MEXICOWANDERER
las peñas, michoacan, mexico
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Much effort is being put in achieving a high reliability faster response Covid test. The number of research companies engaged is over a hundred. Johns Hopkins has not headlined any major news this week.
Failure to wear "cubrebocas" is not a hot topic down here. People are being very mellow about it. Some of the stores are using automated thermal forehead checking machines. Since masks obscure the presence of a smile I lavish "Muchas or Mil Gracias" liberally.
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MEXICOWANDERER
las peñas, michoacan, mexico
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I can only wonder why Pfizer announced a major setback until June 2021 for their vaccine, and then a halt to AstraZeneca trials occured. Trials that the rest of the world promptly resumed.
Now Pfizer has asked the FDA for emergency override on it's MODERNA vaccine for use in the month of December 2020 for the USA. A month before the rest of the world sees the announcement of the Oxford AstraZeneca vaccine.
Can anyone answer this for me?
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JaxDad
Greater Toronto Area
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MEXICOWANDERER wrote:Much effort is being put in achieving a high reliability faster response Covid test. The number of research companies engaged is over a hundred. Johns Hopkins has not headlined any major news this week.
A PCR test is the gold standard, it takes 45 minutes to do such a test. With that type of test by industry leaders like Co-Diagnostics Inc out of Salt Lake City offer 100% accurate results.
The nonsense about 5 minutes is laughable. 5 minutes for ONE test, on ONE machine, plus prepping the sample, loading the sample, unloading the sample, etc, etc.
The Co-Diagnostics unit does 15 tests in the same cycle time as the others do one.
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MEXICOWANDERER
las peñas, michoacan, mexico
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I'd love to have a list of where this test can be performed
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MEXICOWANDERER
las peñas, michoacan, mexico
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The Johns Hopkins Center for Health Security also produces US Travel Industry and Retail Supply Chain Updates that provide a summary of major issues and events impacting the US travel industry and retail supply chain. You can access them here.
EPI UPDATE The WHO COVID-19 Dashboard reports 39.94 million cases and 1.11 million deaths as of 8:00am EDT on October 19. The WHO reported a new record high for global weekly incidence for the fifth consecutive week. The global total reached 2.44 million cases—an increase of more than 5% over the previous week. Additionally, the WHO reported 394,510 new cases on Saturday, a new daily record.
Total Daily Incidence (change in average incidence; change in rank, if applicable)
1. India: 61,391 new cases per day (-9,570)
2. USA: 56,007 (+6,765)
3. France: 23,151 (+6,608; ? 1)
4. Brazil: 20,052 (-5,619; ? 1)
5. United Kingdom: 16,956 (+2,565)
6. Russia: 14,374 (+2,414; ? 1)
7. Argentina: 13,639 (-35; ? 1)
8. Spain: 10,778* (-15)
9. Italy: 8,470 (+4,239; new)
10. Czech Republic: 8,111 (+3,159; new)
Per Capita Daily Incidence (change in average incidence; change in rank, if applicable)
1. Andorra: 1,259 daily cases per million population (+176)
2. Czech Republic: 757 (+295)
3. Belgium: 620 (+90; ? 2)
4. Netherlands: 448 (+126; ? 2)
5. Armenia: 397 (+207; new)
6. Montenegro: 397 (+1; ? 3)
7. France: 355 (+101; ? 1)
8. Slovenia: 345 (+196; new)
9. Liechtenstein**: 322 (+277; new)
10. Argentina: 302 (-1; ? 3)
*Spain’s average daily incidence is not reported for today; these values correspond to the previous day’s averages.
**Liechtenstein is a member of the UN, but not the WHO. Liechtenstein’s COVID-19 data is reported by Switzerland.
Considering the current COVID-19 resurgence in the US, India is unlikely to surpass the US as #1 for cumulative incidence in the near future. India is still reporting more new daily cases than the US; however, India continues its decline, while US daily incidence is increasing again.
Colombia and Mexico fell out of the top 10 in terms of total daily incidence, and they were replaced by the Czech Republic and Italy. Notably, Italy’s daily incidence doubled over the past week, and the daily incidence increased by more than 60% in the Czech Republic. France’s daily incidence has doubled over the past 2 weeks. The Bahamas, Iceland, and Israel fell out of the top 10 in terms of per capita daily incidence, and they were replaced by Armenia, Liechtenstein, and Slovenia. Belgium, which was not in the top 10 per capita daily incidence two weeks ago, has jumped to #3 globally. Armenia’s daily incidence increased by 108% compared to the previous week, Slovenia’s increased by 132%, and Liechtenstein’s increased by 617%.
