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Thursday, March 5, 2020

App, AI work together to provide rapid at-home assessment of coronavirus risk

A coronavirus app coupled with machine intelligence will soon enable an individual to get an at-home risk assessment based on how they feel and where they’ve been in about a minute, and direct those deemed at risk to the nearest definitive testing facility, investigators say.
It will also help provide local and with real time information on emerging demographics of those most at risk for so they can better target prevention and treatment initiatives, the Medical College of Georgia investigators report in the journal Infection Control & Hospital Epidemiology.
“We wanted to help identify people who are at high risk for coronavirus, help expedite their access to screening and to and reduce spread of this infectious disease,” says Dr. Arni S.R. Srinivasa Rao, director of the Laboratory for Theory and Mathematical Modeling in the MCG Division of Infectious Diseases at Augusta University and the study’s corresponding author.
Rao and co-author Dr. Jose Vazquez, chief of the MCG Division of Infectious Diseases, are working with developers to finalize the app which should be available within a few weeks and will be free because it addresses a public health concern.
The app will ask individuals where they live; other demographics like gender, age and race; and about recent contact with an individual known to have coronavirus or who has traveled to areas, like Italy and China, with a relatively high incidence of the viral infection in the last 14 days.
It will also ask about common symptoms of infection and their duration including fever, cough, shortness of breath, fatigue, sputum production, headache, diarrhea and pneumonia. It will also enable collection of similar information for those who live with the individual but who cannot fill out their own survey.
Artificial intelligence will then use an algorithm Rao developed to rapidly assess the individual’s information, send them a risk assessment—no risk, minimal risk, moderate or high risk—and alert the nearest facility with testing ability that a health check is likely needed. If the patient is unable to travel, the nearest facility will be notified of the need for a mobile health check and possible remote testing.
The collective information of many individuals will aid rapid and accurate identification of geographic regions, including cities, counties, towns and villages, where the virus is circulating, and the relative risk in that region so health care facilities and providers can better prepare resources that may be needed, Rao says. It also will help investigators learn more about how the virus is spreading, the investigators say.
Once the app is ready, it will live on the augusta.edu domain and likely in app stores on the iOS and Android platforms.
It is imperative that we evaluate novel models in an attempt to control the rapidly spreading virus, Rao and Vazquez write.
Technology can assist faster identification of possible cases and aid timely intervention, they say, noting the coronavirus app could be easily adapted for other infectious diseases. The accessibility and rapidity of the app coupled with means it also could be utilized for screening wherever large crowds gather, such as major sporting events.
While symptoms like fever and cough are a wide net, they are needed in order to not miss patients, Vazquez notes.
“We are trying to decrease the exposure of people who are sick to people who are not sick,” says Vazquez. We also want to ensure that people who are infected get a definitive diagnosis and get the supportive care they may need, he says.
While stressing that the infection with coronavirus is not a pandemic— defined by the World Health Organization, as the worldwide spread of a new disease, including numerous flu pandemics like HINI, or swine flu, in which people find themselves exposed to a virus for which they have no immunity—”This is what you have to do with pandemics,” says Vazquez. “You don’t want to expose an infected person to an uninfected person.” If problems with infections persist and grow, drive-thru testing sites may be another need, he says.
The investigators hope this readily available method to assess an individual’s risk will actually help quell any developing panic or undue concern over coronavirus, or COVID-19.
“People will not have to wait for hospitals to screen them directly,” says Rao. “We want to simplify people’s lives and calm their concerns by getting information directly to them.”
If concern about coronavirus prompted a lot of people to show up at hospitals, many of which already are at capacity with flu cases, it would further overwhelm those facilities and increase potential exposure for those who come, says Vazquez.
Tests for the coronavirus, which include a nostril and mouth swab and sputum analysis, are now being more widely distributed by the CDC, and the Food and Drug Administration also has given permission to some of the more sophisticated labs, particularly those at like Augusta University Medical Center, to use their own methods to look for signs of the viral infection, which the hospital will be pursuing.
As of this week, about 90,000 cases of coronavirus have been reported in 62 countries, with China having the most cases.
The CDC and WHO say that health care providers should obtain a detailed travel history of individuals being evaluated with fever and acute respiratory illness. They also have recommendations in place for how to prevent spread of the disease while treating patients.
Currently when people do present, for example, at the Emergency Department at AU Medical Center, with concerns about the virus, they are brought in by a separate entrance and escorted to a negative pressure room by employees dressed in hazmat suits per CDC protocols, Vazquez says. As of today, all those who have presented at AU Medical Center have tested negative, he says.
Read the published study here or here.

