CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/24/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/24/2020

11/24/2020

Some good news first:

Data Show Hospitalized Covid-19 Patients are Surviving at Higher Rates, but Surge in Cases Could Roll Back Gains (STAT News) Patients hospitalized with Covid-19 are surviving at higher rates than in the early days of the pandemic, gains that data and interviews with experts suggest are driven by a more refined understanding of the disease and how to treat it — and, crucially, less strain on hospitals that had been inundated at times. But clinicians warn that this progress won’t withstand what happens when crushes of patients again overwhelm hospitals, as is now occurring in dozens of U.S. states. With the country setting new records of hospitalizations daily, care is getting threatened, and death rates — not just deaths — could increase.

HOPKINS SUGGESTIONS:

1. FDA Authorizes Drug Combination for Treatment of COVID-19 The US Food and Drug Administration issued an emergency use authorization for the drug baricitinib, in combination with remdesivir, for the treatment of suspected or laboratory confirmed COVID-19 in hospitalized adults and pediatric patients two years of age or older requiring supplemental oxygen, invasive mechanical ventilation, or extracorporeal membrane oxygenation (ECMO). (FDA, 11/19/2020)

2. Trends in County-Level COVID-19 Incidence in Counties With and Without a Mask Mandate — Kansas, June 1–August 23, 2020 The governor of Kansas issued an executive order requiring wearing masks in public spaces, effective July 3, 2020, which was subject to county authority to opt out. After July 3, COVID-19 incidence decreased in 24 counties with mask mandates but continued to increase in 81 counties without mask mandates. Countywide mask mandates appear to have contributed to the mitigation of COVID-19 transmission in mandated counties. Community-level mitigation strategies emphasizing use of masks, physical distancing, staying at home when ill, and enhanced hygiene practices can help reduce the transmission of SARS-CoV-2. (CDC MMWR, 11/20/2020)

(J. Harris: This is a hard to read article, but the heavily populated cities in Kansas wore masks. Most of the lesser populated counties did not op in to the mask mandates and had a higher incidence of Covid. North and South Dakota and W. Texas have proven that the wide open spaces and lesser populations DO NOT KEEP YOU SAFE FROM COVID. Be smart. It’s most inconvenient to die at Christmas.)

3. FDA Authorizes Monoclonal Antibodies for Treatment of COVID-19 The US Food and Drug Administration issued an emergency use authorization for casirivimab and imdevimab to be administered together for the treatment of mild to moderate COVID-19 in adults and pediatric patients (12 years of age or older weighing at least 40 kilograms with positive results of direct SARS-CoV-2 viral testing and who are at high risk for progressing to severe COVID-19. This includes those who are 65 years of age or older or who have certain chronic medical conditions. (FDA, 11/21/2020)

4.  COVID-19 Outbreak Associated with a 10-Day Motorcycle Rally in a Neighboring State — Minnesota, August–September 2020 Following a 10-day motorcycle rally in South Dakota attended by approximately 460,000 persons, 51 confirmed primary event-associated cases, 21 secondary cases, and five tertiary cases were identified in Minnesota residents. An additional nine likely rally-associated secondary or tertiary cases occurred. Four patients were hospitalized, and one died. Genomic sequencing supported the associations with the motorcycle rally. The impact of gatherings as a source of virus transmission underscores the importance of reducing the number of attendees at gatherings, using face masks, and encouraging physical distancing to prevent ongoing transmission of SARS-CoV-2. Furthermore, these findings demonstrate the rationale for consistent mitigation measures across states. (CDC MMWR, 11/20/2020)

(J. Harris: This was  a predictable and predicted result of the bikers rally in Sturgis, SD. There will be more, unless “Hells Angels” have an innate immunity.)

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/23/2020

11/22/2020

On Sunday, Nov. 22, in TSA Areas G, there were 396 Covid patients hospitalized, 102 of them were in ICU, and there were 37 ICU beds available in the area. 

Stats for today will come in after 16oo. 

Family that got virus warns public to spend holidays at home

From Longview Paper and AP

ARLINGTON — Arlington is using one family’s brush with the coronavirus as a warning to others who might be considering big get- togethers this Thanksgiving.

Alexa Aragonez told the Fort Worth Star-Telegram that her family weighed the risks of catching the virus but decided to get together for a birthday party on Nov. 1.

