CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 5/8/2020

May 8, 2020

Harrison County Judge
May 7, 2020 – Below is an update from the Marshall-Harrison County Health District on testing.
Today we have 8 new cases of the coronavirus and one fatality to report in Harrison County. Our total count is now at 172. Removing the 9 fatalities and 18 recoveries leaves us with 145 active cases.
State deploys team to provide aid at Marshall Manor WestMentioned yesterday, but I have been told that there is a difference between Marshall Manor West and the original Marshall Manor. I apologize for the confusion. The west structure is the former site of the second home of the family of a prominent Marshall lawyer, Clayton Feild. His first house was at the site of the current Marshall Manor, off South Washington. The old house was in a beautiful swale which was destroyed when the nursing home was built, forty or fifty years ago. JH.

From the Tyler Paper: Smith County has 170 coronavirus cases as of Thursday afternoon, according to the Northeast Texas Public Health District. Cases are up by five from Wednesday. In Smith County, there are 71 active cases, 95 recovered patients and four coronavirus deaths. Tyler hospitals are currently treating 43 East Texas COVID-19 patients.
Smith County Sheriff’s Office: 16 North Jail employees, 8 inmates have tested positive for coronavirus.
LSU Health Shreveport becomes site for additional nitric oxide clinical trial
LSU Health Shreveport is now one of five sites in the world and the first in Louisiana involved in a clinical trial that assesses inhaled nitric oxide as a treatment for patients with mild to moderate cases of COVID-19.
To date, there are no targeted therapeutic treatments for COVID-19 and there are no proven interventions to prevent progression of the disease.
This clinical trial in particular will monitor patients with mild to moderate cases of COVID-19 to see how they respond to inhaled nitric oxide as a treatment. Preventing disease progression in spontaneously breathing patients with mild to moderate disease could help to reduce the number of severe cases and deaths, which in turn lessens demand on healthcare resources such a critical care physicians and nurses.

Researchers hypothesize that a highly contagious strain of the coronavirus is spreading, but other experts remain skepticalResearchers hypothesize that a highly contagious strain of the coronavirus is spreading, but other experts remain skeptical
A research paper from scientists at Los Alamos National Laboratory, not yet peer-reviewed, reports that one strain of the novel coronavirus has emerged in Europe and become dominant around the planet, leading the researchers to believe the virus has mutated to become more contagious.
The bold hypothesis, however, was immediately met with skepticism by many infectious-disease experts, and there is no scientific consensus that any of the innumerable mutations in the virus so far have changed the general contagiousness or lethality of COVID-19, the disease caused by the coronavirus.
The Los Alamos scientists, led by computational biologist Bette Korber and working in conjunction with researchers at Duke University and the University of Sheffield in England, examined a global database of strains of SARS-CoV-2, the virus that causes the disease. According to their analysis, one strain featuring a mutation dubbed Spike D614G quickly out-competed other strains after it appeared in Europe.
The mutation affects the structure of a protein, called the spike protein, that is critical to the virus’s ability to infect human cells. The researchers believe this structural change enhances infectivity.
“The mutation Spike D614G is of urgent concern; it began spreading in Europe in early February, and when introduced to new regions it rapidly becomes the dominant form,” the authors write. They describe the mutation “increasing in frequency at an alarming rate, indicating a fitness advantage relative to the original Wuhan strain that enables more rapid spread.”
The paper will now have to survive the intense scrutiny of a research community trying to deliver urgently needed information while remaining scientifically rigorous.

Operational Toolkit for Businesses Considering Reopening or Expanding Operations in COVID-19
FROM JAMA: THIS IS A GOOD ARTICLE TO KEEP FOR YOUR FILES TO REREAD WHEN TESTING BECOMES MORE COMMON.Interpreting Diagnostic Tests for SARS-CoV-2

New Studies Add to Evidence that Children May Transmit the CoronavirusNew Studies Add to Evidence that Children May Transmit the Coronavirus
“…In one study, published last week in the journal Science, a team analyzed data from two cities in China — Wuhan, where the virus first emerged, and Shanghai — and found that children were about a third as susceptible to coronavirus infection as adults were. But when schools were open, they found, children had about three times as many contacts as adults, and three times as many opportunities to become infected, essentially evening out their risk.
“Based on their data, the researchers estimated that closing schools is not enough on its own to stop an outbreak, but it can reduce the surge by about 40 to 60 percent and slow the epidemic’s course.
“’My simulation shows that yes, if you reopen the schools, you’ll see a big increase in the reproduction number, which is exactly what you don’t want,” said Marco Ajelli, a mathematical epidemiologist who did the work while at the Bruno Kessler Foundation in Trento, Italy.’”

Personal comment, J Harris, MD:
Without testing, good testing, who knows where we are in terms of susceptibility in this pandemic.  Nobody. Covid-19 has cleaned out the easy targets like overcrowded nursing homes, prisons, airplanes, flophouses, subways, packing houses, cruise ships, chicken pluckers, and health care workers. Now the hellacious virus can surreptitiously spread to more abundant if more challenging targets such as ordinary if naive people, who are willing to gamble with their lives and with the lives of everyone with whom they come into contact, especially with the elderly, with grandma and grandpa.

And a likely day for the virus to score new victims will be Mother’s Day.  

Fortunately, most older people are retired and don’t have to “meet the public.” Of course, they should be cautious, wear masks, avoid crowds, As for me, I believe I’ll continue to stay home and wait for good tests, case tracking capabilities, effective antiviral drugs, and an effective vaccine — hopefully a long-lasting vaccine. I will continue to assume that everyone I meet is a carrier, including family members and friends who must go to work. I’m not particularly afraid of dying, but I’d rather my terminal breath not be on a noisy ventilator while gasping and coughing and spewing a froth of infected sputum all over ICU. Like most old folks, I’d rather just wake up some morning dead. 

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