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COVID19 Silent Spreaders, Long Haulers, and the Pigpen Effect

Good morning, and a special shout-out to everyone at Northern College, where I will be speaking (virtually) later this morning about the future of higher education, and implications for program innovation.

Today, I want to focus on the latest developments in our scientific understanding of COVID19, which helps us anticipate the scope of the pandemic’s economic and health impacts, and the effectiveness of campus precautions. (Caveat: I must emphasize that I am not an immunologist, nor even a Biology major, but many of these articles are written by expert researchers, or interview them.)

But first, controversies and anxieties over the K-12 return to class may provide a glimpse of what we have in store at PSE. And some breaking news…

Breaking News

There’s no point trying to summarize all the COVID carnage on US campuses right now, but one stands out…

566 Cases at uAlabama

uAlabama reports 566 COVID19 cases in the past 6 days, 531 of them at the flagship campus. Just 1.04% of students and 1.37% of staff/faculty are testing positive upon arrival, but many are exposed at campus parties. The university has cancelled all student events and banned all social gatherings, on or off campus, threatening “harsh disciplinary action.” The mayor of Tuscaloosa has ordered all bars closed for at least 2 weeks due to the outbreak. (Call me a teetotaller, but that seems very sane.) Forbes

In comparison, the Canadian situation is still incredibly mild…

1 Case at Mount Allison

Mount Allison U announced yesterday a COVID19 case associated with their campus community. The case is travel-related and the individual has been in self-isolation since arriving in NB.  Facebook

Back to School Blues

In some regions, K-12 students head back to class later this week, and the chaos makes it clear that the process will not be smooth…

Labour Unions Protest

Despite the promise of $2B from Ottawa to help with back-to-school, chaos and confusion reigns. Almost 10% of teachers in Montréal have requested medical exemptions for classes that begin tomorrow, and many have opted to retire. Substitute teachers in Saskatchewan are concerned about sick days, and travelling between schools and divisions. Ontario teachers’ unions allege that the reopening plans, which do not reduce class sizes, violate the Occupational Health and Safety Act. School bus drivers (many of whom are retirees) want safety protocols.

Parents are Upset

The Hamilton-Wentworth DSB is planning to reduce elementary class sizes and hire more teachers to permit social distancing. Some boards are making masks mandatory for all students. Parents in York Region are outraged that teens will be in class just 25% of the time, while parents in Surrey BC are demanding more remote learning options. Many parents will need to isolate their school-aged children from their grandparents, which will not be possible in the 400,000 multi-generational households across the country. The Ontario government is running a province-wide advertising blitz to reassure parents that it has consulted medical experts to ensure a safe return to school. Critics say the money would be better invested in ventilation upgrades and hiring additional teachers.

Quebecois in Denial

More than 150 Quebec doctors have signed an open letter urging a re-think of the province’s back-to-school plan, because it will make COVID19 outbreaks “inevitable.” Moreover, the Quebec government announced yesterday that it will not adopt the federal COVID19 contact tracing app, COVIDalert, nor develop one of its own, because the pandemic “is currently under control” in the province. (WTF??) Premier Legault “said he would prefer it if the company that developed the app was from Québec.” So far, 2 million Ontarians have downloaded the tool, and the governments of AB, BC, NB and SK have all said they will support it. Globe & Mail

Defining COVID19

Our social, economic, and institutional responses to the COVID19 pandemic have necessarily outpaced the scientific peer review process, so we keep learning more about the SARS-CoV-2 virus – which has implications for health precautions on campus, and the outlook for a speedy end to this pandemic…

“Mild” COVID19 can be a Long Haul

Tens of millions of people have now “recovered” from COVID19 worldwide – and yet, more than 30,000 young, formerly active and healthy people, report ongoing debilitating symptoms for 6 months or more after they ceased to test positive. These so-called “long haulers” experience symptoms including cognitive impairment, headaches, fever, racing heartbeat, fatigue, diarrhea and difficulty breathing. The tips of their fingers and toes often “burn,” and some report hair loss in clumps. “This is not just a respiratory illness.” Patient advocacy groups (like Body Politic and LongCovidSOS) have finally got the attention of the WHO, but so far researchers have no answers for them. Buzzfeed