A couple of days after the party, her 57-year-old mother, Enriqueta Aragonez, and others who were at the party began to feel sick. They got tested, and all 12 who had attended were positive for COVID-19. Three other people with whom they had come in contact with also tested positive, said Alexa Aragonez, 26, who didn’t attend the party.

Arlington is using the family’s experience as part of a public awareness campaign to help reduce the spread of the coronavirus this holiday season by staying home.

The Centers for Disease Control and Prevention is also warning people to not spend Thanksgiving with people from outside of their households and to not travel for the holiday.

Statewide, the Texas health department on Sunday reported 8,554 new virus cases, more than 4,000 less than the state’s one-day high of 12,597 new virus cases a day earlier. The state on Sunday also reported 8,174 virus hospitalizations and 89 new deaths.

In a video that’s part of the campaign in Arlington, Enriqueta Aragonez is in her hospital and says, “I went to my nephew’s house and love seeing my family. But now I’m ghting against COVID-19.”

She is now recovering at home, and although she doesn’t need supplemental oxygen, she still has pain in her lungs, Alexa Aragonez said. Most of the others who caught the virus at the party had milder symptoms, she said.

In the end, “not everyone is as lucky as my family has been,” Alexa told the Star-Telegram. She said she doesn’t want anyone to needlessly lose a family member.

“We were scared that my mother, the matriarch of the family, was going to pass,” she said. “So I think that fear in our hearts made us want to put an awareness in the hearts of others.” 

Texas Public Schools COVID-19 Data:

Public schools are required to report positive COVID-19 cases on school campuses. Due to the Thanksgiving holiday, this dashboard will not be updated again until the week of November 30, 2020.  Two weeks of data will be posted that week.

J. Harris: I wonder if anyone thought about shutting down the school house until January? 

The Coronavirus Is Airborne Indoors. Why Are We Still Scrubbing Surfaces? (New York Times) All over the world, workers are soaping, wiping and fumigating surfaces with an urgent sense of purpose: to fight the coronavirus. But scientists increasingly say that there is little to no evidence that contaminated surfaces can spread the virus. In crowded indoor spaces like airports, they say, the virus that is exhaled by infected people and that lingers in the air is a much greater threat. Hand washing with soap and water for 20 seconds — or sanitizer in the absence of soap — is still encouraged to stop the virus’s spread. But scrubbing surfaces does little to mitigate the virus threat indoors, experts say, and health officials are being urged to focus instead on improving ventilation and filtration of indoor air.

Safety and Immunogenicity of ChAdOx1 nCoV-19 Vaccine Administered in a Prime-boost Regimen in Young and Old Adults (COV002): A Single-blind, Randomised, Controlled, Phase 2/3 trial (The Lancet) In this report of the phase 2 component of a single-blind, randomised, controlled, phase 2/3 trial (COV002), healthy adults aged 18 years and older were enrolled at two UK clinical research facilities, in an age-escalation manner, into 18–55 years, 56–69 years, and 70 years and older immunogenicity subgroups. By 14 days after the boost dose, 208 (>99%) of 209 boosted participants had neutralising antibody responses. ChAdOx1 nCoV-19 appears to be better tolerated in older adults than in younger adults and has similar immunogenicity across all age groups after a boost dose.  (J. Harris: This British vaccine requires only one injection and does produce a good antibody response)

SWEDEN The Swedish government approved a measure to limit public gatherings and events to a maximum of 8 individuals and removed existing exemptions for restaurants or other settings. One notable exception remains in place for funerals, which are limited to 20 individuals. The restrictions will begin on November 24 and builds on a previous decision to prohibit alcohol sales after 10pm to reduce gatherings at bars and restaurants. The new limit on gatherings is a drastic shift from the previous limit on events of more than 300 people, signaling a change in how Swedish authorities are approaching the national COVID-19 response. Sweden was previously known for having a relatively lax set of social distancing recommendations and measures, compared to many other countries, but Prime Minister Stefan Lofven recently urged Swedes to avoid settings like gyms, libraries, and even hosting dinners.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/16/2020

11/16/2020

Area counts seem to be increasing but slowly. I should have new information on Tues. We still have some ICU beds in our Trauma Area G.  There were 64 new Covid cases in Gregg County and 139 in Smith County on Saturday. 

