COVID19 update, August 11, 2020: T-cell immunity; new remdesivir-type drug for oral administration?; HOCQ prophylaxis clinical trial; New Zealand no longer corona-free

(1) Dr. Seheult has a new video up explaining T-cell immunity, and also discusses how this may explain the fairly high percentage of asymptomatic infections:

(2) Miscellaneous updates:

* New Zealand is no longer “corona-free” and Auckland is now back in lockdown 

* “masgramondou” sent me this article about a super-spreader event in western Japan.

* An Israeli company may be close to putting out a new ‘remdesivir’ type drug, reports the Jerusalem Post

The treatment, based on a chemical compound called Opaganib, has already shown very promising result in compassionate use carried out a the Shaarei Zedek Medical Center in Jerusalem, as Gilead Raday, RedHill’s Chief Operating Officer, told The Jerusalem Post.

[… Like for the original Remdesivir, r]esearch on the potential of the compound was carried out in connection with the Ebola pandemic. “Strong evidence emerged that Opaganib provided inhibition of the virus replication. However, by the time we got that data, the epidemic had subsided so we did not continue with the process,” he recalled.

[…] “Researchers compared the impact of giving Opaganib to patients hospitalized in severe conditions who required oxygen supplementation to outcome of patients in in similar conditions who were not given the treatment. They found that while a third of the latter progressed to require mechanical ventilation, none of the former did. In addition, the patients who received the treatment improved much faster and had a better inflammatory response.”

Intriguingly, unlike remdesivir, opaganib can be administered orally, which makes it potentially valuable for prophylaxis

* A new clinical trial that looked at hydroxychloroquine for post-exposure preventive use was just published in the New England Journal of Medicine. While a difference in outcomes (in this case, progression to disease) was seen between the control group and the HOCQ group, the difference (owing in part to the relatively small group) did not rise to the point of statistical significance

https://doi.org//full/10.1056/NEJMe2020388

* a recently published “proof of concept” trial looks experimentally at the effectiveness of various mask types. In brief, fitted N95 masks do best, followed by multilayer surgical masks, while fleece masks are actually worse than no mask at all (as they break up large droplets into smaller ones that actually spread more easily in the air).

(3) A reflection. Hospital-acquired infections, according to CDC data, kill about 70,000 people a year in the USA. So far, COVID19 has killed “only” twice that number. Somehow, while you do see the occasional story about “superbugs” (hospital bacteria resistant to all or near all known antibiotics) in the news, it does not add up to even half a percent of the coverage COVID19 has gotten.

I am by no means saying the problem is being ignored: researchers are hard at work trying to develop novel antibiotics, and on another front, novel approached  are being introduced to block the spread of infections, such as applying antimicrobial coatings to possible “fomites” (objects that can act as a vector for bacterial transmission, such as shared telephones or medical devices). [*]

(4) A review of the Sonovia and Argaman masks will follow once our Argaman masks arrive.  But just one practical tip if you are considering buying the Sonovia: you may be tempted to buy the male or female sizes in bulk to save money. Don’t — the female mask will be a poor fit for almost all adult males, and conversely. 

(Argaman are one-size-fits-all  but don’t do quantity discounts.) 

(5) The last word for today belongs to Instapundit:

And all the “public health” people complaining about this can go [f-word] yourselves. You squandered all your moral authority rushing to line up in favor of the Black Lives Matter protests because you valued politics more than health. Now nobody will listen to you, because you’re a joke. If people die because you squandered your credibility, that’s your fault. You’re not disgraces to your profession, you’ve made your profession a disgrace.

[*] AS AN ASIDE, one often overlooked fomite in healthcare settings are tablet computers (iPads etc.). Applying an antimicrobial coating of copper, zinc, or silver nanoparticles is generally not a practical option, but an apparently quite safe way of sterilizing them is exposure to UV-C light. Another practical trick I heard about is to encase the iPad in a Ziplock bag, wipe that down frequently with disinfectant solutions, and replace the bag whenever it clearly is compromised.

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