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  1. #2701

    Re: covid-19 Virus Updates and Discussion

    I think the Netherlands was slow to respond.
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.




  2. #2702

    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by mmmm8 View Post
    Surprised Netherlands is high on there - older population?
    Not particularly, but why does the situation there suprise you more than in say Belgium or France?

    I think it's partially bad luck, partially high population density and high conectivity to the rest of the world.
    Roger forever

  3. #2703
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    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by suliso View Post
    Not particularly, but why does the situation there suprise you more than in say Belgium or France?

    I think it's partially bad luck, partially high population density and high conectivity to the rest of the world.
    France was one of the hardest and earliest (in Europe) hit, Belgium doesn't surprise me because I was already aware


  4. #2704
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    Re: covid-19 Virus Updates and Discussion

    Nothing from WHO today. That's the third time in about 2 weeks, second time this week.
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  5. #2705

    Re: covid-19 Virus Updates and Discussion

    Amphetamine Use Soars in Locked Down Finland: Study
    June 4, 2020
    AGENCE FRANCE-PRESSE

    HELSINKI (AFP) — Finns may be known for their love of vodka and beer, but growing numbers in the Nordic nation appear to have turned to amphetamines to cope with the coronavirus lockdown, health officials said on Thursday.

    Regular analysis of wastewater in the capital, Helsinki, showed a 15% rise in use of such stimulants since the government told people to stay at home in mid-March.

    Although researchers could not directly link the spike in drug use to the lockdown, “the fact remains that amphetamine use has been higher than ever before, at least in the Helsinki metropolitan area,” said Teemu Gunnar, head of forensic toxicology at the National Institute for Health and Welfare.

    Amphetamines can be used to treat medical conditions such as ADHD, but is also taken recreationally, sometimes under the name “speed.”

    Use of amphetamines in the country of 5.5 million people has tripled since 2013 according to wastewater studies, Gunnar said.

    However, Finns have not turned to other drugs such as cocaine, ecstasy or methamphetamines during the lockdown, the institute’s analysis showed.

    He revealed the findings in a joint statement with the police, who said the analysis suggested amphetamine use in Helsinki had reached “record levels.”

    Health officials have also begun analyzing wastewater for traces of the coronavirus since the crisis began, as international studies suggest it can give a fuller picture of how much the disease is circulating among the population.

    The most recent results from the end of May suggest that, while the virus is still present in the major towns of Helsinki and Turku, coronavirus levels have dropped considerably in other parts of the country.

    On Thursday, Finland’s health officials announced no new coronavirus infections for the first time in more than three months.

    “This is the first ‘zero day’ since February 26,” a spokesperson for the Institute for Health and Welfare told AFP.

    One person did die from the virus on Thursday, however, bringing the death toll to 322 in the Nordic nation of 5.5 million people, the institute said.

    While the country has 50 people still in hospital, seven in intensive care, an estimated 5,800 of Finland’s 7,000 recorded Covid-19 cases have now recovered. More than a third of hospital districts did not register a single case during the final week of May.

    On Thursday, Finnish health authorities said the estimated basic reproduction number is now between 0.75 and 0.80, marking a clear decrease over the past two weeks.

    Since mid-May Finland’s government has begun lifting emergency restrictions that were imposed on March 18.

    Schools were reopened for two weeks before the summer holidays began at the start of June, and earlier this week bars, restaurants, sports facilities and cultural institutions were allowed to reopen under social distancing regulations.

    Officials and the government have said, however, they are braced for a second wave of infections later in the year, and have warned the public to continue following distancing advice and to self-isolate and seek testing if they experience any symptoms.

    © Agence France-Presse

    https://www.courthousenews.com/amphe...finland-study/
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.




  6. #2706
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    Re: covid-19 Virus Updates and Discussion

    WHO's Situation Report for June 4, 2020. Excerpt from the newsletter:

    India’s COVID-19 epidemic continues to accelerate. India again reported its highest daily incidence today, 9,851 new cases. India’s daily incidence has doubled since May 19, and India surpassed Russia as #3 globally in terms of daily incidence.

