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COVID-19 Advisory: Alabama Detections ~ Remdesivir ~ Fauci on the Second Wave

May 28, 2020
To: Distribution
From: Pandemic Working Group
Re: COVID-19: Alabama Detections ~ Remdesivir ~ Fauci on the Second Wave

Alabama Detections Up
As reported in the Alabama Reporter yesterday, for the week ended Sunday, May 24, 2020, coronavirus detections in the state of Alabama rose by 28% as compared to the immediately prior week. During the same week, however, statewide testing only rose by 2%. Taken together, these trends would tend to show an increase in contagion. This is not true of all states. For example, in New York, for the same period, new cases declined by 23%, while testing rose by 24%; this shows a clear drop in contagion even with increased testing. As more of a middle-case, in California, new cases rose by 14%, while tests rose by 24%; this suggests that the increases in detections are largely due to testing and that, otherwise, new cases are declining slightly. This map (from Alabama Reporter) shows the trend of detections in each of the 50 states; pale colors indicate a decline, while darker colors indicate areas of greatest growth. As reported by the New York Times today, the national trend of new cases is running flat to slightly downward, with 15 states up, 17 states down and 21 states about the same. The NYT adds that outbreaks are especially common in nursing facilities, meat processing plants and prisons in various states. We will continue to monitor these measures as states reopen businesses.

Hope for Remdesivir
As reported in Medscape (citing the New England Journal of Medicine), the long-awaited results from the clinical trial of remdesivir on coronavirus patient by NIAID (which is overseen by Dr. Anthony Fauci) have been published. In the study of 1,063 patients, researchers found that administering this therapeutic drug (one which is taken after one is infected to lessen the virus’ effects) over a 10-day course showed a reduced recovery time of 11 days, compared to 15 days for the group that received a placebo. Findings also suggest that remdesivir should be started before severe pulmonary disease sets in (and before use of a ventilator). According to H. Clifford Lane, MD, the benefit “appeared greatest for patients who are hospitalized with severe disease who require supplemental oxygen.” As you may recall, the FDA issued an emergency use authorization for remdesivir earlier this month, based upon early findings that were promising. This publication confirms the agency’s apparent confidence in the drug. In short, this is a step forward. The more advances we have in vaccines and therapeutics, the sooner we can begin to put this pandemic behind us.

Fauci on the Fall
And speaking of Dr. Fauci, as reported by Newsweek (in MSNBC.com), when asked about a possible second wave of the pandemic, he replied that there “doesn’t have to be a true second wave in the sense of a major outbreak. And whether that happens or not depends on how we’re prepared to respond.” Looking ahead, he said that “We have four months to make sure we have in place the system, the test, the capability, the manpower to do the kind of identification, isolation and contact tracing as cases begin to reappear in the fall, because they will reappear.” He noted further that when it comes to infectious disease, we are typically limited to three words – control, elimination and eradication. He does not think it likely that we will eradicate COVID-19 the way that we eliminated smallpox. He notes that we have eliminated polio from entire regions of the world and says it is “conceivable that we will be able to eliminate [coronavirus] in the sense of getting enough herd immunity together with the vaccine that we will have very few cases.” He added that we have certainly shown the ability to control the disease. As cited by Newsweek, as of today, about 4.5% of the US population of 330 million people have been tested for infection (according to Johns Hopkins University). Dr. Fauci (as pictured here, courtesy of Getty Images) reports that the US is scaling up to be able to test 40 million persons per month. However, this requires a proper infrastructure, not only of equipment, supplies and test administrators, but also of persons who do tracking and tracing. In later issues we will explore the country’s infrastructure for those parts of pandemic control plan. 

If you have any questions or comments on this advisory, please contact either kellyw@amvac.com or timd@amvac.com.

COVID-19 Advisory: Alabama Detections ~ Remdesivir ~ Fauci on the Second Wave