2020-06-15/16 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM Highlights: NM case updates. Tribal outreach campaign. Santa Fe firefighters support first responders. US Highlights: COVID-19 hospitalizations rise in Texas. US retail sales up in May. Projected COVID-19 deaths in US. International Highlights: COVID-19 prevention and control in Africa. COVID-19 response and challenge in Africa. Epidemiology Highlights: Herd immunity in Europe. Social distance measures effects. Modeling infections in India. Fecal analysis. Wastewater-based Epidemiology Consortium. Healthcare Policy Recommendations: Public health approach to lockdown debate. All of Us Program adds new COVID-19 initiatives. Practice Guidelines: Guidelines are reviewed on urology care. IBD endoscopy. Convalescent plasma use. Testing: Patient predictors of risk for positive COVID-19 test are reported and an online risk calculator is now available. Drugs, Vaccines, Therapies, Clinical Trials: Steroid dexamethasone reduces 28-day mortality by 1/3. Research links ‘inflamm-aging’ and cytokine storm in elderly. Cancer drug may reduce severe COVID-19. 48 new trials registered. Other Science: Postpone surgery. Proteins predict outcomes. Neurologic manifestations. Thromboembolic risk. Zoonotic transmission. Liver failure. Cardiac complications

2020-06-03/04 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM Highlights: Navajo Nation to end weekend curfew. NM case count. Navajo Nation case updates. Food distribution by PepsiCo. APS to get funding. US Highlights: 5 vaccine candidates. Arizona’s increased cases. Some states postpone primaries. Pork plant infections. Economics, Workforce, Supply Chain, PPE: Impact on global supply chains. Residency selection process disrupted. Facemask filtration efficiency. Resources for underserved countries. Epidemiology Highlights: Morbidity and mortality in Africa. Healthcare Policy Recommendations: Need for social distancing. Psychological support guide. Return to work guidelines. Practice Guidelines: Anesthesia recommendations for ECT. Extracorporeal membrane oxygenation outcomes. Testing: Roche Elecsys IL-6 test is authorized by FDA to identify severe inflammatory response. Drugs, Vaccines, Therapies, Clinical Trials: HCQ RCT does not show disease prevention. Lancet HCQ study retraction. Adjunctive convalescent plasma did not show clinical improvement. Mixed remdesivir results. Virtual drug screening. Heparin improved survival. Moderna phase 3. Skin science for vaccine development. ECMO therapy. 48 new clinical trials. Other Science: Androgens and poor male outcomes. Trust in science enhances prevention compliance. High VTE prevalence in critically ill

2020-05-02/03 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: More NM cases. Free Shiprock testing. Prison release demands. 8 state parks reopen. Higher US deaths. NY PPE case dismissed. Orthopedic Tx down. European deaths down. UK mortality factors. People leaving large cities. Ending lockdown strategies. Public mask impact. Taiwan tracing. Homeless shelter prevalence. Homeless shelter outbreak. 50-state R0. COVID-19 decades later. US county tracking site. Hospital management model. COVID-19 behavioral transformation. Practice guidelines for: cardiology, IBD surgery, and rheumatic physical inactivity. Roche antibody test approved. Abbott antibody test EU-certified. Home anosmia assessment. CVD and ACE/ARBs. Tocilizumab early evidence. Tocilizumab systematic review. WHO vaccines trial. HCQ slower viral clearance. CBC predicts severity. Kidney disease meta-analysis. Innate/adaptive immunity timing. Combating misinformation. Mental health living reviews

Human NCR3 gene variants rs2736191 and rs11575837 alter longitudinal risk for development of pediatric malaria episodes and severe malarial anemia

