Pandemic News Links / Current News Updates

trader32176
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Despite expansion of food assistance programs, levels of food insecurity remain high

10/14/20


https://www.news-medical.net/news/20201 ... -high.aspx


In the last several months, the proportion of New Yorkers reached by the public food programs initiated by New York City to address rising rates of food insecurity has doubled, indicating progress in reaching those in need.

In the latest COVID-19 tracking survey from the CUNY Graduate School of Public Health & Health Policy (CUNY SPH) conducted from September 25 to 27, 34% of the sample of one thousand New York City adults reported that their households had received SNAP benefits since September 1st.

Among the survey participants, 28% reported they had used an emergency food program or soup kitchen since the beginning of September and 26% had received food from the New York City school system's Grab and Go Food program.

In an earlier CUNY SPH survey (April 24-27), only 16% of respondents reported receiving SNAP benefits, 16% reported use of an emergency food program, and 13% reported obtaining food from school-based food programs.

Despite these successes in providing more people with food assistance, levels of food insecurity remain high. In the latest survey, 38% of New Yorkers expressed worry that their household would run out of food before they could buy more and almost a third (31%) said they had actually run out of food for their household during September.

In the May survey (May 1-3), 44% were worried about running out of food and 30% said they had actually run out. Thus, while the proportion of people helped by public food programs doubled, the rates of those reporting worries about food security fell by only 14% and the rates of those running out of money for food did not decline at all.

" Despite its accomplishments in launching new public food programs, New York City must do more to stem the new pandemic of food insecurity triggered by COVID-19. Only by taking on the fundamental drivers of food insecurity--persistent poverty, unemployment, low wages, and lack of affordable housing -- can our city reduce this troubling trend."

- Nicholas Freudenberg, Distinguished Professor, Department of Public Health, CUNY Graduate School of Public Health and Health Policy

Freudenberg is also director of the CUNY Urban Food Policy Institute.

The latest survey also showed that rates of food insecurity are highest in low income, Black and Latinx communities. Table 1 shows that the proportion of New Yorkers who worry that their households will run out of food before they can buy more is twice as high for Latinx as for white city residents and 1.4 times as high for Black as white residents.

Both Latinx and Black residents report substantially higher rates of actually ran out of money for food in the last month. Of interest, 60% of respondents who chose to answer the poll in Spanish (a group that includes Latinx-identified residents as well as other Spanish speakers) reported worries about running out of food and 48% reported actually running out of food, an indicator of high levels of food insecurity in this group.

Survey participants of all races reporting annual household incomes of $100,000 or less are almost twice as likely to report running out of money for food in the last month than those making more than $100,000.

The survey also showed that populations with higher rates of food insecurity participated more in public food programs. As shown in Table 2, Black and Latinx residents used SNAP, emergency food programs, and school feeding programs at higher rates than White or Asian residents.

Respondents who chose to answer the survey in Spanish again had the highest rates of use, with rates of SNAP use at 53%, Emergency Food programs at 37%, and Grab and Go school programs at 45% .

Source:

CUNY Graduate School of Public Health and Health Policy
trader32176
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COVID Crackdowns at Work Have Saved Black and Latino Lives, LA Officials Say

10/15/20


https://khn.org/news/la-county-workplac ... ino-lives/

Los Angeles County officials attribute a dramatic decline in COVID-19 death and case rates among Blacks and Latinos over the past two months to aggressive workplace health enforcement and the opening of tip lines to report violations.

Now, officials intend to cement those gains by creating workplace councils among employees trained to look for COVID-19 prevention violations and correct or report them — without fear of being fired or punished.

Cal/OSHA, the state’s workplace safety and health authority, is overwhelmed with complaints and tips about COVID-19 violations, and the county’s health investigators — there were officially 346 of them as of last Friday — can’t possibly keep tabs on all of Los Angeles’ more than 240,000 businesses, labor advocates say.

The councils could help keep Los Angeles from backsliding on its progress in mitigating cases and racial disparities in the fall as more businesses are likely to reopen, said Tia Koonse, a researcher with the UCLA Labor Center and co-author of an assessment of the workplace council proposal. The L.A. County Board of Supervisors is expected to approve an ordinance this month requiring businesses to permit employees to form the councils, which would troubleshoot compliance issues and report to the health department when necessary.

Critics, including many business leaders, say the measure will create more red tape at the worst possible time for the economy. But labor groups and some businesses say it is crucial to fighting the pandemic. Workers around the country have been sacked or reprimanded for complaining about COVID-related safety violations, and laws protecting them are spotty.

“Workers have a right to be in a safe space and shouldn’t face any retaliation” for noting poor practices, said Barbara Ferrer, director of the L.A. County Public Health Department. Low-wage workers have been “tremendously disadvantaged” by having to work outside the home in contact with other people, often without sufficient protection, she said.

During the upsurge of COVID cases that followed Memorial Day weekend family gatherings and business openings, Latinos in Los Angeles were dying at a rate more than four times higher than that of whites, while Blacks were twice as likely as whites to die of the disease. Two months later, death rates among Blacks and Latinos had fallen by more than half and were approaching the rate for whites, according to age-adjusted data from the county health department.

