CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 5/29/2020

May 29, 2020

COVID REPORT HARRISON COUNTY RECEIVED THURSDAY AFTERNOON FROM MNM
In Harrison County, County Judge Chad Sims reported two more COVID-19 diagnoses on Thursday, bumping his county’s total to 242 cases. He said the county also saw nine more recoveries, raising that total to 80. 
 
The Gregg County Jail’s daily report for Thursday to the Texas Commission on Jail Standards shows the county’s number of inmates who have tested positive now totals 42. The report shows that two jailers have tested positive.
 
In Titus County, the 77 additional cases push that county’s total to 443, the state health department reported. The county has had two deaths from the virus.
 
 
UPDATE: SURFACE TRANSMISSION LESS IMPORTANT:
But while those experiments show how germs can spread on surfaces, the microbe still has to survive long enough and in a large enough dose to make you sick. Eugene M. Chudnovsky, a professor at the City University of New York, notes that surfaces are not a particularly effective means of viral transmission. With the flu, for instance, it takes millions of copies of the influenza virus to infect a person through surface-to-hand-to-nose contact, but it may take only a few thousand copies to infect a person when the flu virus goes from the air directly into the lungs.
 
“I believe the C.D.C. is right when it says that surface transmission is not a dominant one,” said Dr. Chudnovsky. “Surfaces frequently touched by a large number of people, like door handles, elevator buttons, etc., may play a more significant role in spreading the infection than objects touched incidentally, like food packages delivered to homes.”
 
The bottom line is that the best way to protect ourselves from coronavirus — whether it’s surface transmission or close human contact — is still social distancing, washing our hands, not touching our faces and wearing masks.
 
MORE GOOD NEWS FROM NYT: I may have some trouble doing this, but take out food, food in general, is safe if you can avoid crowds of people while you acquire it. Good reassuring article. J. Harris
 
JHH: Very good article with early reports about wearable monitoring devices that might give early warning of impending or incipient COVID.  However, I think I’ll use the oximeter and pulse detector that I already have purchased for about $60. I can watch my oxygen level as well as my pulse and not fiddle with a  bunch of new devices that I can’t read anyway. If my oxygen goes down and my pulse goes us, I’m in trouble. I tried to join the Duke study mentioned in the article, but I couldn’t sign the damn consent with a computer. 
 
Excerpts:
On Thursday, researchers at WVU’s Rockefeller Neuroscience Institute reported that Oura ring data, combined with an app to measure cognition and other symptoms, can predict up to three days in advance when people will register a fever, coughing or shortness of breath. It can even predict someone’s exact temperature, like a weather forecast for the body.
 
There’s more: Researchers at Stanford University studying changes in heart rate from Fitbits tell me they’ve been able to detect the coronavirus before or at the time of diagnosis in 11 of 14 confirmed patients they’ve studied. In this initial analysis, they could see one patient’s heart rate jump nine days before the person reported symptoms. In other cases, they only saw evidence of infection in the data when patients noticed symptoms themselves.
 
(Apple watchers are also discussed)
 
SUMMARY:

In this cross-sectional study, 10 of 60 patients previously diagnosed with and treated for COVID-19 had RT-PCR test results positive for SARS-CoV-2 from 4 to 24 days after index hospital discharge. As discharged patients were provided with home isolation instructions and local cases were rare, their positive results were presumed to be persistent viral shedding rather than reinfection. Consistent with previous studies showing prolonged viral shedding in the feces of patients with COVID-19,4 our results indicated that 6 patients had persistent viral shedding in the gastrointestinal tract after hospital discharge, including 1 patient (patient 2) who had positive results in both samples and showed RT-PCR positivity on March 27, 2020, a viral shedding duration of 56 days from illness onset. Lower threshold cycle values with anal swabs than those with nasopharyngeal swabs were identified in this study; however, the infectivity remains unclear, as infectious viruses have not been isolated from stool samples, to our knowledge.5

This study was limited to a small number of discharged patients who had test results positive for SARS-CoV-2. Further studies using a larger cohort and isolation of the viable virus instead of RT-PCR testing are needed to define infectivity for continued disease management after hospital discharge.

Considering the RT-PCR positivity for SARS-CoV-2 among discharged patients with COVID-19 revealed by this and a previous study,2 appropriate personal protective equipment for medical staff might be important while collecting convalescent plasma, and the effects of convalescent plasma from clinically recovered patients with persistent viral shedding may need to be evaluated separately.

JHH: At the least,  the above small study indicates that people who have had Covid and have been treated or observed may remain contagious for a period of time yet to be determined; they might also become reinfected. 
 
COLLINS PUN FOR THE DAY:  Time flies like an arrow. Fruit flies like a banana.

 
 


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