What is now becoming clear is that mortality is not the only adverse outcome of this infection and our surveillance systems must keep up and reflect that. I am advocating for precise case definitions for covid-19 morbidity that reflect the degree of severity of infection and allow us to measure moderate and long term health and wellbeing outcomes. At this stage of the pandemic, it is vital that we accurately measure and count all degrees of infection, not only in research cohorts, but as part of population-based routine surveillance systems. This includes people like me who were not tested at the time of their initial infection. Death is not the only thing to count in this pandemic, we must count lives changed. We still know very little about covid-19, but we do know that we cannot fight what we do not measure.
Between 44% and 75% of the people at this summer camp were infected. ‘258 staff gathered for three days before the camp started with no precautions. Then on day 1 of camp someone [felt] chills. By day 6, the camp was closed.’ 597 attendees, 344 tested, 260 positive.
Good twitter thread from Megan Ranney MD: * ‘South Korea study — Older kids most likely transmit #COVID19 to their household at rates similar to adults. And younger kids transmit the virus, too. But: no masks or distancing, since this took place at home.’ * ‘Chicago — the level of the virus in kids is AT LEAST as high as the level of virus in adults. (Caveat: we don’t know whether this virus is infectious. But this data matches what we know about other respiratory viruses. The next step will be studying test swabs to see if kids’ virus can reproduce. I suspect it can. […] We can’t let kids ignore #SocialDistancing & #MaskUp just bc they’re kids.)’ * ‘States with early closure of schools had reduced levels of #COVID19 compared with states with late closure, *even after* adjusting for policies like “stay-at-home”. […] Once #COVID19 infection rates start to rise, it would be foolhardy to keep schools open IRL. And we should be planning NOW for how to keep kids healthy, safe, & fed, because that moment will likely come for every state.’ ‘Realistically, we MUST control levels of community transmission of #COVID19 if we want kids & teachers in schools. We may be able to send kids back, but we need PPE & regular, random testing of kids & teachers, whether in elementary, middle, high school, or college.’
Today in “we are still fucked” news:
RCP8.5, the most aggressive scenario in assumed fossil fuel use for global climate models, will continue to serve as a useful tool for quantifying physical climate risk, especially over near- to midterm policy-relevant time horizons. Not only are the emissions consistent with RCP8.5 in close agreement with historical total cumulative CO2 emissions (within 1%), but RCP8.5 is also the best match out to midcentury under current and stated policies with still highly plausible levels of CO2 emissions in 2100.RCP8.5 is the model associated with a planet where a good chunk of the globe is rendered uninhabitable.
While the antibody response to SARS-CoV-2 has been extensively studied in blood, relatively little is known about the mucosal immune response and its relationship to systemic antibody levels. Since SARS-CoV-2 initially replicates in the upper airway, the antibody response in the oral cavity is likely an important parameter that influences the course of infection. We developed enzyme linked immunosorbent assays to detect IgA and IgG antibodies to the SARS-CoV-2 spike protein (full length trimer) and its receptor binding domain (RBD) in serum (n=496) and saliva (n=90) of acute and convalescent patients with laboratory-diagnosed COVID-19 ranging from 3-115 days post-symptom onset (PSO), compared to negative controls. Anti-CoV-2 antibody responses were readily detected in serum and saliva, with peak IgG levels attained by 16-30 days PSO. Whereas anti-CoV-2 IgA antibodies rapidly decayed, IgG antibodies remained relatively stable up to 115 days PSO in both biofluids. Importantly, IgG responses in saliva and serum were correlated, suggesting that antibodies in the saliva may serve as a surrogate measure of systemic immunity.That last line, in particular, is good news.
A handy calculator spreadsheet to estimate how big of a portable air cleaner would be required to protect kids/teachers/admin staff at a typical US school, based on room size, ceiling height, etc. More info: https://twitter.com/cedenolaurent/status/1290447833959747584 (Catherine Lalanne notes: “Airflows in this sheet are about half the Irish regulations, American regulations are pretty weak.”)