COVID-19 Update: Monday, July 27

Prolonged illness, secondary attack rates, mortality predictions, antibodies, and false negatives.

1. A study published in MMWR (morbidity and mortality weekly report) found that people with COVID, even mild cases are experiencing illness for weeks or months. 35% of those ill could not return to normal activities after 3 weeks regardless of age or prior health status. Nearly 25% of those ages 18-34 experienced prolonged illness, and 33% of those 35-49.

2. A study published in Emerging Infection Diseases explored the secondary attack rates when someone was presymptomatic – meaning they were looking at transmission rates from confirmed cases that weren’t yet symptomatic. They found that the overall transmission rate was 3.3% but transmission to household members was 16.6%. They found that transmission from asymptomatic carriers was less likely (0.8%) than asymptomatic people who would develop symptoms (3.5% for mild cases, 5.7% for moderate cases and 4.5% for severe cases). Two days prior to developing symptoms was the highest risk time with risk of infection being 12 -25x higher for those who had close contact or who lived with a case. The takeaway should be that transmission among asymptomatic people is again confirmed and transmission is most likely among close contacts and those living together.

3. The CDC had predicted we would have 148k deaths by the end of July – we hit that number last week, a week early. Current predictions are that if we continue on this trajectory, we will hit 300k deaths in the United States by the end of the year.

4. A cross-sectional study conducted from 23 March – 12 May found that only 1-6.9% of people who took serological tests tested positive for COVID-antibodies. This was highly dependent on where in the country the people lived. However, in all locations, actual cases of COVID were considerably higher than the number of people who tested positive for antibodies. There are, as you know, issues with the serology tests but these tests seem to support prior findings that some percentage of people are not developing immunity (currently we believe that to be around 30%)

5. A new study found that false negatives for COVID are happening 20-67% of the time due to the quality of the tests as well as the timing of when the test is done. A 67% false negative rate (meaning the person has COVID but is told they do not) creates significant issues with controlling the spread.

FINAL THOUGHTS: Kindness should never be confused with weakness. To the contrary, it takes a great deal more strength to show kindness than to engage in conflict. So as we walk into another week, resolve to be strong, to be informed and to show kindness. Educate those around you but do so in a way that is respectful and kind. Recognize that some people simply cannot hear the truth and save your energy for those who can.

Today's 1918 photo is from Stanford University. Students, staff, and faculty were required to mask.