COVID Chronicles: Week 25

Twenty-five weeks into our national pandemic, the United States heads into Labor Day weekend ravaged by uncertainty as much as anything else. It's been eight weeks since the last edition of the COVID chronicles, so let's take a look at the latest information and what it suggests about where things are headed as we head into 2020's final trimester.

International clinical trials recently showed that cheap, broadly-available steroids can help seriously ill patients survive Covid-19. The World Health Organization followed by strongly recommending steroids for the treatment of patients with severe or critical COVID-19 while recommending against giving the drugs to patients with mild disease.

Critically ill COVID patients that received systemic corticosteroids were 34 percent less likely to die over a 28-day period compared to those who received other treatments or placebo in a prospective meta-analysis of seven randomized controlled trials. While the treatments are far from a silver bullet, they give doctors yet another weapon in their arsenal against the disease.

Antiviral drugs developed to treat hepatitis C may also be effective, according to a new report. Researchers looked at over 6,000 drugs with a history of safe use in humans to see if any were capable of blocking the SARS-CoV-2 main protease and hep C drugs, including oceprevir and narlaprevir, were the most effective. Their effects against the coronavirus still need to be tested in clinical trials, however.

In one of the most interesting developments, information gleaned from the world's second-fastest supercomputer may have given researchers key insights int why COVID-19 presents in such varied ways in different subjects. In a genetic data mining research study, Daniel Jacobson, chief scientist for computational systems biology at Oak Ridge National Labs, and his research team fed the Summit supercomputer more than 40,000 genes from 17,000 genetic samples.

The computer's data led to a new theory about how the disease impacts the body called the bradykinin hypothesis. According to the findings, the disease typically begins with the virus entering the body through ACE2 receptors in the nose, where the COVID-friendly receptors abound and move on through the body in places rich in ACE2 cells, including vital organs like the intestines, kidneys, and heart.

The big reveal, however, was that–according to the group's analysis of the data–it sort of tricks the body into upregulating the receptors in areas of the body where they're not present in high levels, including the lungs.

Bradykinin is a chemical that helps to regulate blood pressure. According to Jacobson's team's analysis, COVID's process of impacting ACE2 receptors disrupts the body's ability to regulate the chemical which results in the release of a buildup of bradykinin, which, according to the theory, is what is responsible for many of the disease's most deadly effects. There is obviously much more research required, but the information may hold the key to a greater understanding of how to most effectively treat the disease.

Work on the development of an effective vaccine continues at breakneck speeds. While there has been much promise shown in clinical trials and suggestions that a vaccine could be ready before the end of 2020, former FDA Commissioner Scott Gottlieb says one likely won't be widely available until several months into 2021, but that high-risk groups will likely gain access to the vaccine sooner.

"In terms of having a vaccine available for broad distribution where you can actually go to your doctor’s office or go to a distribution site and get the vaccine, that’s clearly, I think, a 2021 event," Gottlieb told CNBC's Squawk Box on Friday. "I think it’s possible you see it in the first quarter of 2021, you know, maybe it’s the first half of 2021, but I think it’s possible that we’ll see a vaccine broadly available towards the end of the first quarter of 2021."

On the negative news side of things, further evidence that those who contract SARS-CoV-2 can become reinfected in as little as 3-4 months further complicates both vaccine efforts and the idea that herd immunity may be on the horizon.

The first documented reinfection case was a 33-year-old man in Hong Kong who had the virus at the end of March and contracted it again a little over four months later while on a trip to Europe. Genome sequencing of the virus from each infection was significantly different, with the second strain matching the one that had been circulating in Europe at the time.

The man experienced mild symptoms in the first bout and was asymptomatic the second time, which gave hope that his immune system had learned from the initial infection. After a couple more cases of reinfection abroad, the first American case of reinfection was confirmed in Nevada, where a 25-year-old man was reinfected just 48 days after his first bout with the virus.

As much of the world heads into autumn, health care officials worry that as cold weather forces people indoors, the virus could resurge in many northern regions, similar to the way that hot summer weather forcing people to congregate in indoor, air-conditioned spaces is thought to have been a significant contributor to the so-called sunbelt surge that plagued states like Florida, Georgia, North Carolina, Texas, and Arizona this summer. Studies suggest that indoor transmission of the virus is up to 20 times more likely than outside.

Finally, another persistent conspiracy theory went viral on social media, alleging that the CDC finally admitted that only 6 percent of reported COVID deaths were actually caused by the diseases, as opposed to having died of something completely different while SARS-CoV-2 positive. The misinformation confuses the way death US certificates list various factors.

Standard death certificates ask for the final disease or condition resulting in death on the top box in the cause of death section. Below, there are spaces for up to four underlying conditions leading to the cause in the box above, as well as another space for significant conditions contributing to death but not resulting in the underlying causes.

Yes, only around six percent had nothing other than COVID-19 listed. But 95 percent started with coronavirus. If you die from respiratory failure as a result of COVID-19, you still died of COVID-19 the same way that someone dying from organ failure brought on by stage-4 cancer still died from cancer.

And so far as the bottom section for comorbidity factors, around a third of Americans are considered obese, while almost half of American adults are considered hypertensive by current guidelines. Another 10 percent have diabetes. Add in the millions more who have conditions like COPD, heart disease, asthma, cancer, and otherwise compromised immune systems, those numbers shouldn't surprise anyone.