Until listening to NPR this morning, I had not considered  that our nursing homes are currently full all over the US. Where will discharged Covid patients go? There will be a bottleneck that will keep Covid patients in the hospitals longer than necessary. Where are those patients who need rehabilitation and/ or more care at the time of hospital discharge from ICU and the wards. If recovering patients are too weak or unable to be cared for at  home, where will they go — to some makeshift temporary space in a gymnasium or under a large tent? Behind a large rock? 

How about utilizing a nearly empty 5  story (6 floors) hospital that is not being used at this time. Of course, I mean Kahn/Memorial/Good Shepherd/Christus Good Shepherd Marshall Hospital.These newly discharged patients should not be contagious and might even have immunity. They will be well enough to leave a general hospital but too sick or weak to go home. The medical environment should be safer for the level of medical care and rehabilitation that the facility would provide. In a short time, such a facility should provide many new jobs for area people that are medically safe and worthwhile — as well as filling a medical vacuum and utilizing a very large hospital building that seems to be in good condition. 

J. Harris

Staying sane in our new COVID-19 world

(J.Harris: Some explanations and recaps but some comfort and suggestions. Very readable.)

 “… during the pandemic there is also renewed purpose, hope, and community emerging. Scientists have responded with focus to their work and to developing appropriate guidance, treatments, or vaccines. Meanwhile, many citizens have taken on roles in their communities running welfare groups, delivering groceries to elderly neighbours, or working on communal gardens. Early on in the pandemic, health-care workers showed up on COVID-19 wards without appropriate personal protective equipment committed to their vocation of serving others. As we compare our pre and post COVID-19 selves, perhaps we should emphasise how the pandemic has shown who each of us really is…

“…Some governments, such as in the UK, initially turned to experts to become the oracles and predict the future—first to mathematical modellers and behavioural scientists, then to vaccinologists, and, finally, to public health experts and economists. And when these experts are not always able to provide the answers that appease the need for concrete predictions with dates, a backlash followed against experts with their balanced and contextualised statements. This gap was exploited by social media pseudo-scientist celebrities predicting the future and offering comforting lies on easy solutions.

“…One of these comforting lies being told is that we can have our pre-COVID-19 life back for the “acceptable” loss of some old and vulnerable people. Terms like “herd immunity” have been the ammunition of those who would see it as the perfect cover for lifting all restrictions and letting a dangerous virus spread through the population, starting with the young and fit.”

Suggested by Hopkins:

1. CHINA Shanghai, China, reported a locally acquired case of COVID-19 on November 10. While many countries around the world are battling a surge in COVID-19 incidence, this marks the first locally acquired infection in Shanghai in several months. According to local officials in China, the individual worked at Shanghai Pudong International Airport, and at least 25 close contacts have been quarantined. While SARS-CoV-2 emerged in China, China has largely contained its epidemic. In fact, the vast majority of cases over the past several months have been among arriving travelers. In an effort to maintain this level of epidemic control, the Chinese government is reportedly taking new steps to limit the possibility of importing COVID-19. One aspect of these efforts involves disinfecting packaging and transport vehicles carrying imported frozen food, after China identified contaminated food products as the source of several SARS-CoV-2 infections among cargo handlers and port workers.

Lessons From Europe, Where Cases Are Rising But Schools Are Open (NPR) Across Europe, schools and child care centers are staying open even as much of the continent reports rising coronavirus cases, and even as many businesses and gathering places are shut or restricted. Countries such as France, the United Kingdom, Germany and Italy appear to be following the emerging evidence that schools have not been major centers of transmission of the virus, especially for young children. And experts say these nations are also demonstrating a commitment to avoiding the worst impacts of the pandemic on children.

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In Other News

OTHER NEWS

COVID-19 News — 11/30/2020

The United States’ top health officials are bracing for another surge of cases, superimposed on the one the country is already experiencing, after a week of Thanksgiving travel and gatherings. “It looked like things were starting to improve … and now with Thanksgiving, we’re worried that all of that will be reversed,” Deborah Birx, coordinator of the White House coronavirus task force, told CBS News.

Looking toward December, top federal infectious-disease expert Anthony S. Fauci implored Americans to restrict their holiday activities, speaking in an interview with NBC’s “Meet the Press.” He also stressed the importance of complying with mask mandates and social distancing. If your state doesn’t have restrictions, Birx said, you need to “take it upon yourself to be restrictive” so the country can get the pandemic under control.

