NMCP COVID-19 Literature Report #34: Friday, 07 August 2020

Prepared By: Tracy Shields, MSIS, AHIP <[email protected]>

Reference Medical Librarian; Naval Medical Center Portsmouth, Library Services
Purpose: These now weekly reports, published on Fridays, are curated collections of current
research, evidence reviews, and news regarding the COVID-19 pandemic. Please feel free to
reach out with questions and suggestions for future topics.
All reports are available online at https://nmcp.libguides.com/covidreport. Access is private;
you will need to use the direct link or bookmark the URL, along with the case-sensitive
password "NMCPfinest".
Disclaimer: I am not a medical professional. This document is current as of the date noted
above. While I make every effort to find and summarize available data, things are changing
rapidly, with new research and potentially conflicting literature published daily.

Statistics
Global 19,141,627 confirmed cases and 715,803 deaths in 188 countries/regions

United States* top 5 states by cases (Virginia is ranked 14th)

TOTAL US CA FL TX NY GA
Confirmed Cases 4,888,070 541,492 510,389 484,232 418,928 204,895
Tested 59,652,675 8,500,463 3,857,363 3,944,480 6,298,805 1,724,762
Recovered NA NA NA 323,804 73,472 NA
Deaths 160,157 10,024 7,747 8,570 32,756 4,026
*see census.gov for current US Population data; NA: not all data available JHU CSSE as of 1100 EDT 07 August 2020
Newport News

Virginia Beach
Chesapeake

Portsmouth
Hampton

Norfolk

Suffolk
Total

Virginia

Cases 97,882 2,828 1,173 1,788 3,629 1,726 1,231 4,781

Hospitalized 8,281 225 49 80 187 133 93 229
Deaths 2,317 37 7 18 30 25 49 53
VA DOH as of 1100 EDT 07 August 2020

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Special Reports
WHO: COVID-19 Preparedness and Response Progress Report - 1 February to 30 June 2020 (03
August 2020)
"WHO published the first COVID-19 Strategic Response and Preparedness Plan (SPRP) on 3
February, 2020. This report highlights the main points of progress that were made up to 30
June 2020 under the three objectives outlined in the SPRP: scaling up international
coordination and support; scaling up country preparedness and response by pillar; and
accelerating research and innovation. The report also discusses some of the key challenges
faced so far, and provides an update on the resource requirements for the next phase of
WHO's response as part of an unprecedented whole-of-UN approach to the pandemic."
ICNARC: ICNARC report on COVID-19 in critical care (24 July 2020)
This includes data on the first reported 10,624 patients critically ill with COVID-19 in the
United Kingdom National Health Service (NHS) system.
"This report presents analyses of data on patients critically ill with confirmed COVID-19
reported to ICNARC up to 4pm on 23 July 2020 from critical care units participating in the
Case Mix Programme (the national clinical audit covering all NHS adult, general intensive
care and combined intensive care/high dependency units in England, Wales and Northern
Ireland, plus some additional specialist and non-NHS critical care units). Please note that
adult critical care units in Scotland, paediatric intensive care units and neonatal intensive
care units do not participate in the Case Mix Programme."

Evidence Summaries
CEBM: Severe mental illness and risks from COVID-19 (05 August 2020)

• People with severe mental illness (SMI) are a vulnerable population. In the context of
COVID-19, there is reason to suspect they may be at increased risk of contracting SARS-
CoV-2 and have worse outcomes following infection, however we found no existing data
that quantified these risks.
• Public health measures associated with COVID-19, including quarantine of suspected
cases and lockdowns may negatively affect the mental health status of people with SMI,
through change of environment, disruption of services, increased stress and isolation.
• Existing research points to greater psychological distress during the pandemic for people
with SMI, rather than demonstrating this distress is due to the pandemic.

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Selected Literature: Peer-Reviewed Journals
Date given is the date published or posted online; often these papers are ahead of print.

07 August 2020
MMWR: COVID-19–Associated Multisystem Inflammatory Syndrome in Children — United
States, March–July 2020
"Multisystem inflammatory syndrome in children (MIS-C) is a rare but severe condition that
has been reported approximately 2–4 weeks after the onset of COVID-19 in children and
adolescents.
Most cases of MIS-C have features of shock, with cardiac involvement, gastrointestinal
symptoms, and significantly elevated markers of inflammation, with positive laboratory test
results for SARS-CoV-2. Of the 565 patients who underwent SARS-CoV-2 testing, all had a
positive test result by RT-PCR or serology.
Distinguishing MIS-C from other severe infectious or inflammatory conditions poses a
challenge to clinicians caring for children and adolescents. As the COVID-19 pandemic
continues to expand in many jurisdictions, health care provider awareness of MIS-C will
facilitate early recognition, early diagnosis, and prompt treatment."
MMWR: Hospitalization Rates and Characteristics of Children Aged <18 Years Hospitalized with
Laboratory-Confirmed COVID-19 — COVID-NET, 14 States, March 1–July 25, 2020
"Analysis of pediatric COVID-19 hospitalization data from 14 states found that although the
cumulative rate of COVID-19–associated hospitalization among children (8.0 per 100,000
population) is low compared with that in adults (164.5), one in three hospitalized children
was admitted to an intensive care unit.
Children are at risk for severe COVID-19. Public health authorities and clinicians should
continue to track pediatric SARS-CoV-2 infections. Reinforcement of prevention efforts is
essential in congregate settings that serve children, including childcare centers and
schools."
MMWR: Characteristics and Outcomes of Contacts of COVID-19 Patients Monitored Using an
Automated Symptom Monitoring Tool — Maine, May–June 2020
"Maine found that using automated symptom monitoring as a part of the state's contact
tracing program was well received, with the majority of monitored contacts (96.4%)
agreeing to automated symptom monitoring. Automated symptom monitoring promptly
identified COVID-19 diagnoses among monitored contacts. Among 1,622 persons enrolled
into an automated symptom monitoring system, 190 (11.7%) developed COVID-19.

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 Prompt case investigation can rapidly identify contacts and recommend quarantine,
reducing additional exposures and transmission. Automated tools, available in multiple
languages and formats, might improve contact tracing programs and reduce resource
needs, including staffing."
06 August 2020
JAMA: Prevalence of SARS-CoV-2 Antibodies in Health Care Personnel in the New York City Area
"A 13.7% prevalence of SARS-CoV-2 antibodies in this large cohort study of HCP [health care
personnel] in the greater NYC area was similar to that among adults randomly tested in
New York State (14.0%) but higher than among adults in Los Angeles (4.1%). HCP in a single
hospital in Belgium had lower seroprevalence (6.4%), which was significantly associated
only with household contact. In this study, high levels of HCP-reported suspicion of virus
exposure and prior positive PCR testing results were most strongly associated with
seropositivity."
JAMA Intern Med: Clinical Course and Molecular Viral Shedding Among Asymptomatic and
Symptomatic Patients With SARS-CoV-2 Infection in a Community Treatment Center in the
Republic of Korea
"Question: Are there viral load differences between asymptomatic and symptomatic
patients with severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2) infection?
Findings: In this cohort study that included 303 patients with SARS-CoV-2 infection isolated
in a community treatment center in the Republic of Korea, 110 (36.3%) were asymptomatic
at the time of isolation and 21 of these (19.1%) developed symptoms during isolation. The
cycle threshold values of reverse transcription–polymerase chain reaction for SARS-CoV-2 in
asymptomatic patients were similar to those in symptomatic patients.
Meaning: Many individuals with SARS-CoV-2 infection remained asymptomatic for a
prolonged period, and viral load was similar to that in symptomatic patients; therefore,
isolation of infected persons should be performed regardless of symptoms."
NEJM: Preventing a Parallel Pandemic — A National Strategy to Protect Clinicians' Well-Being
"We are calling for several immediate actions to lay the groundwork for a clear and
accountable national strategy to safeguard the health and well-being of our clinician
workforce…
FIVE HIGH-PRIORITY ACTIONS TO PROTECT CLINICIANS' WELL-BEING DURING AND AFTER
THE COVID-19 CRISIS
Organizational Level