    Iran reported 3,574 new cases, continuing its second “wave.” This appears to be Iran’s highest daily incidence to date, surpassing the peak of its first wave (3,186 on March 31). Iran is now #8 globally in terms of daily incidence. After a period of relaxing nationwide social distancing measures, Iranian President Dr. Hassan Rouhani recently emphasized the importance of limiting non-essential travel. Additionally, Iran has deployed medical teams “from successful provinces” to areas where COVID-19 is re-emerging.

    Central and South America continue to be heavily impacted by the COVID-19 pandemic. Brazil reported 30,925 new cases, its second highest daily total to date. Brazil has reported 3 of its 4 highest daily totals in the past 3 days and all 6 of its highest daily totals over the last 6 non-weekend reporting days. Brazil remains #1 in the world in terms of daily incidence—reporting nearly 50% more new cases than the United States—and #7 globally in terms of per capita daily incidence. Chile and Peru continue to exhibit concerning trends as well, currently #3 and #10 in the world, respectively, for per capita incidence. Additionally, Chile is #5 and Peru is #7 globally in terms of total daily incidence. Panama is #11 in per capita incidence, and Mexico is #6 in total daily incidence.

    EASTERN MEDITERRANEAN
    The Eastern Mediterranean region represents 4 of the top 10 countries in terms of per capita incidence—Qatar (#1), Bahrain (#2), Kuwait (#5), and Oman (#8)—as well as the United Arab Emirates at #15 and Saudi Arabia at #17. Many of these countries are relatively small in terms of population, and among these 6 countries, Saudi Arabia is the only one with a population greater than 10 million. In fact, the Eastern Mediterranean has the smallest total population of all WHO regions. The total COVID-19 incidence may not necessarily garner global attention when compared to larger countries like the United States, Brazil, and Russia; however, these COVID-19 epidemics are concerning relative to population size. Saudi Arabia’s and the United Arab Emirates’ daily per capita incidence are down from their highs on May 19 and May 23, respectively, but 4 countries in the top 10 have been increasing over the past several weeks. Notably, Qatar reported a high of 730 new cases per million population (3-day average) on May 31, which doubled from May 9. For reference, this is more than 10 times the per capita incidence in the United States. Bahrain is reporting more than 4 times the daily per capita incidence as the United States, Kuwait is reporting more than 3 times, and Oman is reporting more than double. Additionally, nearby Djibouti and Armenia are #4 and #7, respectively, in terms of per capita incidence.

    Previously, a large majority of COVID-19 cases in some of these countries were identified in expatriate or migrant worker communities, but this trend is shifting to some degree. However, in Saudi Arabia, the proportion of cases among Saudi citizens has increased substantially since we last reported on its national epidemic. On May 10, the Saudi Ministry of Health reported that only 25% of COVID-19 cases were among Saudi citizens, compared to 45% on June 3. Through April 26, Bahrain reported approximately 74% of its total COVID-19 cases among expatriate workers. On May 29, however, the Bahraini Ministry of Health reported 300 new cases, including 183 expatriate workers (61%), potentially indicating an increasing proportion among Bahraini citizens. On May 13, Kuwait reported 648 of 751 new cases (86%) among non-citizens, but yesterday, the Kuwaiti Ministry of Health reported only 385 of 562 new cases (69%) in non-citizens. The Qatari Ministry of Public Health does not explicitly distinguish cases among citizens and non-citizens; however, it continues to report that “the new cases are due to expatriate workers” while also noting that “cases...have also increased among citizens and residents.”

    UNITED STATES
    The US CDC reported 1.84 million total cases (14,676 new) and 107,029 deaths (827 new). The United States could potentially surpass 2 million cases in the next 7-10 days. In total, 14 states (no change) and New York City reported more than 40,000 total cases, including New York City with more than 200,000; New Jersey and New York state with more than 150,000; and California, Illinois, and Massachusetts with more than 100,000.

