Covid19 related Evidence & info

Here is a Resource Hub put together by the CDC and collaborating organizations across the country. This Resource Hub includes fact sheet in a dozen languages, graphic flyers, audio messages, and toolkit materials. https://vaccineresourcehub.org

Here is an up to date page with answers to some recent (2022) questions about COVID19: https://publichealthcollaborative.org/faq/

A nice review of updated research about bivalent vaccination efficacy, as of Jan 2023:

https://erictopol.substack.com/p/the-bivalent-vaccine-booster-outperforms

Project Healings in Minnesota has some wonderful information about COVID19 and the impact on communities, with videos in more than 30 languages

https://projecthealings.info/ and videos here: https://projecthealings.info/psa-videos/

Inter Tribal Council of Michigan and the National Native Network launched the healthcare site Care For Us, By Us

Videos here: https://www.youtube.com/user/NNNKeepItSacred

https://keepitsacred.itcmi.org/

Dolores Huerta Foundation and the California Association of African American Superintendents and Administrators have led town halls on Black & Brown Unity, specifically working on expanding virus protection across communities

April 1st CAAASA Conference Closing Session https://fb.watch/cw7uNFxn5Z/

https://doloreshuerta.org/

African Family Health Organization in Philadelphia serves Pan African and Caribbean refugees and immigrants

@AFAHO (Twitter)

https://drive.google.com/file/d/1A5jorZOXw0b9Pl4ytWdEqN-b_I4hnXDe/view?usp=sharing

AFAHO Video AD Campaign

NIH updated COVID dashboard as of Feb 2021: https://covid19.nih.gov/

NIH Expert panel review of available evidence and coronavirus treatment guidelines

(this is a living document that may change as evidence evolves): https://www.covid19treatmentguidelines.nih.gov/
The research strategic plan and updates on evolving clinical guidelines are posted here: https://www.niaid.nih.gov/

Q&A with Dr. Fauci recorded on June 2, 2020: https://www.youtube.com/watch?v=3MH-3ICY-N4&feature=youtu.be

CDC Resource Hub for COVID19

https://vaccineresourcehub.org

Article about lessons learned on college campuses:

https://www.chronicle.com/article/the-5-biggest-lessons-weve-learned-about-how-coronavirus-spreads-on-campus?cid=gen_sign_in

Selected Peer reviewed publications

We're starting to see some clinical outcomes- here are some publications- **please note that my summaries are for your rapid overview, and you should read the articles and draw your own conclusions** Most of these are available as open access as of this posting. If you would like assistance accessing a full article, please email me directly at trcharisse@gmail.com. (bold print inserted for quick reference)

Fischhoff B. Making Decisions in a COVID-19 World. JAMA. Published online June 04, 2020. doi:10.1001/jama.2020.10178 https://jamanetwork.com/journals/jama/fullarticle/2767028

Bottom line: There are 3 main considerations that you need when making individual decisions: what is the area prevalence of the virus, what is the actual risk of exposure, and what do you do if you are exposed. This is a short article- free access at link above.

Lancet article about physical distancing and masks to reduce risk: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31142-9/fulltext

Bottom line: yes, risk is substantially reduced for the entire population if everyone keeps 1 meter apart and wears a face covering of some kind; note that these estimates are not guesses at your individual risk- these studies are looking at entire populations, and estimating spread and dangerousness of the virus based on different scenarios. Experts make recommendations based on protecting the most amount of people from the most dangerous of outcomes. However- the benefit is only accomplished if 95% of people follow the plan. For every % point of people who do not follow these guidelines, the risk increases for everyone.

Small study in Germany about outcomes: https://www.thelancet.com/journals/lancet/article/PIIS0140-6736(20)31282-4/fulltext

Claus Hann von Weyhern, Ines Kaufmann, Frauke Neff, Marcus Kremer. (Published June 4, 2020) Early evidence of pronounced brain involvement in fatal COVID-19 outcomes.

Bottom line: There is some preliminary evidence that older patients die from cardiorespiratory causes, but younger patients are showing brain bleeds and pulmonary embolism. It appears that there are both direct viral implications and also immune responses that put the body at risk. "In summary, in addition to viral pneumonia, a pronounced CNS involvement with pan-encephalitis, meningitis, and brainstem neuronal cell damage were key events in all our cases. In patients younger than 65 years, CNS haemorrhage was a fatal complication of COVID-19."

Andrea Wolfler, Savina Mannarino, Vania Giacomet, Anna Camporesi, Gianvincenzo Zuccotti (published June 1, 2020) Acute myocardial injury: a novel clinical pattern in children with COVID-19. https://www.thelancet.com/journals/lanchi/article/PIIS2352-4642(20)30168-1/fulltext

Bottom line: While children generally seem to have less serious engagement with the disease, there are some reports of very serious systemic and heart related issues that may be triggered by the immune system response.

