October 2, 2020

In addition to a couple of big COVID cases in Washington, DC, yesterday other notable cases include 9 new cases in Harrison County with 14 in Gregg and 37 in Smith County, including several in Tyler and area schools. 
FAQ: What you need to know about masks and covid-19

Judge Ammerman sent this video article over:Children and Covid
(Short video)

FROM JOHNS HOPKINS GREAT WEB SITE:

1. COVID-19 AGE DISTRIBUTION Researchers from the CDC COVID-19 Response Team published analysis of shifts in the age distribution of US COVID-19 cases. The study, published in the CDC’s MMWR, evaluated age data from COVID-19 cases reported in the US between May and August. The analysis included patients who visited the emergency department with COVID-like illness, patients with positive SARS-CoV-2 tests, and confirmed COVID-19 patients as well as test positivity data among the defined age groups. From May to July, COVID-19 incidence increased among all age groups, but the largest increases were observed in individuals under 30 years old, which drove a decrease in the median age of COVID-19 cases—down from 46 years old in May to 38 years old in August. Similar trends were observed at the regional level, although with some variations between regions. The timing of these shifts coincided with many states’ efforts to relax social distancing in order to resume some social and economic activity. Notably, the researchers identified an increase in test positivity among individuals aged 20-39 years in several regions, particularly in the South, that preceded a similar increase among individuals 60 years and older by an average of 8.7 days—with a range of approximately 1-3 incubation periods. This study provides further evidence that transmission among younger portions of the population can drive subsequent increases among older individuals, who are at elevated risk of severe disease and death.

2.  One Number Could Help Reveal how Infectious a COVID-19 Patient is. Should Test Results Include it?(Science) Ever since the coronavirus pandemic began, battles have raged over testing: Which tests should be given, to whom, and how often? Now, epidemiologists and public health experts are opening a new debate. They say testing centers should report not just whether a person is positive, but also a number known as the cycle threshold (CT) value, which indicates how much virus an infected person harbors.

3. GOOD TESTING SUMMARY:

ANTIGEN TESTING Since the onset of the pandemic, many countries around the world have struggled to establish and maintain sufficient testing capacity to support COVID-19 response and prevention measures. Antigen-based tests could potentially provide rapid, on-site/point-of-care testing capacity on a large scale; however, barriers remain to effectively implementing antigen testing strategies. Antigen tests detect the presence of specific viral proteins, as opposed to antibodies or viral RNA, and they are faster and less expensive than traditional PCR-based diagnostic tests.

In the US, antigen testing is gaining momentum, particularly as some companies and organizations are leaning heavily on antigen testing to resume normal operations. In particular, sports leagues have implemented antigen testing to provide routine surveillance capabilities for athletes, coaches, and other staff (e.g., on a daily basis), and multiple US airlines intend to utilize antigen testing for passengers. These programs may not necessarily be mandatory; however, they can provide increased screening capacity for travelers and crew. United Airlines will begin offering on-site antigen testing for flights from San Francisco to Hawai’i, but passengers will be charged an additional $250 to cover the cost of the test. Passengers will also have the option of conducting the test at home. Lufthansa will implement on-site testing for intercontinental flights in the near future.

President Donald Trump announced a new program that willdistribute 150 million antigen
tests nationwide, with the aim of supporting screening efforts at schools and for higher-risk populations (e.g., long-term care facilities). The tests can provide results in approximately 15 minutes and can be performed by “medical personnel or trained operators in certain non-clinical environments.” The program could begin shipping 6.5 million tests this week, with additional tests to follow. Notably, the program will utilize antigen tests produced by Abbott Laboratories. The US FDA issued an Emergency Use Authorization for the Abbot tests; however, data published on the FDA website do not include any tests on individuals aged 21 or younger. Without testing pediatric specimens, it is unclear how accurate the test is in kids. Also, there are approximately 50 million children enrolled in public schools alone, so it is unlikely that 150 million tests would provide routine screening capacity nationwide. Elected and health officials in some states have commented that they are struggling to control where the tests will be distributed or to gather data on test results.

In addition to antigen tests, the FDA issued its first Emergency Use Authorization for a point-of- care serological test. While traditional PCR-based diagnostic tests and antigen tests detect active infection, serological tests detect antibodies, which indicate prior infection. The test, produced by Assure Tech (China), uses a lateral flow approach and can provide test results in as little as 15 minutes using fingerstick blood specimens. The tests can be administered at common points of care, such as primary care physician offices and emergency departments, without the need to transport specimens to centralized laboratories with specialized equipment and personnel. The expanded availability of serological tests, particularly rapid tests capable of on-site testing, can further increase critical testing capacity and provide valuable data for both individuals and public health officials. 
Study finds 100% death rate in COVID-19 patients after CPR
(J. Harris: Good summary article of JAMA article which illustrates more reasons not to contact COVID.)

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