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 • Integrate the work of chief wellness officers or clinician well-being programs into Covid-
19 "command centers" or other organizational decision-making bodies for the duration
of the crisis.
• Ensure the psychological safety of clinicians through anonymous reporting mechanisms
that allow them to advocate for themselves and their patients without fear of reprisal.
• Sustain and supplement existing well-being programs.
National Level

• Allocate federal funding to care for clinicians who experience physical and mental health
effects of Covid-19 service.
• Allocate federal funding to set up a national epidemiologic tracking program to measure
clinician well-being and report on the outcomes of interventions.
…We have a brief window of opportunity to get ahead of two pandemics, the spread of the
virus today and the harm to clinician well-being tomorrow. If we fail, we will pay the price
for years to come. In the race to respond to the Covid-19 crisis, we must not neglect to care
for those who care for us."
05 August 2020
JAMA: Attacks on Public Health Officials During COVID-19
Commentary: "Amid a global pandemic that has already claimed more than 150 000 lives in
the US, the nation needs strong public health leadership more than ever. Harassment of
public health officials must stop; instead, all efforts and attacks should be directed against
the virus. Success will require overcoming the inaction and division that have allowed it to
spread."
MMWR: Serious Adverse Health Events, Including Death, Associated with Ingesting Alcohol-
Based Hand Sanitizers Containing Methanol — Arizona and New Mexico, May–June 2020
"Alcohol-based hand sanitizers should only contain ethanol or isopropanol, but some
products imported into the United States have been found to contain methanol.
From May 1 through June 30, 2020, 15 cases of methanol poisoning were reported in
Arizona and New Mexico, associated with swallowing alcohol-based hand sanitizers. Four
patients died, and three were discharged with visual impairment.
Alcohol-based hand sanitizer products should never be ingested. In patients with
compatible signs and symptoms or after having swallowed hand sanitizer, prompt
evaluation for methanol poisoning is required. Health departments in all states should
coordinate with poison centers to identify cases of methanol poisoning."
Related: FDA updates on hand sanitizers consumers should not use

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Pediatrics: Racial/Ethnic and Socioeconomic Disparities of SARS-CoV-2 Infection Among
Children
"Results: Of 1000 children tested for SARS-CoV-2 infection, 20.7% tested positive. In
comparison to non-Hispanic (NH)-whites (7.3%), minority children had higher rates of
infection (NH-black: (30.0%; adjusted OR 2.3 [95% CI 1.2, 4.4]; Hispanic: 46.4%; adjusted OR
6.3 [95% CI 3.3, 11.9]). In comparison to children in the highest MFI quartile (8.7%),
infection rates were higher among children in quartile 3 (23.7%; adjusted OR 2.6 [95% CI
1.4, 4.9]; quartile 2 (27.1%; adjusted OR 2.3 [95% CI 1.2, 4.3], and quartile 1 (37.7%;
adjusted OR 2.4 [95% CI 1.3, 4.6]). Rates of reported exposure to SARS-CoV-2 also differed
by race/ethnicity and socioeconomic status.
Conclusions: In this large cohort of children tested for SARS-CoV-2 through a community-
based testing site, racial/ethnic minorities and socioeconomically disadvantaged children
carry the highest burden of infection. Understanding and addressing the causes of these
differences are needed to mitigate disparities and limit the spread of infection."
04 August 2020
Ann Intern Med: Annals Graphic Medicine - Dr. Mom: Work–Life Balance

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JAMA Netw Open: Prevalence of Health Care Worker Burnout During the Coronavirus Disease
2019 (COVID-19) Pandemic in Japan
"In this study, we found that more than 40% of nurses and more than 30% of radiological
technologists and pharmacists met the criteria for burnout. To our knowledge, this was the
first report on burnout comparing job categories and associated risk factors among HCWs
[healthcare workers] in Japan during a pandemic. The explanation for the higher prevalence
of burnout among nonphysicians could be that these job categories have lower dimensions
of control (skill discretion and decision authority) compared with physicians. Also, the desire
for expectations of appreciation or respect, 1 of the social supports (ie, from supervisor,
coworker, and others), may be an important variable in studies exploring the association
between job characteristics and burnout. It is essential that team leaders and peers
appreciate members' dedicated work through positive messages of gratitude and support."
Lancet Psychiatry: Disaster psychiatry and homelessness: creating a mental health COVID-19
response
"In April, 2020, we created and implemented a mental health disaster response at the
Boston Hope Field Hospital (Boston, MA, USA)—a 1000-bed facility for patients testing
positive for COVID-19. Of the available beds, 500 were set aside for homeless patients. The
paucity of published work on how to address mental health challenges and support the
homeless population during disasters created the need to design a new system of care in an
evidence-free area of health-care delivery. Our goal was to develop a mental health disaster
response that treated psychiatric exacerbations, created a therapeutic social environment
with regular groups and daily activities, and prevented undesirable outcomes such as
overdoses and suicide attempts. In designing this response, we sought to apply the
principles of psychological first aid (PFA), the standard-of-care framework for disaster
psychiatry, to our homeless population."
03 August 2020
JAMA Intern Med: Trends in Emergency Department Visits and Hospital Admissions in Health
Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US
"Question: How did emergency department visits and hospitalizations change as the
coronavirus disease 2019 (COVID-19) pandemic intensified in the US?
Findings: In this cross-sectional study of 24 emergency departments in 5 health care
systems in Colorado, Connecticut, Massachusetts, New York, and North Carolina, decreases
in emergency department visits ranged from 41.5% in Colorado to 63.5% in New York, with
the most rapid rates of decrease in visits occurring in early March 2020. Rates of hospital
admissions from the ED were stable until new COVID-19 case rates began to increase
locally, at which point relative increases in hospital admission rates ranged from 22.0% to
149.0%.

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 Meaning: The findings suggest that clinicians and public health officials should emphasize to
patients the importance of continuing to visit the emergency department for serious
symptoms, illnesses, and injuries that cannot be managed in other clinical settings."
JAMA Ophthalmol: Detection of Coronavirus Disease 2019 Viral Material on Environmental
Surfaces of an Ophthalmology Examination Room
"Question: Do ophthalmologists run the risk of encountering individuals who are
asymptomatically carrying severe acute respiratory syndrome coronavirus 2 (SARS-CoV-2)
when maintaining elective examinations during the coronavirus disease 2019 pandemic?
Finding: In this quality improvement study of samples from 1 examination room, slitlamp
breath shield and phoropter surface samples were analyzed by real-time polymerase chain
reaction. In 2 of 7 postexamination samples, SARS-CoV-2 viral material was found.
Meaning: Despite triage systems to exclude patients with coronavirus disease 2019, viral
material was found on ophthalmology examination room surfaces; however, the infectivity
of the virus samples was unknown."
Lancet Child Adolesc Health: Transmission of SARS-CoV-2 in Australian educational settings: a
prospective cohort study
"We examined SARS-CoV-2 transmission among children and adults in 25 educational
settings (primary and secondary schools, and early childhood education and care settings)
together with the rate and characteristics of all paediatric COVID-19 cases in the Australian
state of New South Wales over a 3-month period. We found a low incidence of attendance
of children and staff members with COVID-19 at educational facilities, and low rates of
SARS-CoV-2 transmission in the 15 schools and childcare settings where a case occurred.
The exception was an outbreak in a childcare centre. The use of enhanced surveillance and
serological testing of close contacts within the educational setting enabled detection of a
small number of asymptomatic SARS-CoV-2 secondary infections in schools and the
childcare setting.
This is the first comprehensive population-based assessment of SARS-CoV-2 transmission
among children and adults in educational facilities. Our results show that where effective
case-contact testing and epidemic control strategies exist for the population, children and
teachers did not contribute significantly to COVID-19 transmission via attendance in
educational settings. This study will assist modellers, policy makers, health-care providers,
and the public to understand the risk of COVID-19 occurring in educational facilities and
help in decision making around school closures and reopenings. Our data also provide
insights that can assist in comparing the economic and community costs of school closures
against the potential benefits of reduced virus transmission."

