CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/12/2020

October 12, 2020

There are no Covid counts for the weekend done over the weekend.
Letter to the Editor: Information shared on health care at Christus
(from Brett Kinman, Administrator)
(J. Harris: Brett Kinman is a well trained and experienced hospital administrator. Marshall is fortunate to have him in our community. The Christus Health system likely kept the Good Shepherd hospitals in Marshall and Longview from having to close.   Christus has a healing ministry as well as deep pockets. They have experience in many Texas communities with problems similar to ours. They will be able to recruit badly needed primary care physicians for our hospital and will be able to maintain our hospital as well as their excellent nearby hospitals  in Longview and Tyler. When indicated, other medical services will be reestablished. You can see from the map below that Christus has hospitals in many mid-sized Texas towns, including Texarkana — as well as Shreveport, LA. In short, Christus Health is here to stay. My family and I have continued to utilize their services, here as well as in Longview and Tyler. )

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CHRISTUS and Texas Oncology to build new cancer institute in Tyler

For years, leaders at CHRISTUS Trinity Mother Frances and Texas Oncology met to come up with a partnership to help treat and care for cancer patients. With the new Louise Herrington Cancer Center on the fifth floor of the Bradley-Thompson Tower at CHRISTUS Mother Frances Hospital in Tyler opening, the partnership was announced. Texas Oncology and CHRISTUS said the new outpatient treatment and research center will be called the Northeast Texas Cancer and Research Institute. A groundbreaking ceremony is expected in within four months and the doors will open in summer of 2022.

 (J. Harris: TEXAS ONCOLOGY is, in my opinion, the best group of cancer treating doctors in the state. This new facility and association is news to me. I also wonder what is the relationship of Christus Good Shepherd with the Christus system in Shreveport?)
Change in COVID-19 case reporting shows disagreement over types of testing

Quidel Receives Emergency Authorization for First Rapid Antigen “ABC Test”: A Combination Diagnostic Assay for Influenza A+B and COVID-19
“The new Sofia® 2 Flu + SARS Antigen FIA offers excellent performance for SARS-2 (95.2% PPA versus PCR and 100% NPA versus PCR), as well as for Influenza A (90% sensitivity versus culture and 95% specificity versus culture) and Influenza B (89% sensitivity versus culture and 96% specificity versus culture) in nasal swabs. Quidel’s new Sofia® test delivers a fast, highly accurate result for all three viruses from one nasal swab (or nasopharyngeal swab) sample in just 15 minutes, providing critical answers to patients and healthcare workers alike.”(J. Harris: Hopefully Christus will be offering this combo test locally.)
THE PEOPLE’S PHARMACY ON NPR RADIO
This program comes on KERA Radio on Saturdays at 0600. For years I have stumbled onto it while looking for news. It’s my reminder that Saturday is here. Recently, however, I have appreciated the following programs:1. 1227 regarding airborne virus and ventilation2. 1228 about Covid Vaccines3. 1230 (Saturday) which features a young healthy female PhD who lives in Beaumont, TX  with “Long Haul,” as well as an Alabama MD-Infectious Disease Specialist who had COVID early. This program will make you glad to have a mask and will ensure that you use it. This last program may not be on the web yet, but it will be.
All of these broadcasts are well done, not political, not preachy, just educational conversations with experts who can translate medical happenings in understandable (and believable) language.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/10/2020

October 10, 2020

FROM THE MNM: On Friday Harrison County Judge Chad Sims announced that the county saw 11 new cases of the coronavirus that day, along with five recoveries.

This brings the counties total active cases up to 49 to end the week.

Since the outbreak of COVID-19 Harrison County has seen 949 total positive cases and 865 total recoveries, with 35 fatalities from the virus.

Community members can visit the Convention Center Saturday from 9 a.m. to 4 p.m. for free COVID-19 testing.

No appointment is necessary, and walk-ins are welcome, though a phone number is required with testing since results will only be sent out through text.

Symptoms of Covid-19 are a poor marker of infection 
Symptoms of Covid-19 Are a Poor Marker of Infection (UCL) 86% of people who tested positive for Covid-19 during lockdown did not have virus symptoms (cough, and/or fever, and/or loss of taste/smell), finds a study by UCL researchers. The authors say a more widespread testing programme is needed to catch ‘silent’ transmission.

FROM JOHNS HOPKINS

1. UNITED STATESThe US CDC reported 7.53 million total cases and 211,132 deaths. The US daily COVID-19 incidence continues to climb, now up to 44,984 new cases per day, the highest since August 20. Yesterday, the CDC reported 53,051 new cases, the highest daily total since August 15. The US COVID-19 mortality continues to decline slowly, now down to 675 deaths per day, the lowest daily average since July 10. We have observed previously, however, that mortality trends tend to lag 2-3 weeks behind incidence, so it will be important to monitor mortality over the coming weeks.

