Mathematical modelling has supported the combination of self-isolation, physical distancing and contact tracing as vital to bringing the COVID-19 pandemic under control
Welcome to The Medical Republic‘s live COVID-19 blog.
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The latest
- Afternoon update: Quarantine, self-isolation and contract tracing all needed to control COVID-19, modelling suggests.
- Morning update: Preliminary unpublished data suggests mortality benefit with dexamethasone in ventilated patients.
- The latest confirmed COVID-19 infection figures for Australia.
- Mathematical modelling has supported the combination of self-isolation, physical distancing and contact tracing as vital to bring the COVID-19 pandemic under control.
The study, published in The Lancet Infectious Diseases, estimated that mass random testing of 5% of the population each week would only achieve mean transmission reduction of 2%. However if home quarantine for infected cases, self-isolation for everyone else, and manual contract tracing were used, it could reduce transmission by a mean of 64%.
In an accompanying editorial, Australia’s Professor Raina McIntyre, from the Kirby Institute at the University of New South Wales, argued in favour of the finding, saying that the three strategies – quarantine, contact tracing and home isolation – were not competing choices but should be combined. She also pointed out that the Scientific Advisory Group for Emergencies in the UK concluded back in February that contact tracing would no longer be useful once there was sustained transmission of COVID-19. - While everyone gets very buzzy about the possibilities of dexamethasone to reduce COVID-19 mortality, Australia’s National COVID-19 Clinical Evidence Taskforce has cautiously acknowledged the preliminary findings from the RECOVERY trial but says it will wait for publication of the peer-reviewed data before incorporating the evidence into its living guidelines.
- A silver lining to the COVID-19 cloud may have been avoiding a potential measles outbreak, but experts writing in the Medical Journal of Australia have warned of the possibility of a resurgence once the pandemic ends.
“Australian doctors cannot afford to become complacent about measles, particularly while large outbreaks affect popular tourist and business destinations in the region,” wrote the authors of the article, highlighting that in 2019, Australia had its highest number of measles cases since 2014.
- A new player has made a stunning entrance into the COVID-19 treatment arena, with data suggesting the steroid dexamethasone is associated with significant reductions in mortality among COVID-19 patients requiring respiratory support. However the announcement from the UK-based RECOVERY trial has been clouded by their controversial decision to release their preliminary results by press release, without giving access to the full study data and thus stymieing critical evaluation of the findings.
The RECOVERY trial (Randomised Evaluation of COVid-19 thERapY – yeah, good onya) enrolled more than 11,500 patients from 175 hospitals across the UK to test a range of potential COVID-19 treatments, including hydroxychloroquine and dexamethasone.
The preliminary outcomes from the dexamethasone arm were so strong that researchers stopped recruitment early, after data from 2104 patients treated with daily oral or IV dexamethasone suggested around a one-third decrease in 28-day mortality compared to usual care in patients on ventilators.
There was also a 20% reduction in 28-day mortality in those on oxygen support, but no reduction in patients not receiving any respiratory support.
The publication-by-press release has attracted major criticism, particularly in the wake of the hydroxychloroquine scandal that saw the retraction of two major studies from The Lancet and the New England Journal of Medicine.
It will be great news if dexamethasone, a cheap steroid, really does cut deaths by 1/3 in ventilated patients with COVID19, but after all the retractions and walk backs, it is unacceptable to tout study results by press release without releasing the paper. https://t.co/ZP5GVMUCW3
— Atul Gawande (@Atul_Gawande) June 16, 2020
- The Federal Health department is hosting another webinar update on COVID-19 for GPs this Thursday 18 June at 10.30am, featuring Deputy Chief Medical Officer Professor Michael Kidd and Acting Deputy Director of the ANU Medical School Professor Kirsty Douglas. Register here.
- Victoria continues to recorded the highest numbers of new COVID-19 cases, with another nine people diagnosed in the 24 hours to 9pm yesterday. Three are linked to known outbreaks, two are returned travellers in hotel quarantine, one was picked up through routine testing, but three others are still being investigated.
Here are the latest confirmed COVID-19 cases around Australia:
National – 7347, with 102 deaths and 6856 recovered
ACT – 108
NSW – 3134
NT – 29
QLD – 1065
SA – 440
TAS – 228
VIC – 1741
WA – 602
