Description

Your daily COVID-19 LST Report:

— Climate: Ethicists, microbiologists, and public health experts discuss strategies for optimizing the pandemic response.  Considerations include:

• Increased global surveillance measures
• The ethical implications of quarantine laws and clinical research
• Integrating a comprehensive pandemic preparedness strategy for Latin America

— Epidemiology:  

- Canadian scientists conducted a meta-analysis of 22 articles published between January 24 and April 2, 2020 exploring the virulence of SARS-CoV-2 and they found that:

- the basic reproduction number of SARS-CoV-2 is 3.15,  

- the average incubation time is 5.08 days,  

- the asymptomatic rate of infection rate is 46%, and

- the case fatality rate is 3.34% (however when asymptomatic cases are accounted for in a sensitivity analysis, case fatality rate drops to 1.8%).

• Genetic analysis from 84 COVID-19 patients in New York found “clear evidence of multiple independent SARS-CoV-2 introductions into NYC during the first weeks of March”, with the majority coming from Europe.
  
  

— Understanding the Pathology:  

- Czech researchers studying the immunologic aspects of COVID-19 conclude:

• Both innate and adaptive immune systems are crucial in mounting a response, but it is unknown whether failure to mobilize the adaptive immune system leads to severe disease
• IgA response is stronger than the other antibodies generated and more persistent
• Interleukin(IL)-6 is elevated in greater than 50% of patients
• "Macrophage Activation Syndrome" may explain the unusual finding of elevated CRP in some COVID-19 patients.

- A review of mechanisms that predispose obese and diabetic patients to increased risk of severe COVID-19 disease, implicates a chronic inflammatory state, impaired T cell function, and dysfunction of the RAS system.

— Transmiission and Prevention:   

- A pilot study of a contact tracing strategy in Kentucky reported underwhelming cooperation with contact tracing, finding only 19 of 58 cases provided contact information, with others stating inability or unwillingness to cooperate.  This highlights the need for a unique approach to contact tracing in the US.

- A cross-sectional study from Singapore found SARS-CoV-2 RNA present on 56% of the surfaces and in air samples tested from the airborne infection isolation rooms (AIIR) occupied by COVID-19 patients.  They also found the highest contamination rates within the first 2 weeks of illness.

— Management:  Cardiologists from Tel Aviv conduct echocardiography on 100 COVID-19 patients.  Teledermatology.

— Mental Health and Resilience:   Surveys from the US suggest the older generation have a higher percieved risk of infection, but  lower overall psychosocial stress.