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More information: Arni S.R. Srinivasa Rao et al. Identification of COVID-19 Can be Quicker through Artificial Intelligence framework using a Mobile Phone-Based Survey in the Populations when Cities/Towns Are Under Quarantine, Infection Control & Hospital Epidemiology (2020). DOI: 10.1017/ice.2020.61

California virus crisis as cruise ship held, funding deal struck

California declared a state of emergency over the novel coronavirus Wednesday as a cruise ship was held off the coast over fears of a new outbreak.
Separately, the said it was going to buy 500 million respirators to stockpile for use by healthcare professionals.
The measures came as the in the United States hit 11, including the first fatality in California, and lawmakers in Congress agreed to provide more than $8 billion to fight the rapidly spreading disease.
California Governor Gavin Newsom announced the emergency measures as he reported the death of an elderly person who had taken a cruise to Mexico.
“The State of California is deploying every level of government to help identify cases and slow the spread of this coronavirus,” Newsom told reporters.
The emergency proclamation would help the state prepare “in the event it spreads more broadly,” he said.
Thousands traveling aboard the Grand Princess—the same on which California’s first victim was thought to have contracted the virus—were held offshore Wednesday night.
The ship cut short its current voyage back from Hawaii after passengers and developed symptoms. But its planned return to San Francisco was held up in order to carry out testing on board for those potentially infected.
“We’re holding that ship, which (has) thousands of passengers as well, off the coast, and we’ll be conducting those tests,” Newsom told a press conference.
Eleven passengers and 10 crew members were potentially infected with the virus, Newsom said.
Some 62 guests who remained on board from the earlier Mexico voyage were being restricted to their cabins for testing, the Princess Cruises company said in a statement to AFP.
“In an abundance of caution, these guests and other potential close crew contacts have been asked to remain in their staterooms until screened by our onboard medical team,” it said.
In total, some 2,500 passengers plus crew—typically up to 1,150—were on board for its Mexico voyage, said Newsom.
The Grand Princess belongs to Princess Cruises, the same company which operated the coronavirus-stricken ship held off Japan last month on which more than 700 people on board tested positive.
‘Necessary protections’
Earlier in the day, in nearby Washington state said a 10th person had died there.
Los Angeles County officials reported six new cases in the West Coast metropolis, while the number of confirmed cases in New York state rose to 11.
One of the Los Angeles cases concerns a medical screener at the city’s international airport checking overseas travelers for symptoms.
The Department of Homeland Security said the worker was under self-quarantine at home along with and was showing mild symptoms.
“DHS is happy to report that this individual was highly trained and did everything right both on the job and when they began to feel sick,” a statement said.
“We are told the individual wore all the correct protective equipment and took necessary protections on the job.”
Nationwide, more than 130 people have been infected, with the virus detected in more than a dozen states.
House Speaker Nancy Pelosi said Republicans and Democrats had reached a deal to fund the response to the outbreak to the tune of $8.3 billion.
The House of Representatives passed the measure, and the Senate was to vote Thursday.
Vice President Mike Pence, the White House’s pointman on the crisis, told reporters he would be traveling to Minnesota Thursday to visit a plant manufacturing personal protective equipment including masks.
He will then visit Washington state and meet with Governor Jay Inslee to review containment efforts in the Seattle area.
‘Coordinated, fully-funded response’
All of the newly infected individuals in Los Angeles were exposed to COVID-19 through close contact, health officials said.
Barbara Ferrer, director of the Los Angeles County Department of Public Health, said three of the cases concerned travelers who had gone together to northern Italy—a virus hotspot with more than 100 deaths.
Two other cases involved individuals who had come in contact with a family member who had the virus and the last was the airport screener.
“The step we’re taking today is about preparation, not panic,” said Mayor Eric Garcetti of the emergency declaration.
Officials said they expected the number of infections in California to rise in the coming days and urged families to brace for possible school closures and the cancelation of public events.
https://medicalxpress.com/news/2020-03-california-virus-crisis-cruise-ship.html