Biotech company Moderna announced this morning that it would file for regulatory clearance for its vaccine candidate, which was 94 percent effective in a 30,000-person trial. Pfizer also has submitted an FDA request for emergency approval of its candidate.

With two candidates pending authorization, vaccine planning is heading into overdrive. An advisory panel to the Centers for Disease Control and Prevention is scheduled to meet Tuesday to discuss which groups should be eligible to receive the first doses of an approved vaccine. Around 21 million health-care workers are likely to be at the top of the list, with nursing home residents and staff coming soon after.

Immunization program managers are already concerned about the logistics of a two-dose regimen, which the Pfizer and Moderna candidates require. Getting two or even three shots is routine for immunizations, but it is unprecedented in a pandemic. (You can dive into more details in the Q&A below.) Those challenges are even more intense in poor, rural states like Alabama, where distrust of the medical establishment permeates the Black community.

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Caddo Lake to host annual Floating Christmas Parade — 11/29/2020

UNCERTAIN — The annual Uncertain Floating Christmas Parade will return to the waters of Caddo Lake this holiday season.

Parade Organizer Shirley Moore, who brought back the floating parade in 2017 after a decade hiatus, said this year’s parade is set for 2 p.m. on Dec. 19.

The town’s Christmas parade, which puts a literal meaning to the word parade “float,” has hosted the festive floating parade each Christmas season since its triumphant return in 2017.

Moore, a long-time Uncertain resident, moved back to the town in 2017 and immediately went to work bringing the popular floating Christmas parade back.

Click here for more information

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Murder in Harrison County — 11/27/2020

Harrison County Sheriff’s Office Investigators are compiling information regarding a fatal shooting on Whitehurst Drive in Harrison County. At approximately 12:05 AM on November 27, 2020, Harrison County Sheriff’s Office received a 911 call that a shooting had occurred at a party event location on Whitehurst Dr. in Longview, Texas near the intersection of Loop 281 and I-20. The victim of the shooting was taken by private conveyance to Longview Christus Good Shepherd hospital. Deputies also proceeded to the hospital where it was confirmed that a Black male had been brought to the Emergency Room with a gunshot wound and pronounced deceased. The name of the victim is not being released at this time due to the ongoing investigation. A Longview police officer responded to this location, as well. During a separate fight, not related to the shooting at the location, the officer sustained a broken ankle while assisting Harrison County Deputies in making an arrest. The suspect charged in this incident, is Devin Loyd. He is charged with Resisting Arrest and Aggravated Assault on a Public Servant. His bond is set at $103,000.

If anyone has information regarding this incident, they may anonymously contact Harrison County Investigators at 903-923-4000.

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Michael Flynn — 11/27/2020

President Trump announced on Twitter that he has issued a “full pardon” to his first national security adviser, Michael Flynn. The retired lieutenant general was a major figure in the probe of Russian interference in the 2016 election, and he admitted under oath that he was guilty of lying to the FBI while serving as national security adviser. However, Flynn has since claimed his innocence, and Trump has touted him as a political symbol at rallies. Trump previously pardoned Roger Stone, another ally involved in the investigation, and these acts of clemency will likely color the President’s legacy in the waning days of his administration. Still, this pardon doesn’t necessarily mean Flynn’s legal obligations are over. Flynn admitted to lying about his lobbying for Turkey but was not charged with that crime, and the Justice Department in the Biden administration could have more questions for him.

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Election 2020 — 11/26/2020

President Trump said for the first time that he will leave office if the Electoral College votes for President-elect Joe Biden on December 14, bolstering confidence in a peaceful transition of power — something that, in a democracy, should be a foregone conclusion. The President also said he will travel to Georgia to support the state’s Republican Senate candidates ahead of the January 5 runoff elections. The two races could tip the Senate majority. Meanwhile, Biden faces the test of whether to keep Trump-era security edicts in place. He and his team will soon have to decide whether they want to maintain the Trump administration’s lockdown on highly sensitive information, like transcripts of presidential calls with foreign leaders. These calls were previously shared with a broad, security clearance-holding audience, but the Trump administration claimed it was concerned they might be leaked.

