Tag Archives: COVID-19

Dexamethasone – first drug shown to reduce Covid-19 deaths

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The most severe symptoms of COVID-19 are the result of the an infected person’s immune system’s overreaction to the virus. Dexamethasone is an anti-inflammatory drug that can rein in a person’s immune system attack.

Dexamethasone is a corticosteroid that prevents the release of substances in the body that cause inflammation. It is used to treat many different inflammatory conditions such as allergic disorders and skin conditions.

Dexamethasone is also used to treat ulcerative colitis, arthritis, lupus, psoriasis, and breathing disorders. It may also be used for purposes not listed in this medication guide.

This drug is relatively inexpensive and widely available steroid that blunts many types of immune responses. Doctors have long used it to treat allergies, asthma and inflammation.

In June, it became the first drug shown to reduce Covid-19 deaths. That study of more than 6,000 people, which in July was published in the New England Journal of Medicine, found that dexamethasone reduced deaths by one-third in patients on ventilators, and by one-fifth in patients on oxygen. It may be less likely to help — and may even harm — patients who are at an earlier stage of Covid-19 infections, however.

In its Covid-19 treatment guidelines, the National Institutes of Health recommends only using dexamethasone in patients with COVID-19 who are on a ventilator or are receiving supplemental oxygen.

Steroid medication affects your immune system. You may get infections more easily. Steroids can also worsen or reactivate an infection you’ve already had. Tell your doctor about any illness or infection you have had within the past several weeks.

References:

  1. https://www.drugs.com/dexamethasone.html
  2. https://www.nytimes.com/interactive/2020/science/coronavirus-drugs-treatments.html?referringSource=articleShare

U.S. FDA Approves COVID-19 Plasma Treatment for Emergency Use Authorization

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Eradicating the coronavirus, whether it’s through an effective therapeutic treatment or vaccine, is the key to unlocking the economy.

The U.S. Food and Drug Administration’s granted emergency use authorization of antibody-rich plasma from recovered patients which may lessen the severity of the disease, but experts suggest further research is needed.

Convalescent plasma therapy is an experimental treatment that some physicians are using for people with severe coronavirus disease 2019 (COVID-19). The plasma therapy has shown some promise in battling severe illness. People who’ve recovered from COVID-19 have antibodies — proteins the body uses to fight off infections — to the disease in their blood. The blood from people who’ve recovered is called convalescent plasma.

Researchers hope that convalescent plasma can be given to people with severe COVID-19 to boost their ability to fight the virus. It also might help keep people who are moderately ill from becoming more ill and experiencing COVID-19 complications, according to the Mayo Clinic.

Alex Azar, the U.S. health and human services secretary, said during a White House press briefing on Sunday that the treatment has been delivered to more than 70,000 American patients so far. The treatment, according to the FDA’s evaluation, “may be effective in lessening the severity or shortening the length of COVID-19 illness in some hospitalized patients.”

Source: The New York Times Coronavirus Vaccine Tracker

Over 400 vaccines and therapietic treatments are under study as researchers rush to produce effective medicines for the disease. And, 32 of the vaccines are in human trials. The FDA says that for any vaccine to be approved, it will need to prevent infection or decrease its severity in at least 50% of the people vaccinated. The goal is to inoculate enough people with a vaccine that immunity spreads through a community, even if not everyone gets the vaccine. It’s called “herd immunity”, according to WebMD.

For this coronavirus, some experts say about 60% to 70% of the population would need to develop antibodies, whether from a vaccine or getting and recovering from COVID-19, to create herd immunity.

Currently, the most effective ways to protect yourself and others from being infected by the virus are to:

  • Clean your hands frequently and thoroughly
  • Avoid touching your eyes, mouth, and nose
  • Cover your cough with the bend of elbow or tissue
  • Stay home and isolate yourself if you feel ill or ‘under-the-weather’
  • Maintain social physical distance of at least 6 feet from others

Wearing a mask or face covering is no substitute for these additional effective measures.

