October 6, 2020
On Monday, Harrison County had 6 new Covid cases and the MISD reported a total of only 4 active cases. The USA reported 42, 223 new cases yesterday which is a 6% increase in the daily count. As Dr. Yogi Berra said, “The opera ain’t over till the Fat Lady sings.” I might add that the Fat Lady is available at any time to sing at funerals.
FROM JOHNS HOPKINS SELECTIONS:
1. CARDIAC ARREST & CPR Researcher from a number of US medical institutions published findings from a study on the use of cardiopulmonary resuscitation (CPR) in COVID-19 patients who experience cardiac arrest. The researchers note that “anecdotal reports of poor outcomes in critically ill patients with COVID-19 who have had in-hospital cardiac arrest have prompted discussions on the futility of [CPR] in this patient population.” The study, published in BMJ, included more than 5,000 COVID-19 patients who were admitted to intensive care units at 68 hospitals across the US. Among these patients, 701 participants (14%) experienced cardiac arrest while hospitalized, and 400 (57.1%) of those individuals received CPR. Among the 400 patients who received CPR, 48 (12%) survived to discharge, and 28 (7%) exhibited normal neurological function or only mild neurological impairment. These percentages are relatively consistent with studies of CPR among non-COVID-19 patients, which indicates that CPR does provide benefit to COVID-19 patients. Additionally, the study illustrates the high rate of cardiac arrest among COVID-19 patients, and hospitals and health systems should be prepared for the increased demand among severe COVID-19 patients.(J. Harris: another recent article had indicated even less survival post CPR. Wear your mask).
2. Meeting highlights from the Pharmacovigilance Risk Assessment Committee (PRAC) 28 September – 1 October 2020EMA’s safety committee (PRAC) has started a review of a safety signal to assess reports of acute kidney injury in some patients with COVID-19 taking Veklury (remdesivir).
Kidney injury can be caused by other factors as well, e.g. diabetes; importantly, COVID-19 is itself known to be a cause. The PRAC will now carefully assess all available data to evaluate if the medicine may have been responsible for the kidney problems and if there is a need to update the existing information for Veklury. Recommendations for the use of this medicine have not changed.(J. Harris: Just how likely this new drug is to cause or to accentuate kidney damage is being studied, but it needs to be used with caution and not whim.)
3.Face Masks, Public Policies and Slowing the Spread of COVID-19: Evidence from Canada (National Bureau of Economic Research) We estimate the impact of mask mandates and other non-pharmaceutical interventions (NPI) on COVID-19 case growth in Canada, including regulations on businesses and gatherings, school closures, travel and self-isolation, and long-term care homes. We partially account for behavioral responses using Google mobility data. Our identification approach exploits variation in the timing of indoor face mask mandates staggered over two months in the 34 public health regions in Ontario, Canada’s most populous province. We find that, in the first few weeks after implementation, mask mandates are associated with a reduction of 25 percent in the weekly number of new COVID-19 cases.
4.Changing Age Distribution of the COVID-19 Pandemic — United States, May–August 2020 During June–August 2020, COVID-19 incidence was highest in persons aged 20–29 years, who accounted for >20% of all confirmed cases. Younger adults likely contribute to community transmission of COVID-19. Across the southern United States in June 2020, increases in percentage of positive SARS-CoV-2 test results among adults aged 20–39 years preceded increases among those aged ≥60 years by 4–15 days. Strict adherence to community mitigation strategies and personal preventive behaviors by younger adults is needed to help reduce infection and subsequent transmission to persons at higher risk for severe illness. (CDC MMWR, 10/2/2020)
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