Wednesday COVID-19 Briefing

Top news, reports and insights for today:

  1. Daily headline summaries for Wednesday:
  • Experts continue to urge people to socialize outdoors. Some say we need to prepare for a rough winter because that won’t be possible (The Atlantic)
  • Alabama tried it, but this week Virginia is rolling out a full beta version of a new COVID-19 exposure notification app, called COVIDWISE, based on technology from Apple and Google. This could be big (The Verge)
  • “Uncle Toni” Fauci joined other experts today when he told ABC News that he recommends people wear goggles or an eye shield in public to protect against the coronavirus (Health)
  • Headed to the Big Apple this summer? New York Mayor de Blasio announced Wednesday a first-time effort to create law enforcement checkpoints at key entry points in the city to enforce quarantine regulations (NPR)
  • FDA vaccine advisory panel member says that progress toward a vaccine is being made but doesn’t think one will be ready before the end of the year (NPR)
  1. New coronavirus cases appear to have peaked. Deaths still rising but may be flattening
      After the normal dip in case numbers on Sunday and Monday, the Tuesday’s numbers continue to provide evidence that transmission is slowing in the U.S. nation wide (Figure A). Cumulative growth in cases last week was below 10% for the first time in a month as 403,740 new cases were added, some 50,000 fewer than the week prior to July 26. Figure B shows 1-week new case growth factors, showing that weekly cases were lower in all states in the South except Texas. Both Tennessee and Florida saw substantial drops of around 32%. In the Northeast, cases are rising in Connecticut (+5%), Massachussetts (+51%) and Maryland (+6%). Seven of 13 mid-west states saw new cases fall, particularly Oklahoma (-24%), but rose 24% in South Dakota. Out West, Hawaii continues its most intensive period of transmission with 834 new cases last week, a jump of 47%. New weekly cases fell in Arizona (-15%), California (-20%), Colorado (-28%), New Mexico (-32%) and Utah (-21%).
     The trend of rising COVID-19 deaths continues (Figure C) despite a weekend reporting dip on Sunday and Monday. On Tuesday, 1,265 deaths were recorded, making for 1,000 or more daily deaths for 6 of the last 8 days. As with cases, the rise in deaths varied by region and state (Figure D). All Northeast states saw <5% growth in total deaths last week, while every state in the South was above that mark (except Kentucky at 4%). Deaths are surging substantially in Alabama (+11%), Arkansas (+14%), Florida (+21%), Mississippi (+14%), South Carolina (+18%), Tennessee (+12%), Texas (+24%), and West Virginia (+15%). Total deaths rose by 10% or more in Oklahoma (+11%), and South Dakota (+11%) in the Mid-west. Despite a slowdown in cases in many Western states, Deaths continue to surge in Alaska (+14%), Arizona (+13%), California (+12%), Idaho (+31%), Nevada (+14%), and Utah (+12%).
     The bottom line: Cases may have peaked nationally although we await testing numbers to confirm that the slowing is not a function of testing delays. Deaths continue to be elevated at more than 1,000 a day for 6 of the last 8 days. Deaths continue continue to be high especially in the South and West.
Figure A
Figure B
Figure C
Figure D
  1. Awareness is growing that some COVID-19 patients are “long-haulers” with symptoms and complications lingering for weeks
     One question that has come up in a bunch of reader comments relates to long-term symptoms among some COVID-19 survivors. It’s an important issue and one that has increasingly drawn attention. In recent days, several studies and reports have added to what has been anecdotal thus far. Science magazine had a news article summarizing some of the latest emerging evidence. The list of lingering symptoms being discussed has grown in recent weeks to include prolonged fatigue, racing heartbeat, shortness of breath, achy joints, foggy brain, persistent loss of smell, heart rhythm abnormalities and persistent blood pressure elevation. Researchers in the UK announced this month they will do a large study to follow 10,000 survivors of COVID-19 for at least 1 year. Until bigger studies are done, we are starting to see smaller studies roll out. A study this week in JAMA cardiology looked closely at the hearts of 39 people who died of coronavirus for signs of cellular changes related to infection. Evidence of the virus in heart cells was found in 62% of patients. A second study in the same journal published online this week found that 78% of 100 surviving patients had some impact on the heart and 60% had on-going heart inflammation independent of pre-existing heart disease. In Italy, several follow-up studies have been done among patients who got COVID-19 in the spring. One July study of 143 formerly hospitalized patients who where interviewed 2 months later, found only 13% were completely free of any COVID-19–related symptom, while 32% had 1 or 2 symptoms and 55% had 3 or more.
    What does it mean: We are now realizing that a sizable proportion of patients who were sickened by SARS-CoV-2 are ‘long-haulers’ (people who experience extended and significant on-going symptoms for weeks or months). We don’t yet know the real fraction but it looks like there may be potentially significant ongoing impacts on the heart, brain and body that warrants further attention. I will return to this topic in the coming weeks.
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