References:

  1. https://www.mayoclinic.org/tests-procedures/convalescent-plasma-therapy/about/pac-20486440
  2. https://www.cnet.com/news/coronavirus-plasma-treatment-approved-for-emergency-use-but-questions-remain/
  3. https://www.webmd.com/lung/news/20200610/covid-19-latest-updates

Coronavirus High Frequency Economic Data 8/18/20 || First Trust

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Economic Data consolidated by First Trust

Excerpts from recent Federal Reserve statement:  “The coronavirus outbreak is causing tremendous human and economic hardship across the United States and around the world.”

“Following sharp declines, economic activity and employment have picked up somewhat in recent months but remain well below their levels at the beginning of the year.  Weaker demand and significantly lower oil prices are holding down consumer price inflation.”

“Overall financial conditions have improved in recent months, in part reflecting policy measures to support the economy and the flow of credit to U.S. households and businesses.”

“The path of the economy will depend significantly on the course of the virus. The ongoing public health crisis will weigh heavily on economic activity, employment, and inflation in the near term, and poses considerable risks to the economic outlook over the medium term.”

Sources: First Trust Advisors, Department of Labor, Redbook Research, Box Office Mojo,  Association of American Railroads, American Iron and Steel Institute,  Hotel News Now, Opentable, Transportation Security Administration, Energy Information Administration

  1. Data for level and year ago level are YOY % changes.
  2. Data is provided daily instead of weekly.
  3. Data shows year-over-year seated diners at restaurants on the OpenTable network across all channels: online reservations, phone reservations, and walk-ins. % change month over month is the current reading minus the month ago reading.

Recommendation to wear eye protection against coronavirus

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“If you have goggles or an eye shield, you should use it. It’s not universally recommended, but if you really want to be complete, you should probably use it if you can.”  Dr. Anthony Fauci, the director of the National Institute of Allergy and Infectious Diseases

Updated: August 13, 2020 at 4:59 p.m. ET.

Based on what doctors know about how Covid-19 spreads, it’s possible to get infected through your eyes, but not common.  However, it makes sense to use eye protection and a mask anywhere you can’t effectively maintain social distance from others for an extended period such as on board a plane or in a classroom.

Wearing eye protection in public to fend off COVID-19, according to Dr. Fauci, “…is not universally recommended, but if you really want to be complete, you should probably use it if you can.” But one reason that this hasn’t been pushed for the general public yet, he suggested, is because, “it’s so easy for people to just make a cloth mask.”

GETTY IMAGES

Glasses or sunglasses can provide some protection, but due to the openings on the top, bottom and sides,  aerosols could still get in.

Face shields and protective goggles are advised by medical experts.  Protective eye goggles should “fit snugly around the corners of the eye and across the brow.  Face shields work because they protect the crown and chin from exposure, as well as the eyes.  But, you still must wear a mask when wearing a face shield in order to cover your nose and mouth.

“If you have goggles or an eye shield, you should use it.” — Dr. Anthony Fauci

Fauci explained that the novel coronavirus that causes COVID-19 infects mucosal surfaces — or parts of the body including the eyes, nose and mouth that secrete mucus to stop pathogens and dirt from getting into your body. So “perfect protection” of your mucosal surfaces would include covering every one of them up, he said.

“Theoretically you should protect all of the mucosal surfaces, so if you have goggles or an eye shield, you should use it,” he said.

Centers for Disease Control and Prevention suggests protective eyewear for health care professionals, noting that “use of eye protection is recommended in areas with moderate to substantial community transmission.” As a result, doctors and nurses do wear goggles or face shields in areas where they are coming into close contact with COVID-19 patients.

  1. https://www.marketwatch.com/story/dr-fauci-recommends-wearing-goggles-to-prevent-catching-the-coronavirus-2020-07-29?mod=nicole-lyn-pesce&link=sfmw_fb
  2. https://www.cnbc.com/2020/07/31/dr-anthony-fauci-goggles-and-eye-shields-can-prevent-covid-19-spread.html

55% of coronavirus patients still have neurological problems three months later | MarketWatch

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Published: Aug. 9, 2020 at 9:11 a.m. ET By Nicole Lyn Pesce

Mounting evidence suggests COVID-19 could cause brain damage in adults and kids

“While lung scarring, heart and kidney damage may result from COVID-19, doctors and researchers are starting to clock the potential long-term impact of the virus on the brain.”

