Thank you for joining us on The Medical Republic‘s live COVID-19 blog.
Thanks to our sponsor and supporter for funding this project with an independent grant, Boehringer Ingelheim.
- Two studies – from the US and Italy – estimate seroprevalence of SARS-CoV-2 at 4%-7.1%.
- Tell TMR how the pandemic has impacted your professional finances, in our latest survey.
- AMA champions continuation of telehealth after the COVID-19 pandemic.
4.50pm, 19 May
- And lastly for today, another fine performance from our favourite comedian/Trump lip-syncher Sarah Cooper, who has once again highlighted the jaw-dropping lunacy of the stuff that comes out of the US president’s mouth.
How to hydroxychloroquine pic.twitter.com/yMObDCFGXS
— Sarah Cooper (@sarahcpr) May 19, 2020
- What exactly is the seroprevalence of COVID-19 in various populations? It’s a difficult question to answer, being influenced by the populations being sampled, the tests being used, and the timing of testing. But there’s plenty of research looking at this question.
A study published in JAMA this week presented the results of antibody testing of 865 individuals living within a 24-kilometre radius of a testing site, which found around 4% tested positive.
The researchers initially invited a randomly selected population of 1952 people, but only ended up testing around half. Thirteen percent of the tested cohort reported fever with cough, 9% reported fever with shortness of breath, and 6% reported loss of smell or taste.
The authors noted that there was a risk of selection bias in this sample because people with symptoms might have been more likely to take up the invitation for testing.
A second study, published on the non-peer-reviewed preprint server MedRxiv, reported the outcomes of a random testing of 789 healthy blood donors in Milan, Italy, from late February – when the outbreak began in the region – to late April. These individuals had to be free of COVID-19 symptoms and have had no contact with infected individuals in the prior two weeks, and they were sampled at 20 per day.
At baseline – the first two weeks of sampling – researchers found the prevalence of positive SARS-CoV-2 serology was 4.6%. But this increased to 7.1% in the last three weeks of the study, which was a significant change over time.
The authors calculated that these estimates translated to around 231,000 undiagnosed cases in Milan as of April 8, which meant only around one in 20 individuals with the virus were actually diagnosed.
- How bad is your financial pain during the COVID-19 pandemic? The Medical Republic is doing a short, three-minute survey of GPs about how the pandemic has impacted their practice income, and would love to hear from you.
- The success of telehealth during the COVID-19 pandemic points to a need for long-term support of telehealth, the AMA says.
The organisation has long championed for telehealth to be an integral part of the Australian medical system, and the AMA says the pandemic has provided an opportunity to trial telehealth on a large scale. In March alone, there were over 10 million general practice telehealth consultations.
“Telehealth is not and never likely to be a complete substitute for face to face visits to the doctor, but does provide a convenient and highly appropriate option that can supplement visits to the practice in person,” AMA president Dr Tony Bartone said in a statement.
Dr Bartone called for telehealth to be permanently implemented.
“One suggested approach is to allow GPs or general practices to allow patients to voluntarily nominate a GP and/or a practice in order to be able to access telehealth services from their GP once the current interim telehealth arrangements are due to end,” he said.
- Wondering how you can grow your business in the middle of a pandemic? The Medical Republic has the webinar for you. This Thursday 21 May at 7.30pm AEST, we’re hosting a live free webinar where business adviser David Dahm will provide a DIY guide on how your practice can survive – and maybe even thrive – during this difficult period.
- The RACGP is running a series of webinars on COVID-19 topics, starting with an update for GPs on the COVID-19 response, which is happening this Thursday 21 May at 11.30am AEST.
Other topics include navigating rent reductions, caring for people with cardiovascular disease during COVID-19, and communicating with patients during a crisis. More details are available on the RACGP website.
- The COVID-19 situation in the United States is so dire it has brought the normally reserved Lancet out of its corner with a heavy-hitting editorial that asks US residents not to re-elect Trump in November.
Their beef with Trump is largely over how he and his administration have minimised and undermined the once-respected Centers for Disease Control.
“The Administration is obsessed with magic bullets—vaccines, new medicines, or a hope that the virus will simply disappear,” the editorial’s authors wrote. “But only a steadfast reliance on basic public health principles, like test, trace, and isolate, will see the emergency brought to an end, and this requires an effective national public health agency.”
They pointed to the cutting of CDC staff in China, the removal of Nancy Messonnier, director of the CDC’s National Center for Immunization and Respiratory Diseases, from White House press briefings, and the Trump administration’s questioning of CDC mortality figures and guidelines on COVID-19. The editorial also criticised the CDC’s decisions about testing in the early stages of the pandemic, and the roll-out of faulty test kits.
“A strong CDC is needed to respond to public health threats, both domestic and international, and to help prevent the next inevitable pandemic,” the authors wrote. “Americans must put a president in the White House come January, 2021, who will understand that public health should not be guided by partisan politics.”
- Shit just got real: after numerous studies detecting viral RNA in untreated wastewater, a case study has now emerged of infectious SARS-CoV-2 particles in the faeces of a patient with severe COVID-19.
According to a report in Emerging Infectious Diseases, a 78-year-old man who was treated in China for severe COVID-19, and later died from the condition, was found to have whole virus – complete with the spike proteins it uses to access cells – in his faeces shortly after admission to hospital.
“Isolation of infectious SARS-CoV-2 in feces indicates the possibility of fecal–oral transmission or fecal–respiratory transmission through aerosolized feces,” the authors wrote.
They also pointed out that during the 2003 SARS-CoV-1 epidemic, the infection spread though one private housing estate through what was later discovered to be faulty sewage pipelines that led to aerosolisation of contaminated faeces.
Is this a literal case of the shit hitting the fan? (Sorry.)
- Here are today’s confirmed COVID-19 infection figures from around Australia, to 9pm yesterday. No news is good news, especially for the ACT and Northern Territory, which have now gone for two weeks without any new cases. Bravo.
National – 7060, with 99 deaths and 6389 recovered
ACT – 107
NSW – 3076
NT – 29
QLD – 1057
SA – 439
TAS – 228
VIC – 1567
WA – 557
Disclaimer: The content on the Medical Republic COVID-19 blog is independently created by Medical Republic without input from Boehringer Ingelheim Pty Ltd. The views, information, or opinions expressed on the Medical Republic COVID-19 blog are Medical Republic’s own and do not necessarily represent those of Boehringer Ingelheim Pty Ltd. Boehringer Ingelheim Pty Ltd is not responsible for and does not verify the accuracy of any content on the Medical Republic COVID-19 blog.