Disparities in Case Rates Are Also Closing

The wide gap in people testing positive for COVID-19 has been narrowing in recent weeks, but Latinos are still more likely to test positive than other groups.

While four times as many Latinos as whites were reported COVID-positive in late July, the Latino case rates were only 64% higher by mid-September. The positivity rate among Blacks was 60% higher than that of whites in late July, but the disparity had waned by mid-September.

Experts can’t be certain that any one policy is responsible for the decline in deaths among Blacks and Latinos in Los Angeles — and state and county rates have declined for the entire population in recent weeks. But Ferrer attributed the progress to her department’s focus on workplace enforcement of health orders, which include rules about physical distancing, providing face coverings for workers and requiring face coverings for customers.

“If you’re in violation, at this point we can either issue citations, or there are cases where we just close the place down because the violations are egregious,” she said.

The sharp racial disparities that characterized the pandemic from the beginning are under even more scrutiny now that California has become the first state to make “health equity” a factor in its decisions to allow expanded reopening.

Large counties may not advance toward full reopening until their most disadvantaged neighborhoods, and not just the county as a whole, meet or are lower than the targeted levels of disease. The criteria prod local governments to invest more in testing, contact tracing and education in poor neighborhoods with high levels of the disease.

Ferrer’s focus on workplaces crystallized during a crackdown on Los Angeles Apparel, a clothing factory that had pivoted to face mask manufacturing during the pandemic. Despite the ready inventory of masks, an outbreak at the factory resulted in at least 300 cases — and four deaths.

The health department, acting on a tip from community health centers flooded with sick Los Angeles Apparel workers, shut down the factory on June 27. That action highlighted the need to bring the government and labor unions together to fight the pandemic, said Jim Mangia, CEO of St. John’s Well Child & Family Center, a chain of community health centers in South L.A.

“At St. John’s, almost all of our patients are the working poor,” Mangia said. “They were getting infected at work and bringing it home to their families, and I think intervening at the workplace is what really made all the difference.”

Early in the pandemic, Ferrer had also set up an anonymous complaint line for employees who want to report workplace violations. It gets about 2,000 calls a week, she said. As of Oct. 10, the department’s website lists 132 workplaces that have had three or more confirmed COVID-19 cases, with a total of 2,191 positives. Another table dated Oct. 7 lists 124 citations — mostly to gyms and places of worship — for failing to comply with a health officer order.

“Fortunately, we’re not like Cal/OSHA, in the sense that it doesn’t take us months to complete an investigation,” Ferrer said. “We’re able to move more swiftly under the health officer orders to actually make sure that we’re protecting workers.”

Public health councils are the next phase in Ferrer’s plan to keep workers safe. The plan stemmed from the response of Overhill Farms, a frozen-food factory in Vernon, California, after an outbreak of more than 20 cases and one death. The factory and its temporary job agency were hit with more than $200,000 in proposed penalties from Cal/OSHA in September, but before the fines landed, the factory leadership was already responding by beginning to hold meetings with workers to improve safety there.

“They found that the workers helped them bring down infection rates and helped solve problems,” said Roxana Tynan, executive director of the Los Angeles Alliance for a New Economy, a worker advocacy organization.

While it’s not exactly a feel-good story about corporate beneficence, the turnaround at Overhill Farms added credence to the benefits of workplace councils, said Koonse of UCLA.

No company would have to spend more than 0.44% of its payroll cost on the health councils, she estimated.

Still, the idea has gotten a mixed reception from businesses. In an Aug. 24 statement, CEO Tracy Hernandez of the L.A. County Business Federation wrote that the proposal would add “burdensome and convoluted programs that will further hinder an employer’s ability to meet demands, get back on their feet, and adequately serve their employees and customers.”

But Jim Amen, president of the eight-store Super A Foods grocery chain, said businesses should welcome the councils as a way to keep lines of communication open. Such practices have kept infection rates low at his stores, even without a mandate, Amen said.

“All I know is, for Super A, our employees are heavily involved in everything we do,” Amen said.

Labor groups see the councils as a crucial way for workers to raise concerns without fear of retaliation.

“In low-wage industries like the garment industry, workers coming together gets them fired,” said Marissa Nuncio, director of the Garment Worker Center, a nonprofit that mainly serves immigrants from Mexico and Central America.

While disparities are narrowing in L.A. County, some shops are still unsafe and potential whistleblowers aren’t confident their reports to the county’s tip line are being acted on, she said.

“We continue to get calls from our members who are sick, have COVID and are hospitalized,” Nuncio said. “And the most obvious location for them to have been infected is in their workplace, because so many precautions are not being taken.”
curncman
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Coronavirus second wave looms: 'Hope for the best but prepare for the worst'

https://finance.yahoo.com/news/new-coro ... 37035.html

Yahoo Finance
Coronavirus second wave looms: 'Hope for the best but prepare for the worst'
Seana Smith
Seana Smith·Anchor
Thu, October 15, 2020, 7:11 PM GMT+5:30·4 mins read
New coronavirus cases in the U.S. continue to climb with more than half of the states reporting a rise in recent days. The daily count for new COVID-19 cases totaled more than 52,000 on Tuesday, according to data from Johns Hopkins University, as COVID-19 hospitalizations reached the highest level in months. And the pandemic is expected to get much worse.