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01 August 2020
Lett Spatial Res Sci: The spatial econometrics of the coronavirus pandemic
"In this paper we use spatial econometric specifications to model daily infection rates of
COVID-19 across countries. Using recent advances in Bayesian spatial econometric
techniques, we particularly focus on the time-dependent importance of alternative spatial
linkage structures such as the number of flight connections, relationships in international
trade, and common borders. The flexible model setup allows to study the intensity and type
of spatial spillover structures over time. Our results show notable spatial spillover
mechanisms in the early stages of the virus with international flight linkages as the main
transmission channel. In later stages, our model shows a sharp drop in the intensity spatial
spillovers due to national travel bans, indicating that travel restrictions led to a reduction of
cross-country spillovers."
Translation: Air travel allows viral spread between countries and continents in a short
period of time and closing cross-border air traffic can slow down that process.
31 July 2020
Lancet Public Health: Risk of COVID-19 among front-line health-care workers and the general
community: a prospective cohort study
"We did a prospective observational study of 2 135 190 individuals, comprised of front-line
health-care workers and the general community who were voluntary users of the COVID
Symptom Study smartphone application (app). From self-reported data obtained via this
app, we found that front-line health-care workers had at least a threefold increased risk of
COVID-19. Compared with front-line health-care workers who reported adequate
availability of PPE, those with inadequate PPE had an increase in risk. However, adequate
availability of PPE did not seem to completely reduce risk among health-care workers caring
for patients with COVID-19. We also found that Black, Asian, and minority ethnic health-
care workers might be disproportionately affected.
Front-line health-care workers, particularly those who are from Black, Asian, and minority
ethnic backgrounds, could be at substantially greater risk of COVID-19. Health-care systems
should ensure adequate availability of PPE and develop additional strategies to protect
health-care workers from COVID-19."
This was previously posted 25 May 2020 as a preprint on medRxiv; see:
https://www.medrxiv.org/content/10.1101/2020.04.29.20084111v6
MMWR: SARS-CoV-2 Transmission and Infection Among Attendees of an Overnight Camp —
Georgia, June 2020
"These findings demonstrate that SARS-CoV-2 spread efficiently in a youth-centric overnight
setting, resulting in high attack rates among persons in all age groups, despite efforts by
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 camp officials to implement most recommended strategies to prevent transmission.
Asymptomatic infection was common and potentially contributed to undetected
transmission, as has been previously reported. This investigation adds to the body of
evidence demonstrating that children of all ages are susceptible to SARS-CoV-2 infection
and, contrary to early reports, might play an important role in transmission."
30 July 2020
JAMA: COVID-19 and Dexamethasone: A Potential Strategy to Avoid Steroid-Related
Strongyloides Hyperinfection
"In patients at risk of strongyloidiasis who receive dexamethasone without being tested or
treated for Strongyloides, clinicians should include Strongyloides hyperinfection syndrome
on the differential diagnosis for patients who experience acute clinical decompensation,
especially if gram-negative rod bacteremia or central nervous system infection is detected.
Strongyloides hyperinfection syndrome is potentially catastrophic to patients. It is possible
that as dexamethasone becomes more widely prescribed for individuals with COVID-19, a
substantial number of patients may be at risk. This iatrogenic potentially fatal complication
is avoidable. Clinicians and health care systems should consider implementing a strategy to
prevent hyperinfection syndrome in patients with COVID-19 who are at risk for
strongyloidiasis and are candidates for dexamethasone therapy."
JAMA Otolaryngol Head Neck Surg: Risk of SARS-CoV-2 Transmission During Flexible
Laryngoscopy: A Systematic Review
"Question: What is the evidence for minimizing the use of flexible laryngoscopy during the
coronavirus disease 2019 pandemic?
Findings: This systematic review found a paucity of data regarding the risks of severe acute
respiratory syndrome coronavirus 2 aerosolization and transmission during endoscopic
procedures of the aerodigestive tract. Aggregate data suggested a decreased risk in
endoscopic procedures compared with other aerosol-generating procedures such as
intubation; use of proper personal protective equipment also diminished the risk for
nosocomial transmission during upper airway procedures.
Meaning: Although more clinical and basic science research is needed to formalize
conclusions, flexible laryngoscopy can likely be performed safely during the coronavirus
disease 2019 pandemic with appropriate precautionary measures."
JAMA Pediatr: Age-Related Differences in Nasopharyngeal Severe Acute Respiratory Syndrome
Coronavirus 2 (SARS-CoV-2) Levels in Patients With Mild to Moderate Coronavirus Disease 2019
(COVID-19)
"Our analyses suggest children younger than 5 years with mild to moderate COVID-19 have
high amounts of SARS-CoV-2 viral RNA in their nasopharynx compared with older children
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 and adults. Our study is limited to detection of viral nucleic acid, rather than infectious
virus, although SARS-CoV-2 pediatric studies reported a correlation between higher nucleic
acid levels and the ability to culture infectious virus. Thus, young children can potentially be
important drivers of SARS-CoV-2 spread in the general population, as has been
demonstrated with respiratory syncytial virus, where children with high viral loads are more
likely to transmit. Behavioral habits of young children and close quarters in school and day
care settings raise concern for SARS-CoV-2 amplification in this population as public health
restrictions are eased. In addition to public health implications, this population will be
important for targeting immunization efforts as SARS-CoV-2 vaccines become available."
29 July 2020
Ann Intern Med: Body Mass Index and Risk for Intubation or Death in SARS-CoV-2 Infection: A
Retrospective Cohort Study
"Setting: A quaternary academic medical center and community hospital in New York City.
Participants: 2466 adults hospitalized with laboratory-confirmed severe acute respiratory
syndrome coronavirus 2 infection over a 45-day period with at least 47 days of in-hospital
observation.
Measurements: Body mass index (BMI), admission biomarkers of inflammation (C-reactive
protein [CRP] level and erythrocyte sedimentation rate [ESR]), cardiac injury (troponin
level), and fibrinolysis (D-dimer level). The primary end point was a composite of intubation
or death in time-to-event analysis.
Results: Over a median hospital length of stay of 7 days (interquartile range, 3 to 14) days,
533 patients (22%) were intubated, 627 (25%) died, and 59 (2%) remained hospitalized.
Compared with overweight patients, patients with obesity had higher risk for intubation or
death, with the highest risk among those with class 3 obesity (hazard ratio, 1.6 [95% CI, 1.1
to 2.1]). This association was primarily observed among patients younger than 65 years and
not in older patients (P for interaction by age = 0.042). Body mass index was not associated
with admission levels of biomarkers of inflammation, cardiac injury, or fibrinolysis….
Conclusion: Obesity is associated with increased risk for intubation or death from COVID-19
in adults younger than 65 years, but not in adults aged 65 years or older."
Endocrinology: COVID-19 and Hypercoagulability: Potential Impact on Management with Oral
Contraceptives, Estrogen Therapy and Pregnancy
"As this Commentary is being submitted, no reports of increased incidence of VTEs [venous
thromboembolic events] in pregnant women or women taking estrogen preparations who
also have COVID-19 have emerged. However, a preliminary report indicates that vascular
abnormalities in the placenta can accompany SARS-CoV-2 infection. Many uncertainties
remain regarding the effects of both SARS-CoV-2 and estrogen on coagulation. The

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 emergence of this pandemic and the curious impact of this virus on hypercoagulability
emphasize the continuing need for additional research into coagulation pathology in
women."
27 July 2020
Ann Intern Med: Desperate Times: Protecting the Public From Research Without Consent or
Oversight During Public Health Emergencies
"COVID-19 is an international public health emergency. However, we should not invoke the
Common Rule's public health surveillance exclusion, under questionable pretenses, when
there is clearly also a research intent, whether extant or downstream. Storage of data and
biological specimens for future research should occur with informed consent. Activities that
are truly research should be regulated as such, and public health surveillance should be
done with consent if possible. We must execute good governance of the public health
surveillance and emergency response infrastructure to maintain the public trust and avoid
repeating research abuses of the past."

