September 29, 2020

Harrison County reports 1 new case Monday while 
Gregg had 16 and Smith 46.   (J. Harris: Are we creeping upward again?)

FROM A HOUSTON INTERNIST: “Imagine being the December dead chump with no mask when your friends are getting their vaccine in January..”

Lessons learnt from easing COVID-19 restrictions: an analysis of countries and regions in Asia Pacific and Europe
The COVID-19 pandemic is an unprecedented global crisis. Many countries have implemented restrictions on population movement to slow the spread of severe acute respiratory syndrome coronavirus 2 and prevent health systems from becoming overwhelmed; some have instituted full or partial lockdowns. However, lockdowns and other extreme restrictions cannot be sustained for the long term in the hope that there will be an effective vaccine or treatment for COVID-19. Governments worldwide now face the common challenge of easing lockdowns and restrictions while balancing various health, social, and economic concerns. To facilitate cross-country learning, this Health Policy paper uses an adapted framework to examine the approaches taken by nine high-income countries and regions that have started to ease COVID-19 restrictions: five in the Asia Pacific region (ie, Hong Kong [Special Administrative Region], Japan, New Zealand, Singapore, and South Korea) and four in Europe (ie, Germany, Norway, Spain, and the UK). This comparative analysis presents important lessons to be learnt from the experiences of these countries and regions. Although the future of the virus is unknown at present, countries should continue to share their experiences, shield populations who are at risk, and suppress transmission to save lives.
COVID-SNIFFING DOGS SARS-CoV-2 testing would likely be less scary or uncomfortable if it was conducted by puppies. Perhaps that is part of the motivation behind Finland’s new plan to deploy “coronavirus-sniffing dogs” at the Helsinki Airport. The airport is conducting a pilot project that uses specially-trained dogs to detect SARS-CoV-2 infection in passengers based on their scent. Dogs have been used in a similar manner to detect other infections or diseases that cause a distinct odor in patients, including cancer and Clostridium difficile, sometimes before the onset of symptoms. Samples are taken by swabbing passengers’ necks and then delivered to the dogs in a separate room. One researcher from the University of Helsinki indicated that the dogs can approach 100% sensitivity and can detect infection up to 5 days before the onset of symptoms. A similar program was also recently implemented in the Dubai International Airport. The use of dogs to detect SARS-CoV-2 has not been sufficiently assessed in scientific studies, so passengers identified by the dogs will be administered a more traditional test to confirm infection. Further research is needed to demonstrate the accuracy of this surveillance method, but it could provide rapid assessment capability, particularly for high-traffic areas like airports.

Susceptibility to SARS-CoV-2 Infection Among Children and Adolescents Compared With Adults: A Systematic Review and Meta-analysis (JAMA Pediatrics) In this systematic review and meta-analysis including 32 studies, children and adolescents younger than 20 years had 44% lower odds of secondary infection with SARS-CoV-2 compared with adults 20 years and older; this finding was most marked in those younger than 10 to 14 years. Data were insufficient to conclude whether transmission of SARS-CoV-2 by children is lower than by adults. Preliminary evidence suggests that children have a lower susceptibility to SARS-CoV-2 infection compared with adults, but the role that children and adolescents play in transmission of this virus remains unclear.

Prevalence of SARS-CoV-2 antibodies in a large nationwide sample of patients on dialysis in the USA: a cross-sectional study
” …fewer than 10% of the US population has seroconverted as of July, 2020, and herd immunity remains out of reach, as has been the conclusion from large international surveys from the UK44 and Spain,1 where intense outbreaks of COVID-19 occurred during the spring and summer of 2020…..However recurring monthly testing of remainder plasma of randomly selected sets of people—as is practically feasible in patients receiving dialysis—can serve as a representative surveillance system in the USA…(J. Harris: This Lancet article has a readable and comprehensive “Conclusion” portion that is worth the read.) 

New document reveals scope and structure of Operation Warp Speed and underscores vast military involvement
(J. Harris: Please let me know if you are able to follow their flow sheet.)

My friend’s bakery burned down last night. Now his business is toast.

If toast always lands butter-side down and cats always land on
their feet, what happens if you strap toast on the back of a cat?
~ Steven Wright