Vancouver ICUs Have Strong COVID-19 Outcomes. And More Science Journal News

Compiled by veteran medical journalist Brian Owens, this roundup of some of the newest science on the COVID-19 pandemic, straight from the scientific journals, is presented by Hakai Magazine in partnership with The Tyee.

COVID-19 mortality rates lower in Vancouver

Patients with COVID-19 admitted to intensive care units in Vancouver, British Columbia, had substantially better outcomes than in other jurisdictions. The overall mortality rate for these patients was 15 per cent, compared with 57 per cent in Seattle, 61 per cent in Lombardy, Italy, and 80 per cent in Wuhan, China. The researchers suggest the difference may be due to a successful system-level response that prevented an overwhelming surge of critically ill patients from arriving at Vancouver hospitals.

Canadian Medical Association Journal, May 27, 2020

In the US, longer hospital stays and more ICU admissions

Hospitalized COVID-19 patients in the United States are enduring longer stays and facing higher rates of admission to intensive care units than patients in China. Of 1,271 patients in California and Washington state, 42 per cent required intensive care. In China, the rate was 30 per cent. The average hospital stay for survivors was similar in both countries, at around 11 days. Non-survivors stayed much longer in U.S. hospitals — 15 days, compared with 7.5 days for non-survivors in China. The longer stays indicate that uncontrolled transmission of the virus in the United States could threaten hospital capacity.

British Medical Journal, May 22, 2020

Threat of a second wave if physical distancing is relaxed too soon

If physical distancing measures in Ontario are relaxed too much or too quickly, the province could see a large number of COVID-19 cases that would overwhelm hospitals and lead to an exponential increase in deaths. Modelling by researchers at the University of Guelph found that if physical distancing measures are relaxed in mid-June, the health-care system would be overwhelmed in just 41 days, if no other compensating steps are taken. They also found that had Ontario not imposed strict physical distancing measures in mid-March, the death toll would have been five times higher than it was.

Annals of Internal Medicine, May 27, 2020

Physical distancing, masks and eye protection all help control COVID-19

A comprehensive review of existing studies conducted in health care and non-health-care settings has found that physical distancing of at least one metre lowers the risk of transmitting COVID-19, though two metres is likely more effective. Face masks, both homemade and medical N95 masks, as well as eye protection, also provide some protection for both health-care workers and the public, although the evidence is scarce for both forms of protection. Even when properly used and combined, none of these interventions offers complete protection.

The Lancet, June 1, 2020

Asymptomatic infections may be more common than thought

The prevalence of asymptomatic COVID-19 infections may be higher than previously thought, according to a study of cruise ship passengers. When all passengers and crew on board a ship that departed from Ushuaia, Argentina in mid-March were tested for the virus, more than half tested positive. But of those, 81 per cent showed no symptoms.

Thorax, May 27, 2020

Health-care workers face stress, anxiety and depression

Health-care workers involved in the response to COVID-19 are facing high levels of stressful and traumatic events, and are experiencing significant negative mental health outcomes. Studies of medical personnel in China and Italy found that they had higher levels of anxiety, depression, insomnia and fear of workplace violence.

JAMA Network Open, May 28, 2020

JAMA Network Open, June 1, 2020

No sex please, we’re British

Just 40 per cent of U.K. adults have been sexually active during the COVID-19 lockdown. This could have implications for both physical and mental health, as previous research has shown a frequent and trouble-free sex life is important for higher levels of enjoyment of life and general mental health, and can help protect older people against heart problems. The researchers suggest that the U.K. government’s public health messaging around COVID-19, advocating for self-isolation and social distancing, could be changed to include promoting sexual activity as a way of maintaining physical and mental health.

Journal of Sexual Medicine, May 26, 2020

Remdesivir improves recovery time

The antiviral drug remdesivir can shorten recovery time from COVID-19. According to a clinical trial of the treatment, patients administered remdesivir recovered in 11 days on average, compared with 15 days for those who received a placebo. The drug was most beneficial for hospitalized patients with severe disease who required supplemental oxygen. However, the drug had no apparent effect on mortality rates.

New England Journal of Medicine, May 22, 2020

Those with intellectual disabilities are more likely to die from COVID-19

People with intellectual and developmental disabilities are almost twice as likely to die if they contract COVID-19 than those without disabilities. A study found that for people with an intellectual disability, the death rate is 4,500 per 100,000 people. For COVID-19 patients without an intellectual disability the death rate is 2,700 per 100,000. The researchers suggest the disparity is likely because people with intellectual disabilities are also more likely to have other diseases. They are also more likely to live in residential care homes, which have been particularly hard hit by the pandemic.

Disability and Health Journal, May 24, 2020

SARS-CoV-2 is a combination of bat and pangolin viruses

A genetic study of SARS-CoV-2, the virus that causes COVID-19, has found that it is most closely related to a coronavirus that infects bats, but it gained its ability to infect humans by exchanging a critical gene fragment with a coronavirus that infects a scaly mammal called a pangolin. How this combination happened is not clear, but researchers suggest it could have come from animals being kept in close proximity in a “wet market” setting where live animals are sold.

Science Advances, May 29, 2020