    The New York Times continues to track state- and local-level COVID-19 incidence in a variety of forms. A number of states began to relax social distancing measures—including resuming operations at restaurants, retail stores, and barbershops/salons—at the end of April and in early May.

    As Florida looks ahead to further easing social distancing measures, with most of the state entering Phase 2 of Florida’s recovery plan today, the state reported its highest daily incidence to date. The Florida Department of Health reported 1,419* new cases, surpassing the previous high of 1,413 on April 17. Additionally, Florida reported 1,317 new cases the previous day, which appears to be the state’s fourth-highest daily total. Florida reported decreasing daily incidence from early April through early-to-mid May, but incidence has been increasing over the past several weeks.
    *Note: The media is widely reporting 1,419 new cases as yesterday’s incidence; however, this does not match the value displayed on Florida’s COVID-19 dashboard (“1.3k” cases). The reported cumulative total of 60,183 cases is consistent with the dashboard.

    The Johns Hopkins CSSE dashboard reported 1.88 million US cases and 108,334 deaths as of 11:30am on June 5.

    CONVALESCENT PLASMA TRIAL Researchers in China published findings from a randomized, placebo-controlled clinical trial to evaluate the use of convalescent blood plasma as a treatment for COVID-19. The study, published in The Journal of the American Medical Association, included 103 COVID-19 patients in Wuhan, China, but it was terminated because there were not enough patients to enroll when the outbreak was brought under control. Of the 101 patients that completed the trial, the researchers observed clinical improvement in 51.9%, compared to 43.1% of the control group, although this difference was not statistically significant. Among patients with severe disease, the treatment group exhibited statistically significant improvement over the control group—clinical improvement in 91.3%, compared to 68.2%. Critically ill patients did not experience similar improvements, however. The treatment group also exhibited decreased time to achieving a negative diagnostic test result. Two patients in the treatment group experienced adverse events following the treatment, both of whom responded well to associated treatment.

    This appears to be the first RCT for convalescent plasma treatment for COVID-19. In an associated editorial, several experts from Johns Hopkins University, the Mayo Clinic, and the Montefiore Medical Center, note that the results demonstrate that clinicians now have an additional tool for treating COVID-19 patients, despite the study’s limitations. These experts suggest that additional research is necessary to determine if convalescent plasma could potentially complement remdesivir, the other treatment with documented benefits in a RCT.

    US CDC CRITIQUE The New York Times published a critique of the US CDC’s role in the US government response to COVID-19, highlighting a series of missteps that contributed to the United States leading the world in COVID-19 incidence and mortality. The lengthy article highlights the CDC’s origins, purpose, and culture, with a focus on actions and decisions during the COVID-19 response as well as the agency’s relationship to state-level health departments and officials and US President Donald Trump. The findings are based on “a review of thousands of emails and interviews with more than 100 state and federal officials, public health experts, C.D.C. employees and medical workers.” Much of the article focuses on months-long challenges in scaling up SARS-CoV-2 testing capacity, which CDC Director Dr. Robert Redfield recently refuted as a major barrier early in the response.

    In an accompanying editorial, one of the article’s authors, Michael Shear, highlighted 5 specific areas that factor into these challenges and failures. He explicitly discusses the United States’ fractured and antiquated disease surveillance and reporting systems, perceptions of the CDC as an adversary among White House officials, the CDC’s risk-averse culture, the demand for Dr. Redfield to balance competing demands of the CDC and President Trump, and an absence of timely, reliable, and actionable CDC guidance for state and local health officials.

    In a separate editorial published yesterday in The New York Times, former CDC Director Dr. Tom Frieden argues that the original critique mischaracterized how the US COVID-19 response unfolded and the CDC’s responsibility or authority with respect to the missteps. He emphasizes that chronic under-funding of public health programs at all levels of government underpin the lack of adequate national capacity to respond to events like the COVID-19 pandemic. Additionally, he asserts that efforts by the current Presidential administration hindered CDC response efforts, redirected critical capacity to non-essential tasks, and “stifled [the CDC’s] ability to speak directly to the public.” He argues that the resulting delays and the absence of a “coherent national strategy” are responsible for the poor US response rather than capabilities, expertise, and leadership at the CDC.

