CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/10/2020
From the MNM: Yesterday Harrison County reported 28 new cases, Gregg County had 12 confirmed, 41 probable for a total of 53 new cases. Smith County had 52 confirmed, 224 probable for a total of 276 new cases that accumulated over the weekend and on Monday.
From the MNM re MISD: “…Marshall Independent School District reporting nine new cases, and five recoveries…Out of the nine new cases at MISD, five are at Marshall High School, two at Marshall Junior High School and one at Sam Houston Elementary… some of the “new cases” are students or staff who were already under quarantine for several days due to previous exposure, but are just now receiving a positive test result.
More than 6,000 people are hospitalized for COVID-19 in Texas: GREAT WEBSITE WITH CURRENT STATS AND GOOD INFORMATION AND NEWS AND IS FREE
J. HARRIS COMMENT on the above information: Texas has had almost a million cases of Covid-19. At this time, the hospitalized numbers are up around the state, but the hospital numbers were actually higher in the summer. At that time, there were more vulnerable nursing home residents and elderly people who became ill. In addition, health care providers were less experienced and therapeutic options were less numerous than they are now. Nevertheless, it seems likely to me that we are going to overload the medical system in Texas again and not in a patchwork fashion this time. This Christmas, there may be no room at any of the Inns. I believe I’ll play it safe and severely limit my holiday visiting, shopping, and partying. I’ll wait until next year when it’s safe to have a family reunion or Thanksgiving dinner. I may try and limit most of my giving to the Food Pantry.
1. UNITED STATES
The US CDC reported 9.46 million total cases and 233,129 deaths. The US reported 106,537 new cases yesterday (11/5/20), the first country to surpass 100,000 cases in a single day. The daily COVID-19 incidence continues to increase and set new records, now up to an average of 89,912 new cases per day.
2.EUROPE HEALTH SYSTEMS Under substantial strain due to ongoing COVID-19 resurgence, the health systems in numerous high-resourced European countries—including Germany, Belgium, and France—are nearing their maximum capacity. Some Belgian doctors who have tested positive for SARS-CoV-2 but who remain asymptomatic and have a low viral load have reportedly been directed to continue treating COVID-19 patients in order to maintain sufficient clinical capacity. Some hospitals in Belgium are reportedly trying to reduce the COVID-19 burden by transferring patients to neighboring Germany, but this may not be a viable option in the longer term.
3 Characteristics and Outcomes of COVID-19-associated Stroke: a UK Multicentre Case-control Study (BMJ) This case-control study included patients admitted with stroke to 13 hospitals in England and Scotland between 9th March and 5th July 2020. We collected data on 86 strokes (81 ischaemic strokes and 5intracerebral haemorrhages)in patients with evidence of COVID-19 at the time of stroke onset (Cases).
EXCERPTS: Our study provides the most compelling evidence yet that COVID-19-associated ischaemic strokes are more severe and more likely to result in severe disability or death, although the outlook is not quite as bleak as previous studies have suggested . Our results suggest the following
recommendations for management of stroke patients during the ongoing COVID-19 pandemic.
If at any point a stroke centre is not routinely testing all stroke admissions for SARS-CoV-2, patients presenting with ischaemic stroke and very elevated D-dimers with no other explanation should be considered for testing,even if the clinical suspicion of COVID-19 is otherwise low. Criteria for requesting CT angiography in stroke patients may now need to take account of their COVID-19 status, because the finding of multiple large vessel occlusions may require a specific management strategy such as mechanical thrombectomy or possibly, in the future, a different antithrombotic agent. On the other hand, in most patients with COVID-19-associated ischaemic stroke, very early anticoagulation is probably not warranted as a strategy to prevent inpatient stroke recurrence, as this outcome is too uncommon to justify the increased risk of secondary haemorrhage.
(J. Harris: Covid induced strokes are generally more severe than those without Covid.”Dimers” is a simple blood test that reflects blood clotting in the body. )
Coronavirus disease 2019 (COVID-19) (Another good general site)
(J. Harris: Mayo Clinic’s site. Concise. Complete. Comforting, Commercial. Very proper.)
JOHNS HOPKINS SELECTIONS:
1. Denmark Will Kill All Farmed Mink, Citing Coronavirus Infections (New York Times) The Danish government will slaughter millions of mink at more than 1,000 farms, citing concerns that a mutation in the novel coronavirus that has infected the mink could possibly interfere with the effectiveness of a vaccine for humans. Prime Minister Mette Frederiksen made the announcement at a news conference on Wednesday. There are 15 million or more mink in Denmark, which is one of the world’s major exporters of mink furs.
2. Construction Sites
A study published in JAMA: Network Open developed a stochastic model to analyze exposure risk among construction site workers in Austin, Texas (US). Using local demographic data and reported COVID-19 hospitalization rates, the researchers modeled 15 scenarios representing various worksite area sizes and degrees of transmission between workers, corresponding to the implementation of various COVID-19 control measures. Notably, at the time of the study, the researchers estimated that the per capita COVID-19 hospitalization rate among construction workers was 4.5 times the rate among the entire Austin population. The model illustrated that close contact in high-risk worksites with large construction crews not only corresponded to elevated workplace transmission and construction worker hospitalizations, but also increased community transmission. Based on the results of the study led local authorities in Austin to impose more restrictive worksite safety requirements, including increased cleaning of shared equipment, daily symptom monitoring, and enhanced documentation to support contact tracing.
3. COVID-19 IN CHILDREN According to data published by the American Academy of Pediatrics (AAP), more than 61,000 pediatric cases of COVID-19 were reported in the US in the last week of October, the highest weekly total to date. Through October 29, more than 850,000 pediatric cases have been reported nationally since the onset of the pandemic, representing 11% of all US cases. The data continue to indicate that severe illness is relatively rare among children; however, a number of states—including Missouri and North Dakota—recently reported deaths in teenagers, their youngest COVID-19 deaths to date.
4. Grocery Stores Workers
Researchers from Harvard and Boston Universities (Massachusetts, US) analyzed exposure and infection risks among 104 employees at a Boston-area grocery store. The study, published in BMJ, also evaluated the employees’ mental health, specifically evaluating for signs of anxiety and depression. As part of a testing program mandated by the local government, all employees underwent PCR-based diagnostic testing, and 21 tested positive for SARS-CoV-2. Notably, 76% of the positive employees were not symptomatic at the time of testing. Employees whose jobs involved direct interaction with customers were 5 times more likely to test positive for SARS-CoV-2 than those without direct customer contact. Among 99 participants who completed the mental health assessments, 24 reported “at least mild anxiety” and 8 “screened positive for at least mild depression.” Individuals who were able to practice effective social distancing at work were less likely to experience both anxiety and depression. Additionally, those who were able to commute to work without using public transportation (e.g., walk, bicycle, private vehicle) exhibited a 90% reduction in the risk depression.
(J. Harris: This was an inelegant quick study done in May, 2020 in Boston. It was mostly concerned with mental health when they found the high Covid infection rate. Hopefully now 20% of workers in a grocery would not be Covid positive!)
5. WHO Needs Reforms, While Preserving ‘Political Independence’: Panel (Reuters) An oversight panel called on Thursday for reforms at the World Health Organization including “predictable and flexible” funding and setting up a multi-tiered system to warn countries earlier about disease outbreaks before they escalate. The independent experts said it was essential to preserve the U.N. agency’s “neutrality and political independence” in tackling outbreaks, but did not refer directly to China or the United States.
Your grandparents were called to war. You’re being called to sit on your couch. You can do this!!
Due to panic buying, Walmart has opened register 3.
Pro tip: if you get pulled over, just start coughing.
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