Covid-19: What you need to know today
Globally, the infection seems to be slowing — that could change if the second wave gathers momentum in Europe, and the US sees a third wave (it likely will) — with the number of cases growing by just 9.2% in August, compared to 64% in July. The number of cases in India in August grew 75%, compared to 183% in July.Updated: Sep 11, 2020, 08:20 IST
The US has seen two peaks in its Covid-19 case numbers; Europe is beginning to see its second wave, seemingly bigger than the first (in terms of daily cases) in France and Spain, but smaller in Germany, Italy and the UK. India continues to see a strong and steady increase in daily case numbers — it is yet to reach its peak as active cases near a million, and daily cases, 100,000.
Globally, the infection seems to be slowing — that could change if the second wave gathers momentum in Europe, and the US sees a third wave (it likely will) — with the number of cases growing by just 9.2% in August, compared to 64% in July. The number of cases in India in August grew 75%, compared to 183% in July.
It is clear from the two tables accompanying this column that countries around the world have progressively become better at saving lives. That shouldn’t come as a surprise.There were missteps by both China and the World Health Organization (WHO) when the virus first emerged in Wuhan. In March and early April, when the disease was raging through Europe, and the US was seeing its first wave, no one was even aware that the disease could be transmitted by air. A group of scientists would write of this to WHO in early July. Not all of the symptoms now associated with the virus were known. And some experts believed that Sars-CoV-2 exclusively affected the respiratory system.
Over the months, our understanding of the virus, how it affects the human body (and which systems of the human body), how it travels and infects people, and the therapies and medicines that can help infected patients with severe symptoms fight the disease, have all evolved.
There are studies that show that the use of Remdesivir on early-stage patients and steroids such as Dexamethasone on late-stage ones helps. Countries have also built up capacity of critical care units with oxygen and ventilators — both imperative for patients with severe symptoms who may not be able to breathe on their own.
Plasma therapy has been shown to work in some cases, although more research is needed before its efficacy can be established beyond doubt. Drugs used to treat autoimmune disorders have shown promise in some cases (and some scientists say Covid-19 itself should be treated as an autoimmune disease; I wrote about this in a previous instalment of this column, Dispatch 140 on August 25).
In many parts of the world, the median age of those infected has dropped, and many of the infections are mild ones — both increase the chances of recovery. Indeed, even in India, as testing increases, most new cases are of patients who either have mild symptoms or none at all.
Now, a team of researchers from Yale has discovered, according to a paper on pre-print server medRxiv, that there is something common to most hospitalised patients who subsequently need to be moved to critical care units for assisted breathing or ventilator support (or who eventually succumb to the disease). The study covered 3,300 patients and discovered, using a machine-learning algorithm that most of them whose illness turned severe had a strong signature of a certain neutrophil — on Day 1 of hospitalisation. Neutrophils are a type of white blood cell and are part of the body’s immune system. “Using a machine learning algorithm, we identified a prominent signature of neutrophil activation, including resistin, lipocalin-2, HGF, IL-8, and G-CSF, as the strongest predictors of critical illness. Neutrophil activation was present on the first day of hospitalisation in patients who would only later require transfer to the intensive care unit,” the researchers write in the paper, which is yet to be peer reviewed
They add that the signature was even a predictor of higher mortality.
Prior knowledge of which Covid-19 patients could see their condition deteriorate may help save more lives. Lives lost and lives saved should be the only metrics that really matter.