ICYMI (In Case You Missed It)

Pediatrics: Novel Coronavirus Infection in Febrile Infants Aged 60 Days and Younger (published
online 11 June 2020; in August print journal)
"In this case series, we describe the clinical course and outcomes of 7 febrile infants aged
≤60 days with confirmed severe acute respiratory syndrome coronavirus 2 infection. No
infant had severe outcomes, including the need for mechanical ventilation or ICU level of
care. Two infants had concurrent urinary tract infections, which were treated with
antibiotics. Although a small sample, our data suggest that febrile infants with severe acute
respiratory syndrome coronavirus 2 infection often have mild illness."

Selected Literature: Preprints

Preprints are found on preprint servers; arXiv, bioRxiv, and medRxiv are commonly used for
biomedical research. Per medRxiv:
"Preprints are preliminary reports of work that have not been certified by peer review. They
should not be relied on to guide clinical practice or health-related behavior and should not be
reported in news media as established information."
Preprints may later be published in peer-reviewed journals.

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medRxiv: Covid-19 Risk Among Airline Passengers: Should the Middle Seat Stay Empty? (posted
02 August 2020)
"We use recent data and research results to approximate the probability that an air traveler
in coach will contract Covid-19 on a US domestic flight two hours long, both when all coach
seats are full and when all but middle seats are full. The point estimates we reach based on
data from late June 2020 are 1 in 4,300 for full flights and 1 in 7,700 when middle seats are
kept empty. These estimates are subject to both quantifiable and nonquantifiable sources
of uncertainty, and sustain known margins of error of a factor about 2.5. However, because
uncertainties in key parameters affect both risk estimates the same way, they leave the
relative risk ratio for fill all seats compared to middle seat open close to 1.8 (i.e., close to
1/4,300)/(1/7,700). We estimate the mortality risks caused by Covid-19 infections
contracted on airplanes, taking into account that infected passengers can in turn infect
others. The point estimates, which use 2019 data about the percentage of seats actually
occupied on US flights, range from one death per 400,000 passengers to one death per
600,000. These death-risk levels are considerably higher than those associated with plane
crashes but comparable to those arising from two hours of everyday activities during the
pandemic."
medRxiv: Evidence favouring the efficacy of convalescent plasma for COVID-19 therapy (posted
30 July 2020)
"To determine the effect of COVID-19 convalescent plasma on mortality, we aggregated
patient outcome data from randomized clinical trials, matched control, and case-series
studies. Fixed-effects analyses demontrated that hospitalized COVID-19 patients transfused
with convalescent plasma exhibited a ã57% reduction in mortality rate (13%) compared to
matched-patients receiving standard treatments (25%; OR: 0.43, P < 0.001). These data
provide evidence favouring the efficacy of human convalescent plasma as a therapeutic
agent in hospitalized COVID-19 patients."
medRxiv: SARS-CoV-2, SARS-CoV-1 and MERS-CoV viral load dynamics, duration of viral
shedding and infectiousness: a living systematic review and meta-analysis (posted 29 July 2020)
"Background: Viral load kinetics and the duration of viral shedding are important
determinants for disease transmission. We aim i) to characterise viral load dynamics,
duration of viral RNA, and viable virus shedding of SARS-CoV-2 in various body fluids and ii)
to compare SARS-CoV-2 viral dynamics with SARS-CoV-1 and MERS-CoV.
Methods: Medline, EMBASE, Europe PMC, preprint servers and grey literature were
searched to retrieve all articles reporting viral dynamics and duration of SARS-CoV-2, SARS-
CoV-1 and MERS-CoV shedding. We excluded case reports and case series with < 5 patients,
or studies that did not report shedding duration from symptom onset. PROSPERO
registration: CRD42020181914.

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 Findings: Seventy-nine studies on SARS-CoV-2, 8 on SARS-CoV-1, and 11 on MERS-CoV were
included. Mean SARS-CoV-2 RNA shedding duration in upper respiratory tract, lower
respiratory tract, stool and serum were 17.0, 14.6, 17.2 and 16.6 days, respectively.
Maximum duration of SARS-CoV-2 RNA shedding reported in URT, LRT, stool and serum was
83, 59, 35 and 60 days, respectively. Pooled mean duration of SARS-CoV-2 RNA shedding
was positively associated with age (p=0.002), but not gender (p = 0.277). No study to date
has detected live virus beyond day nine of illness despite persistently high viral loads. SARS-
CoV-2 viral load in the upper respiratory tract appears to peak in the first week of illness,
while SARS-CoV-1 and MERS-CoV peak later.
Conclusion: Although SARS-CoV-2 RNA shedding in respiratory and stool can be prolonged,
duration of viable virus is relatively short-lived. Thus, detection of viral RNA cannot be used
to infer infectiousness. High SARS-CoV-2 titres are detectable in the first week of illness with
an early peak observed at symptom onset to day 5 of illness. This review underscores the
importance of early case finding and isolation, as well as public education on the spectrum
of illness. However, given potential delays in the isolation of patients, effective containment
of SARS-CoV-2 may be challenging even with an early detection and isolation strategy."
medRxiv: Clinical Outcomes With the Use of Prophylactic Versus Therapeutic Anticoagulation in
COVID-19 (posted 26 July 2020)
"Background: This study is the first of its kind to assess the impact of preemptive
therapeutic dose anticoagulation on mortality compared to prophylactic anticoagulation
among COVID-19 patients. Its findings provide insight to clinicians regarding the
management of COVID-19, particularly with the known prothrombotic state.
Research Question: To determine the impact of anticoagulation on in-hospital mortality
among COVID-19 positive patients with the a priori hypothesis that there would be a lower
risk of in-hospital mortality with use of preemptive therapeutic over prophylactic dose
enoxaparin or heparin.
Study Design: Retrospective cohort study from April 1 - April 25, 2020. The date of final
follow-up was June 12, 2020.
Setting: Two large, acute care hospitals in Western Connecticut.
Participants: Five hundred and one inpatients were identified after discharge as 18 years or
older and positive for SARS-CoV-2. The final sample size included 374 patients after applying
exclusion criteria. Demographic variables were collected via hospital billing inquiries, while
the clinical variables were abstracted from patients medical records.
Exposure: Preemptive enoxaparin or heparin at a therapeutic or prophylactic dose. Main
Outcome: In-hospital mortality.

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 Results: When comparing preemptive therapeutic to prophylactic anticoagulation through
multi-variable analysis, risk of in-hospital mortality was 2.3 times greater in patients
receiving preemptive therapeutic anticoagulation (95% CI = 1.0, 4.9; p = 0.04).
Interpretation: An increase in in-hospital mortality was observed with preemptive
therapeutic anticoagulation. Thus, in the management of COVID-19 and its complications,
we recommend further research and cautious use of preemptive therapeutic over
prophylactic anticoagulation."

Events (Webinars, Calls, etc.)

