Weekly Coronavirus Update: Tuesday, September 8, 2020

Here is a recap of the latest Covid-19 research and news from the past week, featuring research on kids, Covid vs. the flu, vitamin D, treatments, long-term effects, another study on poop, and events where the virus was spread.

1) New research is emerging about kids and Covid-19. In South Korea, researchers studied 91 children with a median age of 11, and found that children carried the virus longer than previously thought. The virus was detectable for a mean of 17.6 days, or nearly three weeks, in those with symptomatic cases and 14.1 days, or two weeks, in asymptomatic cases. The study also found that 22% had asymptomatic cases while 20% showed no symptoms at the time of testing but developed symptoms later. That study was published in peer-reviewed journal JAMA: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2770150
— Another peer-reviewed study conducted by researchers at Harvard found that children and young adults had higher levels of the virus in their system than adults who were in intensive care units being treated for Covid-19. Although children are not as likely to become severely ill from the virus, they can still spread the infection even when asymptomatic. The authors concluded, “This study reveals that children may be a potential source of contagion in the SARS-CoV-2 pandemic in spite of milder disease or lack of symptoms”. The study was published in The Journal of Pediatrics and can be read here: https://www.jpeds.com/article/S0022-3476(20)31023-4/fulltext

2) The next time someone tries to tell you that Covid-19 is no worse than the flu, you can cite this study. Researchers in Boston compared hospital data from five years of approximately 1,000 flu patients to 583 Covid-19 patients in just a two-month time period (March-April 2020). They identified 119 deaths from Covid-19 in two months compared to just 34 deaths from the flu over five years. Additionally, 174 of the Covid patients had to be on ventilators over the two months, while the number of flu patients on ventilators was only 84 over five years. Covid patients were on ventilators for a median of two weeks and flu patients were on them a median of three days. Possibly the most alarming finding was that 25% of the Covid patients from this study had no pre-existing health conditions compared to just 4% of flu patients. The study preprint (which means it is still awaiting peer-review) can be read on MedRxiv: https://www.medrxiv.org/content/10.1101/2020.08.19.20163857v1

3) Time to stock up on vitamin D? New research published in peer-reviewed journal JAMA Network Open found that patients who were deficient in vitamin D were 1.77 times more likely to test positive for Covid-19 than those who had a sufficient vitamin D status. The difference between the two groups was statistically significant. The authors recommended that additional research involving randomized trials be conducted to confirm their findings. You can read the full text here: https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2770157?resultClick=1

4) On the treatment front, two types of steroids have been found to reduce the risk of death in seriously ill Covid patients. Dexamethasone and hydrocortisone, both cheap and easily accessible steroids, were used in seven random trials in 12 different countries involving 1,703 patients. The risk of death for those taking the steroids was 32%, while those who took a placebo had a 40% chance of death. The paper was published in peer-reviewed medical journal JAMA, and the authors concluded, “In this prospective meta-analysis of clinical trials of critically ill patients with COVID-19, administration of systemic corticosteroids, compared with usual care or placebo, was associated with lower 28-day all-cause mortality.” You can read the full text of the study here: https://jamanetwork.com/journals/jama/fullarticle/2770279?resultClick=1

5) In long-term effects news, scientists in Austria have been tracking the long-term health of patients who recovered from Covid-19. This week they released preliminary results, which showed that six weeks after leaving the hospital, 88% showed signs of lung damage in CT scans that resembled ground glass, and 47% experienced breathlessness. After 12 weeks, 56% still had lung damage and 39% still experienced breathlessness. The findings were presented at the European Respiratory Society International Congress and the work is ongoing with more patients. The lead researcher, Dr. Sabina Sahanic, said, “The findings from this study show the importance of implementing structured follow-up care for patients with severe COVID-19 infection. Importantly, CT unveiled lung damage in this patient group that was not identified by lung function tests. Knowing how patients have been affected long-term by the coronavirus might enable symptoms and lung damage to be treated much earlier and might have a significant impact on further medical recommendations and advice.” While the findings are not yet published, you can read the study abstract from the conference here (number 4143): https://k4.ersnet.org/prod/v2/Front/Program/Session?e=259&session=12607 and a press release about it here: https://eurekalert.org/pub_releases/2020-09/elf-cps090320.php

