June 16, 2020

TRAUMA AREA TO JUNE1 4/8/20 5/1/20 6/1/20 6/14/20 6/15/20 6/16/20      
MARSHALL/TYLER/LGV 46 26 63 49 54 53 55      
DALLAS 569 579 636 580 729 728 701      
AUSTIN 61 45 69 89 121 123 141      
HOUSTON 480 495 475 482 681 696 730      
STATE OF TEXAS 1670 1491 1778 1756 2242 2287 2326      
     1. Fifty-four Scientists have Lost their Jobs as a Result of NIH Probe Into Foreign Ties (Science) Some 54 scientists have resigned or been fired as a result of an ongoing investigation by the National Institutes of Health into the failure of NIH grantees to disclose financial ties to foreign governments. In 93% of those cases, the hidden funding came from a Chinese institution.
     2.Sinovac Says Early Data Show its COVID-19 Vaccine Generated Immune Responses (STAT) Sinovac Biotech announced preliminary study results on Saturday showing its experimental Covid-19 vaccine generated immune responses in patients and was safe — early data that suggest it might protect people against infections with the novel coronavirus. The Beijing-based drug maker’s vaccine, called CoronaVac, induced neutralizing antibodies in “above 90%” of people who were tested 14 days after receiving two injections, two weeks apart. There were no severe side effects reported, the company said in a statement.
Harrison County sees 1 new COVID-19 case, two more recoveries
Neutralizing antibodies have an important role in the protection or recovery from many viral infections. Several monoclonal antibody products will enter clinical trials over the next few months and be assessed for their ability to limit or modify SARS-CoV-2 infection. In addition, a drug that reliably prevented progression of COVID-19 would greatly reduce the concerns and uncertainty associated with SARS-CoV-2 infection and give physicians a therapeutic tool they must have for their patients. Establishing the therapeutic or prophylactic efficacy of monoclonal antibodies would be a major advance in the control of the COVID-19 pandemic.
Monoclonal antibodies have received less attention even though neutralizing antibodies are a key component of protective immunity for most viral diseases. Neutralizing monoclonal antibodies to SARS-CoV-2 have the potential for both therapeutic and prophylactic applications, and can help to guide vaccine design and development.
J. Harris: This could be an easier type of therapy to develop.
The number of prison inmates known to be infected has doubled during the past month to more than 65,000. Prison deaths tied to the coronavirus have also risen, by 73 percent since mid-May. By now, the five largest known clusters of the virus in the United States are not at nursing homes or meatpacking plants, but inside correction institutions, according to data The New York Times has been collecting about confirmed coronavirus cases since the pandemic reached American shores.
…Prisons that have conducted mass testing have found that about one in seven tests of inmates have come back positive, the Times database shows. The vast majority of inmates who have tested positive have been asymptomatic.
What is added by this report?

Among a convenience sample of 382 young adult U.S. service members aboard an aircraft carrier experiencing a COVID-19 outbreak, 60% had reactive antibodies, and 59% of those also had neutralizing antibodies at the time of specimen collection. One fifth of infected participants reported no symptoms. Preventive measures, such as using face coverings and observing social distancing, reduced risk for infection.

What are the implications for public health practice?

Young, healthy adults with COVID-19 might have mild or no symptoms; therefore, symptom-based surveillance might not detect all infections. Use of face coverings and other preventive measures could mitigate transmission. The presence of neutralizing antibodies among the majority is a promising indicator of at least short-term immunity.

What is added by this report?

In this sample of intensely exposed subjects, assessed at a single point in time, results demonstrated that antibodies developed and that, at the time of specimen collection, many of these were neutralizing antibodies. Affinity maturation of antibodies is an important determinant for the outcome of viral infection. High-affinity antibodies can elicit neutralization by recognizing specific proteins on the surface of the virus, and these might be produced early or late in the course of viral infection. Approximately one half of the participants with positive ELISA results also had neutralizing antibodies, which indicate functional antibodies that would be expected to inhibit SARS-CoV-2 infection. This is a promising indicator of immunity, and in several participants, neutralizing antibodies were still detectable >40 days after symptom onset. Ongoing studies assessing the humoral antibody response over time will aid the interpretation of serologic results in an outbreak investigation such as this.

The steroid, dexamethasone, reduced deaths by a third in patients receiving ventilation, and by a fifth in patients receiving only oxygen treatment, the scientists said. They found no benefit from the drug in patients who did not need respiratory support.
(J. Harris: Dexamethasone is an old drug and should be plentiful and cheap. Think of it as a really strong form of “cortisone” or prednisone. It long been used in some types of respiratory failure or “shocky” conditions. )

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