Here is another study of outcomes in children, with a group in the PICU. Outcomes appear less severe in children than adults, but pre-existing conditions can cause serious complications and increase risk:

Shekerdemian LS, Mahmood NR, Wolfe KK, et al. Characteristics and Outcomes of Children With Coronavirus Disease 2019 (COVID-19) Infection Admitted to US and Canadian Pediatric Intensive Care Units. JAMA Pediatr. Published online May 11, 2020. doi:10.1001/jamapediatrics.2020.1948 https://jamanetwork.com/journals/jamapediatrics/fullarticle66037?resultClick=1

Richardson S, Hirsch JS, Narasimhan M, et al. Presenting Characteristics, Comorbidities, and Outcomes Among 5700 Patients Hospitalized With COVID-19 in the New York City Area. JAMA. 2020;323(20):2052–2059. doi:10.1001/jama.2020.6775 https://jamanetwork.com/journals/jama/fullarticle/2765184?resultClick=1

Bottom line: "In this case series that included 5700 patients hospitalized with COVID-19 in the New York City area, the most common comorbidities were hypertension, obesity, and diabetes. Among patients who were discharged or died (n= 2634), 14.2% were treated in the intensive care unit, 12.2% received invasive mechanical ventilation, 3.2% were treated with kidney replacement therapy, and 21% died." (text from abstract)

Note that the stats here indicate that not everyone who has serious outcomes end up in the ICU- decline may be very rapid, and may not require mechanical ventilation, so the death rate is higher than the rate of people who went to the ICU. In this sample, 21% of the group that they looked at died; that is just about 1 in 5 people who were hospitalized.

(Another outcomes study) Myers LC, Parodi SM, Escobar GJ, Liu VX. Characteristics of Hospitalized Adults With COVID-19 in an Integrated Health Care System in California. JAMA. 2020;323(21):2195–2198. doi:10.1001/jama.2020.7202 https://jamanetwork.com/journals/jama/fullarticle/2765303?resultClick=1

Bottom line: This is a study of a system in California, which surveyed a large number of people presenting to the hospital. Overall mortality rate for those with COVID-19 is around 16%, but only around 8% of the total population of over 16,000 people tested were identified with the virus- of those, 29% were admitted to hospital and 9% were admitted to an ICU.

Li L, Zhang W, Hu Y, et al. Effect of Convalescent Plasma Therapy on Time to Clinical Improvement in Patients With Severe and Life-threatening COVID-19: A Randomized Clinical Trial. JAMA. Published online June 03, 2020. doi:10.1001/jama.2020.10044 https://jamanetwork.com/journals/jama/article-abstract/2766943

Bottom line: This study was stopped early and may not have gone long enough to get truly meaningful results (underpowered). However, findings were that although results were promising, plasma did not significantly change outcomes (time to improvement within 28 days).

Pillemer K, Subramanian L, Hupert N. The Importance of Long-term Care Populations in Models of COVID-19. JAMA. Published online June 05, 2020. doi:10.1001/jama.2020.9540 https://jamanetwork.com/journals/jama/fullarticle/2767062

Bottom line: Overall, approximately 40% of deaths from the virus have been in long term care settings. This article argues for separate risk projections in those settings due to the complexities of those contexts.

Grasselli G, Zangrillo A, Zanella A, et al. Baseline Characteristics and Outcomes of 1591 Patients Infected With SARS-CoV-2 Admitted to ICUs of the Lombardy Region, Italy. JAMA. 2020;323(16):1574–1581. doi:10.1001/jama.2020.5394 https://jamanetwork.com/journals/jama/fullarticle/2764365?resultClick=1

Bottom line: This is another outcomes study, although only looks at people who were patients in Intensive Care in one region of Italy. Majority of patients were male and older; mortality (death) was 26% among this group. Bear in mind that this is not the same as a study of general population- this is mortality rate in an ICU. The Richardson et al study (linked above) has a better estimate of overall population outcomes.

JAMA article (clinical summary as of early April 2020)

open access (April 6, 2020): Omer, Malani, & del Rio wrote a clinical update summary of what is known at this point. doi: 10.1001/jama.2020.5788 Available here: https://jamanetwork.com/journals/jama/fullarticle/2764366

American Geriatrics Association

Coronavirus Disease 2019 in Geriatrics and Long‐Term Care: The ABCDs of COVID‐19: https://onlinelibrary.wiley.com/doi/full/10.1111/jgs.16445
Coronavirus Disease19 in Geriatrics and Long‐Term Care: An Update: https://onlinelibrary.wiley.com/doi/10.1111/jgs.16464

National Academy for State Health Policy

https://nashp.org/states-launch-rapid-response-teams-to-curb-covid-19-outbreaks-in-nursing-homes/

Covid19 Infographics in multiple languages (Arabic, Creole, Portuguese, Spanish, Swahili, Mandarin, and Urdu)

https://drive.google.com/drive/folders/1MEewUT7LRUFapgWhefb9GNAxlQ7SdjXV

World Health Organization (WHO) myth buster page

https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/myth-busters

FEMA rumor control page

- https://www.fema.gov/Coronavirus-Rumor-Control
- Available also in Spanish: https://www.fema.gov/es/Coronavirus-Rumor-Control

American Sign Language (ASL) video resources on Covid19

https://www.youtube.com/playlist?list=PLvrp9iOILTQatwnqm61jqFrsfUB4RKh6J

What's the deal with cloth face coverings for the general public? Glad you asked!

https://www.cdc.gov/coronavirus/2019-ncov/prevent-getting-sick/cloth-face-cover.html (from the US CDC)
- or here: https://www.who.int/emergencies/diseases/novel-coronavirus-2019/advice-for-public/when-and-how-to-use-masks (from the WHO)

What about disinfectants and cleaning products?