6) I’ve talked about Coronavirus spreading through fecal matter before, and now there is more news on the toilet front. A study published last week in the Annals of Internal Medicine studied surfaces, air samples, public areas, and building drainage systems in a high-rise apartment building in China and found nine people infected with Covid-19 from three different families. The three families’ apartments are aligned vertically and are all connected by drainage pipes in the master bathrooms. The observed infections were thought to be the result of aerosol transmission from the infected feces, as there was no evidence of transmission from surfaces or public spaces. The two families that suffered infections after the first family became sick had not travelled or been in close contact with any sick people due to China’s lockdown at the time. Experts recommend minimizing your risk of infection through fecal matter by shutting the toilet lid when you flush, washing your toilet often, and washing your hands. You can read the full study here: https://www.acpjournals.org/doi/full/10.7326/M20-0928#t1-M200928 and a news article from Science about this study and others on fecal matter here: https://www.sciencemag.org/news/2020/09/can-you-catch-covid-19-your-neighbor-s-toilet?utm_campaign=news_daily_2020-09-04&et_rid=715507499&et_cid=3471353

7) Remember when 500,000 people descended upon Sturgis, South Dakota last month for a 10-day motorcycle rally? It turned out to be a super-spreader event. A combination of large crowds, few people wearing masks, and poor social distancing resulted in the spread of 250,000 new Coronavirus cases between August 2 and September 2 (representing 19% of all new US cases during that time) according to researchers from San Diego State University. Using cell phone data and data from the CDC, the researchers were able to track the movements of people who attended the rally, and found that the U.S. counties from which the highest number of people attended experienced between 7% to 12.5% increases in Covid-19 cases compared to those counties from which people did not attend. Conservative estimates show that the public health cost of these cases was $12.2 billion. You can read the full study here: http://ftp.iza.org/dp13670.pdf

8) I know a lot of readers follow “Your Local Epidemiologist”, and this item is from one of her posts a few days ago. A peer-reviewed study published in JAMA Internal Medicine tracked 293 people who attended an outdoor worship event at a Buddhist temple in China in January. Of the attendees, 126 rode on two different buses for 50 minutes to arrive. The buses had air conditioning, windows were closed, there were no bathrooms on the buses, and no one was wearing a mask. The first bus had no virus transmissions, and 24 people on the second bus were infected during the ride by one asymptomatic individual. Seven additional event attendees (who were not on the busses) also tested positive for the virus after spending time mingling outdoors with other attendees. The findings showed that the virus is airborne and can be transmitted through recycled air, it is highly transmissible in enclosed environments, and even those who are asymptomatic can carry a viral load high enough to infect others through breathing. You can read the full study here: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2770172?fbclid=IwAR24A_6qdZFh5gNa4wHpW14mv473k7OYskEmFk3pQieQUQhgaKpwsozO1KU and you can read Your Local Epidemiologist’s fantastic translation of it here: https://yourlocalepidemiologist.com/spread-on-a-bus/

9) Finally, your US and world update. The seven-day average number of new cases in the US is 38,915, which is 9% lower than the previous week’s average. Cases on college campuses continue to be a problem, with over 51,000 cases now linked to over 1,020 universities in the US.
— In the UK, the number of new daily cases has spiked over the past two days. On Sunday 2,988 new cases were reported, which was a 65% increase over the number of cases on Saturday. Yesterday an additional 2,948 new cases were reported. Data shows that cases are rising sharply among young people in the 10–29 age group.
— Spain and France also continue to show rising case numbers. Spain became the first western European country to surpass the half a million case mark, and currently has the fastest rise in daily cases of any European country. Its seven day rolling average of new daily cases is over 8,000, while France’s is just below 6,000.
— India surpassed Brazil as the country with the second-most cumulative number of cases, behind the US at number one. India recorded 75,809 cases yesterday, the country’s lowest total in a week.

Sources for the US and world information:
US case numbers: https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?action=click&module=Top%20Stories&pgtype=Homepage j
US university numbers: https://www.nytimes.com/interactive/2020/us/covid-college-cases-tracker.html
UK case numbers: https://www.theguardian.com/world/2020/sep/07/coronavirus-young-people-urged-to-follow-rules-as-uk-cases-rise
Spain and France: https://www.theguardian.com/world/2020/sep/07/spain-set-to-record-half-a-million-covid-cases
India numbers: https://www.theguardian.com/world/live/2020/sep/08/coronavirus-live-news-spain-cases-top-500000-in-european-first-as-global-deaths-pass-890000?page=with:block-5f5710938f08a919fc878529#block-5f5710938f08a919fc878529

That’s all for this week. I will be moving next Monday and Tuesday and therefore I’m taking next week off, but I’ll be back with my next update in two weeks on September 22. Stay safe, wear your mask, social distance, and please, please, please close that toilet lid when you flush!



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