UNITED STATES
The US CDC reported 8.08 million total cases and 218,511 deaths. The daily COVID-19 incidence continues to increase, now up to 55,323 new cases per day, the highest since August 5. On Saturday (data corresponding to October 16), the CDC reported 70,078 new cases, the highest daily incidence since July 24 and the sixth highest daily total to date. The US COVID-19 mortality continues to hold steady at approximately 700 deaths per day.
The US surpassed 8 million cumulative cases. From the first case reported in the US on January 22, it took 96 days to reach 1 million cases. From there:
1 million to 2 million: 44 days
2 million to 3 million: 27 days
3 million to 4 million: 15 days
4 million to 5 million: 17 days
5 million to 6 million: 22 days
6 million to 7 million: 25 days
7 million to 8 million: 21 days
More than half of all US states have reported more than 100,000 cases, including 10 with more than 200,000 cases:
>800,000: California, Texas
>700,000: Florida
>400,000: New York
>300,000: Georgia, Illinois
>200,000: Arizona, New Jersey, North Carolina, Tennessee
The Johns Hopkins CSSE dashboard reported 8.17 million US cases and 219,811 deaths as of 12:30pm EDT on October 19.
US HOSPITAL SURGE As much of the US continues to face another resurgence of COVID-19, rural hospitals are struggling to manage the patient demand. The US COVID-19 epidemic, which was largely concentrated in higher-density urban populations early on (eg, New York City, Boston, Detroit), has shifted toward rural populations across the country. In fact, the per capita COVID-19 mortality in small towns and rural areas is now more than double the mortality in large cities. Unlike urban areas, which may have many nearby hospitals to provide care for their large populations, and to distribute increased patient load, hospitals and other healthcare facilities in rural areas are spread further apart, covering much larger geographic areas. In some cases, the nearest hospital may be hundreds of miles away. Additionally, these hospitals tend to be smaller than their urban counterparts, and the associated limitations on resources, including hospital and intensive care unit (ICU) beds, increase the burden of COVID-19 patient surges. As we covered early in the pandemic, a growing number of rural hospitals in the US have closed their doors over the past several years, and restrictions on elective procedures during the height of social distancing measures in the US placed additional economic stress on hospitals and health systems, causing more to close.
In an effort to decompress patients from overburdened health systems (ie, transfer them to other facilities), Wisconsin established a temporary field hospital at its state fairgrounds. The facility opened last week, and it will initially be able to accommodate up to 50 patients. It is designed to provide care for patients who are recovering from COVID-19 but who are not yet ready to be discharged. More severe patients will remain at traditional hospitals to receive more advanced clinical care. Ultimately, the field hospital could be expanded to handle more than 500 patients, if necessary. Wisconsin currently has more than 1,000 hospitalized COVID-19 patients statewide, its highest total to date.
SWEDEN SOCIAL DISTANCING Since early in the COVID-19 pandemic, Sweden has largely resisted highly restrictive social distancing and other mitigation measures to limit SARS-CoV-2 transmission. Unlike most other European countries, Sweden placed few restrictions on retail stores, restaurants and bars, or schools. The reluctance to implement widespread social distancing policies has resulted in numerous accusations from the international community that Sweden is pursuing a herd immunity strategy through natural infection—Swedish officials have denied that herd immunity is the goal. In light of increased incidence during Europe’s “second wave,” Swedish officials are reportedly evaluating plans to implement local social distancing restrictions in severely affected areas.
Dr. Anders Tegnell—Sweden’s leading epidemiologist, who received the brunt of opposition to Sweden’s perceived herd immunity strategy—recently commented that the seroprevalence in the population was not as high as previously believed, which likely factors into Sweden’s evolving mindset. It appears as though the new policies will still largely be recommendations, as opposed to mandates, and they will be implemented locally not at the national level. While these measures are not nationwide mandates, it appears that Sweden’s overall strategy toward containing COVID-19 is moving closer to the model implemented across the rest of Europe. On October 13, Sweden reported 970 new cases, its highest daily total since late June.
VATICAN/HOLY SEE When reporting the per capita daily incidence top 10, we typically omit small countries that normally report zero daily cases but occasionally report a minor, temporary spike in incidence in favor of countries that exhibit a trend of elevated incidence. This week, the Vatican/Holy See reported 7 new cases twice, which would put it at #1 globally in terms of per capita incidence, at nearly 2,500 daily cases per million population.
