geoffrey modest medical blogs

A recent study from China raised the potential continued infectivity of SARS-CoV-2 from stool and sputum up to 39 days after pharyngeal samples were negative (see  covid pos sputum feces longterm AIM2020  in dropbox, or doi:10.7326/M20-0991 ) Details: -- 133 patients who were admitted to the hospital with documented Covid-19 infection, over a 5 week period -- 22 of these patients had an initial or follow-up positive sputum or fecal sample for  SARS-CoV-2 while having  negative follow-up pharyngeal samples, per protocol below     -- 545 specimens were collected from these 22 patients: 209 pharyngeal swabs, 262 sputum samples, and 74 feces samples     -- 18 of these patients were 15-65 years old, 14 male, 11 had a history of the travel or exposure to an individual from Hubei province in the past month.     -- 17 had no coexisting condition (of the other 5, 4 had hypertension, 2 diabetes, 1 COPD: ie, none had signficant immu...

a recent mathematical modeling study based on Singapore suggested that quarantine, social/workplace distancing, and school closure were key to decreasing spread of SARS-CoV-2 (see  covid nonmed interventions singapore lancetinfdz2020  in dropbox, or  doi.org/10.1016/ S1473-3099(20)30162-6) Details: -- mathematical modeling was based on:     -- the FluTE influenza epidemic simulation model (accounts for demography, host movement, and social contact rates in workplaces, schools, and homes) to estimate the likelihood of human-to-human transmission of SARS-CoV-2 if local containment fails.     -- the geographical, demographic, and epidemiologic model of Singapore were used as the synthetic but realistic representation of the Singaporean population at the household and individual levels, using national 2010 census data     -- assumption that 7.5% of infections are asymptomatic (based on the flu data of 7.5%-22.7%), the mean inc...