normal” would look like.
“When we go back to normal we will go back gradually to the point where we can function as a society,” he said.
Read the daily developments on COVID-19: https://t.co/PMZ8eFff7S pic.twitter.com/QN1kW4G70a
— Local 12/WKRC-TV (@Local12) April 7, 2020
That was probably one of the more sobering moments of the day.
Quick reminder: I’m not a doctor. For specific questions about your specific health, always consult your doctor, not the internet. Not some guy you know. Not a facebook post. Your doctor. The person who specializes in knowing about how the human body works.
And even though I am not a doctor, these posts are an attempt to be a conduit for new information to keep you updated on the latest numbers, research and information directly from the CDC, WHO, and the medical community.
Latest Numbers
WHO Numbers
Total Worldwide Cases: 1,210, 956
Total Worldwide Deaths: 67,594
CDC Numbers
Total United States cases: 330,891
— Travel-related: 1,600
— Close contact: 6,332
— Under investigation: 322,959
Total deaths: 8,910
States reporting cases: 50 states, District of Columbia, Puerto Rico, Guam, the Northern Mariana Islands, and the U.S. Virgin Islands
COVID-19 cases reported by other medical sites:
Johns Hopkins
Total Worldwide Cases: 1,36,299
Total Worldwide Deaths: 74,679
Total Worldwide Recovered: 276,636
Total US cases: 367,507
Total US deaths: 10,923
Total US recovered: 19,598
Brian McNoldy, Senior Research Associate at Univ. of Miami’s Rosenstiel School, put a chart together of the growth. As it notes, it is pulling numbers from the Johns Hopkins totals.
Regional Numbers
| Cases | Tested | Deaths | %-positive | Mortality Rate | |
| MS | 1738 | N/A | 51 | #VALUE! | 2.93% |
| LA | 14867 | 64656 | 512 | 22.99% | 3.44% |
| AL | 2006 | 14765 | 53 | 13.59% | 2.64% |
| TN | 3802 | 47350 | 65 | 8.03% | 1.71% |
| AR | 927 | 13264 | 16 | 6.99% | 1.73% |
| Total | 23340 | 140035 | 697 | 16.67% | 2.99% |
A few states in the region do release the number of hospitalized people due to COVID-19. Those numbers are as follows:
Mississippi: 334
Louisiana: 1,809 (563 on ventilators)
Alabama: 240
Tennessee: 352
Arkansas: Not given
Making Estimates from past research
I talked about research from the Cruise Ships that may be relevant to estimating the number of cases without testing everyone (since that isn’t a feasible option). Plus, this type of estimate would make a good “first guess” at the number of asymptomatic people (the people who don’t feel sick, but are still infected), too.
This type of estimating isn’t perfect. In fact, it is far from it. And it is just an estimate. But based on the past research, it is at least a start.
| Estimated Symptomatic | Estimated Asymptomatic | Estimated total | |
| MS | 2651 | 582 | 3233 |
| LA | 22675 | 4977 | 27653 |
| AL | 3060 | 672 | 3731 |
| TN | 5799 | 1273 | 7072 |
| AR | 1414 | 310 | 1724 |
| Total | 35598 | 7814 | 43412 |
Hydroxychloroquine research didn’t meet “expected standards”
This isn’t so much new as it is “new developments” on old research. One of the studies (I hadn’t read this one before today) titled, “Hydroxychloroquine and azithromycin as a treatment of COVID-19: results of an open-label non-randomized clinical trial” highlighting Hydroxychloroquine as a remedy for COVID-19 was deemed substandard by the International Society of Antimicrobial Chemotherapy.
A friendly hat-tip to https://retractionwatch.com/ for the heads up on this one.
The original findings from the study’s authors found that: “Despite its small sample size our survey shows that hydroxychloroquine treatment is significantly associated with viral load reduction/disappearance in COVID-19 patients and its effect is reinforced by azithromycin.”
However the ISAC says:
ISAC shares the concerns regarding the above article published recently in the International Journal of Antimicrobial Agents (IJAA). The ISAC Board believes the article does not meet the Society’s expected standard, especially relating to the lack of better explanations of the inclusion criteria and the triage of patients to ensure patient safety.
Despite some suggestions online as to the reliability of the article’s peer review process, the process did adhere to the industry’s peer review rules. Given his role as Editor in Chief of this journal, Jean-Marc Rolain had no involvement in the peer review of the manuscript and has no access to information regarding its peer review. Full responsibility for the manuscript’s peer review process was delegated to an Associate Editor.
Although ISAC recognises it is important to help the scientific community by publishing new data fast, this cannot be at the cost of reducing scientific scrutiny and best practices. Both Editors in Chief of our journals (IJAA and Journal of Global Antimicrobial Resistance) are in full agreement.
What does all of this mean? A good question. If medical journals are anything like meteorological or geological journals, the research paper will be rewritten, re-reviewed and potentially re-published with updated information. But only time will tell. Since it didn’t meet standard for “patient safety” the paper may never be re-published.
Blood type may not increase do decrease susceptibility to COVID-19
I’ve had a few questions from folks recently about certain blood types being at a higher risk for COVID-19. This is from news circulating about a research paper that is in pre-print and is not yet peer-reviewed. I’ve talked about this paper before, but it was a few weeks back. The paper titled, “Relationship between the ABO Blood Group and the COVID-19 Susceptibility” tries to make a connection between blood type and COVID-19 infections.
