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Science & Society

The Newsletter | Dec 18, 2020

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Covid by the Numbers

  • New Daily Cases: 241,620
  • Total US Cases: 17,004,147
  • 7-Day Avg for New Daily Cases: 215,127
  • New Covid Deaths: 3,438
  • Total US Deaths: 308,001
  • 7-day Avg for Covid Deaths: 2,565
  • Currently Hospitalized: 114,237
  • ICU: 21,900
  • Ventilator: 7,847
The EU Covid Surveillance Report on risk groups shows that nearly 22% of fatal cases had no pre-existing condition. A greater proportion of people without pre-existing conditions have a mild illness, so it shouldn’t be taken as 22% of people with no pre-existing conditions died. That would be incorrect.
From people with no pre-existing conditions, 1.43% died. To be clear, that is a high death rate for a pandemic illness. Generally, high death rate diseases do not become pandemic because the severity of illness helps us contain it, though it’s not quite that simple.
About 10% of people with no conditions were hospitalized and 87% had a mild illness. When we look solely at the people who died of Covid, the graph below is the breakdown.
In many cases illnesses like cancer, diabetes, and cardiovascular disease minus high blood pressure, the proportion of fatal cases is actually higher than severe cases. That supports the idea that people with pre-existing conditions who have a serious illness are more likely to die. In the No-pre-existing-conditions group, the percentage of severe cases was 1.32% similar to the 1.43% for fatal cases.
Graphic included to help clarify the risk groups and outcomes.

A Covid Situation Report from the Covid Tracking Project:

“States reported 1.9 million tests, 242k cases, 3,438 deaths, and 114k people currently hospitalized with COVID-19 in the US. Both case and hospitalization counts from today are all-time highs.”
With the exception of New York and Hawaii, every single state has had the most cases it has had over the course of the entire pandemic in November or December of 2020. Things are worse than they have been over the entire pandemic.
“We crossed 300,000 deaths, and there are no signs of this curve slowing down: 17 days into December, this month is already the second deadliest of the pandemic.”
Don’t get too defeated though because apparently, we’re all about to become alligators. It wouldn’t be the worst thing to happen this year. Could be murder hornets.

Science Policy Briefs

“Is your home a covid-19 hotspot?” research brief from Christopher Sampson, MD, FACEP

A new study in JAMA Network Open investigated how dangerous the household is a source of covid-19 infection. Researchers from Florida and Washington combined results from 54 previous studies by other researchers (a “meta-analysis”) in order to estimate the overall household “secondary attack rate”—which measures how many people in a home are infected by a housemate.
 From these 54 studies, the authors were able to include almost eighty thousand patients. An estimated secondary attack rate was calculated at 16.6 percent. This was more than double than attack rates seen for SARS-CoV (the “first” SARS from 2002-2004) and more than triple seen with Middle East Respiratory Syndrome (also a coronavirus).
Secondary attack rates were higher in households in which the initial infected person (“the index case”) was symptomatic (18.0 percent) compared to asymptomatic first household cases (0.7 percent). Spread was higher to other adults (28.3 percent) compared to children (16.8 percent). Attack rates were also far higher among spouses (37.8 percent) when compared to other family members.  Interestingly households with 1 contact had higher attack rates (41.5 percent) than ones with 3 or more contacts (22.8 percent). This is thought possibly due to the spouse rate being so high in 2-person dwellings.
These results, while limited by the fact that they were assembled from retrospective studies, do show how the home, often thought to be a safe place, can be a high-risk area for SARS-COV-2 transmission. This high attack rate may be due to poor isolation behavior observed within the home when a family member tests positive. But practically speaking, it’s almost impossible to stop transmission in homes with many shared spaces, including restrooms and kitchens.

“Trump Administration memos in July encouraged infection of young Americans to achieve herd immunity” policy brief from Miranda Yaver, PhD

