COVID19 ๐Ÿฆ  Newsbites
Should Isolation Periods Be Shorter for People With Covid-19?
Patients are usually most infectious two days before symptoms begin and for five days after, a new analysis finds.

A few patients who are extremely ill or have impaired immune systems may expel — or “shed” — the virus for as long as 20 days, other studies have suggested. Even in mild cases, some patients may shed live virus for about a week, the new analysis found.

The accumulating data presents a quandary: Should public health officials shorten the recommended isolation time if it means more infected people will cooperate? Or should officials opt for longer periods in order to prevent transmission in virtually all cases, even if doing so takes a harsher toll on the economy?

The Centers for Disease Control and Prevention recommends that infected people isolate for a minimum of 10 days from the beginning of their illness. The agency is considering shortening the recommended isolation period and may issue new guidelines as early as next week, according to two federal officials with knowledge of the discussions.

... Setting the isolation period at five days is likely to be much more palatable and may encourage more infected people to comply, said Dr. Muge Cevik, an infectious disease expert at the University of St Andrews in Scotland who led the new analysis, published in the journal The Lancet Microbe.

... Some people who are older or very sick may be infectious for longer than a week. But if a shorter recommended period encourages more people to isolate, the benefit will more than offset any risk to the community from the small amount of virus that a few patients may still carry after five days, said Dr. Stefan Baral, an epidemiologist at Johns Hopkins University.

The Lost Days That Made Bergamo a Coronavirus Tragedy
Bergamo, in Northern Italy, is one of the deadliest killing fields for the virus. More than 3,300 people have officially died from the virus there, although the death toll could be double that. Fatalities in the spring soared to such heights that the local priest ordered a stop to the incessant tolling of the bells for the dead.

The province was wealthy, well educated and had top-level hospitals, so why was the death toll so high?

Faulty guidance from the World Health Organization, which recommended testing only people with a link to China, missed early cases and allowed the virus to spread rapidly throughout the region. Only after a doctor in a nearby province broke protocol, in late February, and tested a man with serious pneumonia who was not responding to standard treatments, did the country discover its first locally transmitted case and the terrifying knowledge that the virus was already spreading in the community.

Even after hospitals became incubators for the virus, businesses lobbied the government to keep the economy open. The bureaucratic back-and-forth between Rome and the regional authorities delayed an early lockdown that might have saved lives.

Turkey announces its strictest lockdown yet as it passes half a million cases.
Turkey is imposing its strictest lockdown since the outbreak of the pandemic, as the country’s total number of cases surpassed half a million, according to government figures released on Monday.

Starting Tuesday night, everyone will be required to stay home from 9 p.m. to 5 a.m. on weekdays and around the clock on weekends, from Friday evening to Monday morning, President Recep Tayyip Erdogan announced.

The hybrid approach is intended to keep the labor force working in an already staggering economy while limiting the spread of the virus as much as possible.

People older than 65 or younger than 20 will be barred from using public transportation. They are already under restrictions that allow them out of their homes for just three hours a day.

Mr. Erdogan also asked people not to allow guests in their homes, and banned large gatherings in private residences for New Year’s celebrations, religious ceremonies or condolence calls.

Funerals and wedding ceremonies will be limited to 30 people. Traditional Turkish baths, saunas, massage parlors and swimming pools will be closed.

Turkey, which only recently began reporting complete data on confirmed cases, has been averaging nearly 23,000 new cases a day over the last two weeks, according to a New York Times database.

Rhode Island hospitals are full. Covid field hospital opening today.
Hospitals in Rhode Island are full and the state opened a 353-bed field hospital today for coronavirus patients, The Providence Journal reports.

... On Monday morning, the Emergency Alert System was used and Rhode Islanders were sent the message, "RIGOV COVID ALERT: Hospitals at capacity due to COVID. Help the frontline by staying home as much as possible for the next two weeks. Work remotely if you can, avoid social gatherings, get tested. If we all decrease our mobility, we will save lives. Learn more about RI on Pause at reopeningRI.com/pause"


New study gives clues to how Covid-19 can cause neurological problems.
One of the coronavirus’s most unexpected tricks is its ability to cause neurological symptoms, including dizziness, headaches and the blunting of taste and smell. Traces of the virus have shown up in brain tissue, examined post-mortem, but scientists don’t know exactly how the virus got there, much less how it might alter neurons’ function.

A new study, based on autopsies of people who died of Covid-19, provides some of the first clues. The virus may spread to the brain through the nose, where it can invade nerve endings deep in the nasal passages. If further tissue analysis is supportive, the findings should help explain how the virus reaches circuits in the brain that support perception, balance and mental acuity.

... The analysis found evidence of the virus in various parts of the brain, and in the olfactory mucosa, where its concentration was highest. Deep in this layer, near nerve endings that project to the brain, the researchers found the coronavirus’s signature spike protein, which it uses to attach to and infect cells.

Taken together, the findings suggest that the virus is “able to use the olfactory mucosa as a port of entry into the brain,” said Dr. Heppner, in a prepared statement.

The authors cautioned that their findings apply only to people with severe disease, and not necessarily to the majority of people infected, who experience modest symptoms, if any.

Moderna Applies for Emergency F.D.A. Approval for Its Coronavirus Vaccine
The first shots could be given as early as Dec. 21, if authorization is granted.

The drugmaker Moderna announced highly encouraging results on Monday, saying that complete data from a large study show its coronavirus vaccine to be 94.1 percent effective, a finding that confirms earlier estimates.

The company said that it applied on Monday to the Food and Drug Administration to authorize the vaccine for emergency use, and that if approved, injections for Americans could begin as early as Dec. 21.