JAMA: Coronavirus Q&A with Anthony Fauci: https://youtu.be/8PgmAWgiL1A
"Anthony Fauci, MD, White House Coronavirus Task Force member and Director of the
National Institutes of Allergy and Infectious Diseases, discusses latest developments in the
COVID-19 pandemic. Recorded August 3, 2020.
Earn Free CME credits by watching JAMA Livestreams and completing a brief questionnaire.
Claim 0.5 credits for each video at https://ja.ma/covidqa.
Topics discussed in this interview:
0:00 Introduction
0:17 What should we expect in the next month?
3:11 Masking etiquette
5:54 Face shields and goggles for COVID-19
7:08 Recent data about children and COVID-19
10:28 Aerosolization, droplets, and recirculated air
13:51 Vaccine approval and transparency
16:32 Early vaccine trial data and press releases
17:35 Vaccine-associated enhanced respiratory disease
19:55 COVID-19 treatments and therapies
22:45 COVID-19, influenza, and the Fall
25:08 Successes (so far) in this pandemic
27:23 What could we have done better as a nation?
28:46 Baseball"

WHAT: FDA: Virtual Town Hall Series - Immediately in Effect Guidance on Coronavirus
(COVID-19) Diagnostic Tests
WHEN: Wednesday, 12 August 2020 1215-1315 ET

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TOPIC: "The U.S. Food and Drug Administration (FDA) will host a virtual Town Hall for
clinical laboratories and commercial manufacturers that are developing or have
developed diagnostic tests for SARS-CoV-2. The purpose of this Town Hall is to
help answer technical questions about the development and validation of tests
for SARS-CoV-2."
DETAILS: https://www.fda.gov/medical-devices/workshops-conferences-medical-
devices/virtual-town-hall-series-immediately-effect-guidance-coronavirus-covid-
19-diagnostic-tests-08122020

News in Brief
Virginia has a smartphone app (called Covidwise) that will send notifications if you were
potentially exposed to coronavirus; it is the first state to use the contact tracing technology
developed by Apple and Google (CNBC).
What have we learned about this pandemic so far? According to this opinion article, nine
important things: 1) outbreaks can happen anywhere; 2) COVID-19 can sicken and kill anyone;
3) the main danger isn't contaminated surfaces; 4) the virus is in the air; 5) many asymptomatic
cases; 6) it's not just seasonal; 7) masks work; 8) racism, not race, is a factor; and 9)
misinformation kills (SciAm).
How Others Are Handling the Outbreak
New York City is setting up quarantine checkpoints at key entry points for travelers from
outbreak hotspots (NPR).
To head off a potential second wave, Germany is testing anyone entering coming from a 'hot
zone' (NYT).
Melbourne, Australia is dealing with a second wave of infections, and this time lockdown means
more restrictions to curb infections (NYT).
In Norway, at least 40 passengers on a Norwegian cruise ship have tested positive for the
coronavirus (BBC).
A data leak and investigation suggests the number of deaths from coronavirus in Iran is nearly
three times Iranian government reports (BBC).
Sweden flattened its curve without a lockdown; a 'good enough' strategy may work, but the
effects may not last (Medpage).
The WHO offers some advice and public health considerations with traveling internationally
(WHO).

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Transmission, Testing, and Tracing
A computer model based on the Diamond Princess outbreak found that coronavirus spread in
microscopic, aerosolized droplets (NYT).
As coronavirus cases surge, the number of people trained to do contact tracing has not kept up
with needs (NPR).
Long read: "The mystery of why some people keep testing positive for COVID-19" (Elemental).
Research and Data
The NIH has started a randomized control trial testing remdesivir plus interferon beta-1a for
COVID-19; this is the third iteration of NIAID's Adaptive COVID-19 Treatment Trial (ACTT) (NIH).
Clinical trials need more minorities enrolling – maybe they should be asked to participate more
(Medpage).
Long read: "How many people in the U.S. are hospitalized with COVID-19? Who knows?"
(ProPublica)
Long read: "Nobody accurately tracks health care workers lost to COVID-19. So she stays up at
night cataloging the dead." (ProPublica)
Vaccines
From adenovirus vectors to mRNA vaccines, here's what we know about COVID-19 vaccines
(Medpage).
A COVID-19 vaccine is needed, but it won't change things right away (WaPo).
The US government will pay Johnson & Johnson over $1 billion for 100 million doses of its
potential COVID-19 vaccine (Reuters).
The Bill and Melinda Gates Foundation is partnering with the Serum Institute of India to
produce a $3 per dose coronavirus vaccine (FC).
A group of biohackers in Boston – including a Harvard geneticist – are testing a homemade
SARS-CoV-2 vaccine on themselves (MIT).
Ripple Effects
"The American food system is not broken -- it is functioning as designed, a system optimized for
efficiency, not one optimized for resilience and nutrition. But our food system is killing us, and
that happened long before COVID-19. It is bound to continue unless we take steps now to
leverage food as medicine." (CNN)
The long-term effects of COVID-19 range from 'brain fog' to chronic pain to cardiac problems,
and scientists aren't sure why (Science).

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Telehealth may be a key feature of healthcare during the pandemic, but reliance on it as a tool
could be leaving patients behind – many older or with limited technological options – and
increase health inequities (Medpage).
Graphic medicine: A neurological research nurse shares his COVID-19 experience (Nib).
Long read: "The shadow pandemic: how do we help domestic-violence victims who stay with
their partners?" (Atlantic)
Mis/Disinformation
A survey of Americans found 71% have heard about the conspiracy theory that powerful people
planned the pandemic; 20% of those who are familiar with it say it is probably true, and 5% say
it is definitely true (Pew).
Russia disinformation and pro-Kremlin English-language websites actively push conspiracy
theories and false information about the COVID-19 pandemic, according to a State Department
report (Defense One).
Health (il)literacy is not new, but the pandemic has magnified problems associated with lack of
understanding medical information (WaPo).
Freaking out over news and other pandemic information sources? Disinformation expert Carl
Bergstrom has tips on how to stay calm and make sense of everything (SciAm).
Other Infectious Diseases and Outbreaks
The first case of bacterial meningitis caused by beta-lactamase–producing, ciprofloxacin-
resistant Neisseria meningitidis in the United States has been reported in a 5-month-old boy
(CIDRAP; see J Pediatr Infect Dis Soc for full text).
Two more cases of West Nile virus in humans have been found in Miami (ONT).
The latest Ebola outbreak in the DRC includes 74 cases (70 confirmed) with 32 deaths and 27
recovered (WHOAFRO).
A free-range egg farm in Victoria, Australia has an outbreak of avian influenza H7N7 (ONT).
Red onions are probably to blame for a multistate outbreak of Salmonella Newport infections
(CDC).
Long read: Tuberculosis, HIV, and malaria – infectious monsters are spreading, and the
coronavirus is not necessarily the deadliest or most concerning long term (NYT).
Thanks, Dr. Fauci
"After each long day of working on the United States' pandemic response, the nation's top
infectious-disease expert power-walks through his Northwest Washington neighborhood with

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his wife and their daughter's dog." Now his neighbors are showing their appreciation for his
pandemic work with yard signs (WaPo).
Another interesting bit of "day in the life" of Dr. Fauci: During a presentation to medical
librarians, a McGraw-Hill publisher representative mentioned that Dr. Fauci still spends his
weekends editing chapters for the next edition of Harrison's Principles of Internal Medicine.
More Long Reads
"Two decades of pandemic war games failed to account for Donald Trump" (Nature).
"How the pandemic defeated America" (Atlantic).
"How the pandemic might play out in 2021 and beyond" (Nature).

References
Statistics
JHU CSSE: Johns Hopkins Center for Systems Science and Engineering. Coronavirus COVID-19
Global Cases. Link: https://coronavirus.jhu.edu/map.html
VA DOH: Virginia Department of Health. COVID-19 in Virginia. Link:
http://www.vdh.virginia.gov/coronavirus/

Special Reports
ICNARC: Intensive Care National Audit & Research Centre. COVID-19 Report (24 July 2020). Link:
https://www.icnarc.org/Our-Audit/Audits/Cmp/Reports Link to full report [pdf]:
https://www.icnarc.org/DataServices/Attachments/Download/42ceb4d2-3dd3-ea11-9128-
00505601089b
WHO: World Health Organization. COVID-19 Preparedness and Response Progress Report - 1
February to 30 June 2020 (03 August 2020). Link:
https://www.who.int/publications/m/item/who-covid-19-preparedness-and-response-
progress-report---1-february-to-30-june-2020

Evidence Summaries
CEBM: University of Oxford, Centre for Evidence-Based Medicine. Barber S, Reed L, Syam N,
Jones N. Severe mental illness and risks from COVID-19 (05 August 2020). Link:
https://www.cebm.net/covid-19/severe-mental-illness-and-risks-from-covid-19/