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mLife Diagnostics of Marshall receives FDA authorization for COVID saliva test — 11/22/2020

mLife Diagnostics LLC of Marshall announced that the U.S. Food and Drug Administration has granted Emergency Use Authorization, or EUA, for the mLife True saliva COVID-19 collection kit for testing at Express Gene Molecular Diagnostics Laboratory of Miami, Florida.

mLife CEO Alan Loudermilk said that this authorization allows any clinic in the country to utilize the new, and less invasive COVID-19 test created by the company.

“Basically, when the EUA is granted for one location, as long as you are doing the exact same thing as they are at the clinic with the EUA, it is counted under the EUA,” Loudermilk explained.

For more info click here

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Federal Reserve Rebukes Treasure Secretary Steven Mnuchin

In an extremely rare rebuke, the Federal Reserve condemned Treasury Secretary Steven Mnuchin’s decision this week to end most of the central bank’s emergency lending facilities, including those that assisted small businesses and local governments. Mnuchin fired back at the bank Friday, signaling a split between two government entities responsible for restoring economic stability during the pandemic.

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Pfizer Applies for Emergency Authorization — 11/20/2020

Pfizer and its German partner BioNTech became the first companies to apply for emergency authorization of their coronavirus vaccine in the United States, a landmark moment in the scientific race against the pandemic.

The application will set off a weeks-long process in which Food and Drug Administration scientists will review data from Pfizer’s safety trials and determine whether the vaccine is safe and effective. If so, government officials expect to have enough doses by December to inoculate 20 million people, and more later as production ramps up.

We wrote yesterday that the country’s covid-19 death toll has surpassed 250,000 victims. A quarter of a million is not an easy number to visualize, so The Post has published some comparisons to help comprehend the loss. In less than a year, the outbreak has killed:

  • Four times as many Americans as have died in the decade-long Vietnam War.
  • Twice as many Americans as were killed over two years in World War I.
  • Nearly two thirds as many Americans as have died during four years of fighting in World War II.
  • More than one-third of an estimated 675,000 Americans who died in the 1918-19 flu pandemic, which was the worst in modern history.

Here’s another way to think about it, from our Graphics team: If all 250,000 victims had come from the U.S. heartland, a region roughly the size of South Dakota would now be devoid of human life.

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/09/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/09/2020

Things are heating up in East Texas. On the 6th, Harrison County had 14 new cases. Gregg County had 32 confirmed, 65 probably for a total of 97 new cases in Gregg County in one day. Smith had 79 confirmed, 82 probable for a total of 161 new cases in one day. There were 46 new cases in Henderson, Texas. We will be running out of hospital bed space if this continues, although most of these cases apparently did not require hospitalization. Today, the bed situation is essentially unchanged. J. Harris

When coffee smells like gasoline: Covid isn’t just stealing senses — it may be warping them

Asymptomatic patient was actively infectious for 70+ days, study finds

Laboratory Findings Associated With Severe Illness and Mortality Among Hospitalized Individuals With Coronavirus Disease 2019 in Eastern Massachusetts

(J. Harris: The main message of this article for our use is that there were lots of younger people who got very sick — they were all sick enough to be admitted to very crowded hospitals. There were almost as many women as men and the majority were white. Wear your masks just like old fat men do.)

“The 2511 individuals hospitalized through June 5, 2020, included 1348 (53.7%) at academic medical centers and 1163 (46.3%) at community hospitals; 1277 (50.9%) were male, 1354 (53.9%) were White, and 679 (27.0%) were Hispanic; the mean (SD) age was 62.6 (19.0) years (Table 1). In all, 215 individuals (8.6%) were admitted to the ICU, 164 (6.5%) required mechanical ventilation, and 292 (11.6%) died….” 

HOPKINS SELECTIONS1. 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.

2EUROPE 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. )

Jokes tomorrow. 

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/06/2020

CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 11/06/2020

 James Harris 2:20 PM (1 hour ago) 
 to Ron 

From NORTH EAST TEXAS HEALTH

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. 

Click here to enlarge the table

(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.)

WHAT TO DO WITH PEOPLE WHO CAN’T SMELL

(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?)

What can we expect from first-generation COVID-19 vaccines?

“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.)

COVID-19 lung damage caused by persistence of ‘abnormal cells’

(J. Harris: An autopsy series of some interest)

‘COVID’ fee showing up on medical bills across the country

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.