    US HEALTH DISPARITIES As a result of the disproportionate impact of the COVID-19 epidemic on racial and ethnic minorities in the United States, the US Department of Health and Human Services issued new COVID-19 laboratory reporting requirements that include direction for key demographic data such as race, ethnicity, age, and sex. These enhanced reporting requirements aim to better capture COVID-19 risk disparities among racial and ethnic communities. This move comes amid increased focus on disparities in justice and health in the US, which motivated widespread protests currently underway.

    https://www.who.int/docs/default-sou...sitrep-136.pdf
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  7. #2707

    Re: covid-19 Virus Updates and Discussion

    Eastern Mediterranean seriously??? The mentioned countries have got nothing to do with Mediterranean neither geographically nor culturally. The true Easter Meditarranean is Greece, Turkey, Cyprus, Israel and Lebanon.
    Roger forever

  8. #2708

    Re: covid-19 Virus Updates and Discussion

    Quote Originally Posted by suliso View Post
    Eastern Mediterranean seriously??? The mentioned countries have got nothing to do with Mediterranean neither geographically nor culturally. The true Easter Meditarranean is Greece, Turkey, Cyprus, Israel and Lebanon.
    I agree with you. The countries listed in E. Mediterranean region includes Afghanistan, Pakistan, Djibouti, Somalia, and Morocco. Sudan is included also, but Ethiopa is somehow in Africa. Go figure. Europe includes Kazakhstan, Uzbekistan, Tajikistan (essential any country that had once belonged to the Soviet Union). Indonesia and Thailand have been placed in SE Asia, but Mayasia, Singapore and the Philippines are in the Western Pacific region along with Mongolia.

    Per the UN website "The assignment of countries or areas to specific groupings is for statistical convenience and does not imply any assumption regarding political or other affiliation of countries or territories by the United Nations"
    "And for my next fearless prediction..."

  9. #2709
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    Re: covid-19 Virus Updates and Discussion

    I get the questions about why the "region" is called what it is by WHO. But just a reminder... That's not really the most important thing happening here.
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

  10. #2710

    Re: covid-19 Virus Updates and Discussion

    They call it The Persian Gulf and the entire region goes berserk. They are not Persians.
    They call it the Arab Peninsula and they go berserk. Not all of them are Arabs.
    The Middle East? Sure. Problem is you have the Far East, the Middle East but no Near East. Confusing.
    The Gulf? Iran has half of it. So confusing again.
    I gather they just went for the Politically acceptable term and deal with the important issue.
    Face it. It's the apocalypse.

  11. #2711

    Re: covid-19 Virus Updates and Discussion

    Vaughn Hillyard
    @VaughnHillyard
    Arizona, today, has the most hospitalizations & ICU beds in use for COVID patients of any day yet (graphs, below).

    In last 48 hours: 2771 newly-reported COVID cases in Arizona & 46 new deaths reported.

    This isn’t going in the right direction.





    Just left favorite coffee shop in midtown Phoenix...just four (including 🙋🏻*♂️) of the 67 folks who passed through had masks over the course of 10 minutes. None of the staff had masks.

    This isn’t a protest for justice... it’s a coffee shop. Folks across city ignoring COVID threat.
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.




  12. #2712

    Re: covid-19 Virus Updates and Discussion

    Noga Tarnopolsky @NTarnopolsky
    3 dead & 160 new cases of #Covid19 in Israel today, which Health Ministry DG says equals Israel's rate of #cornoavirus contagion at peak pandemic. For several days Israel has crossed 100 new cases, the figure PM Netanyahu said triggers a new lockdown. Yet #unlockdown continues

    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.




  13. #2713

    Re: covid-19 Virus Updates and Discussion

    Yaroslav Trofimov
    @yarotrof
    Trump visits the coronavirus swab production line in Maine, without a mask, and the manufacturer says it will now have to throw away the day’s output.