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Selected Literature: Peer-Reviewed Journals
Ann Intern Med: Anderson MR, Geleris J, Anderson DR, Zucker J, Nobel YR, Freedberg D, Small-
Saunders J, Rajagopalan KN, Greendyk R, Chae SR, Natarajan K, Roh D, Edwin E, Gallagher D,
Podolanczuk A, Barr RG, Ferrante AW, Baldwin MR. Body Mass Index and Risk for Intubation or
Death in SARS-CoV-2 Infection: A Retrospective Cohort Study. Ann Intern Med. 2020 Jul
29:M20-3214. doi: 10.7326/M20-3214. Epub ahead of print. PMID: 32726151; PMCID:
PMC7397550. Link: https://www.acpjournals.org/doi/10.7326/M20-3214
Ann Intern Med: Beach MC, Lederman HM, Singleton M, Brower RG, Carrese J, Ford DE, Hansoti
B, Hendrix CW, Jorgensen EV, Moore RD, Rocca P, Zenilman JM. Desperate Times: Protecting
the Public From Research Without Consent or Oversight During Public Health Emergencies. Ann
Intern Med. 2020 Jul 27:M20-4631. doi: 10.7326/M20-4631. Epub ahead of print. PMID:
32718176; PMCID: PMC7401979. Link: https://www.acpjournals.org/doi/10.7326/M20-4631
Ann Intern Med: Farris GE. Web Exclusive. Annals Graphic Medicine - Dr. Mom: Work-Life
Balance. Ann Intern Med. 2020 Aug 4;173(3):W52-W54. doi: 10.7326/G20-0071. PMID:
32745454. Link: https://www.acpjournals.org/doi/10.7326/G20-0071
Endocrinology: Spratt DI, Buchsbaum RJ. COVID-19 and Hypercoagulability: Potential Impact on
Management with Oral Contraceptives, Estrogen Therapy and Pregnancy. Endocrinology. 2020
Jul 29:bqaa121. doi: 10.1210/endocr/bqaa121. Epub ahead of print. PMID: 32725207. Link:
https://academic.oup.com/endo/advance-article/doi/10.1210/endocr/bqaa121/5874354
JAMA: Mello MM, Greene JA, Sharfstein JM. Attacks on Public Health Officials During COVID-19.
JAMA. Published online August 5, 2020. doi:10.1001/jama.2020.14423 Link:
https://jamanetwork.com/journals/jama/fullarticle/2769291
JAMA: Moscola J, Sembajwe G, Jarrett M, et al. Prevalence of SARS-CoV-2 Antibodies in Health
Care Personnel in the New York City Area. JAMA. Published online August 6, 2020.
doi:10.1001/jama.2020.14765 Link:
https://jamanetwork.com/journals/jama/fullarticle/2769322
JAMA: Stauffer WM, Alpern JD, Walker PF. COVID-19 and Dexamethasone: A Potential Strategy
to Avoid Steroid-Related Strongyloides Hyperinfection. JAMA. Published online July 30, 2020.
doi:10.1001/jama.2020.13170 Link:
https://jamanetwork.com/journals/jama/fullarticle/2769100
JAMA Intern Med: Lee S, Kim T, Lee E, et al. Clinical Course and Molecular Viral Shedding
Among Asymptomatic and Symptomatic Patients With SARS-CoV-2 Infection in a Community
Treatment Center in the Republic of Korea. JAMA Intern Med. Published online August 6, 2020.
doi:10.1001/jamainternmed.2020.3862 Link:
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2769235

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JAMA Intern Med: Jeffery MM, D'Onofrio G, Paek H, Platts-Mills TF, Soares WE 3rd, Hoppe JA,
Genes N, Nath B, Melnick ER. Trends in Emergency Department Visits and Hospital Admissions
in Health Care Systems in 5 States in the First Months of the COVID-19 Pandemic in the US.
JAMA Intern Med. 2020 Aug 3. doi: 10.1001/jamainternmed.2020.3288. Epub ahead of print.
PMID: 32744612. Link:
https://jamanetwork.com/journals/jamainternalmedicine/fullarticle/2768777
JAMA Netw Open: Matsuo T, Kobayashi D, Taki F, Sakamoto F, Uehara Y, Mori N, Fukui T.
Prevalence of Health Care Worker Burnout During the Coronavirus Disease 2019 (COVID-19)
Pandemic in Japan. JAMA Netw Open. 2020 Aug 3;3(8):e2017271. doi:
10.1001/jamanetworkopen.2020.17271. PMID: 32749466. Link:
https://jamanetwork.com/journals/jamanetworkopen/fullarticle/2768947
JAMA Ophthalmol: Aytogan H, Ayintap E, Yilmaz NO. Detection of Coronavirus Disease 2019
Viral Material on Environmental Surfaces of an Ophthalmology Examination Room. JAMA
Ophthalmol. Published online August 3, 2020. doi:10.1001/jamaophthalmol.2020.3154 Link:
https://jamanetwork.com/journals/jamaophthalmology/fullarticle/2769121
JAMA Otolaryngol Head Neck Surg: Kay JK, Parsel SM, Marsh JJ, McWhorter AJ, Friedlander PL.
Risk of SARS-CoV-2 Transmission During Flexible Laryngoscopy: A Systematic Review. JAMA
Otolaryngol Head Neck Surg. 2020 Jul 30. doi: 10.1001/jamaoto.2020.1973. Epub ahead of
print. PMID: 32745177. Link:
https://jamanetwork.com/journals/jamaotolaryngology/fullarticle/2768863
JAMA Pediatr: Heald-Sargent T, Muller WJ, Zheng X, Rippe J, Patel AB, Kociolek LK. Age-Related
Differences in Nasopharyngeal Severe Acute Respiratory Syndrome Coronavirus 2 (SARS-CoV-2)
Levels in Patients With Mild to Moderate Coronavirus Disease 2019 (COVID-19). JAMA Pediatr.
2020 Jul 30. doi: 10.1001/jamapediatrics.2020.3651. Epub ahead of print. PMID: 32745201.
Link: https://jamanetwork.com/journals/jamapediatrics/fullarticle/2768952
Lancet Child Adolesc Health: Macartney K, Quinn HE, Pillsbury AJ, et al. Transmission of SARS-
CoV-2 in Australian educational settings: a prospective cohort study. Lancet Child Adolesc
Health. Published: August 03, 2020 DOI: https://doi.org/10.1016/S2352-4642(20)30251-0 Link:
https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30251-0/fulltext
Lancet Psychiatry: Dotson S, Ciarocco S, Koh KA. Disaster psychiatry and homelessness: creating
a mental health COVID-19 response. The Lancet Psychiatry. Published: August 04, 2020 DOI:
https://doi.org/10.1016/S2215-0366(20)30343-6 Link:
https://www.thelancet.com/journals/lanpsy/article/PIIS2215-0366(20)30343-6/fulltext
Lancet Public Health: Nguyen LH, Drew DA, Graham MS, Joshi AD, Guo CG, Ma W, Mehta RS,
Warner ET, Sikavi DR, Lo CH, Kwon S, Song M, Mucci LA, Stampfer MJ, Willett WC, Eliassen AH,
Hart JE, Chavarro JE, Rich-Edwards JW, Davies R, Capdevila J, Lee KA, Lochlainn MN, Varsavsky
T, Sudre CH, Cardoso MJ, Wolf J, Spector TD, Ourselin S, Steves CJ, Chan AT; COronavirus