Abstract Background Plasmodium falciparum malaria is a leading cause of pediatric morbidity and mortality in holoendemic transmission areas. Severe malarial anemia [SMA, hemoglobin (Hb)  G and rs11575837:C > T) and their haplotypes. The prospective observational study was conducted over a 36 mos. follow-up period in a cohort of children (n = 1,515, aged 1.9–40 mos.) residing in a holoendemic P. falciparum transmission region, Siaya, Kenya. Results Poisson regression modeling, controlling for anemia-promoting covariates, revealed a significantly increased risk of malaria in carriers of the homozygous mutant allele genotype (TT) for rs11575837 after multiple test correction [Incidence rate ratio (IRR) = 1.540, 95% CI = 1.114–2.129, P = 0.009]. Increased risk of SMA was observed for rs2736191 in children who inherited the CG genotype (IRR = 1.269, 95% CI = 1.009–1.597, P = 0.041) and in the additive model (presence of 1 or 2 copies) (IRR = 1.198, 95% CI = 1.030–1.393, P = 0.019), but was not significant after multiple test correction. Modeling of the haplotypes revealed that the CC haplotype had a significant additive effect for protection against SMA (i.e., reduced risk for development of SMA) after multiple test correction (IRR = 0.823, 95% CI = 0.711–0.952, P = 0.009). Although increased susceptibility to SMA was present in carriers of the GC haplotype (IRR = 1.276, 95% CI = 1.030–1.581, P = 0.026) with an additive effect (IRR = 1.182, 95% CI = 1.018–1.372, P = 0.029), the results did not remain significant after multiple test correction. None of the NCR3 genotypes or haplotypes were associated with all-cause mortality. Conclusions Variation in NCR3 alters susceptibility to malaria and SMA during the acquisition of naturally-acquired malarial immunity. These results highlight the importance of NK cells in the innate immune response to malaria

2020-06-12/13/14 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM Highlights: NM case count. Increased road travel. ABQ ART to resume. Film industry to reopen. US Highlights: Policy advocacy to end mass Incarceration. International Highlights: COVID-19 cases in Italy. Temperature checks at Canada airports. Economics, Workforce, Supply Chain, PPE: Epidemiology Highlights: Mask stability. Supply operations management. Masks going to transport companies. Digital tools for awareness. Customers like clean stores. Epidemiology: Michigan hospitalization risk factors. Ranking the risks of reopening. Pandemic growth rate scaling. Outbreak detection and contract tracing. Worldwide mortality report. Screening pregnant women. Social learning model for pandemics. Healthcare Policy Recommendations: Re-opening of sports centers. Minimize airborne transmission indoors. Open pathogen genomic analysis. South Korea’s response to pandemic. Practice Guidelines: The accumulating burden of non-COVID-19 illnesses. Caution on early intubation and mechanical ventilation in COVID-19. Recommendations on management of IBD, labor and delivery, spinal surgery (risk stratification), and home dialysis. Testing: Robust antibody response. Missed patients with low viral load. Drugs, Vaccines, Therapies, Clinical Trials: Observational study of ACEIs & ARBs. Benefit of lenzilumab. New COVID-19 trials. Other Science: Cardiac biomarkers and mortality. Telemedicine in neurology. High rates of VTE

Hemoglobinopathies, merozoite surface protein-2 gene polymorphisms, and acquisition of Epstein Barr virus among infants in Western Kenya

Abstract Background Epstein Barr virus (EBV)-associated endemic Burkitt’s Lymphoma pediatric cancer is associated with morbidity and mortality among children resident in holoendemic Plasmodium falciparum regions in western Kenya. P. falciparum exerts strong selection pressure on sickle cell trait (SCT), alpha thalassemia (-α3.7/αα), glucose-6-phosphate dehydrogenase (G6PD), and merozoite surface protein 2 (MSP-2) variants (FC27, 3D7) that confer reduced malarial disease severity. The current study tested the hypothesis that SCT, (-α3.7/αα), G6PD mutation and (MSP-2) variants (FC27, 3D7) are associated with an early age of EBV acquisition. Methods Data on infant EBV infection status ( A)/Chinese (1024 C > T) (OR = 2.614, P = 0.212)] and [Union (1360 C > T)/Kaiping (1388G > A) (OR = 0.321, P = 0.295)]. There was no relationship between EBV acquisition and in-utero exposure to either FC27 (OR = 0.922, P = 0.914) or 3D7 (OR = 0.933, P = 0.921). In addition, EBV acquisition in infants ≥ 6–12 months also showed no association with -α3.7/αα (OR = 0.681, P = 0.442), SCT (OR = 0.513, P = 0.305), G6PD [(Viangchan (871G > A)/Chinese (1024 C > T) (OR = 0.640, P = 0.677)], [Mahidol (487G > A)/Coimbra (592 C > T) (OR = 0.948, P = 0.940)], [(Union (1360 C > T)/Kaiping (1388G > A) (OR = 1.221, P = 0.768)], African A (OR = 0.278, P = 0.257)], or in utero exposure to either FC27 (OR = 0.780, P = 0.662) or 3D7 (OR = 0.549, P = 0.241). Conclusion Although hemoglobinopathies (-α3.7/αα, SCT, and G6PD mutations) and in-utero exposure to MSP-2 were not associated with EBV acquisition in infants 0–12 months, novel G6PD variants were discovered in the population from western Kenya. To establish that the known and novel hemoglobinopathies, and in utero MSP-2 exposure do not confer susceptibility to EBV, future studies with larger sample sizes from multiple sites adopting genome-wide analysis are required

