Tiny (and not so tiny) Human Disease Vectors – the Princeton-led Study

Children and young adults were found to be potentially much more important to transmitting the virus — especially within households — than previous studies have identified, according to a paper by researchers from the United States and India published Sept. 30 in the journal Science.

Researchers from the Princeton Environmental Institute (PEI), Johns Hopkins University and the University of California, Berkeley, worked with public health officials in the southeast Indian states of Tamil Nadu and Andhra Pradesh to track the infection pathways and mortality rate of 575,071 individuals who were exposed to 84,965 confirmed cases of COVID-19, the disease caused by SARS-CoV-2. It is the largest contact tracing study — which is the process of identifying people who came into contact with an infected person — conducted in the world for any disease.

Lead researcher Ramanan Laxminarayan, a senior research scholar in PEI, said that the paper is the first large study to capture the extraordinary extent to which SARS-CoV-2 hinges on “superspreading,” in which a small percentage of the infected population passes the virus on to more people. The researchers found that 71% of infected individuals did not infect any of their contacts, while a mere 8% of infected individuals accounted for 60% of new infections.

Largest COVID-19 contact tracing study to date finds children key to spread, evidence of superspreaders — https://www.princeton.edu/news/2020/09/30/largest-covid-19-contact-tracing-study-date-finds-children-key-spread-evidence

My original Tiny Human Disease Vector post is below:

Twelve children acquired COVID-19 in child care facilities. Transmission was documented from these children to at least 12 (26%) of 46 nonfacility contacts (confirmed or probable cases). One parent was hospitalized. Transmission was observed from two of three children with confirmed, asymptomatic COVID-19.

Transmission Dynamics of COVID-19 Outbreaks Associated with Child Care Facilities — Salt Lake City, Utah, April–July 2020 — https://www.cdc.gov/mmwr/volumes/69/wr/mm6937e3.htm?s_cid=mm6937e3_w

Handing out sugar to tiny humans this year is not happening at our house. AND Thanksgiving is going to be very, very tricky this year.

The Latest in COVID-19 News: Week Ending 10.24.20 – NEJM Journal Watch

Click on the link for the NEJM Journal Watch weekly update.  There are no paywalls on any of the links in this article.  The links in this week’s edition are pretty good. https://www.jwatch.org/fw117158/2020/10/24/latest-covid-19-news-week-ending-oct-24

Meanwhile in El Paso…

EL PASO, Texas — The massive Covid-19 surge in El Paso County went from extremely bad to critically worse on Saturday as all-time highs were shattered for a half-dozen critical markers: New cases, active infections, positivity rate, and hospitalizations – along with ICU and ventilator usage.

The health department reported a record 1,216 new cases on Saturday, as well as 75 unreported cases from earlier, increasing the total number of additional cases reported to 1,291. The number of active infections jumped to just shy of 11,000 at a record-level of 10,911.

There were a record 715 patients in El Paso hospitals due to Covid-related illness as of Saturday morning, representing nearly 2% of hospitalizations nationwide. El Paso hospitals have seen a staggering 203% increase in Covid patients over the past two weeks. In addition, record numbers of virus patients Saturday required intensive care (199) and the use of ventilators (85).

El Paso shatters records for new & active virus cases, positivity rate, hospitalizations, ICUs, ventilators — https://kvia.com/coronavirus/2020/10/24/el-paso-shatters-all-time-highs-for-new-active-virus-cases-positivity-rate-hospitalizations-icus-ventilators/

The city just told everyone to stay home.

There’s Nothing “Radical” About This WFH Plan

This is the latest in a series of major companies having made similar announcements, including Microsoft. But Synchrony’s proposal appears to be more radical in that it:

Allows all its US employees to work from home permanently.

Requires some employees to work from home all the time with no access to an office.

Requires all employees to work from home at least some of the time.

Requires even management with “assigned seats” to work from home at least 1-2 days a week.

In a memo to employees, reported by Bloomberg today, CEO Keane and Synchrony President Brian Doubles explained that Synchrony will have three types of offices:

Virtual offices: employees will work from home permanently, and there is no office they can go to.

Hoteling offices: employees work at home permanently, but if they need to, can book a desk at a nearby office location.

Hybrid offices: employees can work from home but they have an assigned seat at a nearby office where they can work at least three days a week.

