31 Children as super-spreaders
Q: I’ve been hearing lately that some children who have the virus but without COVID-19 symptoms can spread this infection to large numbers of others. Is this true?
A: A “super-spreader” is an infected person who can infect a greater number of people than can a typically infected person. For many diseases, individuals have been identified as causing more than the expected number of infected persons. One familiar example is Mary Mallon who was an asymptomatic carrier of typhoid fever in New York City. She was a cook who infected 51 people in a 7-year period starting in 1902. After finally identifying who this super-spreader was, she became known as “Typhoid Mary.”
Some diseases are known to be highly infectious when children carry the pathogens. Measles is one example in which children are all super-spreaders. But this high rate of infection by any one particular person is halted when the child develops symptoms and is no longer in contact with others. Speculation that asymptomatic children might be spreading COVID-19 to others apparently began in Great Britain as well as Australia. Some of this speculation has been carried over to the United States. After all, young children love to run up to people, touching and hugging. And they love to pick up objects and put them in their mouths. They are really good at all the behaviors we now associate with the spread of the coronavirus-19.
With increasing concerns focused on sending children back to school in the fall, a study is being concluded by Australian researchers. This study will be submitted for peer-review publication. The preliminary data shows that children are not very good at spreading the coronavirus-19 at all. Australia was one of the few countries that kept schools open during this pandemic. Public health officials in the state of New South Wales traced hundreds of close contacts with the nine students and nine teachers who contracted COVID-19. Of the nearly 900 people who were in contact with these infected people, only 2 had become infected. Officials are waiting to see the full report on the study to learn what influences any social distancing and other variables were at play. But the data so far is “exciting and reassuring” according to one investigator The consensus is developing that children are not super-spreaders of COVID-19.
- Accuracy of testing options
Q: Why were some corovinus-19 tests approved when we hear they are not accurate?
A: The White House in April created a checklist of things it needed to accomplish to hasten the opening of the economy to avert a depression. One of these tasks was to have the FDA issue Emergency Use Authorizations (EUAs) for additional testing capabilities. The FDA then processed a large number of applications for testing kits and laboratory processes to satisfy this goal. Usually, the FDA conducts trials and evaluates the validity of such tests before approving them for use. But under the declaration of a national public health emergency, approval under the Emergency Use Authority (EUA) is possible. To qualify, the vendor or agency applying agrees to monitor the accuracy of the tests. So far, 90 different EUAs have been granted to different groups, creating a confusing environment for states seeking a testing system. One such test granted an EUA was the Abbott Labs “ID NOW” “ready test.” This is a diagnostic test evaluating the existence of the coronavirus-19 in a sample specimen. This device allows for testing “at the point of care.” If a patient tests positive, they can be immediately moved to an isolation area. Abbott was Issued its Emergency Use Authorization on March 27. Later, the White House promoted this product during one of the Coronavirus Task Force press briefings because it can deliver a positive finding in just 5 minutes. A negative finding will take up to 12 minutes. The unit is self-contained, and the White House medical staff has decided to use this for periodic testing of the president, vice president and White House staff.
Recently, researchers at the New York University reported on a study they completed with about 100 patients comparing results of the Abbott “ID NOW” unit with a proven accurate test developed by Cepheid. The results were that 48% of the samples testing positive by the Cepheid test were found to be negative with the “ID NOW” test. This false negative result means that a significant number (about half) of the people who are actually infected walk away believing they are not sick and cannot infect other people. Abbott is challenging this finding for several reasons, and the FDA is investigating. Meanwhile, the FDA has issued instructions to physicians using the Abbott test to be aware of the accuracy issues. All negative findings should be retested before assuming the patient is not infected. This means the Abbott “ID NOW” still has FDA authority to continue to sell this test and people continue to be told their test results. Again, this is the test the White House is using daily to determine if any officials – the president and those around him – may actually have the disease.
- Remdesiver update
Q: Is Remdesiver still being tested as a treatment for COVID-19?
A: On May 8, it was reported that the National Institute of Health has begun a clinical study combining Remdesiver with an anti-inflammatory drug, Baricidinib, produced by Eli Lilly and Co. The study will involve more than 1,000 adult hospitalized patients in the United States. There is strong anecdotal evidence that anti-inflammatory medications have an effect to control some of the serious conditions often found in COVOID-19, especially in its advanced stages. This is one of a continuing series of scientific studies hopefully leading to effective therapies reducing the mortality and morbidity of this pandemic.