The hopeful news arrives at a particularly grim moment in the U.S. health crisis. Coronavirus cases have surged and overwhelmed hospitals in some regions, and health officials have warned that the numbers may grow even worse in the coming weeks because of travel and gatherings for Thanksgiving.

The new data from Moderna show that its study of 30,000 people has met the scientific criteria needed to determine whether the vaccine works. The findings from the full set of data match an analysis of interim data released on Nov. 16 that found the vaccine to be 94.5 percent effective.

The study also showed that the vaccine was 100 percent effective at preventing severe disease from the coronavirus. The product was developed in collaboration with government researchers from the Vaccine Research Center at the National Institute of Allergy and Infectious Diseases.

Stรฉphane Bancel, the chief executive of Moderna, said in an interview that the company was “on track” to produce 20 million doses by the end of December, and from 500 million to a billion in 2021. Each person requires two doses, administered a month apart, so 20 million doses will be enough for 10 million people.

Virus May Have Arrived in U.S. in December, but Didn’t Spread Until Later
Blood samples collected in mid-December indicate possible infections more than a month before the known first case of Covid-19, but do not show community transmission.

The coronavirus may have infected a small number of people in the United States as early as Dec. 13, more than a month earlier than researchers had thought, according to scientists who analyzed blood samples taken from American Red Cross donations.

The researchers noted that they could not say whether the apparent infections were in travelers who had caught the virus in other countries, or whether the infections led to wider community transmission.

Before this new report, the earliest documented infection in the country was on Jan. 19 in someone who had traveled to China. Although other genetic studies have suggested the possible presence of the virus earlier than that date, the new study found that blood donations from nine states sent to the Centers for Disease Control and Prevention carried coronavirus antibodies — protein markers of past exposure to the virus, or perhaps to one very similar to it.

Scores of nuns contract coronavirus at German convent
Dozens of nuns at a convent in the German state of Lower Saxony have tested positive for coronavirus. The convent has been in quarantine since last week, after the first cases were identified.

A convent in the northern German town of Thuine on Tuesday said that 76 of its nuns had tested positive for coronavirus.

Sister Superior General of the Sisters of Saint Francis of the Martyr St. George, Maria Cordis Reiker, said a further 85 had tested negative, with more results pending. The cases so far had been mild, she said.

"Nobody has had to go to the hospital, and we are grateful for that," said Reiker.

The order runs several day schools and a boarding school for boys. "How things will continue with the facilities is still in flux," Reiker said.

She added that the necessary steps would be discussed with the health department, which ordered a quarantine for the entire monastery grounds on Friday after the first cases became known.

With the virus spiking on Capitol Hill, the congressional physician asks for more precautions.
Facing a dangerous spike in coronavirus cases among lawmakers, Congress’s attending physician appealed to members on Monday to steer clear of public dinners and receptions, stay in Washington rather than return home to their states between legislative sessions and keep masks on even when speaking on the House and Senate floors.

Dr. Brian P. Monahan’s recommendations were the most aggressive attempt yet to tamp down the spread of the virus around the Capitol, where about a dozen lawmakers have been infected in the last two weeks and a patchwork of rules has led to inconsistent safety protocols.

In a memo, the doctor detailed a relatively new rapid-testing program for lawmakers traveling to and from their home states, but also strongly discouraged them from traveling at all.

“During this time of dramatic and sustained increase in coronavirus transmission nationally, if you can remain in the Washington, D.C., region and avoid travel, that would be preferable,” Dr. Monahan wrote.

After months of unevenly imposed virus guidelines on Capitol Hill, where virus precautions have been the subject of partisan disputes, the physician urged lawmakers to improve their social-distancing and mask-wearing practices.

“Due to experience in the Congress of increased disease frequency occurring in certain circumstances, I recommend that you DO NOT ATTEND dinners, receptions or restaurant gatherings outside of your family unit,” Dr. Monahan wrote.

While face coverings are already mandated on the House floor and strongly encouraged for senators, Dr. Monahan said they would also be “required” anytime lawmakers or aides had contact with people outside their family unit. He also asked lawmakers to keep their faces covered when speaking on the floor of either chamber, a change for many members who routinely remove their masks when speaking.

He added that while those working in the Capitol were allowed to eat with a mask off for brief periods of time, “you MAY NOT sit at a table with a beverage or a partially consumed food item without a face cover for a prolonged period.”

Dr. Monahan also encouraged lawmakers to switch from cloth facial coverings to surgical masks and to consider using face shields, especially when they fly or travel on public transportation.

“Wherever possible, wear a face shield in addition to a face cover if you anticipate close crowding at these occasions,” he wrote.

To stay safe, New Hampshire’s legislature will meet outdoors.
When the New Hampshire legislature — the largest in the country — assembles on Wednesday to launch its new session, it will do so outdoors, for the sake of coronavirus safety.

The 400 members of the lower chamber, the House of Representatives, will congregate with plenty of social distance on a field hockey pitch at the University of New Hampshire in Durham, according to Paul Smith, the House clerk. Members who choose not to wear masks can attend, but will be put in a separate section from those who wear them.

The much smaller Senate, with 24 members, will meet separately at another spot on the campus, and then join with the House later in the day, Mr. Smith said.

The decision to move outdoors, rather than use the university’s sports arena as it had in the spring, was made on Sunday “out of abundance of caution,” he said: “The fact is, we’ve seen an uptick in numbers across the state.”

New Hampshire has been averaging 422 new coronavirus cases a day lately, 27 percent more than the average two weeks ago, according to a New York Times database.