3. Quick COVID-19 Healers Sustain Anti-SARS-CoV-2 Antibody Production

Highlights:

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

                Summary:

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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All-over-the-place

All-over-the-place

By George Smith — 11/05/2020

All-over-the-place thoughts on day-after with no definitive winner for president::

— A majority of Trump voters voted FOR him; a majority of Biden voters voted AGAINST Trump.

— Biden is on the cusp of victory for the simple fact he is not Donald Trump.

— President Trump was his own albatross; he simply could not shut up about how great he had handled the COVID pandemic, and voter fraud by traditional Democrat Party bloc voters and those same voters came out with a vengeance.

— Polls, except to give jobs to pollsters and candidates talking points at political rallies, are useless.

— Trump was, after all NOT the Chosen One.

— Six lawsuits, at deadline, filed by Trump’s campaign against local election laws…all kicked to the curb.

— Trump, if defeated, will start  caterwauling and issue a executive order juggernaut that will rattle the nation’s political structure to its core. The question will be: Will Republicans be string enough and ready to deal with an out-of-control whining loser who is destroying the party.

— Both parties have to change in order to be relevant in the future. Democrats have to stop flirting with the outer edges of socialism  surrealism and sell the idea that this nation is already a democratic socialist republic. And , there’s nothing wrong with that. The Republicans have to stop flirting with the outer edges of systemic racism, Qanon weirdness and alt-right claptrap and sell the idea that this nation is already a democratic socialist republic. And , there’s nothing wrong with that.

— The Electoral College must go.

— Congressional term limits must become a law.

— The fact this presidential race and a host of legislative races garnered record millions of dollars from special donors cries out for political finance reform.

— State election laws must be reviewed and changed as needed to ensure every legal vote cast is counted in a timely manner.

— The Postal Service should never, ever be a part of a political scheme to suppress votes.

— No political party should do anything to suggest that suppression of votes is acceptable; they should rearrange their platforms and priorities to attract the most voters.

— it’s time, past time, actually, for the Dems and GOPers to stop this childish one-up bickering and agree to work together to: Smother COVID, pass a stimulus bill, raise taxes on folks making more than $400,000 a year and raise top tax rate on big companies; create a punitive penalty import tax for any company moving jobs out of the country; get serious about election and campaign security;cut 8-10 percent of nonessential services out of the federal budget; pass a comprehensive infrastructure bill, and; (whew) use a common sense approach to create a system that encourages salons from different parties to … just get along and substitute bickering and name-calling for cooperative efforts on behalf of all residents.

Let’s git ‘r’ done!

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/27/2020

October 27, 2020


Coronavirus: Antibodies fall rapidly after COVID infection, dashing hopes of herd immunity – study
 (J. Harris: Read this! Understandable 5 min. read that dispels any current hope of Herd Immunity)

The Most Important Takeaways from the FDA’s Big Covid-19 Vaccine Meeting

Home tests could help in the fight against the coronavirus. So where are they?
(J. Harris: Readable article about testing)Ten months into the coronavirus pandemic, the promise of a rapid and inexpensive at-home test for the virus remains unfulfilled as companies struggle to overcome final regulatory hurdles. The technology for such tests exists, and early versions are being used in nursing homes and schools. But companies racing to bring the tests to the wider U.S. market must make them more accurate and easier to use before they can meet federal guidelines that would allow sales directly to consumers. Although no single test will end the pandemic in the United States, experts say the ability for people to take a test at home and know within minutes whether they’re infected could be an important component in stanching the spread of the virus.

COVID-19 diagnostic testing
(J. Harris: Great, simple, readable testing summary.)
HOPKINS’ ALL THERE IS TO KNOW ABOUT TESTS