    As Trump touts increased production, coronavirus swabs made during his Maine factory tour will be tossed in the trash
    John Fritze
    Michael Collins
    USA TODAY

    GUILFORD, Maine – President Donald Trump traveled to Maine Friday to tour a facility that makes medical swabs used for coronavirus testing, but the swabs manufactured in the background during his visit will ultimately be thrown in the trash, the company said.

    Puritan Medical Products said it will have to discard the swabs, a company spokeswoman told USA TODAY in response to questions about the visit.

    It is not clear why the swabs will be scrapped, or how many. The company described its manufacturing plans for Friday as "limited" – but the disruption comes as public health officials in Maine and other states have complained that a shortage of swabs has hampered their ability to massively scale up coronavirus testing.

    Workers in white lab coats, hair nets and plastic booties worked at machines making swabs while the president walked through the room. Trump, who did not wear a mask for the visit, stopped at one point to talk with some of the workers.

    “Made in the USA. I’ve been saying it for a long time,” Trump said.

    Trump has repeatedly traveled during the pandemic to call attention to companies who areresponding, sometimes with government help. In those cases, the president has used the factory floors as backdrops to convey a message of American ingenuity and production that he said the country has not witnessed since World War II.

    Those tours generally last only a few minutes.

    https://www.usatoday.com/story/news/...bs/3153622001/
    “No matter how cynical I get, I just can't keep up.” – Lily Tomlin.




  14. #2714

    Re: covid-19 Virus Updates and Discussion

    Again, not sorry. You brought him to your factory, you knew he was not going to follow any directions. For sure he was not going to wear a mask.
    So if you lost your day's production, suck it up. That is what happens when you want to please the supreme leader.
    Face it. It's the apocalypse.

  15. #2715
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    Re: covid-19 Virus Updates and Discussion

    WHO's Situation Report for June 7, 2020. There's A LOT in the newsletter, so for the first time, I am sharing everything rather than just select excerpts.

    https://www.who.int/docs/default-sou...sitrep-139.pdf

    :

    EPI UPDATE The WHO COVID-19 Situation Report for June 7 reports 6.80 million confirmed cases (136,409 new) and 397,388 deaths (4,586 new). This appears to be the highest global daily incidence* to date. The global totals could reach 7 million cases by tomorrow’s WHO Situation Report and 400,000 deaths by today’s update.
    *This analysis uses data from the European CDC, not the WHO.

    We continue to observe shifts in the geographic distribution of COVID-19 incidence. Since the end of May, Europe has reported fewer than 15% of the new COVID-19 cases each day, and North America has reported approximately 20-25% of new cases over the past week. Asia’s contribution to the global incidence continues to increase, now reporting more than 25% of new cases each day since the beginning of June. With the exception of June 6, South America’s proportion of COVID-19 cases continues to grow as well, now up to approximately 30-35% of the global total. The relative contribution by Africa continues to increase as well, but more slowly. Africa is now reporting approximately 5% of the global daily incidence.

    India’s COVID-19 epidemic continues to accelerate, setting a new high for daily incidence today, 9,983 new cases. India has now reported more than 250,000 total cases nationwide. India’s COVID-19 incidence has leveled off over the past few days, just shy of 10,000 new cases per day, but it is still increasing slightly from day to day.

    Iran reported 2,389 new cases, down from more than 3,500 new daily cases last week. Iran is now #11 globally in terms of daily incidence.

    Brazil updated its COVID-19 dashboard, removing cumulative incidence and deaths as well as figures displaying various epidemiological trends. Brazil reported 18,912 new cases, which would be its lowest daily total since late May. Other sources, however, indicate that the daily incidence is considerably higher, in the range of 27,000 new cases. The source of this discrepancy is not clear. Depending on which daily incidence value is used, Brazil could be #11-13 globally in terms of per capita daily incidence, but it is still #1 or #2 in terms of total daily incidence. Brazil is also currently #3 globally in terms of cumulative COVID-19 deaths, but recent trends put it on track to surpass the United Kingdom in the coming days. Chile’s epidemic continues to exhibit a concerning acceleration, and it remains #3 in the world in terms of per capita daily incidence and #5 for total daily incidence.