“We’re still in the early days for the second wave but the numbers are very concerning and definitely heading the wrong direction,” Dr. Thomas Tsai of the Harvard Global Health Institute, told Yahoo Finance. “It’s hard to tell where this wave is going to end up but it’s definitely continuing to grow… We should hope for the best but prepare for the worst.”

The magnitude of a second wave is what health officials are trying to gauge as we see a surge of cases in the Midwest and West. Some estimates are for it to get much worse through the winter months, as colder weather makes it more likely people will congregate indoors, where the chance of transmission is much higher. According to the University of Washington’s Institute for Health Metrics and Evaluation, the death toll could climb to nearly 400,000 by February, that’s nearly double from the current total of 216,000.

“It’s about the risk of the airborne transmission. You’re at greater risk if you’re closer to an individual for a longer duration of contact, meaning within six feet for greater than 15 minutes, and those situations are more likely to happen as the weather gets colder and people are indoors more frequently,” said Tsai.

Thirteen states are now considered hotspots where stay-at-home orders become necessary again, according to the Brown School of Public Health COVID-19 Risk Level Dashboard. To be designated as a hotspot, there are more than 25 positive cases per 100,000 people. States currently with the highest number of cases per 100,000 people are North Dakota, South Dakota, Montana, Wisconsin, and Utah.

A second wave could strain the health care system

A second wave could strain the health care system
With U.S. hospitalizations reaching their highest level since August 28, according to data from The Covid Tracking Project, climbing 17% since the beginning of the month, government officials are expressing concern, warning of the stress it could put on state health care systems if residents don’t work together to slow the spread. Arkansas Governor Asa Hutchinson took to Twitter to urge residents to “work together to reduce our cases & hospitalizations” while Ohio Governor Mike DeWine tweeted “It's up to all of us to slow the spread.”

Although the sudden rise in hospitalizations is alarming, the U.S. health care system is much better equipped to handle a second wave, thanks to a better understanding of the virus, more personal protective equipment and progress on treatments.

“The situation that is playing out now in the Midwest is different than the situation we were seeing in New York and Boston back in March and April. We’ve learned a lot about the protocols for managing the critically ill patients with COVID-19 in terms of ventilator settings. There are some newer medications and treatment regimens that are available like Remdesivir and some of the steroid treatments as well, so we’ve made some progress in terms of our ability to treat COVID-19, and our ability to plan for surge capacity has also improved,” said Tsai.

Now that it’s mid-October, the next big worry on health officials’ minds is the holiday season. Of course the concern here is that larger family gatherings could potentially lead to bigger outbreaks, especially in parts of the country where there are higher levels of COVID-19 cases and community spread. Earlier this week the Centers for Disease Control and Prevention (CDC) issued guidelines for attending holiday celebrations, urging people to consider the location of the gathering, the duration of the gathering, and the number of people attending, as well as the behaviors of attendees prior to and at the gathering.

“We’re concerned about holidays coming up over the next few months,” said Tsai. “There’s an occasion for social gatherings indoors that could pose risks as well.”
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Previous infections with seasonal coronaviruses might protect against SARS-CoV-2

10/15/20


https://www.news-medical.net/news/20201 ... CoV-2.aspx


A new study conducted by researchers at University Hospital Münster suggests that previous infection with seasonal coronaviruses may protect against critical cases of coronavirus disease 2019 (COVID-19).

Seasonal coronaviruses, which generally cause mild respiratory illness and symptoms of the common cold, belong to the same viral family as severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) – the agent that causes COVID-19.

Intriguingly, Joachim Kühn and colleagues found that patients with critical cases of COVID-19 had significantly lower levels of antibodies against seasonal coronaviruses than patients who had less severe disease.

More specifically, levels of immunoglobulin G (IgG) antibodies against the human coronaviruses (HCoVs) OC43 and HKU1 were significantly lower among COVID-19 patients with critical disease than among those with moderate-to-severe or mild disease.

The researchers say this finding should be validated in other settings and could identify high-risk individuals before they become infected.

Identifying such individuals is a priority during this stage of the pandemic to help guide protective measures and vaccination strategies says the team.

A pre-print version of the paper is available in the server medRxiv* while the article undergoes peer review.

Clinical course of COVID-19 is highly variable

The clinical course of COVID-19 is highly variable between individuals. While the majority of patients develop mild disease that can be managed in the outpatient setting, 10 to 20% require hospitalization and around 5% require admission to intensive care units, where the fatality rate is high.

Known risk factors for more severe disease include older age, male gender, high body mass index, and comorbidity. However, young and apparently healthy individuals can also die from COVID-19, and the variability in the disease course is not well understood.

Recently, a survey found that patients who experienced mild COVID-19 symptoms reported having frequent contact with small children, potentially suggesting that exposure to common childhood infections might reduce the severity of the disease.

“This corresponds to the low incidence of severe COVID-19 infections in small children,” writes Kühn and colleagues.

Furthermore, some studies have recently reported immunological cross-reactivity against SARS-CoV-2 among individuals who have not been exposed to the virus.

Where do seasonal coronaviruses come in?