Can We Test Our Way Out of the COVID-19 Pandemic? (J. Harris: Complicated article about testing.)
ABSTRACT
Frequent, low-cost, universal testing for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) with quarantine of those with a positive result has been suggested as a strategy to address the coronavirus disease 2019 (COVID-19) pandemic in the United States. Specifically, home or community use of tests that use paper strip detection devices, which may have reduced sensitivity for SARS-CoV-2, has been advocated. There are several potential challenges or problems with this strategy, including the limited availability of such tests, consequences of incorrect test results, difficulties with adherence to testing, and the questionable accuracy of such tests for detection of infectious people. Because of these, we think it is premature to strongly advocate for such a testing strategy, as the adverse consequences may outweigh any benefits. High-quality outcome data demonstrating the efficacy of this testing strategy are needed before widespread implementation.
MORE Johns Hopkins Selections:1.  At Capacity’: Covid-19 Patients Push U.S. Hospitals to Brink(New York Times) More than 41,000 people are currently hospitalized with the coronavirus in the United States, a 40 percent rise in the past month, and cooler weather that pushes more people indoors is threatening to expand the outbreak still more. At least 14 states saw more people hospitalized for the virus on a day in the past week than on any other day in the pandemic, according to the Covid Tracking Project. Seven more states are nearing their peaks.
A 7-hour flight has been linked to 59 coronavirus cases in Ireland, researchers say

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CORONAVIRUS INFO PROVIDED BY DR. JIM HARRIS – 10/16/2020

October 16, 2020

(TOMORROW, ONLY ONE GREAT ARTICLE )
Friday Harrison County had 3 new Covid cases; Gregg had 16 and Smith 18. 

White House Outbreak Is Not a Failure of Testing
But rapid tests have an important limitation. They can accurately detect Covid-19 once a person has symptoms and is highly infectious, but unlike PCR tests, they are not sensitive enough to detect most infections earlier on, when a person has a relatively small amount of the virus, or does not have symptoms but could be infectious.

In short: Rapid tests produce a high rate of false negatives….“Testing will never stop somebody from getting the virus…To stop yourself from getting the virus, you need to not come in contact with the virus or you need to protect yourself through wearing a mask… Testing does not substitute for avoiding crowded indoor spaces, washing hands, or wearing a mask when you can’t physically distance,” Adm. Brett Giroir, the official at the Department of Health and Human Services who is in charge of the administration’s testing effort, said in a September 28 statement. “Further, a negative test today does not mean that you won’t be positive tomorrow.”

The COVID-19 Fall Surge Is Here. We Can Stop It.
(J. Harris: Excellent, readable Covid update covering the US and Europe. They are using a statistic to which I haven’t previously  paid any attention, “Deaths/million residents for individual countries.)
MASKS DO WORK AND SHOULD BE WORN (U. of Washington)

“…Our model predicts that moderately efficacious masks will lower exposure viral load 10-fold among people who get infected despite masking, potentially limiting infection severity. Because peak viral load tends to occur pre-symptomatically, we also identify that antiviral therapy targeting symptomatic individuals is unlikely to impact transmission risk. Instead, antiviral therapy would only lower Re if dosed as post-exposure prophylaxis and if given to ~50% of newly infected people within 3 days of an exposure. These results highlight the primacy of masking relative to other biomedical interventions under consideration for limiting the extent of the COVID-19 pandemic prior to widespread implementation of a vaccine.”
(J. Harris: Despite all of the deficiencies with masks like discomfort, poor fit, unsightliness, sissy wear, they are are our first, most accessible, most affordable, and most practical defense against Covid).

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Social Security and Medicare are on the ballot this November

Ever since President Franklin D. Roosevelt’s son, Rep. James Roosevelt, Sr., founded our organization to protect Social Security and Medicare in 1982, we have not endorsed presidential candidates, focusing instead on congressional races. Until now. For the first time in 38 years, we are throwing our weight behind Joe Biden for President of the United States. As an organization rooted in the social insurance policies of FDR’s New Deal — and after observing relentless attacks on lifeline programs like Social Security and Medicare — we could not in good conscience remain neutral this year. 

For us, the straw that broke the camel’s back was the president’s reckless payroll tax cut, which he unilaterally imposed in an executive order last month. Without hesitation, he interfered with the funding stream for Social Security, going so far as to pledge to “terminate” payroll taxes altogether in his second term. Social Security’s chief actuary estimates that if payroll taxes were to be terminated (without replacing the lost revenue), the program’s trust fund would run dry by 2023. A president who promises to cut off the revenue for one of our most cherished and successful social insurance programs should not be re-elected. 

“There’s a reason Social Security and Medicare have been around for 85 and 55 years. Americans value and depend on them,” says FDR’s grandson and vice-chair of our advisory board, James Roosevelt, Jr. “Joe Biden is the candidate who can be trusted to protect seniors’ earned benefits from any attempts to undermine or privatize them.” 

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