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How did COVID-19 first appear in the Bay Area then spread across California?

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Health officials have recently come across newfound research on how COVID-19 first began in California. According to findings published on Monday in the journal Science, an international team of scientists used epidemiology with newfangled genetic sleuthing to determine that the Bay Area’s outbreak was generated by a mix of foreign and domestic arrivals.

In nine Bay Area counties, visitors from China were only among several sources of spread within the community as well as Europe were also widely apparent. The group of cases within Santa Clara County spread to neighboring San Mateo County and further away to Solano County.

There is no single source of infection that played a role in the region’s coronavirus outbreak other than the Grand Princess cruise ship, which sailed from San Francisco to Mexico and Hawaii twice in February and March. 

The new study states that at least one passenger aboard the ship’s first of the two sailings was infected and originated from Washington state. Dozens of passengers then became sick during the second sailing after being exposed. Those passengers then carried the virus into San Francisco, Marin, Sonoma, Solano, and San Joaquin counties, among other places elsewhere in the state and country, including Minnesota.

The analysis combines genetic sequencing of viral samples from 36 infected patients from across Northern California with data collected by public-health officials. This data can be used to determine how, when, where, an individual may have been infected and went on to infect others. Using phylodynamic analysis, a technique that can be used to explore how a virus is established in a new place, including how widely and quickly it spread out.

Scientists can timestamp a random assortment of viral samples and arrange them into family trees to outline their movements using inexpensive genetic technology. When the travel patterns are gathered and exposure records collected by public health investigators allow a new way to recreate the outbreak’s spread for analysis.

Researchers chose to focus on nine counties surrounding San Francisco that attract domestic travelers and prominent gateway from abroad. Health officials concentrated on viral samples collected during a brief period near the start of the virus’s spread in the U.S.

The results provide insights that the virus spread quickly in the Bay area before it traveled inland and across California. In mid-march, when testing started to expand, there was an increase in cases and deaths throughout the state. For example, in San Mateo County, new cases spiked in early April by February and early March as the virus spread from person to person transmission in Northern California. 

In San Benito and Solano counties, utilizing methods such as contact tracing helped eliminate outbreaks before transmitting any more infections to neighboring counties.

Dr. Charles Y. Chiu is an infectious disease specialist at UC San Francisco and the paper’s senior author. When health officials are prepared, the chances of containing the virus increase. Chiu stated that the use of genetic analysis and public health investigative work “has given us actionable data that could have kept the virus from spreading” beyond the limits of other counties.

The study benefited from a more substantial, international collaboration by many of the same researchers to decode, compare, and track the genetic sequences of viral samples taken from patients across the globe. By March 20, they had already collected and organized 753 such genomes into family trees, allowing geneticists and public health officials to examine how the coronavirus outbreak became the COVID-19 pandemic today.

Researchers continue to make progress to help diagnose and treat COVID-19 patients. Many companies are using innovative techniques from an FDA approved portable x-ray device to active clinical trials for possible treatments. 

Sources: 

  1. https://www.latimes.com/science/story/2020-06-09/the-coronavirus-entered-northern-california-many-times-from-many-places
  2. https://www.latimes.com/science/story/2020-02-22/by-decoding-the-coronavirus-genome-scientists-hope-to-gain-the-upper-hand-in-the-outbreak
  3. https://profiles.ucsf.edu/charles.chiu
  4. https://wordofhealth.com/2020/03/06/coronavirus-update-first-death-reported-in-california/
  5. https://wordofhealth.com/2020/01/29/what-you-need-to-know-about-the-coronavirus/
  6. https://wordofhealth.com/2020/05/20/woh-series-part-2-current-treatments-for-covid-19/
  7. https://wordofhealth.com/2020/06/08/portable-x-ray-receives-fda-clearance-for-covid-testing/

Covid-19

Orange County Update: COVID-19 Cases and Hospitals Preparing for Crisis Care

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On Tuesday, July 7, the Orange County Health Care Agency reported 1,010 new coronavirus cases. The total number of cases reached 18,892 since testing began in March. There were three new deaths reported in Tuesday’s update as the death toll climbs to 369

The California Department of Health announced 91 COVID-19 deaths in Orange County in the last fourteen days. The state department reports 839 hospitalized patients in the last 14 days suspected and positive in 33 hospitals across Orange County. The state’s COVID-19 tracking dashboard also shows the county has at least 40% of its ICU beds still available.