2020-04-29 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM cases. NM coronavirus origins. Governor update tomorrow. Temporary drivers licenses. Negative tracing app sentiment. CA reopening plans. US travel screening. Influenza reductions w/COVID control. German flu vaccine prep. 1.5B jobs at risk. National health expenditures. US economy shrinks. Aerosolized virus in hospitals. Cellphone disease spread prediction. Social distancing study. Isolation policy effectiveness. Contact tracing to end AIDS/HIV. Homeless shelter prevalence. Predicting herd immunity. Cooler temperatures reduce transmission. NEJM rationing rationalization. ECMO regional planning. Canadian ECMO prioritization. Healthcare worker mental health. Infectious Diseases Society guidelines. US hospitalist guide. Managing pregnancies. Coagulopathy management. Hysteroscopy consensus. Renal transplant immunosuppression. Two RT-PCR alternatives. Remdesivir RCT success. Novaferon promising study. Probiotics evidence summary. Tocilzumab rationale. 53 new clinical trials. Continue ACE use. Coagulopathy risk screening. Liver tests predict progression. Stem-cell organoid model. Phylogenetic network analysis. Severity: innate vs. adaptive immunity. ECMO update

2020-05-06 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM COVID case update. Temporary hospitals for non-COVID patients. Mandatory face coverings for businesses. NM income shortfall. Potential $2 billion NM budget deficit. Relief fund for rural health care providers. Meals for children, seniors, and tribal members. National parks phased reopening. Rural hunger program. Bangladesh to make remdesivir. Healthcare worker infections. Indian police force infections. Shanghai Disneyland reopens. Mask diaper linings. Mask/respirator review. Hospitals need bailouts. Provider financial resources. African lockdown hunger. Virus jumped late 2019. Mortality rates decrease. Early case in France. International reopening recommendations. WHO: don’t rush reopening. CDC: prison management. Timing important. Dedicated COVID-19 facility. Guidelines for: maternal-fetal medicine, neurosurgery, long-QT treatment, gastroenterology. UK testing in low demand. HIV screening efforts continued. Inactivated vaccine candidate. Natural products. Convalescent plasma effectiveness. Clinical trial tracker. 47 new trials. Children couch potatoes. Adolescents troubled. Climate effects deaths. Lupus anticoagulant. Shock in children. Intestinal viral replication. Tocilizumab patient recovery. Protein target. Genomic diversity

2020-04-28 DAILY UNM GLOBAL HEALTH COVID-19 BRIEFING

Executive Summary: NM case update. NM antibody testing. Las Cruces essential worker screening. Small business closure inequity. More jobless benefits. Santa Fe furloughs. NM Funeral homes prepared. NM oil sector hit. State-by-state restrictions/reopenings. US testing expansion. JAMA on prisons. NY reopening focus. Farmers euthanizing animals. New Zealand success. Stockholm herd immunity. UK worst-hit in Europe. Japanese island lockdown. Spain multi-phase plan. Economic damage lockdown duration. Oil price impacts. Aerosol intubation box. Family cluster transmission. US contact tracing lacking. Chinese tracing system. Early US deaths undercounted. More poison center calls. Homeless shelter infection. Reduced coronary syndrome admissions. Italian predicted model. GIS spatial modeling. Exit strategy schemes. Reopening public buildings. Preventive health screening declines. Stress prevention on return to work. Mental health consequences. Protecting healthcare worker well-being. Mental health training lacking. Hospital toilet viral hotspot. Mobile phone tracking. Creating equitable society. Prone positioning protocol. Negative-pressure tracheostomy. Glucocorticoids adrenal insufficiency. ICU team models. Healthcare worker grief. Conducting clinical trials. UK home-care testing. Dry swabbing. ACE inhibitor benefits. 90 vaccines in development. Heparin and thrombocytopenia. 53 clinical trials registered. Respirator comparison. SARS-coV-2 genetic diversity. Transmission with temperature. Antibody dynamics. Vitamin D and severity. Immunosuppression and severity. Temporal artery thermometers low sensitivity. Digestive symptoms and hospitalization