Confirmation of COVID-19 in Pet Dog in New York
Washington, D.C. June 2, 2020 – The United States Department of Agriculture’s (USDA) National Veterinary Services Laboratories (NVSL) today announced the first confirmed case of SARS-CoV-2 (the virus that causes COVID-19) infection in a pet dog (German shepherd) in New York state. This is the first dog in the United States to test positive for SARS-CoV-2.
Samples from the dog were taken after it showed signs of respiratory illness. The dog is expected to make a full recovery. One of the dog’s owners tested positive for COVID-19, and another showed symptoms consistent with the virus, prior to the dog showing signs. A second dog in the household has shown no signs of illness; however, antibodies were also identified in that dog, suggesting exposure.
SARS-CoV-2 infections have been reported in a small number of animals worldwide, mostly in animals that had close contact with a person who was sick with COVID-19. At this time, routine testing of animals is not recommended. State and local animal health and public health officials will work with USDA and the U.S. Centers for Disease Control and Prevention (CDC) to make determinations about whether animals should be tested for SARS-CoV-2, using a One Health approach.
USDA will announce cases of confirmed SARS-CoV-2 in animals each time it is found in a new species. All confirmed cases in animals will be posted at https://www.aphis.usda.gov/aphis/ourfocus/animalhealth/sa_one_health/sars-cov-2-animals-us.
The initial dog tested presumptive positive for SARS-CoV-2 at a private veterinary laboratory, which then reported the results to state and federal officials. The confirmatory testing was conducted at NVSL and included collection of additional samples. NVSL serves as an international reference laboratory and provides expertise and guidance on diagnostic techniques, as well as confirmatory testing for foreign and emerging animal diseases. Such testing is required for certain animal diseases in the U.S. in order to comply with national and international reporting procedures. The World Organisation for Animal Health (OIE) considers SARS-CoV-2 an emerging disease, and therefore USDA must report confirmed U.S. animal infections to the OIE.
While additional animals may test positive as infections continue in people, it is important to note that performing this animal testing does not reduce the availability of tests for humans.
We are still learning about SARS-CoV-2 in animals, but there is currently no evidence that animals play a significant role in spreading the virus. Based on the limited information available, the risk of animals spreading the virus to people is considered to be low. There is no justification in taking measures against companion animals that may compromise their welfare.
It appears that people with COVID-19 can spread the virus to animals during close contact. It is important for people with suspected or confirmed COVID-19 to avoid contact with pets and other animals to protect them from possible infection.
For more information about COVID-19 and animals and recommendations for pet owners, visit https://www.cdc.gov/coronavirus/2019-ncov/animals/pets-other-animals.html
For more information about testing in animals, see https://www.aphis.usda.gov/animal_health/one_health/downloads/faq-public-on-companion-animal-testing.pdf
WEDNESDAY, APRIL 22, 2020
APHIS Confirmation of COVID-19 in Two Pet Cats in New York
Substantial undocumented infection facilitates the rapid dissemination of novel coronavirus (SARS-CoV-2)
View ORCID ProfileRuiyun Li1,*, View ORCID ProfileSen Pei2,*,†, View ORCID ProfileBin Chen3,*, View ORCID ProfileYimeng Song4, Tao Zhang5, View ORCID ProfileWan Yang6, View ORCID ProfileJeffrey Shaman2,† See all authors and affiliations
Science 01 May 2020: Vol. 368, Issue 6490, pp. 489-493 DOI: 10.1126/science.abb3221
Undetected cases The virus causing coronavirus disease 2019 (COVID-19) has now become pandemic. How has it managed to spread from China to all around the world within 3 to 4 months? Li et al. used multiple sources to infer the proportion of early infections that went undetected and their contribution to virus spread. The researchers combined data from Tencent, one of the world's largest social media and technology companies, with a networked dynamic metapopulation model and Bayesian inference to analyze early spread within China. They estimate that ∼86% of cases were undocumented before travel restrictions were put in place. Before travel restriction and personal isolation were implemented, the transmission rate of undocumented infections was a little more than half that of the known cases. However, because of their greater numbers, undocumented infections were the source for ∼80% of the documented cases. Immediately after travel restrictions were imposed, ∼65% of cases were documented. These findings help to explain the lightning-fast spread of this virus around the world.