Seasonal coronaviruses such as the human coronaviruses (HCoVs) 229E, NL63, OC43, and HKU1, which frequently infect children, generally only cause mild respiratory illness and symptoms of the common cold.

These pathogens belong to a subfamily of viruses called orthocoronavirinae – the same group that SARS-CoV-2 belongs to.

“From a public health perspective, the relatively high proportion of COVID-19 patients with critical disease poses the key problem of this pandemic: overload of the healthcare system,” said Kühn and team.

If it is the case that previous infection with a known pathogen could modify the course of COVID-19 and therefore reduce the need for intensive care, this could become an important step in fighting the pandemic.

People at risk for severe disease could be identified before they become infected, and appropriate protective measures could be taken.

“Of note, this might also be relevant for vaccination strategies,” added the researchers.

Testing the association in hospital inpatients and outpatients

The team conducted an observational study to assess whether previous infection with seasonal coronaviruses (as measured by antibody levels) may be associated with the severity of COVID-19.

Serum samples were taken from 60 patients, aged a median of 58 years (age range 30 to 82), with RT-qPCR-confirmed COVID-19 infection. Fifty-two of the participants were male, and eight were female.

Nineteen of the participants were inpatients who required critical care (ICU group); 16 were inpatients who had severe or moderate disease (non-ICU group), and 25 were patients with disease that could be managed in the outpatient setting.

What did the team find?


The study found that elevated levels of HCoV OC43 and HCoV HKU1 antibodies were associated with less need for intensive care therapy.

Patients in the ICU group had significantly lower levels of IgG antibodies against HCoV OC43 and HCoV HKU1, compared with all other patients.

The team also observed a trend towards reduced length of hospital stay among those with higher levels of these antibodies.

Long hospital stays were predominantly observed among patients with low levels of the antibodies, although this correlation was not significant.

What did the authors conclude?


“Our results indicate that previous infections with seasonal coronaviruses might protect against a severe course of disease,” said Kühn and colleagues.

The researchers propose that previous exposure to seasonal coronaviruses might facilitate immune responses to SARS-CoV-2 but say further studies are needed to assess the molecular mechanism underlying the findings.

Further studies should also be conducted to validate the findings and to explore the potential to identify people at risk for severe disease before they have become infected with SARS-CoV-2, they say.



“Identification of vulnerable individuals is a key priority in the current stage of the pandemic to guide protective measures and to design vaccination strategies,” concludes the team.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:


Kühn J, et al. Less severe course of COVID-19 is associated with elevated levels of antibodies against seasonal human coronaviruses OC43 and HKU1 (HCoV OC43, HCoV HKU1) medRxiv, 2020. doi: https://doi.org/10.1101/2020.10.12.20211599, https://www.medrxiv.org/content/10.1101 ... 20211599v1
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News coverage contributes to drug shortages in COVID-19

10/15/20


https://www.news-medical.net/news/20201 ... ID-19.aspx


Researchers at Boston Children's Hospital in the U.S. have reported that the recent shortage of medicines used to treat coronavirus disease 2019 (COVID-19) could be due to extensive news media coverage that results in individual hoarding or institutional stockpiling of medicines. The study is currently available on the medRxiv* preprint server.

As of October 16, 2020, highly infectious and deadly severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) has infected more than 38.8 million people and claimed more than 1 million lives globally. Rigorous testing, together with strict implementation of non-pharmaceutical control measures (masking, hand washing/sanitizing, movement restriction, etc.), is believed to be the most effective way to contain the viral spread.

Regarding pharmaceutical interventions to manage COVID-19 patients, several medicines have been proposed for repurposing as COVID-19 treatment. However, the US Food and Drug Administration (FDA) has reported that there is a nation-wide shortage of many of these medicines.

In the current study, the scientists investigated if this shortage is caused by the hoarding of drugs by individuals or stockpiling of drugs by institutions. They also investigated whether media news coverage has any influence on drug hoarding/stockpiling.

Current study design


The scientists analyzed US news media coverage and internet search related to eight repurposed medicines reported to be in shortage by the FDA between January 1, 2020, and June 30, 2020. These medicines include azithromycin, famotidine, hydroxychloroquine, cisatracurium, dexmedetomidine, continuous renal replacement therapy (CRRT), midazolam, and propofol.

A pharmacist associated with federal COVID-19 response selected and categorized eight repurposed medicines based on the data collected from the American Society of Hospital Pharmacists and national and international workgroups.

Of eight medicines, three were categorized as “able to be hoarded by individuals or stockpiled by institutions,” as people can directly purchase these medicines from pharmacies. These medicines include azithromycin, famotidine, and hydroxychloroquine.

Five repurposed medicines, including cisatracurium, dexmedetomidine, continuous renal replacement therapy (CRRT), midazolam, and propofol, were categorized as “able to be stockpiled by institutions only,” as people generally do not purchase these medicines on their own.

For each medicine, the scientists analyzed news media coverage by Media Cloud’s National Corpus. They separately analyzed the media coverage about medicines, excluding the word “shortage” and medicines, including the word “shortage.” Regarding internet search volume for each repurposed medicine, the scientists collected the data from Google Health Trends.