Synchrony Financial Disclosed Radical Work-from-Home Plan, Layoffs, and “Office Footprint” Reduction — https://wolfstreet.com/2020/10/20/consumer-finance-giant-synchrony-disclosed-radical-permanent-work-from-home-plan/

I have been a WFH (work from home) warrior since 2006. There is absolutely nothing radical about the plan outlined above. I’ve been patiently waiting all these years for the business world to come around to my way of thinking. To be be clear, a lot of businesses would not adopt WFH without a nasty virus driving the agenda.

Too bad I’m currently a W2 worker. If I was still consulting I would make a MINT advising companies how to do the WFH thing effectively.

And what not to do when you’re on a Zoom call.

The Sturgis Motorcycle Event and the Death of Common Sense

South Dakota, which had the most attendees, saw coronavirus cases surge within weeks of the rally’s Aug. 16 close, with the seven-day rolling average going from 84 on Aug. 6 to 214 on Aug. 27. The numbers remained elevated into October: The first day of the month, the seven-day rolling average was 434. The state is second in the nation in cases per capita behind North Dakota, with numbers high enough for the Harvard Global Health Institute to recommend stay-at-home orders.

How the Sturgis Motorcycle Rally may have spread coronavirus across the Upper Midwest — https://www.washingtonpost.com/health/2020/10/17/sturgis-rally-spread/

Blood Group O Linked to Decreased Risk for SARS-CoV-2 Infection

The authors speculated on two possible causes of the lower prevalence of SARS-CoV-2 infection in the blood group O population. The first is that anti-A and anti-B antibodies may have an effect on neutralizing SARS-CoV viruses and that anti-A and anti-B are present on mucosal surfaces in some individuals lacking the corresponding ABO blood group. The second is that the association between ABO blood groups and levels of von Willebrand factor, which is higher in non-O individuals and is tied to an increased likelihood of arterial and venous thrombosis, could have an indirect or unknown impact on susceptibility to infection, according to the authors.

Blood Group O Linked to Decreased Risk for SARS-CoV-2 Infection – Medscape – Oct 15, 2020. SOURCE: Barnkob MB et al. Blood Adv. 2020 Oct 14. doi: 10.1182/bloodadvances.2020002657. — https://www.medscape.com/viewarticle/939216?src=rss

I am Oriental Positive.

An Outbreak of COVID-19 Associated with a Recreational Hockey Game

The ice rink provides a venue that is likely well suited to COVID-19 transmission as an indoor environment where deep breathing occurs, and persons are in close proximity to one another. An Italian study estimating the rate of SARS-CoV-2 emission by infectious persons based on viral load in the mouth showed that during heavy exercise, a high viral emission rate can be reached during oral breathing (6). The higher proportion of infected players on the index patient’s team might result from additional exposures to the index patient in the locker room and on the player bench, where players sit close to one another.

Atrubin D, Wiese M, Bohinc B. An Outbreak of COVID-19 Associated with a Recreational Hockey Game — Florida, June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1492–1493. DOI: http://dx.doi.org/10.15585/mmwr.mm6941a4external

Cost effectiveness of dietetic intervention in management of type 2 diabetes — Journal of Human Nutrition and Dietetics Notes

Siopsis et al., JHND Early View Background The management of diabetes costs in excess of $1.3 trillion per annum worldwide. Diet is central to the management of type 2 diabetes. It is not known whether dietetic intervention is cost effective. This scoping review aimed to map the existing literature concerning the cost effectiveness of medical […]

Cost effectiveness of dietetic intervention in management of type 2 diabetes — Journal of Human Nutrition and Dietetics Notes

Of 2387 abstracts assessed for eligibility, four studies combining 22 765 adults with type 2 diabetes were included. Dietetic intervention was shown to be cost‐effective in terms of diabetes‐related healthcare costs and hospital charges, at the same time as also reducing the risk of cumulative days at work lost to less than half and the risk of disability ‘sick’ days at work to less than one‐seventh.

Conclusions: The findings highlight the importance of advocacy for medical nutrition therapy for people with type 2 diabetes, with respect to alleviating the great global economic burden from this condition. Further studies are warranted to elucidate the factors that mediate and moderate cost effectiveness and to allow for the generalisation of the findings.

First published: 14 October 2020
https://doi.org/10.1111/jhn.12821