Science, this issue p. 489
Abstract Estimation of the prevalence and contagiousness of undocumented novel coronavirus [severe acute respiratory syndrome–coronavirus 2 (SARS-CoV-2)] infections is critical for understanding the overall prevalence and pandemic potential of this disease. Here, we use observations of reported infection within China, in conjunction with mobility data, a networked dynamic metapopulation model, and Bayesian inference, to infer critical epidemiological characteristics associated with SARS-CoV-2, including the fraction of undocumented infections and their contagiousness. We estimate that 86% of all infections were undocumented [95% credible interval (CI): 82–90%] before the 23 January 2020 travel restrictions. The transmission rate of undocumented infections per person was 55% the transmission rate of documented infections (95% CI: 46–62%), yet, because of their greater numbers, undocumented infections were the source of 79% of the documented cases. These findings explain the rapid geographic spread of SARS-CoV-2 and indicate that containment of this virus will be particularly challenging.
Reducing transmission of SARS-CoV-2
Kimberly A. Prather1, Chia C. Wang,2,3 Robert T. Schooley4
1Scripps Institution of Oceanography, University of California San Diego, La Jolla, CA 92037, USA. 2Department of Chemistry, National Sun Yat-sen University, Kaohsiung, Taiwan 804, Republic of China. 3Aerosol Science Research Center, National Sun Yat-Sen University, Kaohsiung, Taiwan 804, Republic of China. 4Department of Medicine, Division of Infectious Diseases and Global Public Health, School of Medicine, University of California San Diego, La Jolla, CA 92093, USA. Email: kprather@ucsd.edu
Masks and testing are necessary to combat asymptomatic spread in aerosols and droplets
Respiratory infections occur through the transmission of virus-containing droplets (>5 to 10 μm) and aerosols (≤5 μm) exhaled from infected individuals during breathing, speaking, coughing, and sneezing. Traditional respiratory disease control measures are designed to reduce transmis- sion by droplets produced in the sneezes and coughs of in- fected individuals. However, a large proportion of the spread of coronavirus disease 2019 (COVID-19) appears to be occurring through airborne transmission of aerosols pro- duced by asymptomatic individuals during breathing and speaking (1–3). Aerosols can accumulate, remain infectious in indoor air for hours, and be easily inhaled deep into the lungs. For society to resume, measures designed to reduce aerosol transmission must be implemented, including uni- versal masking and regular, widespread testing to identify and isolate infected asymptomatic individuals.
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Aerosol transmission of viruses must be acknowledged as a key factor leading to the spread of infectious respiratory diseases. Evidence suggests that SARS-CoV-2 is silently spreading in aerosols exhaled by highly contagious infected individuals with no symptoms. Owing to their smaller size, aerosols may lead to higher severity of COVID-19 because virus-containing aerosols penetrate more deeply into the lungs (10). It is essential that control measures be intro- duced to reduce aerosol transmission. A multidisciplinary approach is needed to address a wide range of factors that lead to the production and airborne transmission of respira- tory viruses, including the minimum virus titer required to cause COVID-19; viral load emitted as a function of droplet size before, during, and after infection; viability of the virus indoors and outdoors; mechanisms of transmission; air- borne concentrations; and spatial patterns. More studies of the filtering efficiency of different types of masks are also needed. COVID-19 has inspired research that is already lead- ing to a better understanding of the importance of airborne transmission of respiratory disease.
In summary, this multinational, observational, real- world study of patients with COVID-19 requiring hospitalisation found that the use of a regimen containing hydroxychloroquine or chloroquine (with or without a macrolide) was associated with no evidence of benefit, but instead was associated with an increase in the risk of ventricular arrhythmias and a greater hazard for in-hospital death with COVID-19. These findings suggest that these drug regimens should not be used outside of clinical trials and urgent confirmation from randomised clinical trials is needed...end
Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
In summary, this multinational, observational, real- world study of patients with COVID-19 requiring hospitalisation found that the use of a regimen containing hydroxychloroquine or chloroquine (with or without a macrolide) was associated with no evidence of benefit, but instead was associated with an increase in the risk of ventricular arrhythmias and a greater hazard for in-hospital death with COVID-19. These findings suggest that these drug regimens should not be used outside of clinical trials and urgent confirmation from randomised clinical trials is needed...end
Hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19: a multinational registry analysis
Mandeep R Mehra, Sapan S Desai, Frank Ruschitzka, Amit N Patel
Summary
Background Hydroxychloroquine or chloroquine, often in combination with a second-generation macrolide, are being widely used for treatment of COVID-19, despite no conclusive evidence of their benefit. Although generally safe when used for approved indications such as autoimmune disease or malaria, the safety and benefit of these treatment regimens are poorly evaluated in COVID-19.
