Weekly Coronavirus Update: Tuesday, September 22, 2020

Happy Tuesday, everyone! This week’s post includes updates on super-spreaders, transmission on flights, antibody treatment news, Covid’s impact on young adults, symptoms in children, research on competitive athletes’ hearts, Covid and cats, the ineffectiveness of plastic face shields, and world updates.

1) Social events appear to be prime candidates for super-spreading. A recent peer-reviewed study published in Nature Medicine showed that of the Coronavirus cases in Hong Kong, 106 were linked to to musicians who performed in four bars, 22 cases were linked to a wedding and a preceding social event, and 19 cases were linked to a temple where a monk was asymptomatic. The authors concluded that a small fraction of infected people can result in a high number of cases. They found that 19% of all the cases in Hong Kong were responsible for 80% of the total cases, highlighting the impact of super-spreading. You can read the full study here: https://www.nature.com/articles/s41591-020-1092-0

2) Two new peer-reviewed studies published in the journal Emerging Infectious Disease point to transmission of the virus during airline flights. The first study tracked 217 passengers from a 10-hour commercial flight from London to Hanoi, Vietnam, and 16 passengers were found to be infected with SARS-CoV-2. Of those, 12 were seated in business class. The researchers believe one infected person caused the other 15 cases and noted that seating proximity was strongly associated with transmission. The authors concluded, “We found no strong evidence supporting alternative transmission scenarios. In-flight transmission that probably originated from 1 symptomatic passenger caused a large cluster of cases during a long flight.”
— The second study showed genetic evidence that two business-class airline passengers spread the virus to two crew members on a flight from the US to Hong Kong in March. The authors concluded, “Our results demonstrate that SARS-CoV-2 can be transmitted on airplanes. To prevent transmission of the virus during travel, infection control measures must continue.”

The first study can be found here: https://wwwnc.cdc.gov/eid/article/26/11/20-3299_article
The second study can be found here: https://wwwnc.cdc.gov/eid/article/26/11/20-3254_article

3) In treatment news, drug manufacturer Eli Lilly reported promising results from an antibody treatment it developed using a clone of an antibody from the blood of a Covid-19 survivor. A trial of 452 patients (including a placebo group) with mild or moderate cases of Coronavirus showed that those who received the antibody treatment had a 72% reduction in their risk of being hospitalized. None of the patients experienced any serious side effects from the treatment. Next, the company will test the antibody treatment in more patients as well as another similar treatment it has developed. This article from Science summarizes the findings of the first trial: https://www.sciencemag.org/news/2020/09/eli-lilly-reports-first-promising-results-antibody-against-covid-19?utm_campaign=news_daily_2020-09-16&et_rid=715507499&et_cid=3484077

4) We know a lot about Covid’s impact on older people, but new research sheds light on the virus in young adults. Researchers at Harvard examined the data of 3,222 patients between ages 18–34 who needed hospitalization, finding that 21% required intensive care. Of those, 10% needed a ventilator and 2.7% died. Published in the journal JAMA Internal Medicine, the study also highlighted the patients’ comorbidities, showing that 36.8% of the hospitalized patients were obese, 24.5% were morbidly obese, 18.2% had diabetes, and 16.1% had hypertension. Those with morbid obesity and hypertension were associated with a greater risk of death or mechanical ventilation, which seems to align with the comorbidity risks we know about in other age groups of hospitalized patients. You can read the study here: https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2770542?guestAccessKey=87e8344a-8e2f-4ca8-8e1a-95be53bbf71e&utm_source=silverchair&utm_medium=email&utm_campaign=article_alert-jamainternalmedicine&utm_content=olf&utm_term=090920

5) Kids are now back to school in most parts of the world, and the UK-based COVID Symptom Study, which tracks millions of people’s daily health and symptoms, recently released information on the most common symptoms in school-aged children who tested positive for the virus. The report stated that the top five symptoms were fatigue (55%) headache (53%), fever (49%), sore throat (38%) and loss of appetite (35%). Conversely, in adults the top five symptoms according to the study’s data were fatigue (87%), headache (72%), loss of smell (60%), persistent cough (54%) and sore throat (49%). The report also noted that 15% of children who tested positive for Coronavirus also had an unusual skin rash. The COVID Symptom Study is run by researchers at King’s College London, and you can read this report here: https://covid.joinzoe.com/post/back-to-school