Amid unrelenting covid-19 deaths and hospitalizations across the United States, a leaked memo from a Trump Administration official indicates there was actually an effort to encourage the spread of coronavirus among children and young adults in order to achieve “herd immunity.” If so, such a policy would go down as one of the most inept of many poor choices made during the pandemic.
Then-science adviser Paul Alexander wrote in a July 4 memo, “Infants, kids, teens, young people, young adults, middle-aged with no conditions, etc. have zero to little risk….so we use them to develop herd…we want them infected…” Alexander argued further in a July 27 memo to US Centers for Disease Control and Prevention Director Robert Redfield that colleges should stay open specifically so as to allow infections to proliferate. He also characterized school closures as taking “off the battlefield the most potent weapon we had,” with this weapon being the mass infection of younger individuals. “The issue is who cares? If it is causing more cases in the young, my word is who cares,” Alexander wrote in July.
So, who should care? While it is true that young individuals are at lower risk of complications from coronavirus than are those who are elderly, the CDC reports that 553 individuals under the age of 25 have died from coronavirus. In fact, recent research suggests that July, when Alexander’s memos were drafted, may have been the deadliest month for young adults in modern American history, with nearly 12,000 more deaths among 25-44 year-olds than were projected based on historical trends. What’s more, children and young adults are able to transmit coronavirus to those who are more vulnerable, whether due to older age or preexisting medical conditions, who may in turn experience complications from the virus.
Experts estimate that in the United States, approximately 70 percent of the population would need to have recovered from the virus in order to halt the epidemic through herd immunity. Such proliferation of the novel coronavirus would quickly overwhelm the American health care system at a time when hospitalizations are already at record levels and with available ICU beds few and far between in many parts of the country. The death toll would be staggering—and avoidable given emerging vaccines.
Politico reported that not only did Alexander argue in defense of a herd immunity strategy but watered down agency guidelines and pressured the CDC on guidance documents. As we continue to see devastating numbers of cases, hospitalizations, and deaths across the nation, the human cost resulting from individuals such as Paul Alexander having been in positions of influence during crucial moments of this pandemic are not exactly immeasurable. In fact, the mayhem is quite measurable, given the data that we now have. The level of havoc is only now becoming objectively apparent.

2020 the Infographic Timeline

We Way Underestimated This Virus

  • Elevated biomarker for blood vessel damage found in all children with SARS-CoV-2: “Although most children with COVID-19 do not have severe disease, our study shows that there may be other effects of SARS-CoV-2 that are worthy of investigation,” Dr. Teachey said. “Future studies are needed to determine if hospitalized children with SARS-CoV-2 should be screened for TMA, if TMA-directed management is helpful and if there are any short- or long-term clinical consequences of complement activation and endothelial damage in children with COVID-19 or MIS-C. The most important takeaway from this study is we have more to learn about SARS-CoV-2. We should not make guesses about the short and long-term impact of infection.”

  • People Thought Covid-19 Was Relatively Harmless for Younger Adults. They Were Wrong. (New York Times) Young adults are dying at historic rates. In research published on Wednesday in the Journal of the American Medical Association, we found that among U.S. adults ages 25 to 44, from March through the end of July, there were almost 12,000 more deaths than were expected based on historical norms. For context, in 1953, a little over 3,000 died of polio. We shut the country down. This was back when kids still regularly died from infectious diseases, too.

Yale’s Dorothy Horstmann traveled to Hickory, NC to one of the worst outbreaks of Polio in the country. “The United States had never experienced a higher crest of the epidemiological wave,” a journalist noted of the 57,000 reported cases that year, “and never would again.”

“Our analyses … align with the view that there are chronic cognitive consequences of having COVID-19,” the researchers wrote in a report of their findings. “People who had recovered, including those no longer reporting symptoms, exhibited significant cognitive deficits.”

“People have been worried that COVID-19 survivors will be at greater risk of mental health problems, and our findings … show this to be likely,” said Paul Harrison, a professor of psychiatry at Oxford.

Signs of thromboembolic events and SARS-CoV-2 in the CNS of a person who died of COVID-19. The virus is causing CNS infarctions—this would be better known as mini-strokes, strokes, or brain bleeding.
  • The new analysis adds another possible route. Not only did researchers find intact viral particles within the lining of the nasal cavity, but they also found viral RNA in the upper part of the nose – known as the mucous membrane – as well as several regions of the brain.

    The leftover genetic material was minimal, but that might have been because the autopsy took place a month after death on average. It’s not a question of whether it’s infecting the brain so much as it is what it’s doing. Just this year researchers showed that the herpes virus caused plaques to develop in brain tissue samples that looked very much like what we see with Alzheimer’s.

    Herpes is a very common virus. We massively underestimated viruses in general but also SARS-2 specifically.

  • “I wouldn’t want my pandemic plan to be Let’s have hundreds of thousands of young people with lifelong illnesses. I wouldn’t want to tell 30-to-50-year-olds that we’ve signed them up for a high risk of heart disease and chronic organ damage.” –What Do Young People Have to Worry About?

  • COVID-19 Can Wreck Your Heart, Even if You Haven’t Had Any SymptomsA German study found that 78 percent of recovered COVID-19 patients, the majority of whom had only mild to moderate symptoms, demonstrated cardiac involvement more than two months after their initial diagnoses. Six in 10 were found to have persistent myocardial inflammation. While emphasizing that individual patients need not be nervous, lead investigator Elike Nagel added in an e-mail, “My personal take is that COVID will increase the incidence of heart failure over the next decades.”