Half of all US states are reporting more than 100,000 cases, including California with more than 800,000 cases; Texas and Florida with more than 700,000; New York with more than 400,000; Georgia and Illinois with more than 300,000; and ArizonaNew JerseyNorth Carolina, and Tennessee with more than 200,000.

The Johns Hopkins Coronavirus Resource Center reported 7.62 million US cases and 213,016 deaths as of 12:30pm EDT on October 9.

UNITED STATES

The US CDC reported 7.45 million total cases and 209,560 deaths. The US is averaging 43,852 new cases and 708 deaths per day. The daily mortality increased for the second consecutive day, after falling below 700 for the first time since mid-July.


2. 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.

3. ‘Rural Surge’ Propels India Toward More Covid-19 Infections Than U.S. (NYT) The defiance of the coronavirus rules is being reflected across rural India, and it is propelling this nation’s virus caseload toward the No. 1 spot globally. Infections are rippling into every corner of this country of 1.3 billion people. In the Indian megacities where the pandemic first hit, vigorous public awareness campaigns have left the populace mostly on guard. But when it comes to government efforts to contain the virus, rural India is resisting.

4.”….A single test intended to detect COVID-19, influenza and respiratory syncytial virus (RSV) will receive advanced development support …. test is being designed to provide rapid, qualitative detection of SARS-CoV-2, Influenza A, Influenza B, and RSV; as well as distinguish between these diseases in a single-patient sample. The test will operate on Cepheid’s GeneXpert systems, in both laboratory and point-of-care settings.(J. Harris:  Having one test to diagnose and differentiate the common causes of viral respiratory infections available at the point of care and immediately would be great.  Multiple agencies are working on it.)

Have a Nice Weekend!

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/9/2020

October 9, 2020

On Thursday Harrison County reported 2 new cases, Gregg 3 and Smith 1. Covid Testing will again be available today and tomorrow at theCivic/Convention Center. 
FROM JOHNS HOPKINS SELECTIONS:1. A Global Data Effort Probes Whether Covid Causes Diabetes(Wired) From Mohammad Shafi Kuchay, an endocrinologist who consulted on the cases, told WIRED via email that he and the other doctors assigned to the cases assumed the virus had somehow knocked out these patients’ insulin-making cells, giving them type 1 diabetes. And so the doctors put the men on a regimen of insulin injections. But as the months went by, they needed the injections less and less. They were shifted to oral antidiabetic drugs, and have been managing like this for more than two months now.
2. Global Shortage of Key Covid Drug Leads to NHS Rationing (The Guardian) A global shortage of remdesivir, one of the key Covid-19 drugs given to Donald Trump since he tested positive for the virus, is leading to rationing in the UK and pressure on the manufacturer to allow other companies to supply it. Remdesivir, made by the US company Gilead, is one of only two drugs proven to work against Covid-19. It has been shown to help patients recover faster from the disease and shorten the length of hospital treatment but is not a cure.
3.Eli Lilly Says its Monoclonal Antibody Cocktail is Effective in Treating Covid-19 (STAT News) Eli Lilly said Wednesday a monoclonal antibody treatment is effective in reducing levels of the virus that causes Covid-19 in patients, and also appears to prevent patients from visiting the emergency room or hospital.(J. Harris: Don’t buy stock yet; the results were barely significant statistically. However, it’s early yet; they will continue to improve their products.)
4. Analysis of Genomic Characteristics and Transmission Routes of Patients With Confirmed SARS-CoV-2 in Southern California During the Early Stage of the US COVID-19 Pandemic(JAMA) This case series of 192 patients found that 82% of SARS-CoV-2 isolates from Los Angeles shared closest similarity to those originating in Europe vs those from Asia (15%). Using the variation signature of the viral genomes, 2 main clusters were identified, with the top variants sharing genomic features from European SARS-CoV-2 isolates, and several subclusters of SARS-CoV-2 outbreaks represented trackable community spread in Los Angeles. These findings suggest that SARS-CoV-2 genomes in Los Angeles were predominantly related to the isolates originating from Europe, which are similar to viral strain distributions in New York, New York; a smaller subgroup of SARS-CoV-2 genomes shared similarities to those from originating from Asia, indicating multiple sources of viral introduction within the Los Angeles community.
5. Science Is Needed to Rescue the Nation From COVID-19, but Not Just Traditional Biomedical Science (JAMA) As the US pushes rigorous education in STEM (science, technology, engineering, and mathematics), it is worth reflecting on this global pandemic and what kind of science society is not effectively using. So far, the greatest unmet need in successfully fighting coronavirus disease 2019 (COVID-19) in the US relates to the insights provided by the social sciences rather than by the traditional biomedical sciences. Sociologists and psychologists are as important in this crisis as virologists and epidemiologists. In the US, people are comfortable with and accustomed to scientists rescuing them or helping them avoid disaster. But when that does not work perfectly, or leaves temporary gaps, people are left to rely on something less predictable—the human psyche and human interaction—to prevent the spread of the virus.
‘SNL’ Nixes Morgan Wallen Appearance After Singer Violates COVID-19 Safety Protocols

THIS JUST IN: Dr. Jim Harris has been selected as the official doctor of the Dallas Cowboy Cheerleaders. Jerry Jone says that Harris is a natural fit. 

