The Count

Region	Cases	Deaths
World	26,676,065	216,809
US	6,372,029	191,712

HOW TO INFECT YOUR STATE IN THREE EASY STEPS It takes a special kind of magic to make South Dakota the pandemic poster child. With only eleven people per square mile, the state has almost the lowest population density in the country (46th out of 50). That translates to an average social distance of about 1,500 feet.

Research News

Korea and Australia had most efficient response to the pandemic. The US had the worst In a model analyzing the number of newly confirmed cases in each of 24 countries during the first 120 days after the first case and adjusting for population density and degree of urbanization, Taiwanese researchers ranked the USA, Brazil, Russia, Spain and Italy as the countries with the least efficient public health response. The one caveat involves the study's failure to adjust for testing rates.

Prevalence of mask wearing dramatically reduces reproduction number (Rt) for COVID-19 A Harvard led team of multi-institutional investigators used serial cross-sectional surveys to evaluate the impact of prevention behavior on Rt. Mask wearing and social distancing behavior clearly reduces Rt, but mask wearing rates are extremely low for much of the US.

SARS-CoV-2 produces severe damage to cardiac cells in vitro and in vivo UCSF researchers demonstrated fragmentation of sarcomeres and enucleation of cardiomyocytes in cell cultures and in autopsy specimens from COVID-19 patients. These effects were linked to a robust transcriptomic signature. These findings raise serious concerns about the potential for long term cardiac damage following COVID-19 infections.

SARS-CoV-2 re-infection possible but rare A study of 133,266 laboratory confirmed cases in Qatar found 0.04% reinfection rate with the majority of those second infections being asymptomatic and none being severe. Reinfection was defined as a positive swab more than 45 days after an initial positive swab. This study was records based and didn't involve a cohort or regular follow-up of all subjects. Also, it did not explicitly confirm resolution of initial infection.

Outbreak risk for nursing homes increases dramatically with the number of residents. A British study found a steady increase in COVID-19 outbreak risk with increased size of nursing homes. Nursing homes with more than 50 residents had 22 times the risk of an outbreak when compared to facilities with fewer than ten. Discharge of hospitalized patients to nursing homes did not appear to pose a risk for outbreaks once facility size was taken into account.

No need to rotate swab for Nasopharyngeal (NP) SARS-CoV-2 sample collection A comparison of NP sampling with and without rotation found no difference in sensitivity of the two methods, but far higher discomfort with rotation.

Point mutation in original SARS-CoV-2 now dominant An analysis by Swiss and British investigators found that, following the initial outbreaks of COVID-19 in Southeast Asia, a single point mutation occurred. A subsequently, strains of the virus with that mutation have become the predominant worldwide. This is the clearest evidence to date of a specific genetic shift in SARS-CoV-2.

Convalescent COVID-19 Patients show decreases in NK cells months after infection Wuhan researchers found lower levels of NK cells and NKT-like cells in patients recovering from COVID-19 more than two months after initial infection when compared to matched, uninfected controls.

Qualitative fit tests for masks are unreliable A comparison of perceived fit to objectively measured fit for a range of mask types shows that conventional fit tests are unreliable and that most N95 masks did not fit adequately. All non-N95 achieved low fit scores.

Loud speaking and singing sharply increases droplet and aerosol generation* Quiet singing and speaking was similar to breathing in terms of aerosol and droplet generation. Loud singing and speaking resulted in 3-4 times the number of particles across the size distribution.

Model offers more nuanced view of indoor air safety MIT researchers provide a model of risk to estimate safe occupancy time for indoor spaces based on occupancy rates, ventilation, and adherence to 6 foot spacing.

Inconsistency in lockdown rules limits their efficacy. A Harvard study of data from Santiago shows that the impact of local lockdown rules is limited if surrounding communities are not implementing and enforcing the same rules. This effect could help explain the persistence of the outbreak in the US.

Belief in conspiracy theories associated with decreased likelihood of social distancing A cohort of subjects were recruited online and followed with serial questionnaires over March and April. Subjects who reported belief in conspiracy theories were less likely to report that they were avoiding gatherings and observing social distancing.

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*peer reviewed.

Recent Posts Covid19- Ahead of the Curve.

TRUMP'S KNEE ON THE NECK OF SCIENCEThe FDA and the CDC have collapsed to the pavement. Scientific rigor has been cast as Deep State conspiracy. Its subjugation for political expediency has already cost human lives.

Robert Morris, MD, PhD, Editor Dr. Morris is an epidemiologist and award-winning author who has taught epidemiology at Tufts and Harvard and has advised the CDC, the EPA, NIH, and the President's Cancer Panel.

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