6) You’ve probably heard that more research is showing heart damage in many Covid-19 survivors. There are so many studies on this topic that it is hard to choose just one to highlight, but given that I’m a sport business professor, this one caught my eye. A study published in JAMA Cardiology examined the hearts of 26 competitive college athletes who had recovered from Covid-19. Athletes from football, soccer, lacrosse, basketball, and track were included, and none of them had been hospitalized or received antiviral therapy. Only 12 of the athletes (5 men, 7 women) were symptomatic and experienced mild symptoms such as sore throat, shortness of breath, fever, and myalgias. Of all the athletes, four (15%) had cardiac magnetic resonance (CMR) images that suggested myocarditis, which is inflammation of the heart muscle. Myocarditis can cause arrhythmias and heart failure. Additionally, eight (30.8%) other athletes showed evidence of prior myocardial injury. The authors concluded that “CMR may provide an excellent risk-stratification assessment for myocarditis in athletes who have recovered from COVID-19 to guide safe competitive sports participation.” You can read the full study here: https://jamanetwork.com/journals/jamacardiology/fullarticle/2770645

7) New research has been published on cats and Coronavirus. A study in the journal Emerging Microbes & Infections took blood samples from 102 cats in Wuhan, China, where the virus first emerged. Of those, 15 cats had antibodies for Covid-19, and 11 had neutralizing antibodies, or the ones capable of blocking infection. The cats came from animal shelters, pet hospitals, and private family homes. The cats with the highest levels of antibodies were owned by people who had been diagnosed with Covid-19. The authors suggested that people who have Coronavirus should take measures to distance themselves from their companion animals such as cats and dogs. You can read the full study here: https://www.tandfonline.com/doi/full/10.1080/22221751.2020.1817796

8) A simulation conducted by the world’s fastest supercomputer in Japan showed that plastic face shields are “almost totally ineffective at trapping respiratory aerosols” according to a news report by The Guardian. Though the simulation has not undergone peer-review, it was conducted by Riken, a Japanese government research institute. In the simulation, nearly 100% of the aerosol droplets escaped from the plastic visors. The researchers urged people to wear face masks instead of plastic face shields. Again, this research has not undergone peer review, but you can read the news article about it here: https://www.theguardian.com/world/2020/sep/22/face-shields-ineffective-trapping-aerosols-japanese-supercomputer-coronavirus

9) Finally, your US and world update. The seven-day average number of new cases per day in the US is 41,101, and after today the country will most likely record over 200,000 total deaths from the virus (at the time I’m writing this the number is 199,789). A total of 17 states are classified as “where new cases are higher and staying high”, including North Dakota, South Dakota, Wisconsin, Oklahoma, and Arkansas as the worst. Over 88,000 cases have been recorded on US university campuses.
— The UK has seen a dramatic uptick in the number of daily new cases, with 4,368 yesterday, which represents a 93% rise in cases over a two-week time period. Yesterday the country’s Coronavirus alert level was raised from 3 to 4 (on a scale of 5), and the government’s scientific advisor warned of the possibility of up to 50,000 cases per day by mid-October if actions were not taken. Today Prime Minister Boris Johnson announced new restrictions, including a maximum of 15 guests at weddings, no in-person sport competitions, a ban on indoor team sports, mandatory mask wearing for retail workers and hospitality staff, mandatory mask wearing in taxis, pubs and restaurants must close at 10pm, and people who can work from home should do so. Johnson told the British public to be prepared to follow these measures for the next six months.
— Elsewhere, the weekly number of worldwide cases of Coronavirus hit an all-time high last week, with just under 2 million new cases, a 6% rise from the previous week. Yesterday Iran had its highest daily total of new cases since February with 3,712, and the Netherlands had a weekly record number of cases at 13,471, which was 60% higher than the week before.

US data: https://www.nytimes.com/interactive/2020/us/coronavirus-us-cases.html?action=click&module=Top%20Stories&pgtype=Homepage
UK information: https://www.bbc.co.uk/news/uk-54241580 and https://www.theguardian.com/world/2020/sep/22/coronavirus-boris-johnson-sets-out-new-covid-restrictions-at-perilous-turning-point
Worldwide numbers: https://www.who.int/docs/default-source/coronaviruse/situation-reports/20200921-weekly-epi-update-6.pdf?sfvrsn=d9cf9496_6 and https://www.theguardian.com/world/live/2020/sep/22/coronavirus-live-news-us-nears-200000-deaths-as-england-pubs-face-curfew?page=with:block-5f69f0938f08aee39a1136b2#block-5f69f0938f08aee39a1136b2

That’s all for this week! I’ll be back with more research updates next week. Until then, please stay safe, keep your distance, wash your hands, close the toilet lid when you flush, and wear your mask!



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