Important observations


For all three medicines that can be individually hoarded or institutionally stockpiled, news about medicines either including or excluding the word “shortage” sharply increased before the FDA-announced shortage. Moreover, internet searches related to these medicines also increased significantly before the shortage announcement.

A similar trend was observed for five medicines that are most likely to be stockpiled by institutions only. Media news about these medicines, either including or excluding the word “shortage,” also sharply increased before the FDA-announced shortage. However, no variation in internet search related to these medicines was observed before the shortage announcement.

Study significance


The study findings indicate that extensive news media coverage about essential COVID-19 treatment medicines can influence the hoarding/stockpiling behaviors of both individuals and institutions prior to the shortage. This, in turn, can deprive COVID-19 patients who are in the actual need of these medicines for off-label usage.

The increase in internet search patterns observed in the study indicates that people who are influenced by news actually try to look for medicines they can directly purchase and hoard for future use.

Because institutions are less likely to search drug-related information on the internet before purchasing, no variation in internet search pattern was observed in the case of medicines that can only be purchased by institutions. Thus, internet search trends seem to differentiate between individual hoarding and institutional stockpiling correctly.

*Important Notice

medRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

medRxiv preprint server. 2020. Catillon M. News Coverage and Drug Shortages during the COVID-19 Pandemic. https://www.medrxiv.org/content/10.1101 ... 20211656v1
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New technique uses ultrasound to provide non-invasive assessments of lung health

10/15/20


https://www.news-medical.net/news/20201 ... ealth.aspx


Researchers from North Carolina State University and the University of North Carolina have developed a technique that uses ultrasound to provide non-invasive assessments of pulmonary fibrosis and pulmonary edema. The technique has been shown to both quantify lung scarring and detect lung fluid in rats. A study on pulmonary edema in humans is under way.

The new ultrasound technique is significant because it would allow healthcare providers to determine how effective medical interventions are at reducing lung scarring (pulmonary fibrosis) or fluid in the lungs (pulmonary edema).

Assessing the extent of fibrosis in the lung currently requires computerized tomography (CT) scans, and sophisticated pulmonary function tests. Both aspects of the assessment present challenges.

" CT scans use radiation, so you want to limit their use. They are also expensive, and require a trained radiologist. For all of these reasons, they are not suitable for frequent monitoring. Ultrasound is a good solution because it does not pose a cancer risk, it's portable, it's relatively inexpensive, and our technique effectively gives users a quantitative assessment of the fibrosis."

- Marie Muller, co-senior author of the study and associate professor of mechanical and aerospace engineering at NC State

"One of the pulmonary function tests is called a DLCO test," says Dr. Tom Egan, co-senior author on the study and a professor of surgery at UNC. "The DLCO test measures the amount of gas exchange surface in the lung, and it requires specialized equipment that you won't find outside of hospitals and some large pulmonary clinics. The specialized technology means that this testing can be expensive - particularly now, due to heightened decontamination procedures associated with the COVID-19 pandemic. If this new ultrasound technology can reduce our reliance on DLCO tests, that would likely reduce costs for patients."

"Being able to monitor pulmonary edema in patients with heart failure would also be very useful," Muller says. "This is often done by assessing fluctuations in a patient's body weight in order to estimate how much fluid has collected in the patient's lungs - which is not as specific as we'd like it to be.

"We've recently received a grant from NIH to investigate if our novel ultrasound technique can quantify pulmonary edema in heart failure patients."

"Pulmonary fibrosis is a major public health problem," Egan says. "The most common form of pulmonary fibrosis affects 200,000 Americans, with 50,000 new cases diagnosed each year.

"Pulmonary edema is another common condition. It can be caused by a number of health conditions, but affects more than 75% of patients with heart failure."

The new technique makes use of the multiple transducer elements on conventional ultrasound probes to direct multiple ultrasound waves at lung tissue. As the ultrasound waves bounce back to the transducer, the data is collected and fed into a computational model that determines the density of healthy alveoli in the lung. This can be used to provide a quantitative assessment of the amount of fibrosis in the lung tissue. Researchers are testing whether it can also quantify the amount of water in the lung.

The current paper demonstrates the efficacy of the technique in assessing pulmonary fibrosis and edema in rats, and distinguishing between the two lung abnormalities.

"The automated quantitative assessment would allow the technology to be used by personnel with minimal training, and would allow healthcare providers to compare data across time," Muller says. "For example, caregivers would be able to tell if a patient's edema is getting better or worse."

"Because this is ultrasound, people have a hard time grasping this concept: there are no images; the output is a number," Egan says.

"The quantitative element of this work is particularly important, given that previous approaches to assessing lung health with ultrasound could really only provide qualitative assessments," Muller says. "They could say that lung health was bad or good, but couldn't give you measurable gradients between the two."

The researchers have received funding for a study focused on using the technique to assess pulmonary edema in human patients, and are applying for funding to pursue the work in patients with pulmonary fibrosis.

"We've seen new treatments come online in recent years for pulmonary fibrosis patients," Egan says. "It would be valuable to determine how effective they are, and what factors may contribute to their effectiveness."