Taking Long-COVID Seriously

Research from Bristol, UK found that 74% of patients who survived hospitalized for COVID19 were still suffering complications 3 months after discharge, including breathlessness, “brain fog,” excessive fatigue and muscle aches. Many reported improvements in their fever, cough, and sense of smell, and most showed no signs of lung scarring.  In July, the UK government launched a new $14.5 M study of the long-term impacts of COVID19 on 10,000 patients. UK Independent

“Alarming” Mental Health Impacts

New research finds that 55% of patients who recover from COVID19 still score as having at least one mental disorder a month after hospital treatment: 42% had clinical anxiety, 40% insomnia, 31% depression, 28% PTSD, and 20% OCD. Other coronaviruses, like SARS and MERS, have been linked to neuropsychiatric disorders beginning anywhere from 1-50 months after treatment. CTV

“Death is not the only thing that counts. We must also count lives changed.”  — The Atlantic

 

Containment Challenges

COVID19 is mutating to be more contagious, although perhaps less deadly – and our understanding of the vectors for infection keeps evolving too. Kids spread more than we think, and adults lie more than we think…

Kids may be “Silent Spreaders”

Harvard researchers have found significantly higher concentrations of the COVID19 virus in the airways of infected children of all ages, than in adults hospitalized for the virus, making the children much more contagious, even if asymptomatic. “The viral loads of these hospitalized patients are significantly lower than a ‘healthy child’.” It is unwise to rely on screening for symptoms or temperature checks when reopening K-12 schools; actual COVID19 testing is required. Before a vaccine is rolled out to children, scientists need much more conclusive data about MIS-C, the multi-organ systemic infection that can cause severe cardiac problems in children after a COVID19 infection. Harvard Gazette

Patients Always Lie

If you were (like me) a fan of the TV series House, you already assume that “everybody lies” to their doctor. But new Health Psychology research out of Brock U puts a finer point to it: 34% of COVID-positive Americans also denied having any symptoms when asked, 55% concealed their symptoms to some extent, and a frightening 53% denied needing to quarantine when asked by others. Dishonesty dropped among females, older participants, and those who scored as “community-oriented.” Brock

The PigPen Effect

UC Davis researchers warn that in addition to respiratory droplets and aerosols, microscopic dust particles (or “aerosolized fomites”) could also act as a vector to spread viruses like COVID19. In their studies with guinea pigs and influenza, “the more a rodent moved, the more particles spread around.” And lest you think you’re cleaner than a pig, “a human spreads microscopic dust particles at a similar rate… dead skin, environmental particles, and miscellaneous gunk that we constantly shed.” (This cloud of personal aerosols has been called “The Pigpen Effect.”) A study in Wuhan found the highest concentration of viral genetic material in healthcare workers’ changerooms, not in patient rooms. Popular Science

The G-Variant Coronavirus

Los Alamos researchers have identified a D614G mutation, or “G-variant” of the coronavirus, which emerged in Europe mid-February and has quickly become the dominant form of the virus spreading around the world. Compared to the original Wuhan strain, the G variant appears to be more contagious and transmissible, but even though patients carry more copies of the virus, their illness is not more severe. Los Alamos

COVID19 Grows “Less Angry”

Across Europe, COVID19 appears to be growing less fatal than early in the pandemic. The infection fatality rate has dropped 55-80% in England this summer, from a case fatality rate of 18% in April to just 1% in August. In part this could be the G variant (although there remains considerable disagreement amongst scientists), in part it could be attributable to improvements in hospital treatment, and in part to the fact that a larger proportion of young people are getting infected. New Scientist

 

Tomorrow, we’ll look at some of the most recent developments regarding COVID19 immunity and treatments, and some experts who are optimistic that we’ll see an end to this pandemic…

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