Thursday, May 14, 2020

Notations On Our World (Special Thursday Edition): ; On #LifeIntheTimeofCorona & #LifeAfterCovid

As our World grapples with COVID-19 and countries start to open up....

Today's Headlines: May 12, 2020
New from the Center for Health Security


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Clinical Practice

Association of Treatment With Hydroxychloroquine or Azithromycin With In-Hospital Mortality in Patients With COVID-19 in New York State (JAMA) Hydroxychloroquine, with or without azithromycin, has been considered as a possible therapeutic agent for patients with coronavirus disease 2019 (COVID-19). However, there are limited data on efficacy and associated adverse events. Among patients hospitalized in metropolitan New York with COVID-19, treatment with hydroxychloroquine, azithromycin, or both, compared with neither treatment, was not significantly associated with differences in in-hospital mortality.

Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units (JAMA Pediatrics) This early study shows that COVID-19 can result in a significant disease burden in children but confirms that severe illness is less frequent, and early hospital outcomes in children are better than in adults.

With Little Data, Doctors Struggle to Decide Which Covid-19 Patients Should Get Remdesivir (STAT) Now that the federal government has begun distributing the experimental Covid-19 drug remdesivir, hospitals are in a bind. So far, it’s the only medication that has shown benefit for coronavirus patients in rigorous studies. But there isn’t enough for everyone who’s eligible. That leaves doctors with a wrenching ethical decision: Who gets the drug, and who doesn’t?

Public & Global Health

COVID-19 and Postinfection Immunity, Limited Evidence, Many Remaining Questions (JAMA) Understanding whether and how recovery from COVID-19 confers immunity to, or decreased severity of, reinfection is needed to inform current efforts to safely scale back population-based interventions and has important implications for epidemiologic assessments, serologic therapies, and vaccines. This article describes what is currently known about the immune response to COVID-19, highlight key gaps in knowledge, and identify opportunities for future research.

Preliminary Estimate of Excess Mortality During the COVID-19 Outbreak — New York City, March 11–May 2, 2020 (CDC MMWR) Counting only confirmed or probable COVID-19–associated deaths likely underestimates the number of deaths attributable to the pandemic. The counting of confirmed and probable COVID-19–associated deaths might not include deaths among persons with SARS-CoV-2 infection who did not access diagnostic testing, tested falsely negative, or became infected after testing negative, died outside of a health care setting, or for whom COVID-19 was not suspected by a health care provider as a cause of death.

After Six New Cases, Wuhan Plans to Test all 11 Million Residents for Coronavirus (Washington Post) Authorities in the Chinese city of Wuhan plan to test all 11 million residents for the novel coronavirus by the end of next week in a massive push to extinguish any remnants of the virus from the original epicenter of the global pandemic.

China’s Coronavirus Back-to-Work Lessons: Masks and Vigilance (New York Times) The country’s efforts to get back to business have been inconsistent and sometimes stricter than workers elsewhere might tolerate. Still, it could set a path for the rest of the world.

WHO Tackles Reopening Issues, Posts COVID-19 Guidance for Schools, Workplaces (CIDRAP) As more countries took further steps at easing COVID-19 restrictions this week, some that are further along in the process are battling clusters and upticks in cases, as the World Health Organization (WHO) released new guidance on reopening schools and workplaces. The WHO today also warned that disruptions related to the COVID-19 battle could hurt the battle against HIV.

Science & Technology 

The ‘Biggest Challenge’ Won’t Come Until After a Coronavirus Vaccine is Found (Politico) Meeting the overwhelming demand for a successful coronavirus vaccine will require a historic amount of coordination by scientists, drugmakers and the government. The nation’s supply chain isn’t anywhere close to ready for such an effort.

Ethics and Governance for Digital Disease Surveillance (Science) Focusing on core public health functions of case detection, contact tracing, and isolation and quarantine, we explore ethical concerns raised by digital technologies and new data sources in public health surveillance during epidemics.

Respiratory Disease in Rhesus Macaques Inoculated with SARS-CoV-2 (Nature) The rhesus macaque recapitulates moderate disease observed in the majority of human cases. The establishment of the rhesus macaque as a model of COVID-19 will increase our understanding of the pathogenesis of this disease and will aid development and testing of medical countermeasures.

Government Affairs & National Security

Fauci Expected to Warn Senate that Reopening U.S. Too Quickly Could Lead to ‘Needless Suffering and Death’ (Washington Post) Top federal health officials will be pressed during a highly anticipated Senate hearing Tuesday on whether the country is ready to reopen, with Anthony S. Fauci, the nation’s top infectious-disease expert, expected to warn that moving too quickly could lead to “needless suffering and death."

COVID-19 Public Health Emergency: General Considerations for Pre-IND Meeting Requests for COVID-19 Related Drugs and Biological Products (US FDA) FDA plays a critical role in protecting the United States from threats such as emerging infectious diseases, including the Coronavirus Disease 2019 (COVID-19) pandemic. FDA is committed to providing timely guidance to support response efforts to this pandemic.

Checkpoint Clash Escalates Between South Dakota Governor, Tribal Leaders (NPR) South Dakota Gov. Kristi Noem says she will follow through on her threat to take legal action against two Native American tribes that have defied orders to remove highway checkpoints onto tribal land in an effort to prevent the spread of the coronavirus on their reservations.

We conclude with this from Professor Harrari --We will be back next week:

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