Source:

North Carolina State University

Journal reference:


Mohanty, K., et al. (2020) In-Vivo Assessment of Pulmonary Fibrosis and Pulmonary Edema in Rodents Using Ultrasound Multiple Scattering. IEEE Transactions on Ultrasonics, Ferroelectrics, and Frequency Control. doi.org/10.1109/TUFFC.2020.3023611.
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High-titer convalescent plasma reduced COVID-19 symptom severity in green monkeys

10/16/20


https://www.news-medical.net/news/20201 ... nkeys.aspx


Even as the world attempts to limp back to a semblance of normalcy after the initial phase of the COVID-19 pandemic, a massive second wave threatens to swamp healthcare facilities again.

As scientists scramble to find effective vaccines and antivirals for severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2), a recent study published on the preprint server bioRxiv* in October 2020 reports that the use of convalescent plasma to treat COVID-19 disease early in the course of the illness may be among the best available strategies at present.

The Current State of CP Therapy

Historically, convalescent plasma has been used to treat many infectious diseases, including influenza. At present, many centers in the US, for instance, have also resorted to this strategy to treat COVID-19. However, the fact that these are not part of a randomized clinical trial has made many clinicians skeptical of this therapeutic agent's real value.

Many trials have thus been set up to examine the efficiency and safety of CP in COVID-19 patients with acute illness. While most investigators concur that CP is possibly beneficial, there are many unknowns, including the effective dose, the route of viral exposure, and the incubation period's actual length. This points to the need for experimental studies using treated subjects and controls to understand this therapy's value and risks.

Some studies using rodent models show CP to be beneficial, but they did not shed light on how it affects disease parameters in this infection. Earlier studies in non-human primates (NHPs) infected with MERS have shown the benefit of hyperimmune plasma, but no such studies exist in NHPs for CP.

CP Mitigates Clinical Disease Markers


The current study examines convalescent plasma's role containing high antibody titers in an infected NHP model. It thus seeks to offer direct proof that CP is useful as a tool to manage this pandemic. The researchers used their newly developed African green monkey model for this study since it recapitulates the characteristic features of human COVID-19.

Groups of monkeys were inoculated with SARS-CoV-2 and then treated with pooled CP, classified as either high or low, concerning their neutralizing antibody titer. They found that animals treated with high-titer CP showed lower viral loads in the lungs than those treated with low-titer CP and untreated controls.

Animals in the high-dose CP group also had less severe lung lesions and lower levels of clotting factors and other inflammatory markers, compared to either the group treated with low-dose CP or controls. These markers include clotting times, fibrinogen, cytokine levels, and platelet counts.

There was no discernible difference in viral load or tissue pathology among the monkeys that were treated with CP containing low titers of nAbs and the untreated controls. Despite this, they found that overall, all monkeys treated with CP had lower viral load in the lung tissue, less severe lesions in the lungs, and lower levels of the disease indicators compared to controls.

This shows that the CP exerted an antiviral effect, shown as the absence of infectious virus in the bronchoalveolar lavage fluid from all treated animals, and less severe lung disease, even when the CP contained only a low level of nAbs. However, the best strategy appears to be to use CP containing a high level of potent nAbs.

Other Benefits of CP

The researchers admit that the antiviral effect may be due not only to the presence of nAbs but also other antibody-related effects and antiviral effects caused by other soluble factors generated as a result of the natural response to the viral infection. Moreover, a meta-analysis of all available information on the thousands of patients who have been given CP in this pandemic indicates its benefit in reducing the duration of hospital stay, as well as a good safety profile. It does not seem to be associated with antibody-dependent enhancement (ADE).

The latter is a valid fear given earlier research on rhesus monkeys who were vaccinated with SARS-CoV-2 spike vaccine and developed worsening lung disease due to ADE.

Timing and Titer Are Crucial


Some recent papers show the influence of timing and antibody titer in determining the usefulness of CP therapy since patients with advanced disease at the time of CP initiation tend to recover less well compared to those who receive it early in the course of the disease.

A large clinical trial from India (using donor CP with a median titer of 1:40), which was prematurely terminated for want of preliminary evidence of benefit, shows that this may be derived only when the CP has a high median antibody titer. In the current study, the low dose group had a median titer of ~1:128 and the high dose group ~1:2048.

Conclusion


The study sums up: "Our data support human studies suggesting that convalescent plasma therapy is an effective strategy if donors with a high level of antibodies against SARS-CoV-2 are employed and if recipients are at an early stage of the disease."

CP's advantage is its ready availability, which may allow clinicians to effectively treat COVID-19 patients early and thus prevent an acute surge in severely ill patients, overwhelming intensive care units, and hospitals. Its correct use may bridge the current gap between demand and supply for more effective drugs in the current pandemic.

*Important Notice

bioRxiv publishes preliminary scientific reports that are not peer-reviewed and, therefore, should not be regarded as conclusive, guide clinical practice/health-related behavior, or treated as established information.