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/8/2020

October 8, 2020

This is an unprecedented editorial from the best medical journal in the world. If you want to know what virtually all good doctors think, read this editorial. As a political conservative, I regret the need for this message, but, …”truth is neither liberal nor conservative.” Jim Harris, MD

CLICK HERE TO READ THE NEW ENGLAND JOURNAL OF MEDICINE ARTICLE

From the MNM: Harrison County reported 3 new Covid cases. “The county judge reminded that free walk-up testing will be offered, again, this weekend, from 9 a.m. to 4 p.m., Friday and Saturday, at Marshall Convention Center, located at 2501 E. End Blvd. South.”
Cases at Marshall Independent School District are also climbing with six new active cases reported, on Wednesday.

“We have six new active cases to report, which gives us a total of 11 active cases currently in MISD,” David Weaver, MISD’s pubic information director, indicted.

Weaver said three of the new cases were at Marshall High School; the other three were at Sam Houston Elementary.

“With 13 recoveries overall on the year, we now have had a total of 24 cases throughout the district this year,” he said.

The county judge reminded that free walk-up testing will be offered, again, this weekend, from 9 a.m. to 4 p.m., Friday and Saturday, at Marshall Convention Center, located at 2501 E. End Blvd. South.

Dying in a Leadership Vacuum

Editorial from The England Journal of Medicine

Covid-19 has created a crisis throughout the
world. This crisis has produced a test of leadership.
With no good options to combat a novel
pathogen, countries were forced to make hard
choices about how to respond. Here in the
United States, our leaders have failed that test.
They have taken a crisis and turned it into a
tragedy.

The magnitude of this failure is astonishing.
According to the Johns Hopkins Center for Systems
Science and Engineering,1 the United States
leads the world in Covid-19 cases and in deaths
due to the disease, far exceeding the numbers in
much larger countries, such as China. The death
rate in this country is more than double that of
Canada, exceeds that of Japan, a country with a
vulnerable and elderly population, by a factor of
almost 50, and even dwarfs the rates in lowermiddle-
income countries, such as Vietnam, by a
factor of almost 2000. Covid-19 is an overwhelming
challenge, and many factors contribute to its
severity. But the one we can control is how we
behave. And in the United States we have consistently
behaved poorly.

We know that we could have done better.
China, faced with the first outbreak, chose strict
quarantine and isolation after an initial delay.
These measures were severe but effective, essentially
eliminating transmission at the point where
the outbreak began and reducing the death rate
to a reported 3 per million, as compared with
more than 500 per million in the United States.
Countries that had far more exchange with China,
such as Singapore and South Korea, began intensive
testing early, along with aggressive contact
tracing and appropriate isolation, and have ….

READ COMPLETE ARTICLE BY CLICKING HERE

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/7/2020

October 7, 2020

Harrison County had 9 new cases on Tuesday while Gregg had 14 and Smith had 25. 

HOUSTON CHRONICLE BRIEF HISTORICAL TEXAS EPIDEMIC REVIEW FROM MNM (J. Harris: There is a reason that Houstonians remain deeply concerned about COVID — much the same as are New Yorkers. When you see  dead bodies loaded with fork lifts into refrigerated trucks, you remember that this nasty little virus can overwhelm your local facilities and kill lots of folks.)

FROM JOHNS HOPKINS1. Follow-up of Adults With Non-critical COVID-19 Two Months After Symptoms’ Onset(Clinical Microbiology and Infection) Up to 2 months after symptom onset, two thirds of adults with non-critical COVID-19 had complaints, mainly anosmia/ageusia, dyspnea or asthenia. A prolonged medical follow-up of patients with COVID-19 seems essential, whatever the initial clinical presentation. 

2. Case Series of Multisystem Inflammatory Syndrome in Adults Associated with SARS-CoV-2 Infection — United Kingdom and United States, March–August 2020 (MMWR) Multisystem inflammatory syndrome in children is a rare but severe complication of SARS-CoV-2 infection in children and adolescents. Since June 2020, several case reports and series have been published reporting a similar multisystem inflammatory syndrome in adults.

