CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/06/2020
|James Harris||2:20 PM (1 hour ago)|
Covid counts for 6 Nov.
Gregg County include 16 confirmed and 52 probable for a daily new total of 68 cases.
Smith County reports 15 confirmed, 70 probably for 85 new cases.
3 confirmed cases. No matter where tests are run, positive results are reported to the patients county of record. “Recoveries” are non hospitalized Covid positive cases after 14 days. They are not routinely retested. At this time, I don’t know how death locations are tabulated–county of death or county of residence?
MNM reports 3 “confirmed” cases in Harrison County for 5 Nov.
(J. Harris: We are holding our own in TSA “G.” If we continue to be smart, we may have less trouble than some areas and not get in a bind like we did in the summer.)
(J. Harris: Remember that diminished ability to “smell things” goes with aging. Should you keep me off an airplane if I flunk a smell test?)
“Crucially, it will be important to communicate to policy makers and the general public that first-generation vaccines are only one tool in the overall public health response to COVID-19 and unlikely to be the ultimate solution that many expect.”
(J. Harris: A Sept. article that I missed. This summary is worth your time and is readable.)
(J. Harris: An autopsy series of some interest)
FROM JOHNS HOPKINS REVIEWS
1. Review Finds Almost 20% of COVID-19 Patients Only Show Gastrointestinal Symptoms (Eureka Alert) The findings of the review suggest abdominal radiologists need to remain vigilant during the pandemic while imaging patients. Gastrointestinal symptoms associated with COVID-19 vary widely but can include loss of appetite, nausea, vomiting, diarrhea and generalized abdominal pain. The researchers who conducted the review report that 18 per cent of patients presented with such symptoms, while 16 per cent of COVID-19 cases may only present with gastrointestinal symptoms.
(J. Harris: In other words, almost 20% of Covid cases had ONLY
gastrointestinal symptoms, not respiratory! It’s getting hard to distinguish between a hangover and Covid, or both.)
2. Longitudinal Monitoring of SARS-CoV-2 RNA on High-touch Surfaces in a Community Setting (MedRxiv) We conducted longitudinal swab sampling of high-touch non-porous surfaces in a Massachusetts town during a COVID-19 outbreak from April to June 2020. Twenty-nine of 348 (8.3 %) surface samples were positive for SARS-CoV-2, including crosswalk buttons, trash can handles, and door handles of essential business entrances (grocery store, liquor store, bank, and gas station). The estimated risk of infection from touching a contaminated surface was low (less than 5 in 10,000), suggesting fomites play a MINIMAL role in SARS-CoV-2 community transmission.
SARS-CoV-2 antibody responses range from negligible to robust in mild COVID-19
Some individuals maintain stable or increased SARS-CoV-2 IgG, while most decline
Those who sustain virus-specific IgG production tend to have shorter disease courses
Virus-specific B cells from “sustainers” have more SHM early after disease resolution
Antibodies are key immune effectors that confer protection against pathogenic threats. The nature and longevity of the antibody response to SARS-CoV-2 infection is not well defined. We charted longitudinal antibody responses to SARS-CoV-2 in 92 subjects after symptomatic COVID-19. Antibody responses to SARS-CoV-2 are unimodally distributed over a broad range, with symptom severity correlating directly with virus-specific antibody magnitude. Seventy-six subjects followed longitudinally to ∼100 days demonstrated marked heterogeneity in antibody duration dynamics. Virus-specific IgG decayed substantially in most individuals, whereas a distinct subset had stable or increasing antibody levels in the same timeframe despite similar initial antibody magnitudes. These individuals with increasing responses recovered rapidly from symptomatic COVID-19 disease, harbored increased somatic mutations in virus-specific memory B cell antibody genes, and had persistent higher frequencies of previously activated CD4+ T cells. These findings illuminate an efficient immune phenotype that connects rapid symptom clearance to differential antibody durability dynamics.
(J. Harris: This study will be ongoing and should be of help in vaccine design and development.)
4. A Rapid Virus Test Falters in People Without Symptoms, Study Finds (New York Times) One strategy has involved the widespread use of rapid tests, which forgo sophisticated equipment and can return results in minutes. Purchased in bulk by the federal government and shipped nationwide, millions of these products have already found their way into clinics, nursing homes, schools, athletic teams’ facilities and more, buoying hopes that the tests might hasten a return to normalcy. But a new study casts doubt on whether rapid tests perform as promised under real-world conditions, especially when used in people without symptoms.
5. Remdesivir for the Treatment of Covid-19 — Final Report (NEJM) We conducted a double-blind, randomized, placebo-controlled trial of intravenous remdesivir in adults who were hospitalized with Covid-19 and had evidence of lower respiratory tract infection. Our data show that remdesivir was superior to placebo in shortening the time to recovery in adults who were hospitalized with Covid-19 and had evidence of lower respiratory tract infection.
(J. Harris: This was a double blind study, which means the doctors didn’t know which patients got the experimental medicine. Ultimately, the data showed that hospitalization was 5 days shorter for patients treated with remdesivir. Side effects were actually higher in placebo patients. Fewer treated patients who received remdesivir progressed to a need for respirators. Apparently no one died in either group. Had I Covid with lung involvement, I would welcome the treatment, as did President Trump.)
2. United States Tops 100,000 New Virus Cases in a Day for First Time (Washington Post) The United States reported more than 100,000 new coronavirus cases on Wednesday, according to data tracked by The Washington Post. Seventeen states — including Kansas, Tennessee, Virginia, Oklahoma, Montana, Iowa, North Dakota, South Dakota, Ohio, Nebraska, Minnesota, Indiana and West Virginia — on Wednesday reported record numbers of patients hospitalized with covid-19, the disease caused by the virus. In many of these states, hospital capacity is under serious threat.
A FEW MORE OLDIES, ANYONE?
Q. Which of your five senses tends to diminish as you get older?A. Charley Weaver: My sense of decency.
Q. Paul, why do Hell’s Angels wear leather?
A. Paul Lynde: Because chiffon wrinkles too easily.
Q. Can boys join the Camp Fire Girls?
A. Marty Allen: Only after lights out.
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