Beware the Toilet Burps. And More COVID-19 Info Straight from Science Journals

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.

Toilet burps could spread the virus

Flushing a toilet creates a vortex that expels droplets from the toilet bowl into the air to a height of nearly one metre. The tiny droplets, which can contain pathogens, can float in the air for up to a minute where they can be inhaled or settle onto nearby surfaces. Since the SARS-CoV-2 virus has previously been detected in fecal matter, researchers warn that it is possible that flushing a toilet could spread the virus. Close that lid!

Physics of Fluids, June 16, 2020

Immune response is weaker and shorter-lived in asymptomatic patients

People infected with SARS-CoV-2 but who never show any symptoms of COVID-19 seem to have a weaker immune response to the virus. A study of asymptomatic patients in China found that they had lower levels of neutralizing antibodies than those with symptoms, and their antibody levels began to diminish within two to three months. The researchers say this highlights the risks of using “immunity passports” to manage the pandemic, as those that had asymptomatic cases may not be immune to the disease for long.

Nature Medicine, June 18, 2020

Refugee camps are vulnerable to outbreaks

A COVID-19 outbreak in a refugee camp, if left unchecked, would likely spread quickly through the entire population and overwhelm medical services. A modelling study of a hypothetical outbreak in the Kutupalong-Balukhali Expansion Site camp in Bangladesh, home to 600,000 Rohingya refugees, predicts that between 420,000 to 590,000 people would be infected within one year and between 2,000 and 3,000 would die. Refugee camps are especially vulnerable to COVID-19 because they have high population densities, poor access to water and sanitation, and limited health services.

PLOS Medicine, June 16, 2020

SARS-CoV-2 is just as infectious before symptoms appear

People infected with the coronavirus that causes COVID-19 are at least as infectious before they develop symptoms as during their actual illness, according to a study of household transmission in China. This is different from the 2003 SARS virus, which had little or no transmission before symptoms appeared. That delay in transmissibility made 2003’s SARS much easier to control. Researchers estimate that in Guangzhou, prompt case isolation prevented only 20 to 50 per cent of secondary cases (where someone caught COVID-19 from the primary case in their household).

The Lancet Infectious Diseases, June 17, 2020

How Washington state flattened the curve

Despite having the first confirmed case of COVID-19 in the United States, and the first major outbreak, Washington state managed to keep its death rate among the lowest of all states with major outbreaks. An expert panel analyzed the state’s response and identified six important factors that contributed to that success: early communication and co-ordination among stakeholders; regional co-ordination and situational awareness of the health-care system; rapid development and access to testing; proactive management of long-term care facilities and vulnerable populations; and effective physical distancing in the community.

Journal of the American College of Surgeons, June 16, 2020

Staffing and quality linked to nursing home deaths

Residents of long-term care facilities with lower nurse staffing levels, poorer quality scores and higher concentrations of disadvantaged residents suffer from higher rates of confirmed COVID-19 cases and deaths, according to a study of facilities in Connecticut. Higher nurse staffing ratios in particular are strongly associated with fewer cases and fewer deaths.

Journal of the American Geriatrics Society, June 18, 2020

Critically ill patients more likely to suffer heart complications

Patients with COVID-19 who are admitted to an intensive care unit are 10 times more likely than other hospitalized COVID-19 patients to suffer cardiac arrest or heart rhythm disorders. Researchers say this indicates that cardiac complications are likely triggered by a severe, systemic form of the disease and not just the viral infection itself.

Heart Rhythm, June 22, 2020

Household density more important than overall urban density

Greater household crowding increases the risk of becoming infected with SARS-CoV-2, according to a study in New York City. People who lived in a neighbourhood with high household membership are three times more likely to be infected with the virus. But another study of 913 cities in the United States found that urban density has no effect on infection rates, and higher density was in fact linked to lower death rates — possibly because denser places have better health-care facilities.

JAMA, June 18, 2020

Journal of the American Planning Association, June 18, 2020

Knowledge gaps linked to risky behavior

According to a survey in the United States, people’s lack of knowledge about COVID-19 is linked to riskier behaviors during the pandemic. The survey found that African Americans, men and people younger than 55 are less likely to know what symptoms to watch for and how the disease is spread. They are also washing their hands less frequently and leaving the home more often.

JAMA Network Open, June 18, 2020

Cause of more severe disease in minority populations remains a mystery

Higher rates of severe COVID-19 infections in Black, Asian and Minority Ethnic or BAME populations in the United Kingdom are not adequately explained by socioeconomic or behavioural factors, cardiovascular disease risk or by vitamin D status. Researchers suggest the relationship between COVID-19 and ethnicity is more complex than thought and will require more dedicated research.

Journal of Public Health, June 19, 2020

U.S. cases may have been 80 times higher than thought

A surge of flu-like illnesses in March, detected by an existing surveillance network for influenza-like infections, suggests that there may have been 8.7 million new infections of SARS-CoV-2 in the United States between March 8 and March 28 — 80 times greater than the roughly 100,000 officially confirmed cases during that time.

Science Translational Medicine, June 22, 2020