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Pandemic Epidemiology Consortium. Risk of COVID-19 among front-line health-care workers
and the general community: a prospective cohort study. Lancet Public Health. 2020 Jul
30:S2468-2667(20)30164-X. doi: 10.1016/S2468-2667(20)30164-X. Epub ahead of print. PMID:
32745512. Link: https://www.thelancet.com/journals/lanpub/article/PIIS2468-2667(20)30164-
X/fulltext
Lett Spatial Res Sci: Krisztin T, Piribauer P, Wögerer M. The spatial econometrics of the
coronavirus pandemic. Letters in Spatial and Resource Sciences. Published 01 August 2020. DOI:
10.1007/s12076-020-00254-1 Link: https://link.springer.com/article/10.1007%2Fs12076-020-
00254-1
MMWR: Godfred-Cato S, Bryant B, Leung J, et al. COVID-19–Associated Multisystem
Inflammatory Syndrome in Children — United States, March–July 2020. MMWR Morb Mortal
Wkly Rep. ePub: 7 August 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6932e2 Link:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6932e2.htm
MMWR: Kim L, Whitaker M, O’Halloran A, et al. Hospitalization Rates and Characteristics of
Children Aged <18 Years Hospitalized with Laboratory-Confirmed COVID-19 — COVID-NET, 14
States, March 1–July 25, 2020. MMWR Morb Mortal Wkly Rep. ePub: 7 August 2020. DOI:
http://dx.doi.org/10.15585/mmwr.mm6932e3 Link:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6932e3.htm
MMWR: Krueger A, Gunn JK, Watson J, et al. Characteristics and Outcomes of Contacts of
COVID-19 Patients Monitored Using an Automated Symptom Monitoring Tool — Maine, May–
June 2020. MMWR Morb Mortal Wkly Rep 2020;69:1026–1030. DOI:
http://dx.doi.org/10.15585/mmwr.mm6931e2 Link:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e2.htm
MMWR: Szablewski CM, Chang KT, Brown MM, et al. SARS-CoV-2 Transmission and Infection
Among Attendees of an Overnight Camp — Georgia, June 2020. MMWR Morb Mortal Wkly Rep.
ePub: 31 July 2020. DOI: http://dx.doi.org/10.15585/mmwr.mm6931e1 Link:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6931e1.htm
MMWR: Yip L, Bixler D, Brooks DE, et al. Serious Adverse Health Events, Including Death,
Associated with Ingesting Alcohol-Based Hand Sanitizers Containing Methanol — Arizona and
New Mexico, May–June 2020. MMWR Morb Mortal Wkly Rep. ePub: 5 August 2020. DOI:
http://dx.doi.org/10.15585/mmwr.mm6932e1 Link:
https://www.cdc.gov/mmwr/volumes/69/wr/mm6932e1.htm
NEJM: Dzau VJ, Kirch D, Nasca T. Preventing a Parallel Pandemic - A National Strategy to Protect
Clinicians' Well-Being. N Engl J Med. 2020 Aug 6;383(6):513-515. doi: 10.1056/NEJMp2011027.
Epub 2020 May 13. PMID: 32402153. Link:
https://www.nejm.org/doi/full/10.1056/NEJMp2011027

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Pediatrics: Goyal MK, Simpson JN, Boyle MD, Badolato GM, Delaney M, McCarter R, Cora-
Bramble D. Racial/Ethnic and Socioeconomic Disparities of SARS-CoV-2 Infection Among
Children. Pediatrics. 2020 Aug 5:e2020009951. doi: 10.1542/peds.2020-009951. Epub ahead of
print. PMID: 32759379. Link:
https://pediatrics.aappublications.org/content/early/2020/08/03/peds.2020-009951
Pediatrics: McLaren SH, Dayan PS, Fenster DB, Ochs JB, Vindas MT, Bugaighis MN, Gonzalez AE,
Lubell TR. Novel Coronavirus Infection in Febrile Infants Aged 60 Days and Younger. Pediatrics.
2020 Jun 11:e20201550. doi: 10.1542/peds.2020-1550. Epub ahead of print. PMID: 32527752.
Link: https://pediatrics.aappublications.org/content/early/2020/08/04/peds.2020-1550

Selected Literature: Preprints

medRxiv: Barnett A. Covid-19 Risk Among Airline Passengers: Should the Middle Seat Stay
Empty? medRxiv 2020.07.02.20143826; doi: https://doi.org/10.1101/2020.07.02.20143826
Link: https://www.medrxiv.org/content/10.1101/2020.07.02.20143826v3
medRxiv: Cevik M, Tate M, Lloyd O, et al. SARS-CoV-2, SARS-CoV-1 and MERS-CoV viral load
dynamics, duration of viral shedding and infectiousness: a living systematic review and meta-
analysis. medRxiv 2020.07.25.20162107; doi: https://doi.org/10.1101/2020.07.25.20162107
Link: https://www.medrxiv.org/content/10.1101/2020.07.25.20162107v2
medRxiv: Joyner MJ, Klassen SA, Senefeld J, et al. Evidence favouring the efficacy of
convalescent plasma for COVID-19 therapy (posted 30 July 2020). medRxiv
2020.07.29.20162917 https://doi.org/10.1101/2020.07.29.20162917 Link:
https://www.medrxiv.org/content/10.1101/2020.07.29.20162917v1
medRxiv: Motta JK, Ogunnaike RO, Shah R, et al. Clinical Outcomes With the Use of Prophylactic
Versus Therapeutic Anticoagulation in COVID-19 (posted 26 July 2020). medRxiv
2020.07.20.20147769 https://doi.org/10.1101/2020.07.20.20147769 Link:
https://www.medrxiv.org/content/10.1101/2020.07.20.20147769v1

News in Brief
Atlantic: The Atlantic. Helen Lewis. The Shadow Pandemic. (04 August 2020). Link:
https://www.theatlantic.com/international/archive/2020/08/are-refuges-only-solution-
domestic-violence/614392/
Atlantic: The Atlantic. Ed Yong. How the Pandemic Defeated America. (03 August 2020; updated
04 August 2020). Link: https://www.theatlantic.com/magazine/archive/2020/09/coronavirus-
american-failure/614191/

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BBC: BBC News. Dozens test positive for Covid-19 on Norwegian cruise ship (03 August 2020).
Link: https://www.bbc.com/news/world-europe-53636854
BBC: BBC News. Coronavirus: Iran cover-up of deaths revealed by data leak (03 August 2020).
Link: https://www.bbc.com/news/world-middle-east-53598965
CDC: Centers for Disease Control and Prevention. CDC Investigation Update: Multistate
Salmonella Outbreak Continues to Grow; Now Linked to Red Onions (31 July 2020). Link:
https://www.cdc.gov/media/releases/2020/s0731-salmonella-red-onions.html
CIDRAP: CIDRAP News. Chris Dall. First US case of resistant bacterial meningitis noted (06
August 2020). Link: https://www.cidrap.umn.edu/news-perspective/2020/08/first-us-case-
resistant-bacterial-meningitis-noted
CNBC: CNBC. Kif Leswing. Virginia launches the first U.S. app using Apple-Google coronavirus
notification technology (05 August 2020). Link: https://www.cnbc.com/2020/08/05/first-us-
app-using-apple-google-coronavirus-notification-technology.html
CNN: CNN. Akash Goel, Michel Nischan, Bill Frist, and Tom Colicchio. The US food system is
killing Americans (03 August 2020). Link: https://www.cnn.com/2020/08/02/opinions/us-
nutrition-insecurity-snap-goel-nischan-frist-coliccio/index.html
Defense One: Defense One. Patrick Tucker. Russian Disinformation Networks Detailed in New
State Department Report (06 August 2020). Link:
https://www.defenseone.com/technology/2020/08/russian-disinformation-networks-detailed-
new-state-department-report/167537/
Elemental: Elemental. Roxanne Khamsi. The Mystery of Why Some People Keep Testing Positive
for Covid-19 (28 July 2020). Link: https://elemental.medium.com/the-mystery-of-why-some-
people-keep-testing-positive-for-covid-19-3c0c11a6bd10
FC: Fast Company. Adele Peters. The Gates Foundation is helping back a $3 COVID-19 vaccine
(07 August 2020). Link: https://www.fastcompany.com/90537951/the-gates-foundation-is-
helping-back-a-3-covid-19-vaccine
J Pediatr Infect Dis Soc: Taormina G, Campos J, Sweitzer J, Retchless AC, Lunquest K, McNamara
LA, Reese N, Karlsson M, Hanisch B. β-Lactamase-Producing, Ciprofloxacin-Resistant Neisseria
meningitidis Isolated From a 5-Month-Old Boy in the United States. J Pediatric Infect Dis Soc.
2020 Aug 3:piaa085. doi: 10.1093/jpids/piaa085. Epub ahead of print. PMID: 32743638. Link:
https://academic.oup.com/jpids/advance-article-abstract/doi/10.1093/jpids/piaa085/5876038
Medpage: Medpage Today. Kristina Fiore. How Did Sweden Flatten Its Curve Without a
Lockdown? (29 July 2020). Link:
https://www.medpagetoday.com/infectiousdisease/covid19/87812