    UNITED STATES
    The US CDC reported 1.92 million total cases (29,214 new) and 109,901 deaths (709 new). Over the weekend, the United States reported its 2 highest daily totals since May 16, and the United States could potentially surpass 2 million cases in the next 3-5 days. In total, 14 states (no change) and New York City reported more than 40,000 total cases, including New York City with more than 200,000; New Jersey and New York state with more than 150,000; and California and Illinois with more than 125,000.

    The New York Times continues to track state- and local-level COVID-19 incidence in a variety of forms. A number of states began to relax social distancing measures—including resuming operations at restaurants, retail stores, and barbershops/salons—at the end of April and in early May. Increased social interaction as well as mass gatherings associated with the Memorial Day holiday weekend and ongoing large-scale protests against racial injustice could potentially contribute to transmission. We will continue monitoring these trends over the coming weeks.

    New York continues to exhibit encouraging progress in containing COVID-19. In its most recent update, the statewide test positivity was 1.3%. In New York City it was 1.8%. New York reported 781 new cases statewide, its lowest daily total since March 17, and New York City reported 56 new cases, it lowest since March 14.

    Florida continues to report elevated and increasing daily incidence. In fact, its 7-day average is approximately equal to its peak in early April and is still increasing. Georgia appears to have passed a second peak in mid-May; however, its recent incidence data, which may not yet be complete, already indicate another increase in the 7-day average. California’s daily incidence continues to increase, with 3 of its 5 highest daily totals reported in the last 3 days. While the number of tests conducted in Utah is holding steady or possibly decreasing slightly, the COVID-19 incidence has increased dramatically over the past 2 weeks, up from 150-200 new cases per day to 447 and 547 new cases on June 4 and 5, respectively. Arizona continues to report increasing COVID-19 incidence as well. Arizona reports its cases by specimen collection date (which means that data from the past 7 days may be incomplete) and it reported its 2 highest daily totals on June 1 and 2, both more than 1,000 new cases per day. Arizona’s daily incidence has more than doubled since early May.

    The Johns Hopkins CSSE dashboard reported 1.95 million US cases and 110,734 deaths as of 1:30pm on June 8.

    WHO UPDATES MASK GUIDANCE The WHO released updated guidance on mask usage last Friday, including information on who should use a mask and when masks should be worn, as well as the materials or type of mask that should be used. The new recommendations deviate from previous guidance in a few key areas, particularly for areas experiencing widespread SARS-CoV-2 transmission. The WHO now recommends that masks be worn by all health personnel seeing patients in areas of widespread transmission, not just clinicians treating COVID-19 patients. In areas experiencing community transmission (a step below widespread transmission), individuals at elevated risk of severe COVID-19 disease or death, including those over the age of 60 or those with underlying health conditions, should wear medical masks whenever physical distancing from other people is not possible. The general public should wear masks in crowded areas when physical distancing from other people is not possible in areas experiencing widespread transmission.

    In terms of materials, the WHO now recommends that cloth masks be made out of at least 3 layers of different materials, ideally an inner layer of absorbent material (e.g., cotton), a middle layer of non-woven material (e.g., polypropylene), and an outer layer of non-absorbent material (e.g., polyester). WHO Director-General Dr. Tedros Adhanom Ghebreyesus emphasized that mask use alone does not protect against SARS-CoV-2 infection and that masks should be used as part of a “comprehensive strategy” of protective measures.

    HYDROXYCHLOROQUINE TRIAL TERMINATED The United Kingdom terminated the hydroxychloroquine arm of its RECOVERY clinical trial after finding no evidence of treatment benefit for COVID-19 patients. The UK’s Randomised Evaluation of COVID-19 Therapy (RECOVERY) trial, a national clinical trial to test the efficacy of potential COVID-19 treatments, has stopped enrolling new patients in a trial arm testing hydroxychloroquine. In a statement released Friday, the study’s chief investigators stated that preliminary findings from 1,542 patients demonstrated that there was no clinical benefit from the use of hydroxychloroquine. The trial participants in the hydroxychloroquine treatment arm showed no significant improvements in mortality or hospital stay length compared to other participants receiving usual medical care. The statement committed to publishing the full results in the near future.