The estimated number of those recovered from the virus within the county is approximately 8,867 in Tuesday’s report. Countywide, 278,696 tests have been reported since testing began, with data through July 4. 

The state’s coronavirus dashboard gave an 11.2% test positivity rate for the county.

Orange County hospitals are preparing for crisis care strategies as the number of coronavirus patients increases since mid-June, with the patients’ counts rising by about 130 patients per week. 

 If the number of hospitalizations continues to rise at the current speed, there could be over 750 COVID-19 patients in local hospitals by early next week. This is one of the several key metrics county officials and hospitals monitor for activating hospital surge plans called “crisis care strategies.

Those strategies include switching standard hospital rooms into intensive care units, extending beds by adding them to surge tents, conference rooms, and convert waiting areas to treatment areas; add staffing by switching to longer shifts; canceling elective procedures; and further rationing of personal protective equipment.

The 750-patient guideline “is one of several important factors to monitor, and it is a consideration that numbers are getting to a point that stresses the system,” said Dr. Gagandeep Grewal, associate medical director of emergency medical services at the OC Health Care Agency. He emphasized the data is not an “absolute trigger,” but instead a guide that’s looked at in the context of other critical measures.

The face mask order is intended to help slow the spread of the coronavirus to maintain open hospital beds for possible COVID-19 patients. 

Sources: 

  1. https://occovid19.ochealthinfo.com/coronavirus-in-oc
  2. https://covid19.ca.gov/roadmap-counties/#track-data
  3. https://voiceofoc.org/2020/07/oc-hospitals-preparing-for-crisis-care-strategies-as-coronavirus-patients-rise-sharply/
  4. https://wordofhealth.com/2020/06/30/california-places-orange-county-on-coronavirus-watch-list/
  5. https://wordofhealth.com/2020/06/20/gov-newsom-issues-new-face-mask-order-for-californians/
  6. https://wordofhealth.com/2020/03/24/coronavirus-how-do-we-flatten-the-curve/

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Covid-19

FDA Warns to Avoid Purchasing These 9 Hand Sanitizers That Could Be Toxic

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During the ongoing coronavirus pandemic people continue to take preventative measures by using hand sanitizer, wearing face masks, and practicing social distancing. 

Late June, the Food and Drug Administration warned the public to avoid nine hand sanitizers containing methanol, a substance that can be toxic when absorbed through the skin. Many hand sanitizers were labeled as containing ethanol, which is safe but tested positive instead for methanol, also known as wood alcohol. 

The FDA announced July 2, it was aware adults and children who ingested the hand sanitizers contaminated with methanol caused blindness, hospitalizations, and death. The FDA warns buyers to be mindful of any sanitizer labeled as being FDA-approved as the agency has not approved any sanitizer. 

Products manufactured by Eskbiochem SA de CV in Mexico included in the warning are listed below:

  • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-008-04)
  • All-Clean Hand Sanitizer (National Drug Code: 74589-002-01)
  • Esk Biochem Hand Sanitizer (NDC: 74589-007-01)
  • Lavar 70 Gel Hand Sanitizer (NDC: 74589-006-01)
  • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-005-03)
  • CleanCare NoGerm Advanced Hand Sanitizer 80% Alcohol (NDC: 74589-003-01)
  • The Good Gel Antibacterial Gel Hand Sanitizer (NDC: 74589-010-10)
  • CleanCare NoGerm Advanced Hand Sanitizer 75% Alcohol (NDC: 74589-009-01)
  • Saniderm Advanced Hand Sanitizer (NDC: 74589-001-01)

Also, the FDA said the sanitizers made by Grupo Insoma, S.A.P.I de CV have tested positive for methanol. The agency has asked the company to recall the products and asked for voluntary recalls of several other products. See the full list on the FDA website

The FDA released a statement asking Eskbiochem to stop selling the hand sanitizers, but the company has not done so. For those who have been exposed to a hand sanitizer with methanol should seek medical attention right away.

According to the FDA, methanol exposure can be fatal and lead to nausea, a headache, blurred vision, blindness, seizures, and permanent damage to the nervous system.