At least 11 of the 14 new COVID-19 cases are among the Swiss Guard, who provide security for the Pope. Additionally, a man who lives “in the same Vatican residence as Pope Francis” tested positive for SARS-CoV-2. Pope Francis is 83 years old, and he reportedly “had part of one lung removed during an illness when he was a young man,” which could further increase his risk for severe COVID-19 disease. The Pope undergoes regular testing, and there is no indication that he has been directly exposed to any infectious individuals. These are the first cases reported by the Vatican/Holy See since mid-March—and more than doubled the country’s cumulative total—but considering that both reports included multiple cases and that most of the cases were among a small group of individuals, it is worth monitoring for early signs of sustained transmission.
LITHUANIA ELECTION Lithuania updated its policies regarding COVID-19 isolation and quarantine to provide an exemption that would allow quarantined citizens to vote during the upcoming elections. Under the new policy, individuals who have exposure to known COVID-19 cases but who have not tested positive are permitted to leave quarantine to participate in a limited window of early voting, October 19-22 from 7-8pm only. Voters must be transported to the polling station in their own car, wear a face covering while voting, and then return directly home. Reportedly, 4 polling stations have set up drive-through ballot drop-off. Individuals with active COVID-19 disease are not permitted to participate in early voting, but they can “vote from home,” presumably by mail. According to a report by the Associated Press, Lithuania did not offer an option for quarantined individuals to vote in person during the previous round of the national election.
WHO SOLIDARITY TRIAL Last week, the WHO published preliminary results from the Solidarity Therapeutics Trial, the world’s largest randomized controlled trial evaluating candidate COVID-19 treatment drugs. Despite high hopes, the findings indicated that remdesivir, hydroxychloroquine, lopinavir/ritonavir, and interferon—all of which are repurposed drugs—had “little or no effect on…mortality or the in-hospital course of COVID-19 among hospitalized patients.”
?Physicians and researchers have expressed mixed reviews of the trial, however, including criticism of the study design and inconsistency between the Solidarity Trial’s results and other major clinical trials, particularly for remdesivir.
Notably, Gilead Sciences, the company that produces remdesivir, issued a press release that leveled criticism against the WHO’s findings. In particular, Gilead argued that while the international, multi-center nature of the Solidarity Trial increased availability of the drugs, it also introduced heterogeneity that could call into question the validity of the results. Additionally, Gilead noted that the data had not yet been peer reviewed. Solidarity Trial researchers submitted a manuscript discussing the Solidarity Trial data for peer review, but a preprint version is available here.
VACCINE ROLLOUT Despite Pfizer’s recent announcement that it would not seek an Emergency Use Authorization (EUA) from the US FDA before late November, US government planning continues for the future rollout of a COVID-19 vaccine. Last Friday marked the deadline for US states to submit preliminary plans to the US CDC regarding future vaccine distribution programs. The CDC released its own
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BCSnob
Middletown, MD
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Did you get your flu vaccine this year?
Quote:Co-infection of influenza A virus enhances SARS-CoV-2 infectivity
doi: https://doi.org/10.1101/2020.10.14.335893
Abstract
The upcoming flu season in the northern hemisphere merging with the current COVID-19 pandemic raises a potentially severe threat to public health. Through experimental co-infection of IAV with either pseudotyped or SARS-CoV-2 live virus, we found that IAV pre-infection significantly promoted the infectivity of SARS-CoV-2 in a broad range of cell types. Remarkably, increased SARS-CoV-2 viral load and more severe lung damage were observed in mice co-infected with IAV in vivo. Moreover, such enhancement of SARS-CoV-2 infectivity was not seen with several other viruses probably due to a unique IAV (influenza A virus) segment as an inducer to elevate ACE2 expression. This study illustrates that IAV has a special nature to aggravate SARS-CoV-2 infection, and prevention of IAV is of great significance during the COVID-19 pandemic.
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MEXICOWANDERER
las peñas, michoacan, mexico
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No me. Not yet.
In fact Senor BCSnob I was hoping (actually praying) for you to return and offer your expertise. I do not need or want a IAV primer handing out complimentary tickets for a Covid free-for-all.
Do all types of Influenza vaccines do the pre-sensitation IAV for Covid19 (same pathway?) or are there exceptions?
At least I'll know dept.
Which strains of virus are getting top billing for this coming seasons influenza?
Again, Thank You!
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BCSnob
Middletown, MD
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I checked the WHO recommendations for the 2020/2021 flu vaccine and it includes flu A.
Quote:The WHO recommends that quadrivalent vaccines for use in the 2020–2021 northern hemisphere influenza sea- son contain the following:
Egg-based Vaccines
? an A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus; ? an A/Hong Kong/2671/2019 (H3N2)-like virus;
? a B/Washington/02/2019 (B/Victoria lineage)-like virus; and
?a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.