    PEDIATRIC MULTISYSTEM INFLAMMATORY SYNDROME Two recently published studies provide new analysis of pediatric multisystem inflammatory syndrome (PIMS) associated with COVID-19 in children. The first study, published in Eurosurveillance, describes the results of a nationwide surveillance effort in France conducted March 1-May 7. The researchers identified 156 potential cases of PIMS over that period, including 79 confirmed, 16 probable, and 13 possible cases (48 were ruled out based on the study’s case definition). The PIMS incidence in France peaked several weeks after the national COVID-19 peak, which suggests that PIMS may be a “post-infectious manifestation” of COVID-19, and the geographic distribution of PIMS cases largely correlated with COVID-19 incidence. Based on a maximum estimated COVID-19 incidence in French children (defined as those under the age of 15) of 5%, the researchers estimate the risk of PIMS to be fewer than 2 cases per 10,000 children.

    The second study, published in The BMJ, looked at the clinical presentation of PIMS in Paris, France. The prospective study identified 21 PIMS patients in Paris between April 27 and May 11. Of these children, 12 presented with Kawasaki disease, and 16 presented with myocarditis. Among these patients, 9 reported previously experiencing “viral-like symptoms” (e.g., fever, headache), and the mean duration between these symptoms and the onset of Kawasaki disease was 45 days. In total, 8 (38%) of the PIMS patients tested positive for SARS-CoV-2 infection during the study, and only 1 had symptoms consistent with COVID-19 during the study. In contrast, 19 of the 21 (90%) patients tested positive for IgG antibodies, indicating prior infection. The delay following viral symptoms and the prevalence of IgG antibodies relative to active infection further support the idea that PIMS is a post-infectious manifestation of COVID-19. The researchers also observed disease severity in these patients, with 17 (81%) of them requiring intensive care and 11 (52%) requiring mechanical ventilation. Notably, 57% of the patients were of African ancestry, but further data and analysis are needed to characterize any potential association.

    COVID-19 ELIMINATED IN NEW ZEALAND New Zealand Prime Minister Jacinda Ardern announced that New Zealand has eliminated COVID-19, following 17 days with no new reported cases and the discharge of the country’s last remaining active COVID-19 patient. New Zealand subsequently transitioned to Alert Level 1 and lifted nearly all remaining COVID-19 restrictions. The notable exception is continued strict border controls, including mandatory 14-day quarantine for arriving travelers, to mitigate the risk of imported cases and travel-associated outbreaks. Additionally, New Zealand shifted its COVID-19 mindset from “Unite Against COVID-19” to “Unite for Recovery,” which will focus on economic recovery while maintaining vigilance and enhanced hygiene to mitigate the risk of COVID-19. Prime Minister Arden emphasized that the dedication and commitment to the successful response has placed New Zealand at an advantage in terms of economic recovery, particularly as many countries remain under restrictive social distancing measures. In total, New Zealand reported only 1,154 confirmed infections and 22 deaths.

    SOCIAL DISTANCING IMPACT Two new articles were published in Nature today that describe the effects of social distancing and other interventions on the COVID-19 pandemic. One article used data from 1,717 different interventions at the local, regional and national level in the United States, France, Iran, Italy, South Korea, and China. Based on econometric modeling techniques, which are typically used to evaluate economic impact of events and policies, the researchers evaluated the impact of various non-pharmaceutical interventions (NPIs), including large-scale social distancing policies, on the epidemic growth. They concluded that interventions in these countries may have prevented 62 million confirmed COVID-19 cases worldwide, which corresponds to an estimated 530 million total SARS-CoV-2 infections. These include 4.8 million confirmed cases (60 million infections) in the United States alone.