Journal reference:

Cross, R. et al. (2020). Use of Convalescent Serum Reduces Severity Of COVID-19 In Nonhuman Primates. bioRxiv preprint. doi: https://doi.org/10.1101/2020.10.14.340091. https://www.biorxiv.org/content/10.1101 ... 4.340091v1
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NFID issues new report detailing risks of co-infection with flu and COVID-19 in vulnerable adults

10/16/20


https://www.news-medical.net/news/20201 ... dults.aspx


The National Foundation for Infectious Diseases (NFID) issued a new Call to Action report detailing the risks of co-infection with influenza (flu) and COVID-19 in adults with chronic health conditions, and the importance of flu vaccination during the 2020-2021 season.

The goals of the report, The Dangers of Influenza and COVID-19 in Adults with Chronic Health Conditions, have been supported by more than 35 leading medical organizations, including the American College of Cardiology, American College of Emergency Physicians, American Diabetes Association, and American Lung Association, who are now urging their stakeholders to prioritize flu vaccination for these high-risk populations.

In the US, six in ten adults have one or more chronic health conditions, including heart disease, lung disease, and diabetes, that put them at increased risk for flu and COVID-19.

For this population, related complications include the potential exacerbation of underlying health condition(s), as a result of flu-related inflammation that may persist long after the acute infection, as well as increased risk of long-term complications, such as heart attack and stroke, after experiencing acute flu or COVID-19 infection.

According to the Centers for Disease Control and Prevention (CDC), annual flu vaccination has been proven to mitigate serious flu-related complications, preventing an estimated 7.5 million flu illnesses, 3.7 million flu-associated medical visits, 105,000 flu hospitalizations, and 6,300 flu deaths in 2019-2020 alone.

Yet, a recent NFID survey found that nearly one in four US adults at high risk for flu-related complications said they did not intend to get vaccinated during the 2019-2020 flu season.

" Amidst the COVID-19 pandemic, patients with chronic health conditions are facing not one, but two viruses that pose a serious threat to their health and independence. While we currently don't have an approved COVID-19 vaccine in the US, we know that annual flu vaccination can help protect these patients from hospitalization, progressive disability, and even death. It is imperative that healthcare professionals educate patients with chronic health conditions about their risks and implement strategies to increase flu vaccination rates during the COVID-19 pandemic."

- William Schaffner, MD, Medical Director, National Foundation for Infectious Diseases

In advance of an unprecedented 2020-2021 flu season, NFID convened a multidisciplinary virtual roundtable with leading experts to explore the risks of co-circulation and co-infection with flu and SARS-CoV-2 (the virus that causes COVID-19) in adults with chronic health conditions.

The resulting NFID Call to Action, which summarizes the roundtable discussions, includes best practices for administering flu vaccines in conjunction with COVID-19 mitigation efforts.

Despite the limited data currently available on outcomes from co-infection with the two viruses, insights from the roundtable highlighted that the impact on patients and the US public health system could be catastrophic.

"It won't take a 'bad' flu season--just 'a' flu season to make things more difficult in the ER and elsewhere in the US healthcare system," said Nicholas F. Vasquez, MD, vice chair of the Diversity, Inclusion, and Health Equity Section of the American College of Emergency Physicians. "Further strain due to the co-circulation of flu and COVID-19 could disrupt routine care and have detrimental consequences for adults with chronic health conditions."

The relationship between flu and heart disease is of particular concern during the current pandemic, as severe COVID-19 outcomes have also been associated with pre-existing cardiovascular conditions and post-infection injury to heart tissue.

Over the past eight US flu seasons, nearly 47 percent of patients hospitalized for flu had heart disease, making it the most common underlying health condition associated with flu-related complications. Fortunately, flu vaccination can serve as an effective prevention strategy in these patients.

One study estimated the flu vaccine is between 15 to 45 percent effective in preventing heart attacks and strokes, making it equal to or more effective than smoking cessation, statins, and antihypertensive therapy.

"I am greatly concerned for heart disease patients this flu season. It is already well-documented that heart disease is a risk factor for severe flu-related illness, but with COVID-19, we are entering a dangerous and uncharted territory," said William B. Borden, MD, professor of medicine and health policy at George Washington University, representing the American College of Cardiology.

"The most important thing we can do to protect these patients is to ensure they are getting their annual flu vaccine. I am making it a point this season to strongly recommend a flu vaccine to every heart patient I see and urge my colleagues to do the same."

To help increase flu vaccination rates, the NFID Call to Action offers strategies and tactics for healthcare professionals, particularly specialists treating adults with chronic conditions during the 2020-2021 flu season, including communication methods for discussions with both patients and office staff, vaccine implementation strategies specific to the COVID-19 pandemic, and techniques for addressing vaccine misinformation.

"All healthcare professionals, including specialty care providers, have a duty to understand the risks our patients face and advocate for any preventive measure that can preserve health and save lives," said NFID President Patricia N. Whitley-Williams, MD, also representing the National Medical Association. "If you treat a patient with heart disease, lung disease, diabetes, or another chronic health condition, then you have a responsibility to insist upon annual flu vaccination."

Source:


National Foundation for Infectious Diseases
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Control trial proves effectiveness of repurposed drugs for COVID-19 treatment

10/16/20


https://www.news-medical.net/news/20201 ... tment.aspx


In just six months, the world's largest randomized control trial on COVID-19 therapeutics has generated conclusive evidence on the effectiveness of repurposed drugs for the treatment of COVID-19.