Methods We did a multinational registry analysis of the use of hydroxychloroquine or chloroquine with or without a macrolide for treatment of COVID-19. The registry comprised data from 671 hospitals in six continents. We included patients hospitalised between Dec 20, 2019, and April 14, 2020, with a positive laboratory finding for SARS-CoV-2. Patients who received one of the treatments of interest within 48 h of diagnosis were included in one of four treatment groups (chloroquine alone, chloroquine with a macrolide, hydroxychloroquine alone, or hydroxychloroquine with a macrolide), and patients who received none of these treatments formed the control group. Patients for whom one of the treatments of interest was initiated more than 48 h after diagnosis or while they were on mechanical ventilation, as well as patients who received remdesivir, were excluded. The main outcomes of interest were in-hospital mortality and the occurrence of de-novo ventricular arrhythmias (non-sustained or sustained ventricular tachycardia or ventricular fibrillation).
Findings 96 032 patients (mean age 53·8 years, 46·3% women) with COVID-19 were hospitalised during the study period and met the inclusion criteria. Of these, 14 888 patients were in the treatment groups (1868 received chloroquine, 3783 received chloroquine with a macrolide, 3016 received hydroxychloroquine, and 6221 received hydroxychloroquine with a macrolide) and 81 144 patients were in the control group. 10 698 (11·1%) patients died in hospital. After controlling for multiple confounding factors (age, sex, race or ethnicity, body-mass index, underlying cardiovascular disease and its risk factors, diabetes, underlying lung disease, smoking, immunosuppressed condition, and baseline disease severity), when compared with mortality in the control group (9·3%), hydroxychloroquine (18·0%; hazard ratio 1·335, 95% CI 1·223–1·457), hydroxychloroquine with a macrolide (23·8%; 1·447, 1·368–1·531), chloroquine (16·4%; 1·365, 1·218–1·531), and chloroquine with a macrolide (22·2%; 1·368, 1·273–1·469) were each independently associated with an increased risk of in-hospital mortality. Compared with the control group (0·3%), hydroxychloroquine (6·1%; 2·369, 1·935–2·900), hydroxychloroquine with a macrolide (8·1%; 5·106, 4·106–5·983), chloroquine (4·3%; 3·561, 2·760–4·596), and chloroquine with a macrolide (6·5%; 4·011, 3·344–4·812) were independently associated with an increased risk of de-novo ventricular arrhythmia during hospitalisation.
Interpretation We were unable to confirm a benefit of hydroxychloroquine or chloroquine, when used alone or with a macrolide, on in-hospital outcomes for COVID-19. Each of these drug regimens was associated with decreased in-hospital survival and an increased frequency of ventricular arrhythmias when used for treatment of COVID-19.
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In summary, this multinational, observational, real- world study of patients with COVID-19 requiring hospitalisation found that the use of a regimen containing hydroxychloroquine or chloroquine (with or without a macrolide) was associated with no evidence of benefit, but instead was associated with an increase in the risk of ventricular arrhythmias and a greater hazard for in-hospital death with COVID-19. These findings suggest that these drug regimens should not be used outside of clinical trials and urgent confirmation from randomised clinical trials is needed.
Funding William Harvey Distinguished Chair in Advanced Cardiovascular Medicine at Brigham and Women’s Hospital. Copyright © 2020 Elsevier Ltd. All rights reserved. Published Online
May 22, 2020 https://doi.org/10.1016/ S0140-6736(20)31180-6
See Online/Comment https://doi.org/10.1016/ S0140-6736(20)31174-0
Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA, USA
(Prof M R Mehra MD); Surgisphere Corporation, Chicago, IL, USA (S S Desai MD); University Heart Center, University Hospital Zurich, Zurich, Switzerland (Prof F Ruschitzka MD); Department of Biomedical Engineering, University of Utah, Salt Lake City, UT, USA (A N Patel MD); and HCA Research Institute, Nashville, TN, USA (A N Patel)
Correspondence to: Prof Mandeep R Mehra, Brigham and Women’s Hospital Heart and Vascular Center and Harvard Medical School, Boston, MA 02115, USA mmehra@bwh.harvard.edu
SUNDAY, MAY 17, 2020
CORONAVIRUS IN TEXAS, More than 700 new cases of coronavirus meatpacking plants Amarillo region, 11 county deaths connected to Long Term Care Facility at Texas City
CORONAVIRUS IN TEXAS
SATURDAY, MAY 9, 2020
Covid-19 Mortality, Crunching the Numbers, Children, The Jungle 1906 to 2020
Galveston County Death rate rising
Galveston County Case Rate rising
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