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Medpage: Medpage Today. Joyce Frieden. Efforts Needed to Get Minorities Into Clinical Trials,
Experts Say (03 August 2020). Link:
https://www.medpagetoday.com/publichealthpolicy/clinicaltrials/87869
Medpage: Medpage Today. Judy George. Telehealth Boom Misses Older Adults (04 August
2020). Link: https://www.medpagetoday.com/practicemanagement/telehealth/87901
Medpage: Medpage Today. Elizabeth Hlavinka. Here's What We Know About COVID-19
Vaccines (06 August 2020). Link:
https://www.medpagetoday.com/infectiousdisease/covid19/87933
MIT: MIT Technology Review. Some scientists are taking a DIY coronavirus vaccine, and nobody
knows if it's legal or if it works (29 July 2020). Link:
https://www.technologyreview.com/2020/07/29/1005720/george-church-diy-coronavirus-
vaccine/
Nature: Nature. Amy Maxmen and Jeff Tollefson. Two decades of pandemic war games failed to
account for Donald Trump (04 August 2030). Link: https://www.nature.com/articles/d41586-
020-02277-6
Nature: Nature. Megan Scudellari. How the pandemic might play out in 2021 and beyond (05
August 2020). Link: https://www.nature.com/articles/d41586-020-02278-5
Nib: The Nib. Daniel Locke. What It's Like to Be a Nurse During COVID-19 (23 July 2020). Link:
https://thenib.com/nurse-interview-covid/
NIH: National Institutes of Health. NIH clinical trial testing remdesivir plus interferon beta-1a for
COVID-19 treatment begins (06 August 2020). Link: https://www.nih.gov/news-events/news-
releases/nih-clinical-trial-testing-remdesivir-plus-interferon-beta-1a-covid-19-treatment-begins
NPR: National Public Radio. Brian Mann. NYC Setting Up Quarantine Checkpoints For Travelers
From COVID-19 Hotspots (05 August 2020). Link: https://www.npr.org/sections/coronavirus-
live-updates/2020/08/05/899337278/nyc-setting-up-quarantine-checkpoints-for-travelers-
from-covid-19-hotspots
NPR: National Public Radio. Selena Simmons-Duffin. Coronavirus Cases Are Surging. The Contact
Tracing Workforce Is Not (07 August 2020). Link: https://www.npr.org/sections/health-
shots/2020/08/07/899954832/coronavirus-cases-are-surging-the-contact-tracing-workforce-is-
not
NYT: New York Times. Benedict Carey and James Glanz. Aboard the Diamond Princess, a Case
Study in Aerosol Transmission (30 July 2020). Link:
https://www.nytimes.com/2020/07/30/health/diamond-princess-coronavirus-aerosol.html

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NYT: New York Times. Damien Cave. What Lockdown 2.0 Looks Like: Harsher Rules, Deeper
Confusion (04 August 2020). Link:
https://www.nytimes.com/2020/08/04/world/australia/coronavirus-melbourne-lockdown.html
NYT: New York Times. Melissa Eddy. Welcome Back to Germany. Now Take Your Free Virus
Test. (05 August 2020). Link: https://www.nytimes.com/2020/08/05/world/europe/germany-
coronavirus-test-travelers.html
NYT: New York Times. Apoorva Mandavilli. 'The Biggest Monster' Is Spreading. And It's Not the
Coronavirus. (online 03 August 2020; updated 05 August 2020). Link:
https://www.nytimes.com/2020/08/03/health/coronavirus-tuberculosis-aids-malaria.html
ONT: Outbreak News Today. Miami: Two additional West Nile virus cases reported (05 August
2020). Link: http://outbreaknewstoday.com/miami-two-additional-west-nile-virus-cases-
reported-88616/
ONT: Outbreak News Today. Australia: Avian influenza H7N7 in Victoria (06 August 2020). Link:
http://outbreaknewstoday.com/australia-avian-influenza-h7n7-in-victoria-67442/
Pew: Pew Research Center. Katherine Schaeffer. A look at the Americans who believe there is
some truth to the conspiracy theory that COVID-19 was planned (24 July 2020). Link:
https://www.pewresearch.org/fact-tank/2020/07/24/a-look-at-the-americans-who-believe-
there-is-some-truth-to-the-conspiracy-theory-that-covid-19-was-planned/
ProPublica: ProPublica. Nina Martin. Nobody Accurately Tracks Health Care Workers Lost to
COVID-19. So She Stays Up At Night Cataloging the Dead. (02 August 2020). Link:
https://www.propublica.org/article/nobody-accurately-tracks-health-care-workers-lost-to-
covid-19-so-she-stays-up-at-night-cataloging-the-dead
ProPublica: ProPublica. Charles Ornstein. How Many People in the U.S. Are Hospitalized With
COVID-19? Who Knows? (31 July 2020). Link: https://www.propublica.org/article/how-many-
people-in-the-us-are-hospitalized-with-covid-19-who-knows
Reuters: Reuters Health News. Michael Erman. U.S. to pay $1 billion for 100 million doses of
Johnson & Johnson's COVID-19 vaccine candidate (05 August 2020). Link:
https://www.reuters.com/article/us-health-coronavirus-usa-johnsonandjohn/u-s-to-pay-1-
billion-for-100-million-doses-of-johnson-johnsons-covid-19-vaccine-candidate-idUSKCN2511VH
SciAm: Scientific American. Lauran Helmuth. Nine Important Things We've Learned about the
Coronavirus Pandemic So Far (04 August 2020). Link:
https://www.scientificamerican.com/article/nine-important-things-weve-learned-about-the-
coronavirus-pandemic-so-far/
SciAm: Scientific American. Scott Hershberger. How to Evaluate COVID-19 News without
Freaking Out (03 August 2020). Link: https://www.scientificamerican.com/article/how-to-
evaluate-covid-19-news-without-freaking-out1/
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Science: Science Magazine. Jennifer Couzin-Frankel. From 'brain fog' to heart damage, COVID-
19's lingering problems alarm scientists (31 July 2020). Link:
https://www.sciencemag.org/news/2020/07/brain-fog-heart-damage-covid-19-s-lingering-
problems-alarm-scientists
WaPo: Washington Post. Eve Glicksman. Health illiteracy is nothing new in America. But the
pandemic magnifies how troubling it is. (02 August 2020). Link:
https://www.washingtonpost.com/health/health-illiteracy-is-nothing-new-in-america-but-the-
pandemic-magnifies-how-troubling-it-is/2020/07/31/091c8a18-d053-11ea-9038-
af089b63ac21_story.html
WaPo: Washington Post. Marisa Iati. As Fauci battles the pandemic and politics, his grateful
neighbors celebrate him as a hero (07 August 2020). Link:
https://www.washingtonpost.com/dc-md-va/2020/08/07/fauci-thank-you-signs/
WaPo: Washington Post. Carolyn Y. Johnson. A coronavirus vaccine won't change the world
right away (02 August 2020). Link:
https://www.washingtonpost.com/health/2020/08/02/covid-vaccine
WHO: World Health Organization. Public health considerations while resuming international
travel (30 July 2020). Link: https://www.who.int/news-room/articles-detail/public-health-
considerations-while-resuming-international-travel
WHOAFRO: World Health Organization African Region. Tweet: #Ebola Outbreak Update (05
August 2020). Link: https://twitter.com/WHOAFRO/status/1290933970197196801?s=20

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