“Many COVID-19 patients have continued showing symptoms for months after the initial infection passed, reported neurological problems such as confusion and had difficulty concentrating (or brain fog), as well as headaches, extreme fatigue, mood changes, insomnia and loss of taste and/or smell.”

“The CDC recently warned that it takes longer to recover from COVID-19 than the 10- to 14-day quarantine window that has been touted throughout the pandemic. In fact, one in five young adults under 34 was not back to their usual health up to three weeks after testing positive. And 35% of surveyed U.S. adults overall had not returned to their normal state of health when interviewed two to three weeks after testing.”

“Now a study of 60 COVID-19 patients published in Lancet this week finds that 55% of them were still displaying such neurological symptoms during follow-up visits three months later. And when doctors compared brain scans of these 60 COVID patients with those of a control group who had not been infected, they found that the brains of the COVID patients showed structural changes that correlated with memory loss and smell loss.”

“The most severe illness and complications of COVID-19 appear to stem from the body’s immune response to the viral invader, as opposed to the virus itself causing damage.”

Read more: https://www.marketwatch.com/story/55-of-coronavirus-patients-still-have-neurological-problems-three-months-later-study-2020-08-07?mod=mw_latestnews&link=sfmw_fb

How Vaccines Work, How They’re Developed and What’s the Latest on One for COVID-19

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By Andrea Klemes, DO, FACE, CMO MDVIP

Since the coronavirus pandemic began in early 2020, we’ve heard a lot about vaccines. There have been promises for quick vaccine development as well as warnings about how long it really takes to develop a safe, effective vaccine.

You’ve also probably heard that a coronavirus vaccine is necessary for us to return to normal. The good news? Surprising progress has been made in creating vaccines for COVID-19. As of now, there are more than 160 vaccines in various stages of development, and many are already into the human testing phase. While the path to success is still uncertain, never in human history have so many scientists and resources been devoted to a single public health crisis.

In July, multiple vaccine manufacturers released preliminary data from phase 1 studies that showed new vaccines are well tolerated and created antibodies. This is good news because it shows success in human subjects; in phase 1 trials, small groups of people receive the vaccine. Three vaccines are either currently in a later phase of development, where they are being tested on thousands of people, or about to enter that phase.

While it’s good news, there’s a long way to go. Here’s a quick primer on how vaccines work, how they’re developed and where we stand developing a vaccine for the current coronavirus outbreak.

How Vaccines Work
Vaccines work by mimicking a virus or bacteria that enters the immune system to build up antibodies. Ironically, vaccines are one of our oldest modern medical treatments. The first effective vaccination — to smallpox — was developed in the late 18th century. Over the last 220 years, scientists have advanced the process and effectiveness for vaccines.

Modern vaccines are simple in concept: create a synthetic compound that behaves like a real live pathogen that doesn’t cause illness. The compound will instead provoke the immune system to create antibodies that teach the body to react quickly and forcefully if the real pathogen invades the body.

Antibodies are an essential part of your immune system. When a pathogen, like bacteria or a virus, invades your body, antibodies bind to the invader and neutralize it, minimizing its damage. Your body came with some antibodies, which were passed from your mother. But most antibodies are developed over time when you’re exposed to pathogens. Vaccines make that natural process happen without infecting you with a real virus or bacteria.

How Vaccines Are Made
There are four basic types of vaccines, but regardless of the type, the process to produce safe and effective vaccines is typically long and difficult. When we’re not in crisis mode, vaccine labs can take anywhere from 10 to 15 years to develop a new vaccine. Of course, when we’re in the throes of a pandemic, labs generally move quicker. For example, during the mumps outbreak, a vaccine was generated in four years – the quickest in U.S. history.

Labs are currently working on an even faster timetable, with hopes that a COVID-19 vaccine might be available by the end of 2020 or by the middle of next year.