    The other article focused on interventions in Europe through May 4, 2020, when some countries began to relax national social distancing measures. Considering available data from serological studies, the researchers estimated the true number of infections in order to evaluate the effects of social distancing policies on transmission and mortality. This study found that nonpharmaceutical interventions, including national “lockdowns,” could have averted approximately 3.1 million COVID-19 deaths across 11 European countries.


    State and local governments across the United States continue to relax social distancing measures. Notably, New York City and Las Vegas are expanding business and social activities. The changes in Las Vegas, in particular, have raised concern about increased transmission risk as videos and photos have circulated showing individuals crowding into casinos with questionable social distancing and many people not wearing face masks.

    GENETIC VARIATIONS & COVID-19 A recent study (preprint, not yet peer reviewed) indicates that individuals with certain blood types and other genetic variations may be at elevated risk of respiratory failure due to COVID-19. The genome-wide association study (GWAS), included 1,980 participants experiencing respiratory failure due to COVID-19 in Italy and Spain were included in the genome-wide association analysis. One key finding suggested that individuals with Type A blood were at 50% higher risk of requiring oxygen therapy or mechanical ventilation. Notably, genetic variations related to the ACE2 receptor, which is how the SARS-CoV-2 virus attaches to human cells, did not show any significant impact on infection. Results of this study could help clinicians to identify patients at higher risk of respiratory failure that may need aggressive, proactive measures. Considering the broad range of disease severity for COVID-19, from asymptomatic infection to severe disease and death, information regarding risk factors is important to characterizing the disease and pandemic and potentially identify targets for treatment or vaccine development.

    IRAN SECOND WAVE Iran has reported decreased daily COVID-19 incidence over the past several days, following increasing incidence since early May, a second “wave” that drove incidence higher than the peak of Iran’s first wave in late March. It is too early to tell, however, whether this indicates that Iran has passed its second peak. As a result of the second wave, Iran once again scaled up response activities and implemented additional restrictions in an effort to contain the epidemic. In order to increase national screening for SARS-CoV-2 infection, Iran deployed 23,000 teams of health experts across the country and implemented both online and phone-based screening programs. In total, Iran has screened more than 50 million individuals nationwide. Iran also increased domestic production of critical supplies, including personal protective equipment. Notably, Iran scaled up production capacity for N95 respirators from 5-10,000 to 85,000 per day and increased production of surgical masks by a factor of 8. Iran also scaled up diagnostic testing capacity, setting a new national record with 25,000 tests performed in a single day.

    Schools are beginning to reopen in Iran, with additional protective measures in place to mitigate COVID-19 risk. Previously, Iran suspended schools and universities, although some medical schools remained in operation in order to allow students to graduate and immediately support the COVID-19 response. Iran’s Ministry of Health and Medical Education cancelled in-person interviews for international students hoping to study “medical sciences” at Iranian universities and announced that the application process will proceed via an online system in order to comply with COVID-19 social distancing measures. Schools across the country will reopen at the direction of local governments, and capacity will be limited, particularly in dormitory settings. Additionally, students taking in-person classes will undergo health screening, and diagnostic testing will be available on campus, with a focus on symptomatic students.

    US REMDESIVIR SUPPLY The US government is coordinating with Gilead Sciences to facilitate increased production and distribution of remdesivir, the only drug that has been demonstrated to provide treatment benefit for COVID-19 patients in a randomized clinical trial. Gilead previously donated its available remdesivir inventory to the US government; however, this supply is expected to be exhausted by the end of June. Gilead is working to increase production capacity, with material support from the US government; however, the next delivery may not be available until July or August. The US Department of Health and Human Services Assistant Secretary for Preparedness and Response, Dr. Robert Kadlec, expressed confidence that additional remdesivir will be available this summer and that production will increase substantially into the fall and beyond. It is unclear at this point how much Gilead will charge for subsequent shipments, and the incredibly high demand—as the only available treatment with demonstrated efficacy—has raised concerns about the potential that the drug could be expensive.
    Winston, a.k.a. Alvena Rae Risley Hiatt (1944-2019), RIP

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