CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 9/3/2020

September 3, 2020

The MNM reports zero new cases in Harrison County, 10 in Gregg,  and 20 in Smith County. 

These are the top coronavirus vaccines to watch
(J. Harris: This vaccine summary from the Post is worth keeping and following; it features a simple vaccine classification and, hopefully, will be continually updated. World wide cooperation and unlimited budgets should speed up functional vaccine availability and use. Very encouraging)

Seroprevalence of SARS-CoV-2 Among Frontline Health Care Personnel in a Multistate Hospital Network — 13 Academic Medical Centers, April–June 2020

“Among a convenience sample of HCP (HEALTH CARE PERSONNEL) who routinely cared for COVID-19 patients in 13 U.S. academic medical centers from February 1, 2020, 6% had evidence of previous SARS-CoV-2 infection, with considerable variation by location that generally correlated with community cumulative incidence. Among participants who had positive test results for SARS-CoV-2 antibodies, approximately one third did not recall any symptoms consistent with an acute viral illness in the preceding months, nearly one half did not suspect that they previously had COVID-19, and approximately two thirds did not have a previous positive test result demonstrating an acute SARS-CoV-2 infection. These findings suggest that some SARS-CoV-2 infections among frontline HCP are undetected and unrecognized, possibly because of the minimally symptomatic or subclinical nature of some infections, underreporting of symptoms, or nonsystematic testing of some personnel with symptomatic infections.

MORE FOR JOHNS HOPKINS:1. Unexpected Health Insurance Profits and the COVID-19 Crisis(JAMA Health Forum) The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented financial stress on most of the US health care system, including physician practices, emergency medical service systems, and hospitals. But there is one notable exception: health insurance companies. Sharp declines in elective care during the pandemic have reduced health care expenditures and contributed to earnings that are twice as large as those earned last year.Unexpected Health Insurance Profits and the COVID-19 Crisis(JAMA Health Forum) The coronavirus disease 2019 (COVID-19) pandemic has placed unprecedented financial stress on most of the US health care system, including physician practices, emergency medical service systems, and hospitals. But there is one notable exception: health insurance companies. Sharp declines in elective care during the pandemic have reduced health care expenditures and contributed to earnings that are twice as large as those earned last year.

2. Association Between Administration of Systemic Corticosteroids and Mortality Among Critically Ill Patients With COVID-19 A Meta-analysis (JAMA) In this prospective meta-analysis of clinical trials of critically ill patients with COVID-19, administration of systemic corticosteroids, compared with usual care or placebo, was associated with lower 28-day all-cause mortality. (MORE ON THIS TOMORROW)
See also:Steroids Can Be Lifesaving for Covid-19 Patients, Scientists Report (New York Times)

3. Humoral Immune Response to SARS-CoV-2 in Iceland (New England Journal of Medicine) Our results indicate that antiviral antibodies against SARS-CoV-2 did not decline within 4 months after diagnosis. We estimate that the risk of death from infection was 0.3% and that 44% of persons infected with SARS-CoV-2 in Iceland were not diagnosed by qPCR. (MORE LATER ABOUT ICELAND)
4. 
Can Europe tame the pandemic’s next wave? (Science) “We’re at risk of gambling away our success,” virologist Christian Drosten warned in the German newspaper Die Zeit last month. His message referred to Germany, but it could have been addressed to all of Europe. After beating back COVID-19 in the spring, most of Europe is seeing a resurgence.

5.COVID-19 case fatality in the US has been declining since its peak (approximately 6%) in mid-May, but it is beginning to level off…..States that were severely affected during the summer resurgence—including Arizona (2.5%), California (1.8%), Florida (1.8%), and Texas (2.1%)—have fared much better in terms of case fatality; however, they had the advantage of advanced warning that provided additional time to improve preparedness and acquire necessary resources (eg, PPE, ventilators) as well as increased testing capacity, which identified many more cases than early in the pandemic. Additionally, the summer resurgence was spread across a larger geographic area, which mitigated to some extent the patient surge on individual health systems. A number of states remain at or below 1% case fatality, including Alaska, Hawai’i, North Dakota, and Utah.The Importance of Reestablishing a Pandemic Preparedness Office at the White House


(J. Harris: A brief history of American attempts at pandemic vigilance. It seems that the “Pandemic Office” in the White House, was started by Clinton and then closed only to be reopened and closed and opened as needed for the various epidemic threats by George W Bush and Obama and finally closed by Trump. This article from JAMA suggests that the Office of Global Affairs in the Department of Health and Human Services (DHHS) is the appropriate agency to maintain medical supplies and to oversee the CDC and FDA and to work closely with the military in the future. I don’t know what the function of the Surgeon General is to be, perhaps to look good in a uniform and pal around in the White House. There are so many agencies and Chiefs and causes and claims as well as so much confusion, but maybe that’s the price of living in a democracy with freedom of independent thought. It’s pretty easy to run a “tight ship” if it’s small and tidy and the weather is good….Nevertheless, when I am Czar, I plan to tighten things up a bit).

My ex-wife still misses me. (But her aim is starting to improve).

I just found out that I’m color blind. The news came completely out of the green!.

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