The reason it takes so long it that there are five phases of vaccine development:

  • Exploration: In this stage, drug companies investigate different approaches to the vaccine. Historically, this phase lasts between two and four years; however, evolving technology has help quicken the pace of this phase for some vaccines, including COVID-19. Another factor that has helped speed up the exploratory stage of the COVID-19 vaccine is information sharing among scientists; for example, scientists genetically mapped the virus as early as January — something that would have taken much longer 10 or 20 years ago. Also, since COVID-19 is similar to SARS — another coronavirus that caused a six-month pandemic in 2003 — scientists working on the COVID-19 vaccine were able to learn from those working on the SARS vaccine — a significant head start.
  • Preclinical: Once researchers develop a vaccine candidate, it’s tested in cell cultures and animals to see if it triggers an immune response without damaging cells. This takes about a year. And if the vaccine doesn’t work, researchers circle back to the exploration phase. But if it is successful, it moves on the testing phase.
  • Testing: Vaccines are tested through clinical trials – research studies that evaluate the effectiveness and safety of vaccines, medications, medical devices, surgical procedures or behavioral interventions on a group of people. Most trials start with a small group of people (phase 1), and, if they go well, they are expanded to include a moderate size group of people (phase 2) and then a large group (phase 3). Of course, if issues arise during clinical trials, the vaccine reverts to the preclinical phase.
  • Regulatory review: If clinical trials go well, the drug company submits a Biologics License Application and product label for the vaccine. In the United States, applications and labels are sent to the U.S. Food and Drug Administration (FDA). In the U.S., this process takes about 10 months, although in a circumstance such as the COVID-19 pandemic, the process will probably be accelerated.
  • Production: Once the drug manufacturers have been given a green light, they can begin producing the vaccine. In the U.S., the FDA continues overseeing the production of the vaccine.


Where COVID-19 Vaccines Stand
At the end of July there were 23 vaccines in clinical testing and another 137 in pre-clinical development, according to the World Health Organization.

Dr. Erica Saphire, an infectious disease authority and professor at La Jolla Institute for Immunology, recently told medical officials that the earliest a vaccine may be available is January 2021, but it’s more likely that a viable vaccine won’t be available until July 2021 or later. Even when one is available, it will take time to get the vaccine manufactured and distributed. Of course, once a vaccine is available, healthcare workers, first responders and those at the highest risk – nursing home patients, for example — will probably be the first to have access to the vaccine.

Until a vaccine is available, continue to take precautions such as wearing a face mask and social distancing to lower your risk of contracting COVID-19. And continue working closely with your physician to help you control chronic conditions and maintain a strong immune system that can lower your chances of developing serious complications should you catch COVID-19.

Wearing a Facial Mask in Public

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Updated:  August 5, 2020, 10:45 p.m.

Masks are important tools in slowing or stopping the spread of COVID-19.

Wearing masks in public has become a politically charged subject. Even with the rise of COVID-19 infections and deaths across the South and West, Americans continue to debate the need to wear facial coverings in public despite the plethora of scientific evidence showing mask effectiveness in preventing the virus spread.

Despite the universal recommendation to wear masks while out in public from government officials, epidemiologists and medical experts, there stills appears to be a reluctance by the American public to adhere to the guidelines.

Everyday while out in public, even in locations and inside establishments where facial coverings are mandatory, you can observe people out in public refusing to wear masks or wearing them incorrectly and ineffectually.

Periodically, you can observe people with their noses, a critical pathway of the respiratory system, exposed from beneath their masks or their masks worn on their chins.

Whether donning masks incorrectly was being done out of ignorance or political sensibilities, it accomplishes the same end, it does not help reduce the public spread of the coronavirus.

Cloth masks

Cloth masks are at their best when preventing the wearer of the mask from spreading the virus to other people, either when they are already sick, asymptomatic, or even pre-symptomatic.

N95 masks or surgical masks work

According to the CDC, N95 masks and surgical masks are best used in a medical setting, when the amount of virus in the environment is quite a bit higher. The intention of these masks is to reduce the transmission of the virus to the person wearing the mask.

