Tuesday, March 2

#3 Cause of Death, Mutation Spreading


Here are the coronavirus stories Medscape’s editors around the globe think you need to know about today.

#3 Cause of Death

More than 170,000 people have died of COVID-19 in the United States since the pandemic began, according to data from Johns Hopkins University, making it the third-leading cause of death in the country, former Director of the Centers for Disease Control and Prevention Thomas Frieden, MD, told CNN.

“COVID is now the No. 3 cause of death in the US ― ahead of accidents, injuries, lung disease, diabetes, Alzheimer’s, and many, many other causes,” Frieden said.

In 2017, the most recent year for which public data are available, nearly 170,000 Americans died of accidents and unintentional injuries, 160,000 died of chronic lower respiratory diseases, 146,000 died of stroke and cerebrovascular disease, 121,000 died of Alzheimer’s disease, 83,000 died of diabetes, and 55,000 died of influenza and pneumonia. The top two causes of death were heart disease, with nearly 650,000 deaths, and cancer, which killed nearly 600,000.

Mutation Spreading

A particular strain of SARS-CoV-2 has reached Southeast Asia. Scientists have found the strain, called D614G, in the Philippines, in recent outbreaks in China, and in a Malaysian cluster of 45 cases that came from someone who had traveled to India and who had not followed quarantine rules upon return.

The D614G variant has become the most common worldwide, according to a research report published by the World Health Organization (WHO) in June. So far, the WHO has said there’s no evidence that the mutation has made the virus more infectious or that it leads to more severe disease. Scientists are investigating these questions, but the answers are not clear yet.

Evidence Mounts for Thyroid Effects

Rates of thyrotoxicosis are significantly higher among patients who are critically ill with COVID-19 than among patients who are critically ill but who do not not have COVID-19, suggesting an atypical form of thyroiditis related to the novel coronavirus infection, according to new research.

The study did not find that thyroid disorders increase the risk of developing COVID-19.

“This study joins at least six others that have reported a clinical presentation resembling subacute thyroiditis in critically ill patients with COVID-19,” said one expert who was not involved in the research.

HCQ and COVID-19: A Journal Gets Stung, and Swiftly Retracts

Two scientists submitted an article entitled “SARS-CoV-2 Was Unexpectedly Deadlier Than Push-Scooters: Could Hydroxychloroquine Be the Unique Solution?” to the Asian Journal of Medicine and Health, which they and others suspect of being a predatory publication, as a sting to see whether the journal would take their money and publish the article, which they wrote as a joke.

Their goal: to highlight a concerning article the journal had previously published titled “Azithromycin and Hydroxychloroquine Accelerate Recovery of Outpatients With Mild/Moderate COVID-19,” whose authors included several hydroxychloroquine partisans, among them a member of the French parliament.

It worked, Retraction Watch reports. “The goal was indeed to focus attention on predatory journals and also on the scientists using these methods to make the general public believe that their studies are serious because they are published,” said one of the authors.

Las Vegas Is “Gambling With Lives”

Las Vegas casinos, which reopened June 4, are a likely hotbed for the spread of COVID-19, ProPublica reports. An analysis of cellphone location data conducted for the news organization demonstrated how visitors to Las Vegas during a single 4-day period in mid-July traveled back across the country to every state in the lower 48 except Maine.

Contact tracing is hard enough, but it’s next to impossible when tourists return to homes across the country if the local health agencies that trace contacts don’t communicate with each other. If a cluster outbreak or a superspreading event occurred among visitors to a casino, it’s unlikely contact tracing would catch it, one expert said.

Casinos also combine multiple factors that make them high-risk venues for spreading COVID-19: They are indoors, are often crowded, and are often filled with people prone to taking risks.

In Memoriam

As frontline healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk for infection. Thousands throughout the world have died.

Medscape has published a memorial list to commemorate them. We will continue updating this list as, sadly, needed. Please help us ensure this list is complete by submitting names with an age, profession or specialty, and location through this form.

If you would like to share any other experiences, stories, or concerns related to the pandemic, please join the conversation here.

Ellie Kincaid is Medscape’s associate managing editor. She has previously written about healthcare for Forbes, the Wall Street Journal, and Nature Medicine. She can be reached at ekincaid@medscape.net or on Twitter @ellie_kincaid.

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