Interim results from the Solidarity Therapeutics Trial, coordinated by the World Health Organization, indicate that remdesivir, hydroxychloroquine, lopinavir/ritonavir and interferon regimens appeared to have little or no effect on 28-day mortality or the in-hospital course of COVID-19 among hospitalized patients.

The study, which spans more than 30 countries, looked at the effects of these treatments on overall mortality, initiation of ventilation, and duration of hospital stay in hospitalized patients. Other uses of the drugs, for example in treatment of patients in the community or for prevention, would have to be examined using different trials.

The progress achieved by the Solidarity Therapeutics Trial shows that large international trials are possible, even during a pandemic, and offer the promise of quickly and reliably answering critical public health questions concerning therapeutics.

The results of the trial are under review for publication in a medical journal and have been uploaded as preprint at medRxiv available.

The global platform of the Solidarity Trial is ready to rapidly evaluate promising new treatment options, with nearly 500 hospitals open as trial sites.

Newer antiviral drugs, immunomodulators and anti-SARS COV-2 monoclonal antibodies are now being considered for evaluation.

Source:

The World Health Organization

Journal reference:


Pan, H., et al. (2020) Repurposed antiviral drugs for COVID-19; interim WHO SOLIDARITY trial results. BMJ. doi.org/10.1101/2020.10.15.20209817.
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Indoor sports potential superspreader events, CDC says, after most ice hockey players in Florida game infected with Covid-19

10/15/20


https://www.cnn.com/2020/10/15/health/c ... index.html


One hockey player infected as many as 14 other people at a single indoor ice hockey game last spring, Florida health department officials reported Thursday.
That means indoor sports games can turn into superspreader events, the researchers said in the US Centers for Disease Control and Prevention's weekly report.
The game was played on June 16 at an ice rink in Tampa and by the following day, a player, considered the index patient, experienced symptoms of Covid-19, including fever, cough, sore throat and a headache. Two days later, he tested positive for the virus, the Florida Department of Health reported.

Coronavirus spreads at hockey game

Each team had 11 players, all male, between the ages of 19 and 53, with six on the ice and five on the bench at any given time during the game, the researchers reported. Each team also shared separate locker rooms, typically for 20 minutes before and after the 60-minute game, and no one wore cloth face masks for disease control.

"During the five days after the game, 15 persons experienced signs and symptoms compatible with coronavirus disease 2019; 13 of the 15 ill persons had positive laboratory test results indicating infection with SARS-CoV-2, the virus that causes COVID-19," researchers wrote. Two of the sick individuals did not get tested.
While 62% of the players experienced Covid-19 symptoms, the on-ice referees did not, nor did the one spectator in the stands.

Ice rink well-suited to Covid-19 transmission


Ice hockey involves vigorous physical exertion with heavy respiration during the game and frequent contact between the players.
"The ice rink provides a venue that is likely well suited to COVID-19 transmission as an indoor environment where deep breathing occurs, and persons are in close proximity to one another," the researchers noted.
More than one player may have been infectious during the game, the researchers acknowledged, but they believe that the index patient was the source of the transmission while he was still asymptomatic.

The analysis was limited because not all the players were tested for the virus and asymptomatic infections may not have been identified.
"The indoor space and close contact between players during a hockey game increase infection risk for players and create potential for a superspreader event, especially with ongoing community COVID-19 transmission," the study concluded.
"The ice rink provides a venue that is likely well suited to COVID-19 transmission as an indoor environment where deep breathing occurs, and persons are in close proximity to one another," they added.

Sparse information on Covid-19 spread at sports events


There are few published studies or reports on Covid-19 transmission associated with specific sports games or practices, other than what has been reported in the news, the CDC noted.
The median incubation time for Covid-19 is four to five days from exposure to symptom onset and ranges from two to 14 days, according to the CDC.

In New Hampshire, 158 residents associated with 23 different ice hockey teams or organizations have been diagnosed with Covid-19 over the past two months, Dr. Benjamin Chan, the state epidemiologist, said Thursday. Of the 158 cases, 117 have been linked to separate outbreaks and 41 are not related to a specific outbreak, but are connected to ice hockey, Chan said. "Hockey has been one of the high-risk activities where we have seen substantial spread," Chan added.
People who are believed to have contracted coronavirus through their association with hockey have also potentially exposed others in at least 24 different K-12 schools in the state, he said, noting that the game is increasing the risk of exposure and spread to other facilities and organizations.
On Thursday, New Hampshire Gov. Chris Sununu ordered all ice activities at indoor facilities halted for the for the next two weeks.

Other potential superspreader events


Other documented cases of a superspreader event include a choir in Washington last spring where 53 out of 122 members of the Skagit Valley Chorale contracted the virus and two died after attending two rehearsals in March.

"The act of singing, itself, might have contributed to transmission through emission of aerosols, which is affected by loudness of vocalization," a report on the event by the CDC found.

Some public health experts have called a Rose Garden ceremony at the White House in late September a superspreader event after dozens who attended the event contracted the coronavirus, including President Donald Trump and members of his administration, although it's unclear exactly where the President first became infected.

The coroanvirus has also spread through meat processing plants and was linked to an outbreak involving 57 participants in a high-intensity fitness dance class in South Korea.
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