3. The CDC Calls for Quarantining Even After a Negative Test. The White House Isn’t Listening. (VoxThe CDC Calls for Quarantining Even After a Negative Test. The White House Isn’t Listening. (Vox) The CDC is very clear about this: If a person comes into close contact with someone known to have a coronavirus infection, defined as being within 6 feet for at least 15 minutes, that person should get a test and quarantine for 14 days. The CDC says the person should self-isolate for the two full weeks even if they test negative and don’t develop symptoms.

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Confederate Statues Come Down Around U.S., But Not Everywhere

About 60 Confederate monuments have come down across the U.S. amid a national reckoning on race — but nearly half as many localities that considered removing their statues have decided to keep them.

NPR recently visited Marshall, Texas, and Shreveport, La. — neighboring cities that fiercely debated their Confederate monuments and had two different outcomes.

Back in July, it seemed like officials in Marshall — tucked in the piney woods of northeast Texas — were on the verge of moving their marble statue of a rebel soldier. The curly-haired infantryman gripping a muzzleloader rifle has stood beside the courthouse for 114 years.

Even Bill Elliott with the Sons of Confederate Veterans, which defends the monuments as important parts of history, was pessimistic.

“We ain’t won anywhere. I’ll be honest with you,” Elliott said earlier in the summer. “If it’s got to be moved, we’re for working with everybody. We just want it to go somewhere that’s gonna be safe.”

But Marshall’s experience shows that Confederate statues are not so easy to topple.

Click here to read the complete NPR article

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/6/2020

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 JAMALong-term Health Consequences of COVID-19

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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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/2/2020

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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You really shouldn’t be intimidated by advanced math… it’s easy as pi

 I just found out that I’m color blind. The news came completely out of the green!

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/1/2020

October 1, 2020

Wednesday, Harrison County reports 7 new cases, Gregg 12, and Smith 19. There were 5335 new cases in Texas. 

FROM JOHNS HOPKINS:

1. CDC SAYS TO KEEP TRYING THERAPY WITH PLASMA FROM RECOVERED PATIENT.”In summary, taking the totality of evidence into account, including prior experience with convalescent plasma in other outbreak settings, data from animal studies, data in the published literature from clinical studies performed during the current outbreak, and the results obtained from the hospitalized patients evaluated in the EAP, FDA continues to find that COVID-19 Convalescent Plasma has met the “may be effective” standard for a EUA. However, because the efficacy analysis of the EAP did not include an untreated group of patients for comparison who did not receive convalescent plasma, FDA strongly encourages the continuation of randomized controlled clinical trials to more definitively evaluate the potential benefits of this therapy.

2. The COVID-19 Dashboard: Deciphering the Data, Visualizing the Virus The Johns Hopkins University (JHU) COVID-19 dashboard has become one of the most widely used resources for health care professionals, policymakers, researchers, news organizations, and individuals who want to be in the know. We have assembled the experts from JHU to help us better understand how they gather, segment, and express massive amounts of complex data so that it can be used to improve our understanding of the pandemic and, ultimately, inform our response. 

3. Coronavirus is in the air. Here’s how to get it out.. (J. Harris: Good general ventilation article with audio reference as well)
IMPORTANT:Asymptomatic Reinfection in Two Healthcare Workers from India with Genetically Distinct SARS-CoV-2 (Clinical Infectious Diseases) Authors highlight the possibility of undetected SARS-CoV-2 reinfections and the need for surveillance of SARS-CoV-2 reinfections in healthcare systems.“Taken together our analysis suggests that asymptomatic reinfection may be a potentially under-reported entity. Genetically distinct SARS-CoV-2 rules out persistent viral shedding or reactivation. Both individuals had a higher viral load during reinfection highlighting the need for continuous surveillance.’
(J. Harris: Sadly, this report concerns two health care workers with documented COVID infection who recovered, went back to work, and a few months later became reinfected with a mutant strain of the virus with and without symptoms. This has vast implications for testing and vaccine use and administration).

J. Harris: This just in, two new area cases, identities shielded but who could be like a lot of people we know. I hope you’re not one of them:

1) Sick68 y/o female, obese, prior MI, along with hubby, they see 15 revolving family members every day or two, usually several at a time, none wearing masks. Of these young visitors, so far, only one has had a Covid case amongst them…so far. 

2) Sick 75 y/o obese man, a smoker, who goes to a wedding with his wife–90 people in “snug” rehearsal dinner for two hours, zero masks. The next day the wedding was attended by 150 maskless guests.
    (J. Harris:  If I can, I’ll let you know if they survive. Wow, what were they thinking???? Covid is still here! Wear masks when you’re out. Wear masks when you’re around people who are out and about and keep your distance. This is your (and my) only defense available at this time. Six feet of spacing also helps. Avoid crowds. )

A cabbage and celery walk into a bar and the cabbage gets served first because he was a head

What happens when you witness a ship wreck? You let it sink in.

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