GENETIC VARIATIONS & COVID-19 A recent study (preprint, not yet peer reviewed) indicates that individuals with certain blood types and other genetic variations may be at elevated risk of respiratory failure due to COVID-19. The genome-wide association study (GWAS), included 1,980 participants experiencing respiratory failure due to COVID-19 in Italy and Spain were included in the genome-wide association analysis. One key finding suggested that individuals with Type A blood were at 50% higher risk of requiring oxygen therapy or mechanical ventilation. Notably, genetic variations related to the ACE2 receptor, which is how the SARS-CoV-2 virus attaches to human cells, did not show any significant impact on infection. Results of this study could help clinicians to identify patients at higher risk of respiratory failure that may need aggressive, proactive measures. Considering the broad range of disease severity for COVID-19, from asymptomatic infection to severe disease and death, information regarding risk factors is important to characterizing the disease and pandemic and potentially identify targets for treatment or vaccine development.
IRAN SECOND WAVE Iran has reported decreased daily COVID-19 incidence over the past several days, following increasing incidence since early May, a second “wave” that drove incidence higher than the peak of Iran’s first wave in late March. It is too early to tell, however, whether this indicates that Iran has passed its second peak. As a result of the second wave, Iran once again scaled up response activities and implemented additional restrictions in an effort to contain the epidemic. In order to increase national screening for SARS-CoV-2 infection, Iran deployed 23,000 teams of health experts across the country and implemented both online and phone-based screening programs. In total, Iran has screened more than 50 million individuals nationwide. Iran also increased domestic production of critical supplies, including personal protective equipment. Notably, Iran scaled up production capacity for N95 respirators from 5-10,000 to 85,000 per day and increased production of surgical masks by a factor of 8. Iran also scaled up diagnostic testing capacity, setting a new national record with 25,000 tests performed in a single day.
Schools are beginning to reopen in Iran, with additional protective measures in place to mitigate COVID-19 risk. Previously, Iran suspended schools and universities, although some medical schools remained in operation in order to allow students to graduate and immediately support the COVID-19 response. Iran’s Ministry of Health and Medical Education cancelled in-person interviews for international students hoping to study “medical sciences” at Iranian universities and announced that the application process will proceed via an online system in order to comply with COVID-19 social distancing measures. Schools across the country will reopen at the direction of local governments, and capacity will be limited, particularly in dormitory settings. Additionally, students taking in-person classes will undergo health screening, and diagnostic testing will be available on campus, with a focus on symptomatic students.
US REMDESIVIR SUPPLY The US government is coordinating with Gilead Sciences to facilitate increased production and distribution of remdesivir, the only drug that has been demonstrated to provide treatment benefit for COVID-19 patients in a randomized clinical trial. Gilead previously donated its available remdesivir inventory to the US government; however, this supply is expected to be exhausted by the end of June. Gilead is working to increase production capacity, with material support from the US government; however, the next delivery may not be available until July or August. The US Department of Health and Human Services Assistant Secretary for Preparedness and Response, Dr. Robert Kadlec, expressed confidence that additional remdesivir will be available this summer and that production will increase substantially into the fall and beyond. It is unclear at this point how much Gilead will charge for subsequent shipments, and the incredibly high demand—as the only available treatment with demonstrated efficacy—has raised concerns about the potential that the drug could be expensive.
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