‘No evidence’ dogs, cats can pass on coronavirus, but can test positive

Pet cats and dogs cannot pass the new coronavirus on to humans, but they can test positive for low levels of the pathogen if they catch it from their owners.
That’s the conclusion of Hong Kong’s Agriculture, Fisheries and Conservation Department after a dog in quarantine tested weak positive for the virus Feb. 27, Feb. 28 and March 2, using the canine’s nasal and oral cavity samples.
A unidentified spokesman for the department was quoted in a news release as saying. “There is currently no evidence that can be a source of infection of COVID-19 or that they become sick.”
Scientists suspect the virus known as SARS-CoV-2 that causes the disease originated in bats before passing it on to another species, possibly a small wild mammal, that passed it on to humans. However, experts from the School of Public Health of The University of Hong Kong, the College of Veterinary Medicine and Life Sciences of the City University of Hong Kong and the World Organisation for Animal Health (OIE) have unanimously agreed that the dog has a low-level of infection and it is “likely to be a case of human-to-animal transmission.”
The dog, and another also in quarantine which has tested negative for the virus, will be tested again before being released. The department suggested any pets, including and cats, from households where someone has tested positive for the virus should be put into quarantine.
In general, pet owners should maintain good hygiene, including washing hands before and after handling animals, their food and supplies and no kissing them. People who are sick should avoid contact with pets and a veterinarian’s advice should be sought if changes in a pet’s are detected.
“Apart from maintaining good hygiene practices, pet owners need not be overly concerned and under no circumstances should they abandon their pets,” the spokesman said.
https://medicalxpress.com/news/2020-03-dogs-cats-coronavirus-positive.html

Merck KGaA 4Q Net Profit Fell, Warns of Coronavirus Hit

Merck KGaA said Thursday that its fourth-quarter net profit fell, and warned that it expects its 2020 sales to be hit by the coronavirus.
The German pharmaceuticals and chemicals company made a net profit of 318 million euros ($354.4 million) in the final quarter of 2019, down from EUR2.45 billion during the same period a year earlier.
Net sales for the quarter rose 13% to EUR4.38 billion, slightly higher than analysts’ expectations of EUR4.33 billion, according to a consensus estimate provided by FactSet. Sales growth was driven by the health-care and life science business sectors, Merck said.
Sales for the year rose to EUR16.15 billion, growing organically by 5.3%. Merck had guided for organic revenue growth of 3%-5%.
The closely watched company metric Ebitda pre–or earnings before interest, taxes, depreciation and amortization before one-time items–was EUR1.21 billion for the quarter, up from EUR950 million during the same period a year ago.
Merck said it is difficult to determine the effect the coronavirus epidemic will have on its business, but that it is currently working with the assumption that the epidemic will peak during the first quarter of the year and subside over the course of the second. Based on this, the virus should deal a 1% hit on Merck’s 2020 sales, the company said.
“Yet, should the crisis grow or trigger a global recession, the company would adapt its business forecast,” Merck said.
For 2020, the company guided for strong organic growth in sales and Ebitda pre. It proposed a dividend of EUR1.30 a share, up from EUR1.25 a share the year prior.

https://www.marketscreener.com/MERCK-KGAA-436395/news/Merck-KGaA-4Q-Net-Profit-Fell-Warns-of-Coronavirus-Hit-30112020/

‘Vulnerable’ German industry faces prolonged recession – BDI association

The coronavirus is exposing the export-orientated German economy’s vulnerability to disruptions in global trade that will likely keep the industrial sector mired in recession this year, business association BDI said on Thursday.

Weighed down by global trade conflicts and Brexit uncertainty, German industry had already contracted for six quarters in a row before the outbreak of the coronavirus early this year.
“This year, the industial sector is likely to remain in recession, which will stretch to the longest since reunification (in 1990),” the BDI industry group wrote in a quarterly report.
“With the production slumps in China and the quarantine measures taken by individual countries, it is becoming clear how vulnerable the export-oriented and internationally organised German economy is,” the BDI added.
Earlier on Thursday, the VDMA engineering association said that after a “surprisingly good start” to the year it expected supply chain disruptions due to the virus, which it said would have a significant impact on bookings in the coming months.
“We have to expect disruptions along the supply chain from China to Germany,” VDMA’s chief economist Ralph Wiechers said.
https://www.marketscreener.com/EURO-BRITISH-POUND-EUR-4593/news/Vulnerable-German-industry-faces-prolonged-recession-BDI-30113025/

