The Outbreak Breakdown

My AdvaMed colleague, Kristina Shultz, and I produce a weekly newsletter on aspects of the #COVID19 pandemic. Here's some of the content from this week's edition. Happy Fourth!

Something Completely Different

Speaking of meltdowns…these radioactive gobstoppers may be the key to less expensive, safer, plentiful nuclear power. Meaning you might be able to take this guide to rebuilding civilization from scratch out of your ultimate bug-out bag, but it’s still recommended reading during a socially distanced holiday weekend. Speaking of fireworks…please choose between infection prevention and blowing your hand off, because both at the same time are too dangerous.

 Pandemic Snapshot

Global: Current Cases: 10.7 million+ Deaths: 516,392

• New cases are increasing across the world, with daily incidence fluctuating between 150,000 – 200,000 new cases per day during this past week.
• The U.S. continues to lead the world in new daily cases. Brazil has the second highest average daily incidence, and India follows in third.
• The Eastern Mediterranean Region is a global hotspot of concern, with five of its countries in the top 10 in terms of per capita incidence: Bahrain (#1), Qatar (#2), Oman (#4), Kuwait (#6), and Saudi Arabia (#9).

 United States: Current Cases: 2.7 million+ Deaths: 128,103

• In the past three weeks, new daily cases have increased from around 20,000/day to a new record yesterday (July 1) of 50,000/day.
• 38 states are reporting increasing incidence over the past two weeks. Test positivity, the percent of tests performed that are positive, is rising in 28 states.
• The COVID Tracking Project recently shared a blog post explaining why tests per positive, the number of tests needed to find one positive result, is easier to understand.

News & Insights

U.S. Senate HELP Committee Hearing: At this week’s hearing on getting back to work and school, Dr. Anthony Fauci testified that new COVID-19 cases could rise to 100,000 per day.

Testing Targets: Harvard researchers updated their analysis of the number of tests needed to mitigate the pandemic, calling for 1.2 million tests per day – and 4.3 million tests per day to suppress the pandemic. Harvard’s Pandemics Explained website provides global and U.S. state-by-state data on progress toward testing targets and test positivity rates.

Pool Testing: The concept of pool testing has received additional attention as the Administration has discussed deploying it as a screening strategy. Pool testing is a method of screening patients for SARS-CoV-2 as a group rather than as individuals. The FDA has an explanation of pool testing and information regarding validation of pool testing methods available here.

Mandatory Masks: Goldman Sachs released a “Face Masks and GDP” analysis of mask mandates that concluded that a federal mask mandate would “meaningfully” increase mask usage across the country and prevent a 5% GDP loss caused by additional lockdown measures.

Undercounting Deaths: A study published in JAMA this week reinforced an earlier CDC analysis that found that deaths in the United States between March 1 and May 30 were 19% higher than what would normally be expected. The findings suggest that the true number of deaths due to COVID-19 is likely higher than reported.

Multisystem Inflammatory Syndrome in Children (MIS-C): Two groups of researchers published studies describing 300 children who develop a severe inflammatory reaction following infection with COVID-19. The vast majority (80%) of children with the syndrome required intensive care and many (10-20%) required mechanical ventilation. Four of the observed children died. (See associated study #1 and study #2).

 If June Was the Month the Pandemic Spiraled Out of Control in the U.S., July May Show How Bad It Can Get | New York Times, July 2

Coronavirus Autopsies: A Story of 38 Brains, 87 Lungs, and 42 Hearts | Washington Post, July 1

Most People with Coronavirus Won’t Spread It. Why Do a Few Infect Many? | New York Times, June 30

U.S. Could See 100,000 New COVID-19 Cases per Day, Fauci Says | STAT News, June 30

Better COVID-19 Data Is Coming By August 1 – But Will the Public See It? | COVID Tracking Project, June 29

Millions Track the Pandemic on Johns Hopkin’s Dashboard. Those Who Built It Say Some Miss the Real Story | Washington Post, June 29

This Coronavirus Mutation Has Taken Over the World. Scientists Are Trying to Understand Why | Washington Post, June 29

Swedish COVID Expert Says the World Still Doesn’t Understand | Bloomberg, June 28

How the World Missed COVID-19’s Silent Spread | New York Times, June 27