Covid 5/19/20

Today there is a plenty of good news – so buckle up and enjoy the update.

Clearly politics is so much more involved than it needs to be – case in point is the reporting on HCQ. So many media reports are noting HCQ as dangerous and fatal drug….relative to other drugs it is well known drug used for decades to treat malaria and lupus – the side effects and who should use it is well known so its danger is being exaggerated in the press. The other hilarious connection is there is some big money grab made by Trump – HCQ is manufactured by over 11 companies – it is generic drug! And Zinc well its like vitamin C….IF he really wanted to make money go pick a drug that is patented. Can we really hate someone so much we would spite our own self and society?

Good news – https://www.medrxiv.org/content/10.1101/2020.05.02.20080036v1.full.pdf

“Conclusion: This study provides the first in vivo evidence that zinc sulfate in

combination with hydroxychloroquine may play a role in therapeutic management for

COVID-19.”

Same critique as the other HCQ study – this is statistical review not a study. HOWEVER unlike the other ones this one did include and focused on the addition of zinc which is what the doctors in France was noting.

“The addition of zinc sulfate did not impact the length of hospitalization,

duration of ventilation, or ICU duration. In univariate analyses, zinc sulfate

increased the frequency of patients being discharged home, and decreased the need

for ventilation, admission to the ICU, and mortality or transfer to hospice for patients

who were never admitted to the ICU. After adjusting for the time at which zinc sulfate

was added to our protocol, an increased frequency of being discharged home (OR 1.53,

95% CI 1.12-2.09) reduction in mortality or transfer to hospice remained significant (OR

0.449, 95% CI 0.271-0.744).”

Perhaps plane travel is “safe”. This study shows many long flights taken by sick people but they don’t highlight any significant spread in the plane unlike restaurant, gym, or office studies. Is it because the plane is relatively “safe” or was they didn’t study it hard enough? I am going to be optimistic and hope its because it is safe. https://www.thelancet.com/journals/laninf/article/PIIS1473-3099(20)30314-5/fulltext

“Patient 0, who was an employee of the Chinese branch of a German company based in greater Munich, travelled from Shanghai to Munich by aeroplane on Jan 19, 2020, to facilitate workshops and attend meetings in the company building. The day after arrival (Jan 20, 2020), patient 0 felt chest and back aches—which she reported to be unusual—and took a single dose of medicine containing paracetamol. The patient reported fatigue during her whole stay in Germany and attributed the symptom to jetlag. After an overnight flight back to Shanghai on Jan 22, the patient felt feverish. With a self-measured temperature of 38·6°C and cough on Jan 24, the patient visited a physician’s office on Jan 25. The patient tested positive for SARS-CoV-2 on Jan 26 and was hospitalised the next day. The clinical situation in both parents also deteriorated during the primary case’s stay in Germany and both were laboratory-confirmed with COVID-19 later.7 The German company was informed of the primary case’s infection in the morning of Jan 27, 2020, and immediately informed its employees as well as the local health authority.”

“A Chinese colleague (patient 13) of patient 0 accompanied them in multiple activities while in Germany. Patient 13 travelled back to China with patient 0, developed symptoms on Jan 27, and tested SARS-CoV-2 positive a few days later.”

“Patient 12 departed for vacation to Spain 3 days later (Jan 28). After Spanish authorities were informed, patient 12 was isolated in hospital on Jan 30 and diagnosed with COVID-19.”

Extensive contact tracing involved the international flights from Munich to Shanghai (patient 0 on Jan 22, 2020) and from Munich to Tenerife (patient 12 on Jan 28, 2020). As of May 2, no further cases have been identified among flight passengers or other (personal) contacts.

I would really like more details on the flight HVAC system. Clearly IF airline trip for 14h and 15 min travel time in an enclosed environment can contain the virus from not spreading compared to the restaurant, gym, and office building that has been highlighted – we need to replicate this!

Here is an interesting approach – a quasi treatment/vaccine – https://www.france24.com/en/20200519-scientists-in-china-believe-new-drug-can-stop-pandemic-without-vaccine

“A drug being tested by scientists at China’s prestigious Peking University could not only shorten the recovery time for those infected, but even offer short-term immunity from the virus, researchers say.”

“"When we injected neutralising antibodies into infected mice, after five days the viral load was reduced by a factor of 2,500," said Xie.

"That means this potential drug has (a) therapeutic effect."

The drug uses neutralising antibodies — produced by the human immune system to prevent the virus infecting cells — which Xie’s team isolated from the blood of 60 recovered patients.

A study on the team’s research, published Sunday in the scientific journal Cell, suggests that using the antibodies provides a potential "cure" for the disease and shortens recovery time.

Xie said his team had been working "day and night" searching for the antibody.

"Our expertise is single-cell genomics rather than immunology or virology. When we realised that the single-cell genomic approach can effectively find the neutralising antibody we were thrilled."

He added that the drug should be ready for use later this year and in time for any potential winter outbreak of the virus, which has infected 4.8 million people around the world and killed more than 315,000.”

“Using antibodies in drug treatments is not a new approach, and it has been successful in treating several other viruses such as HIV, Ebola and Middle East Respiratory Syndrome (MERS).

Xie said his researchers had "an early start" since the outbreak started in China before spreading to other countries.”

Great news on the update US deaths still under 1K at 785. Brazil is not looking good at 735.

NY did lead the way for the US again but at amazingly low 107

County view still highlights Cook county IL being the concern along with Orange County CA. PA is starting to show deaths beyond Phil. Area – Berks county.

The states opening up are seeing drops in Death now – more surprisingly is the confirmation numbers are not rising.

Brazil is about to take over US as the leader in daily deaths. Russia continues to report confirmations but barely any deaths.

Brazil, Mexico, and India still rising in the 7 day MA daily death chart. Pakistan and Peru has been able to plateau.