Monthly Archives

July 2020

M1

New Data On COVID Risk and Recovery as Trump Urges Mask Wearing

Masks take the spotlight as new data emerges, showing a large portion of the United States at risk for severe COVID complications, while natural immunity amongst recovered patients remains in question. 

New Data On COVID-19 Risk and Recovery as Trump Urges Mask Wearing 

Nearly six months after the Trump administration declared COVID-19 a public health emergency, new data has emerged regarding the percentage of Americans at risk for severe COVID-related complications. Meanwhile, researchers continue to explore the efficacy of coronavirus antibodies to ward off reinfection. With the U.S. now reporting 4 million cases, President Trump has come out more strongly in favor of mask-wearing, and the efficacy of the controversial hydroxychloroquine is receiving new press.     

40 percent of Americans at Risk for Severe COVID-19 Complications 

A brand new report by the CDC says that roughly 40 percent of Americans have at least one underlying health condition that puts them at risk for severe complications due to the novel coronavirus. These chronic conditions include obesity, Type 2 diabetes, kidney disease, heart disease, and chronic obstructive pulmonary disease. Early in the pandemic, data emerged showing the COVID-related death rate to be as much as 12 times higher amongst those with chronic health conditions compared to those without. Underlying conditions also significantly increase hospitalization rates.

Such chronic medical conditions where found to be more widespread in rural areas, and according to the study, “Counties with the highest prevalences of any condition were concentrated in Southeastern states, particularly in Alabama, Arkansas, Kentucky, Louisiana, Mississippi, Tennessee and West Virginia, as well as some counties in Oklahoma, South Dakota, Texas and northern Michigan.”  

Studies Suggest a Moderate Level of COVID-19 Antibody Protection 

Early research has also suggested that those who recover from COVID-19 may lose their immunity within a matter of months, casting doubt on the development of herd immunity in the population. In some milder cases, no antibodies were detectable after 50 days. However, a more recent study out of Icahn School of Medicine at Mt. Sinai in New York gives a somewhat more optimistic picture. Of nearly 20,000 people with mild or moderate illness, nearly 90% showed an antibody response of at least three months.  According to Florian Krammer, a scientist in the study, “It’s reasonable to assume that there will be protection for a time frame of one to three years.” 

Nevertheless, scientists are still looking to an eventual vaccine as the best hope for widespread immunity. Adrian Hill, the principal investigator for a promising vaccine study out of the University of Oxford, says, “We know from many other infections, the vaccine response can be much more durable than the natural infection response. I’m pretty confident that in COVID we’re going to see the vaccines are more durable than a natural COVID infection. But again, we don’t know yet. We need to wait and see.”  

Trump Promotes Mask-Wearing

As COVID-19 cases continue to increase, President Trump, who did not appear publicly in a mask until July, has recently become more vocal about the importance of mask-wearing. During a recent press conference, Trump spoke of the uptick in cases, saying, “It will likely unfortunately get worse before it gets better,and voiced his support for masks, saying, “Whether you like the mask or not, they have an impact.” 

The president also tweeted a picture of himself wearing a mask, calling mask-wearing “patriotic.” While cloth masks for the general public have become easier to find than they were in the early days of the pandemic, supply of hospital-grade masks, such as the N95, remain a great concern for many medical facilities and first responders in light of recent surges. Blueflame Medical is amongst those who have stepped into the fray to procure and distribute these high-demand pieces of PPE. 

Meanwhile, the drug hydroxychloroquin, touted by Trump, decried by others, has received new press. Harvey Risch, professor of epidemiology at the Yale school of Public Health, penned a piece advocating the use of hydroxychloroquine to improve health outcomes for COVID-19 patients, saying, “When this inexpensive oral medication is given very early in the course of illness, before the virus has had time to multiply beyond control, it has shown to be highly effective, especially when given in combination with the antibiotics azithromycin or doxycycline and the nutritional supplement zinc.” 

The Association of American Physicians and Surgeons has also filed new evidence with a federal court in an attempt to prevent FDA and Department of Health and Human Services interference with doctors’ use of the drug, saying, “As confirmed by another recent study of thousands of patients at the Henry Ford Health System in Michigan, HCQ is both very safe and highly effective in treating COVID-19, reducing mortality by 50%. Countries with underdeveloped health care systems are using HCQ early and attaining far lower mortality than in the United States, where [HHS and the FDA] impede access to HCQ.” 

On the other hand, a study led by researchers out of Brazil and published in The New England Journal of Medicine claims the use of hydroxychloroquine does help COVID patients. 

A Serious Situation 

What is clear is that the novel coronavirus pandemic remains a serious situation that scientists, doctors, and politicians are trying to understand and deal with in real time. Also evident is the fact that life will not return to normal for a while, making the need for masks and PPE a long-term, critical need.     

teacher

New Science Emerges as COVID Cases Surge and Schools Make Plans for Fall

New Science Emerges as Coronavirus Cases Surge, Schools Make Plans for Fall 

Amidst a nationwide surge in COVID-19, scientists are learning more about the activity of the virus and investing in new treatment options. Nevertheless, much uncertainty remains, with limitations on drug supply and questions about the financial resources required to head safely into fall.   