  • The lasting misery of coronavirus long-haulers: Months after infection with SARS-CoV-2, some people are still battling crushing fatigue, lung damage, and other symptoms of ‘long COVID’. Viruses are known for causing long-term chronic illness like this in a small percentage of people, but this is much more common.

Lung scans from a 50-year-old show that damage from COVID-19 (red) can improve with time — but many patients have lasting symptoms. Credit: Prof. Gerlig Widmann, Dr. Christoph Schwabl, Dr. Anna Luger - Dpt. of Radiology, Innsbruck Medical University.

When can children get the COVID-19 vaccine? 5 questions parents are asking

  • When can my child be vaccinated?

  • Will children need more shots than adults?

  • Is vaccinating adults enough?

  • Do we have to keep wearing masks and social distancing?

  • Are the vaccines safe for kids?


Stories for the Moment

The FDA Has Authorized Ellume’s At-Home COVID-19 Test—and Doctors Say It’s Promising
A new at-home COVID-19 test has also been granted an EUA—no prescription needed. It’s called the Ellume COVID-19 Home Test, and it’s approved by the FDA to test people age two and up for a COVID-19 infection

Can Joe Biden Rebuild the Ravaged US Environmental Protection Agency? (Nature)

Sidebar: It’s a big job, and hard to overstate the damage that has been done in the past several years. (See: Trump’s Chemical Romance which details 146 people with ties to the chemicals industry working in the agency charged with regulating chemicals—and read: EPA scientists found toxic chemical damages fetal hearts and causes miscarriage and stillbirth before the Trump White House rewrote their assessment.) Here’s a detailed list of who, where, and what conflicts they have.

Expectations are high that the next four years will see improvements under incoming president Joe Biden — and there are clear and positive steps he can take, according to more than a dozen current and former EPA scientists interviewed by Nature. But these insiders also say that Biden will have his work cut out in repairing the damage, including restoring the role of science — and scientists — in crafting environmental rules to protect public health

The Coronavirus May Sometimes Slip its Genetic Material Into Human Chromosomes—But What Does that Mean? (Science) A study now hints at a different explanation in which the virus hides in an unexpected place. The work, only reported in a preprint, suggests the pandemic pathogen takes a page from HIV and other retroviruses and integrates its genetic code—but, importantly, just parts of it—into people’s chromosomes. The phenomenon, if true and frequent, could have profound implications that range from false signals of active infection to misleading results from COVID-19 treatment studies.

Some States May Lack Facilities for Administering COVID-19 Vaccine to Residents(EurekAlert) As the biggest vaccination effort in U.S. history gets underway, several states may not have a sufficient number of facilities in some areas to administer the COVID-19 vaccine to all residents who want it, according to a new analysis from the University of Pittsburgh School of Pharmacy and the nonprofit West Health Policy Center.

New Zealand Will Give Free Coronavirus Vaccines To Residents, Neighboring Nations (NPR) New Zealand has advance purchased two new coronavirus vaccines from pharmaceutical companies AstraZeneca and Novavax, giving the small island country the ability to vaccinate its 5 million residents. Government officials also announced Thursday they will go a step further and provide free doses to its population as well as neighboring nations Tokelau, Cook Islands, Niue, Samoa, Tonga, and Tuvalu, should they want them.

Pfizer Decision to Turn Off Temperature Sensors Forced Scramble to Ensure Covid-19 Vaccines Kept Ultra-Cold (STAT News) Pfizer, the officials told STAT, planned to disconnect temperature-monitoring sensors on the containers once they were delivered to health care providers — though many of the providers needed to use the boxes to store the vials for up to 30 days. Without the monitoring systems, providers would have no way of knowing if the vials had thawed prematurely, rendering the vaccine unusable.

People Thought Covid-19 Was Relatively Harmless for Younger Adults. They Were Wrong. (New York Times) Young adults are dying at historic rates. In research published on Wednesday in the Journal of the American Medical Association, we found that among U.S. adults ages 25 to 44, from March through the end of July, there were almost 12,000 more deaths than were expected based on historical norms.

COVID-19 Neutralizing Antibodies Predict Disease Severity and Survival (Cell) COVID-19 exhibits variable symptom severity ranging from asymptomatic to life-threatening, yet the relationship between severity and the humoral immune response is poorly understood. We examined antibody responses in 113 COVID-19 patients and found that severe cases resulting in intubation or death exhibited increased inflammatory markers, lymphopenia, pro-inflammatory cytokines, and high anti-RBD antibody levels.

A wild mink in Utah has Covid-19. Veterinarians fear this is just the beginning.Here’s what that means and why it matters.

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