Cell- or recombinant-based Vaccines
? an A/Hawaii/70/2019 (H1N1)pdm09-like virus;
? an A/Hong Kong/45/2019 (H3N2)-like virus;
? a B/Washington/02/2019 (B/Victoria lineage)-like virus; and ?a B/Phuket/3073/2013 (B/Yamagata lineage)-like virus.
The WHO recommends that trivalent influenza vaccines for use in the 2020–2021 northern hemisphere influenza season contain the following:
Egg-based Vaccines
? an A/Guangdong-Maonan/SWL1536/2019 (H1N1)pdm09-like virus; ? an A/Hong Kong/2671/2019 (H3N2)-like virus; and
?a B/Washington/02/2019 (B/Victoria lineage)-like virus.
Cell- or recombinant-based Vaccines
? an A/Hawaii/70/2019 (H1N1)pdm09-like virus;
? an A/Hong Kong/45/2019 (H3N2)-like virus; and
?a B/Washington/02/2019 (B/Victoria lineage)-like virus.
Recommended composition of influenza virus vaccines for use in the 2020–2021 northern hemisphere influenza season
Source: WHO
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BCSnob
Middletown, MD
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COVID infection rates increase exponentially. Most data is presented with the rates plotted linearly vs linear time axis. In this study, the reported infection rate, hospitalization rate, and death rate were plotted on a log2 y-axis (to remove the exponential factor) vs a linear time axis. The rates were now linear with time with slope changes (exponential rate changes) which were then correlated with lockdowns, school closings, bar closings, and mask mandates and then the removal of these mandates. There were slope decreases (reduction in rates) with the addition of these health orders and slope increases with the removal of these orders. There were delays between the orders and the change in slopes which correlated well with expected times from exposure to infection, infection to hospitalization (when required) and hospitalization to death (when it occurred).
This analysis found:Quote:… school closings dropped infection rates in half, lockdowns dropped the rates 3 to 4 fold, and other actions (such as closing bars and mandating masks) brought the rates even further down.
Strong impact of closing schools, closing bars and wearing masks during the Covid-19 pandemic: results from a simple and revealing analysis
doi: https://doi.org/10.1101/2020.09.26.20202457
Quote:Figures 1-4 show that rates of new daily hospitalizations and new deaths seem to parallel those of new cases, with lag times of about three days to a week for hospitalizations, and a further lag of 3 - 10 days for deaths. Although improvements in medical care may start to change this picture, it currently appears that a fairly constant proportion of infected people will become ill and die.
* This post was
edited 10/20/20 08:51am by BCSnob *
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BCSnob
Middletown, MD
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We have heard the call for letting the young become exposed while protecting the vulnerable so that the population can develop herd immunity. This study suggests that protecting the vulnerable from infections within college populations is easier said than done.
SARS-CoV-2 sequencing reveals rapid transmission from college student clusters resulting in morbidity and deaths in vulnerable populations
doi: https://doi.org/10.1101/2020.10.12.20210294
The researchers collected samples from infected students and members of the community during the return of studies to college and the rising infection rate of COVID. The researchers then sequenced the viruses in these samples and found that students got sick, spread the infection to the greater community, eventually infection two care homes leading to deaths; and the infections were from the same genetic strain of SARS-CoV-2 that started in the student population.
Quote:We detected these student-amplified infection clusters as part of a 21-county surveillance program in the Gundersen Healthcare System’s service area. Because this program was not student focused, we were collecting and sequencing other community cases in parallel. This allowed us to quickly detect the overspill from the college-age population in older adults. While these findings were consistent with public health expectations about risk to older population in settings of wide community spread and with epidemiological studies showing a statistical association in which case increases in young adults are typically followed by cases among older adults (12), our ability to genetically link these groups of cases provides direct evidence of transmission between these different age groups. Of particular concern, was the rapid transmission of one of these SARS-CoV-2 substrains into two skilled nursing facilities, causing sustained outbreaks with two fatalities so far. Our first case of what we came to call the “College B” cluster was collected on 8/27/20, a time when cases were slowly but steadily rising (Figure 1). The inflection point on the curve when cases began to rise more rapidly was on 9/10/20 (Figure 1) and the first skilled nursing facility patient specimen associated with this cluster was detected on 9/14/20.
Here is an analysis of increasing infection rates in communities after the start of in-person college classes.
Quote:Return to University Campuses Associated........th 9% Increase in New COVID-19 Case Rate
We find a significant surge of 9% in new cases in a 21-day time frame in college counties, a finding consistent across U.S. Census divisions. These results suggest the need for institutions of higher education and the communities where these institutions reside work together quickly and effectively to mitigate viral transmission and to prevent overwhelming local healthcare infrastructure in college counties.
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