Sources: 

  1. https://www.webmd.com/lung/news/20200624/fda-warning-these-9-hand-sanitizers-may-be-toxic
  2. https://www.fda.gov/drugs/drug-safety-and-availability/fda-advises-consumers-not-use-hand-sanitizer-products-manufactured-eskbiochem
  3. https://www.cdc.gov/niosh/ershdb/emergencyresponsecard_29750029.html

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Covid-19

Are Temperature Checks an Ineffective Testing Method for COVID-19?

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Temperature checks are commonly used during the COVID-19 pandemic in public spaces like LAX, or retail stores using “non-contact infrared thermometers” to identify people who might have and could spread infectious disease. Since many people infected with the virus are asymptomatic, temperature checks could prove to be an ineffective response to the pandemic. 

A growing body of science suggests that smell tests could be a more useful way to detect the virus. The Transportation Security Administration told reporters that temperature checks do not guarantee that passengers who don’t have an elevated temperature do not have COVID-19, and vice versa.

The loss of the sense of smell, also known as anosmia, could work well as an add-on to temperature checks. The smell test could significantly increase the ability to identify infected people by screening in airports, workplaces, and other public places. 

Andrew Badly is a physician who oversees a virus lab at the Mayo Clinic stated that anosmia is an early symptom of COVID-19. Anosmia is relative to fever, and some infected individuals can have anosmia with no other visible symptoms. 

A recent study conducted by Badley and colleagues discovered that Covid-19 patients were 27 times more likely than others to have lost their sense of smell. COVID-19 patients were only 2.6 times more likely to experience fever or chills, suggesting that anosmia produces a more precise signal and could be a better COVID-catching net than fever.

As experts have searched for other screening tools, some have zeroed in on smell tests, which could be as simple as asking people to identify a particular scent from a scratch-and-sniff card. Loss of sense of smell is one of the earliest signs of COVID-19. Support cells in the olfactory epithelium, the tissue that lines the nasal cavities, are coated with the receptors that SARS-CoV-2 uses to enter cells. They become infected early on in the disease development, usually before the body has mounted the immune response that causes fever.

In an evaluation of 24 individual studies, with records from 8,438 confirmed COVID-19 patients from thirteen countries, 41% reported they had lost their sense of smell partially or entirely, according to researchers’ data reported in Mayo Clinic Proceedings. Though in studies that used objective measurements of smell rather than asking patients, the chances of anosmia was 2.3 times higher.

A Monell analysis of 47 studies finds that nearly 80% of COVID-19 patients have lost their sense of smell as determined by scratch-and-sniff tests. Approximately 50% include that in self-reported symptoms meaning people don’t realize they had partially or entirely lost their sense of smell. This could be because they’re suffering more severe symptoms, causing them to miss this sign, or because the smell isn’t something they focus on.

In a recent study of 1,480 patients led by otolaryngologist Carol Yan of UC San Diego Health, someone with anosmia was “more than ten times more likely to have Covid-19 than other causes of infection,” she said. Nasal inflammation from cold, flu and other viruses can cause it, she said, but especially during the summer, when those infections are not as common the possibility that anosmia is the result of Covid-19 increases.

In contrast, a fever has multiple possible causes. Therefore, temperature checks will flag people as potentially infected with COVID-19. The likelihood that anosmia indicates someone will test positive for COVID-19 the predictive value increases

UC San Diego Health is currently doing that by asking about the loss of smell (and taste) when screening visitors and staff before allowing them to enter its buildings. Since many people are unaware of their anosmia, testing would be better rather than asking.

The gold-standard test is the University of Pennsylvania Smell Identification Test, called UPSIT. It uses 40 microencapsulated scents — including dill pickle, turpentine, banana, soap, licorice, and cedar that are released by scratching it with a pencil. The tester has a choice of four answers for each, and the entire test takes 10 to 15 minutes.

A screening test for anosmia to detect those who could potentially be infected with COVID-19 could be much simpler instead of relying solely on temperature checks that could be inaccurately detecting the virus according to experts.  

Sources: 

  1. https://www.statnews.com/2020/07/02/smell-tests-temperature-checks-covid19/
  2. https://www.pennmedicine.org/updates/blogs/penn-physician-blog/2020/june/upsit-article
  3. https://wordofhealth.com/2020/03/24/coronavirus-how-do-we-flatten-the-curve/
  4. https://wordofhealth.com/2020/03/02/key-questions-surrounding-the-coronavirus/

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