Wearing a mask

Wearing a mask in your neighborhood, in your workplace, or around your community is a way to show you care about those around you. You are essentially saying, “I care about you. I am member of this community. And my intention is to not give this infection to you, even if I don’t know if I’ve got it.”

Washing cloth masks

Cloth masks should be washed every day. It’s helpful to have multiple cloth masks available so you can rotate through your supply while others are washing or drying.

N95 masks or surgical masks are intended to be worn through the course of one day and discarded.

COVID-19 vs. 1918 Spanish Influenza Pandemic | The Daily Social Distancing Show with Trevor Noah

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One of the lessons experts learned from the 1918 flu pandemic is how quickly the pandemic was forgotten and how fast it disappeared from the political discourse.

The one lesson learned from a pandemic should be to never forget because forgetting doesn’t lead to positive public health outcomes.

There has been several global public health emergencies since 1918 such as SARS in 2003 and the 2009 H1N1pandemic influenza. Yet, these events have caught authorities and the general public by surprise, but not the epidemiologist who have been studying pandemics were not surprised.

Another lesson to remember is that governments have the responsibility to prepare for a pandemic; they have the obligation to invest in public-health systems to protect their citizens from both the threat and the reality of the next pandemic.

References:

  1. https://news.harvard.edu/gazette/story/2020/05/harvard-expert-compares-1918-flu-covid-19/

USG Ordered 100M Doses of Experimental Covid-19 Vaccine | Barron’s

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U.S. Government has ordered from Pfizer and BioNTech 100M Doses of Experimental Covid-19 Vaccine.

The U.S. government has put in an order for enough doses of Pfizer and BioNTech experimental Covid-19 vaccine to inoculate nearly every American.

Pfizer and BioNTech said that the companies are selling 100 million doses of the vaccine to the U.S. Department of Health and Human Services and the Department of Defense for $1.95 billion, a deal that prices each dose of the experimental vaccine at $19.50.

The deal allows the U.S. government the option of buying an additional 500 million doses.

Americans would receive the vaccine free, according to the companies. Pfizer and BioNTech would provide the doses after the vaccine receives approval or emergency authorization from the Food and Drug Administration, and the government will make the payment after the first 100 million doses are delivered.

Read more: https://www.barrons.com/articles/pfizer-covid-19-vaccine-price-government-deal-51595425522?mod=bol-social-fb

Pfizer and BioNTech announced that two of the companies’ investigational COVID-19 vaccine candidates have received “Fast Track” designation from the U.S. Food and Drug Administration (FDA). Fast Track is a process designed to facilitate the development, and expedite the review, of new drugs and vaccines that are intended to treat or prevent serious conditions that have the potential to address an unmet medical need.

Stock Market Reaction to Expiring COVID-19 Programs | Charles Schwab

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Key Points

  • Stock markets around the world welcomed the COVID-19 fiscal stimulus programs; but now those programs are starting to expire.
  • If not extended or replaced, the fading support for the unemployed raises the risk of weakening economic momentum, turning the V-shaped recovery into a W. 
  • As investors seem to be discovering with international stocks outperforming in recent weeks, there are very different implications for U.S. and European workers.

Stock markets around the world welcomed the COVID-19 fiscal stimulus programs; the passage of the CARES Act in the U.S. in late March coincided with the start of the market rebound.

But now these programs are starting to expire. Key support for the unemployed in the U.S. and Europe is set to fade, raising the risk of weakening economic momentum and turning the V-shaped recovery into a W.

In the United States, an additional $600 per week for the unemployed expires July 31. The average unemployment payout without the CARES Act benefit is only $333 per week. Losing the extra $600 a week is like a two-thirds cut to income for 17 million Americans receiving state unemployment benefits. 

Investing implications

International stocks have outperformed U.S. stocks during six of the past eight weeks, including last week. One of the reasons may be the looming expiration of labor support programs and the different impact this could have on the unemployed in the U.S. compared with Europe.

https://www.schwab.com/resource-center/insights/content/stock-market-reaction-to-expiring-covid-19-programs