Coronavirus updates, March 5

Amazon (NASDAQ:AMZN) told employees in Seattle to avoid coming into their offices for the rest of the month after an employee tested positive and Washington state emerged as one of the hardest hit by the coronavirus.
Facebook (NASDAQ:FB) also confirmed that a contractor at at its Seattle office was been diagnosed with the disease and it would close that location until March 9.
Hours after the first coronavirus death was reported outside Washington state – an elderly person in California – CA Governor Gavin Newsom declared a statewide emergency.
New York Governor Cuomo confirmed five new cases, saying, “This is literally like trying to stop air.”
The U.S. House passed a bill allocating more than $8B in emergency funds to combat the spread of the deadly virus, including $3B in vaccine research and $2.2B in prevention and preparedness efforts. The IMF also announced a $50B aid package to combat the disease and called for an all-out offensive to counteract the epidemic.
Visa (NYSE:V) is cutting costs and American Express (NYSE:AXP) reported a material slowdown in Asia travel spending as the coronavirus starts taking a bite out of revenue at the two companies. Mastercard (NYSE:MA) is deciding whether to implement expense cuts, but doesn’t have enough clarity yet on the severity and duration of the problem.
Vice President Mike Pence plans to meet with face mask maker 3M (NYSE:MMM) in Minneapolis today to discuss supply chain issues.
https://seekingalpha.com/news/3548859-coronavirus-updates

Wednesday, March 4, 2020

Medical screener at LAX airport tests positive for coronavirus

A medical professional who conducted passenger screenings at Los Angeles International Airport tested positive for the coronavirus late Tuesday , according to the Department of Homeland Security and an internal email obtained by NBC News.
The person last worked screening air travelers for illness on Feb. 21, DHS said in a statement, which also said the medical professional had worn the proper protective gear while working. The internal email described the person as a “contract medical screener” for the Centers for Disease Control and Prevention.
The email also said “these screeners are predominantly assigned to the CDC in-transit lounge and a few support jetway screening on direct flights from China.”
In its statement, DHS said: “Late last night, DHS headquarters was alerted to a situation where one of our contracted medical professionals conducting screenings at LAX international airport had tested positive for COVID-19, also known as the coronavirus. This individual is currently under self-quarantine at home with mild symptoms and under medical supervision. Their immediate family is also under home quarantine.”
According to DHS, the person began to exhibit cold-like symptoms Saturday and visited a primary care doctor Sunday. The person was tested for COVID-19, which came back positive Tuesday.
The person’s last shift at LAX was Feb. 21, more than a week before the appearance of symptoms. According to the internal email, the screener worked at LAX from Feb. 14 to 21 and became symptomatic on Feb. 29.
“DHS is happy to report that this individual was highly trained and did everything right both on the job and when they began to feel sick,” DHS said. “We are told the individual wore all the correct protective equipment and took necessary protections on the job. Additionally, as soon as the individual began to feel sick, they self-quarantined, saw a physician, and reported to the appropriate authorities and officials.”
DHS said it is working to communicate with the person’s co-workers and to trace contacts.
“At this time we do not know if this case is a result from community spread or through their work as a medical screener,” DHS said. “There have been no positive COVID-19 detections reported from the LAX screened travelers. This is an evolving situation that the CDC, DHS and county public health officials continue to examine.”
The internal email said the “CDC contracted screener was an augmented screener secured” by the Countering Weapons of Mass Destruction Office, or CWMD, which is part of DHS.
Acting Deputy Homeland Security Secretary Ken Cuccinelli said at a White House briefing by the President’s Coronavirus Task Force on Jan. 31 that “our chief medical officer in the department is in CWMD, and [we] were providing medical support at the airports.”
“We’re using contract authority that we have to backfill the CDC personnel, so they can be freed up for other missions at the airports where medical screening is being focused,” Cuccinelli said.
At a news conference Wednesday, Los Angeles Mayor Eric Garcetti said: “I want to go out of my way to thank our federal officials we have been working with. [They] have really worked to make sure that ships that are coming into the port are screened, the passengers that are coming into LAX are being screened — the fourth-busiest airport in the world and the busiest container terminal in the Americas.”
https://www.nbcnews.com/health/health-news/medical-screener-lax-airport-tests-positive-coronavirus-n1149986