In the paper, the authors note:
The ABO group in 3694 normal people in Wuhan showed a distribution of 32.16%, 24.90%, 9.10% and 33.84% for A, B, AB and O, respectively, versus the distribution of 37.75%, 26.42%, 10.03% and 25.80% for A, B, AB and O, respectively, in 1775 COVID-19 patients from Wuhan Jinyintan Hospital. The proportion of blood group A and O in COVID-19 patients were significantly higher and lower, respectively, than that in normal people (both P < 0.001). Similar ABO distribution pattern was observed in 398 patients from another two hospitals in Wuhan and Shenzhen. Meta-analyses on the pooled data showed that blood group A had a significantly higher risk for COVID-19 (odds ratio-OR, 1.20; 95% confidence interval-CI 1.02~1.43, P = 0.02) compared with non-A blood groups, whereas blood group O had a significantly lower risk for the infectious disease (OR, 0.67; 95% CI 0.60~0.75, P < 0.001) compared with non-O blood groups.
This new research cites older research as a starting point. The older paper paper, titled, “Blood Groups in Infection and Host Susceptibility” discusses the SARS outbreak and how a certain group of people – in a small sample – were infected.
Like other human coronaviruses, SARS-CoV infects the mucosal epithelium, causing an acute respiratory illness often accompanied by gastroenteritis. In a Hong Kong outbreak, there was an apparent association between disease transmission and ABO type. An epidemiology study of 34/45 hospital workers who contracted SARS after exposure to a single index patient showed that most of the infected individuals (23/34) were non-group O individuals (groups A, B, and AB). Group O individuals were relatively resistant to infection, with an OR of 0.18 (95% CI, 0.04 to 0.81; P = 0.03).
In short, both the new research and the older research suggest Blood Type A, B and AB had a higher rate of infection than those with Type O.
Before you get too concerned, or breathe a sigh of relief… The new research is not yet peer-reviewed and the old research was one, single and very small, study. On a similar, but not the same, virus.
Now that the paper is in peer review, peers are poking holes in the legitimacy of the claims being made. Doctors and virologists are pointing to potential conflicts within the data, data errors, and population data skewing results.
This is why – a lot like “breaking news” in a way – the first numbers and research aren’t always the most accurate.
Long-Term Care Facility in King County
A recent paper titled, “Epidemiology of Covid-19 in a Long-Term Care Facility in King County, Washington” published in the New England Journal of Medicine, researchers looked at the outbreak of COVID-19 in a long-term care facility in Washington. This was one of the cases that was big in the national news for a short period of time.
This was the situation that prompted Public Health–Seattle, King County, and the CDC to pursue an investigation. The authors of the study note:
As of March 18, a total of 167 confirmed cases of Covid-19 affecting 101 residents, 50 health care personnel, and 16 visitors were found to be epidemiologically linked to the facility. Most cases among residents included respiratory illness consistent with Covid-19; however, in 7 residents no symptoms were documented. Hospitalization rates for facility residents, visitors, and staff were 54.5%, 50.0%, and 6.0%, respectively. The case fatality rate for residents was 33.7% (34 of 101). As of March 18, a total of 30 long-term care facilities with at least one confirmed case of Covid-19 had been identified in King County.
Researchers also laid down a list of steps to make certain that a similar event does not occur elsewhere. Noting that “proactive steps by long-term care facilities to identify and exclude potentially infected staff and visitors, actively monitor for potentially infected patients, and implement appropriate infection prevention and control measures are needed to prevent the introduction of Covid-19.”
Masks now recommended by the CDC
This is something that seemed to gain traction over the weekend. Today, some states – including Mississippi, started recommending the use of protective masks when out in public.
According to the CDC:
Cloth face coverings should…
— fit snugly but comfortably against the side of the face
— be secured with ties or ear loops
— include multiple layers of fabric
— allow for breathing without restriction
— be able to be laundered and machine dried without damage or change to shape
CDC recommends wearing cloth face coverings in public settings where other social distancing measures are difficult to maintain (e.g., grocery stores and pharmacies), especially in areas of significant community-based transmission.
CDC also advises the use of simple cloth face coverings to slow the spread of the virus and help people who may have the virus and do not know it from transmitting it to others. Cloth face coverings fashioned from household items or made at home from common materials at low cost can be used as an additional, voluntary public health measure.
Cloth face coverings should not be placed on young children under age 2, anyone who has trouble breathing, or is unconscious, incapacitated or otherwise unable to remove the mask without assistance.
The cloth face coverings recommended are not surgical masks or N-95 respirators. Those are critical supplies that must continue to be reserved for healthcare workers and other medical first responders, as recommended by current CDC guidance.
The CDC says that you should be careful not to touch your eyes, nose, or mouth when removing the mask. And wash your hands immediately after removing.
The CDC has a few quick tips on making your own mask. One way, with no sewing needed, is by cutting an old Tshirt.
There is more information and a tutorial on how to make your own mask here: https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/diy-cloth-face-coverings.html
For now…
Do what you can to protect yourself from getting sick, or infecting others. Even if you “Feel fine” it doesn’t mean you are not infected. As we learned a few weeks ago, even those who are asymptomatic can pass the virus along to others. So even if you feel fine, you can still accidentally infect others.
Practice good social distancing and hang in there. I know this is difficult. I know this isn’t fun. But we are all in this together. We are all struggling.
We have to stick together through this. Because it takes all of us – working together – to beat COVID-19.
Nick, have you seen any information as to whether having the pneumonia shot and the flu shot affects the severity of the virus in the elderly?
I read that getting any other vaccine will, sadly, not help you against COVID-19. That was on the World Health Organization’s website.