As the COVID-19 pandemic rages on, states across the nation report a continued surge in new cases. California alone saw a recent two-week infection rate increase of 43% with ICU admissions up 37%. Meanwhile, new science is painting a better picture of the virus and honing in on treatment while schools grapple with how to safely educate students in the fall. 

 

Recent Discoveries Provide Better Understanding of COVID-19

In Spain, one of the hardest-hit European countries, new data suggests that only 5% of the country’s residents have developed antibodies through exposure to the virus, leaving 95% of the population susceptible to illness. Similar studies in China and the United States also show that the vast majority of individuals remain vulnerable. By some estimates, a 60% exposure rate is necessary to develop herd immunity, but according to Isabella Eckerle, head of the Geneva Centre for Emerging Viral Diseases, and Benjamin Meyer, a virologist at the University of Geneva, “In light of these findings, any proposed approach to achieve herd immunity through natural infection is not only highly unethical, but also unachievable.” 

In addition, researchers have learned more about the behavior of the virus itself. A study out of UC San Francisco has determined that cells infected with COVID-19 grow arms, called filopodia, that reach into neighboring cells to infect them with the virus. While other viruses also replicate using filopodia, COVID-19 appears unusual in that it grows these tentacles so rapidly. 

Moreover, a mutated form of the virus, known as G614, appears to spread more rapidly than the earlier D614 variety, being three to nine times more infectious. It is now the dominant viral strain. Fortunately, while more infectious, this mutation does not appear to cause more severe illness. Theoretical biologist Bette Korber of Los Alamos National Laboratory indicates, “We interpret [the more rapid spread of G614] to mean that the virus is likely to be more infectious. Interestingly, we did not find evidence of G614 impact on disease severity.” 

Similarly, Lawrence Young, a professor of medical oncology at the UK’s University of Warwick, has said, “The current work suggests that while the G614 variant may be more infectious, it is not more pathogenic. There is a hope that as SARS-CoV-2 infection spreads, the virus might become less pathogenic.” 

 

Drug Remdesivir Shows Promise, Pricing and Supply an Issue 

Gilead Sciences has developed a new antiviral drug, called Remdesivir, which is the first to show effectiveness against COVID-19 in a large clinical trial, reducing patients’ recovery time by an average of four days. The drug works by disrupting the virus’s ability to replicate within the patient’s cells. 

Since its approval for emergency use in May, the U.S. Government has been distributing Remdesivir donated by Gilead. This month, though, Gilead will begin charging for the drug, which will cost U.S. hospitals an average of $3120 per patient. However, Gilead estimates a savings of $12,000 per patient in reduced hospitalization time. While some politicians have criticized the price of the drug, Steven D. Pearson, President of the Institute for Clinical and Economic Review, said in a written statement, “Gilead made a responsible pricing decision based on the evidence we have today. If further data do not show a clear mortality benefit for remdesivir, then the price of the drug should be dramatically reduced.”    

With the donated supply of Remdesivir now used up, the Trump administration has made a deal with Gilead to procure the first 500,000 doses, which amounts to all of July’s production and 90% of August and September’s. According to Health and Human Services Secretary Alex Azar,  “President Trump has struck an amazing deal to ensure Americans have access to the first authorised therapeutic for Covid-19. To the extent possible, we want to ensure that any American patient who needs Remdesivir can get it.” 

Schools Make Plans for Fall 

As summer moves along and cases spike, educators are contending with the very real challenges that back-to-school will bring. In the Ivy League, Harvard has announced that the majority of classes will be taught online, with no reduction in tuition, and up to 40% of students may be allowed to live on campus.  Similarly, Princeton plans to offer mostly online instruction, but is offering a 10% tuition reduction and considering a plan to allow 50% of students back for a semester at a time during the coming school year. 

Other colleges and universities are likewise making plans, in many cases investing large sums of money to create a safe learning environment. Already facing budget crunches due to lower anticipated enrollment, these institutions are spending millions on everything from plexiglass barriers to face masks and other protective gear. The University of Southern Florida recently placed an order for 1,200 hand sanitizing stations, while Purdue University has budgeted $50 million dollars for safety gear and has begun a fundraising campaign to assist with the effort. Fortunately, supplies of Personal Protective Equipment (PPE) are rising to meet the demand with new manufacturers and suppliers such as Blueflame Medical entering the fray.    

Blueflame Medical

Adding to budget concerns, schools must take on significant added cost to hire new, hourly employees to wipe down doorknobs and other surfaces throughout the day and to take the temperatures of all students and faculty entering buildings on campus, With the viability of sports, another significant source of revenue for universities in question, much uncertainty looms on the horizon this coming fall. 

Evidence of Progress and a Hopeful Outlook 

Even as cases spike, however, good news remains. With a better understanding of coronavirus and the development of promising treatments, plans to resume schooling reflect a certain optimism in our ability to manage this deadly pandemic and get on with life.