EPA guidance on cleaning products for the virus: https://www.epa.gov/pesticide-registration/list-n-disinfectants-use-against-sars-cov-2
CDC guidance: https://www.cdc.gov/coronavirus/2019-ncov/community/disinfecting-building-facility.html or https://www.cdc.gov/coronavirus/2019-ncov/community/general-business-faq.html
- en Español: https://www.cdc.gov/coronavirus/2019-ncov/hcp/infection-prevention-control-faq-sp.html

Air conditioning related

Info from ASHRAE (the American Society of Heating, Refrigerating and Air-Conditioning Engineers) about Covid19 (including their guidance to WHO, CDC, and EPA): https://www.ashrae.org/technical-resources/resources
- - en Español: https://www.ashrae.org/file%20library/technical%20resources/covid-19/declaraci%C3%B3nes.pdf
from the EPA: https://www.epa.gov/coronavirus/there-hvac-guidance-building-and-maintenance-professionals-can-follow-help-protect-covid
study in China: Lu J, Gu J, Li K, Xu C, Su W, Lai Z, et al. COVID-19 outbreak associated with air conditioning in restaurant, Guangzhou, China, 2020. Emerg Infect Dis. 2020 Jul [date cited]. https://doi.org/10.3201/eid2607.200764 https://wwwnc.cdc.gov/eid/article/26/7/20-0764_article

National Organizations (Professional)

The National Institute for Health Care Management is a great resource: https://www.nihcm.org/categories/covid-19-resources
The Society for Post-Acute and Long-term care medicine resource page for Covid19: https://paltc.org/COVID-19
John A Hartford Foundation Resources for Long-term Care: https://www.johnahartford.org/dissemination-center/view/nursing-home-long-term-care-resources?utm_source=E-News&utm_medium=Email&utm_campaign=April%20E-News

Centers for Disease Control and Prevention (CDC)

The US Center for Disease Control and Prevention (CDC)'s official information and data page: https://www.cdc.gov/coronavirus/2019-ncov/index.html

Tracking prevention, treatments and vaccines

Does that social distancing thing work? Can the virus survive in Canada? Yes- and Yes- https://www.sciencedaily.com/releases/2020/05/200508083551.htm Canadian Medical Association Journal. "Canadian study finds temperature, latitude not associated with COVID-19 spread: School closures, physical distancing and public health measures have effect." ScienceDaily. ScienceDaily, 8 May 2020.
1. - and citing this article: Peter Jüni, Martina Rothenbühler, Pavlos Bobos, Kevin E. Thorpe, Bruno R. da Costa, David N. Fisman, Arthur S. Slutsky, Dionne Gesink. Impact of climate and public health interventions on the COVID-19 pandemic: A prospective cohort study. CMAJ, May 8, 2020; DOI: 10.1503/cmaj.200920
The Milken Institute is tracking treatments being developed and vaccine development related to the novel coronavirus. Information can be found here: https://milkeninstitute.org/covid-19-tracker
The World Health Organization (WHO): https://www.who.int/emergencies/diseases/novel-coronavirus-2019
Testing potential vaccines (phase 1 human trial): https://www.niaid.nih.gov/news-events/nih-clinical-trial-vaccine-covid-19-now-enrolling-older-adults
There is currently no evidence that presence of antibodies indicates immunity (as of June 2020): https://khn.org/news/consumer-beware-coronavirus-antibody-tests-are-still-a-work-in-progress/

Discussions regarding social equity, justice, and policy

The Urban Institute is considering important questions about social justice, equity, and policy related matters: https://www.urban.org/features/covid-19-policies-protect-people-and-communities#chapter-2
Racial inequity is a massive problem in our healthcare system, and race and economic inequity are playing out in the unequal mortality rates across the country. We will need good data about disparities to be able to address this in action when this is over. Learn more here: https://www.propublica.org/article/early-data-shows-african-americans-have-contracted-and-died-of-coronavirus-at-an-alarming-rate and in this Twitter thread with additional info and links: https://twitter.com/nhannahjones/status/1247176506452905986
Some REALLY important information about stigma and assumptions being made during this crisis, from the CDC: https://www.cdc.gov/coronavirus/2019-ncov/daily-life-coping/reducing-stigma.html

Some context about the history and legality of public health rules and restrictions:

Gostin LO, Wiley LF. Governmental Public Health Powers During the COVID-19 Pandemic: Stay-at-home Orders, Business Closures, and Travel Restrictions. JAMA. 2020;323(21):2137–2138. doi:10.1001/jama.2020.5460 https://jamanetwork.com/journals/jama/fullarticle/2764283?resultClick=1

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