COVID-19 Scan for Oct 05, 2020

Pandemic-related mental health
SARS-CoV-2 survival on skin
COVID spread at family gathering

More mental health web searches detailed during NY COVID-19 lockdown

A JAMA study today analyzing trends in internet searches found increased queries for anxiety, panic attack, and insomnia during the New York statewide lockdown in March, with searches for depression and suicide remaining at expected levels.

Quarantines have demonstrated negative effects on mental health arising from social isolation, restriction of activities, financial losses from workplace closures, and fears of illness. The JAMA study sought to assess mental health concerns during a portion of the New York lockdown by analyzing trends in internet searches for mental health issues from Mar 22 to May 15.

The study authors used anonymous, publicly available Google Trends and user location data to compare search volumes for specific mental health terms with expected volumes based on historical search data. Relative search volumes (RSV)—absolute search volumes standardized from 0 to 100—were calculated for each week of the lockdown.  

Searches for anxiety increased significantly and RSVs remained an average of 18% higher than expected for three consecutive weeks following the Mar 22 lockdown order [95% prediction interval (PI), 5% to 29%]. RSVs for panic attack soared during the first week of lockdown (56% increase, 95% PI, 37% to 97%), and remained at higher-than-expected levels for 5 consecutive weeks, while searches for insomnia were 21% higher than expected (95% PI, 1% to 55%) during the study period.

Significantly, despite a 40% increase in calls to the New York City crisis line during the lockdown, internet searches for suicide and depression did not increase. The study authors caution that continued quarantines with resulting economic turmoil might lead to future increases in these queries.

While recognizing limitations in internet search trends, the study authors advocate for providing competent online and telemedicine service during quarantines. "With the possibility of a second wave of [SARS-CoV-2] looming and a return to lockdowns, we should ensure that individuals searching the internet can rapidly obtain reliable information on strategies to cope with distress and online help from authoritative sources," the study authors wrote.
Oct 5 JAMA


COVID-19 virus survives on skin, hand hygiene highly effective, study finds

SARS-CoV-2, the virus that causes COVID-19, survives on human skin for 9 hours, much longer than a strain of influenza A virus (IAV). A study in Clinical Infectious Disease indicates that the long survival time on human skin may increase the contact-transmission risk of SARS-CoV-2 compared to other viruses, but finds hand hygiene is highly effective at neutralizing the virus.

Contact transmission is considered a significant risk factor in the spread of COVID-19, highlighting the critical need for information about survival of the virus on skin. Previous studies have identified higher stability for coronaviruses compared with other enveloped viruses—those bearing a protective, fatty outer wrapping—like IAV.

The stability of viruses on human skin is not well understood because of the dangers of exposing test subjects to pathogenic viruses. The study authors developed a model for testing viral stability using human skin obtained from autopsy specimens and compared viral survival of SARS-CoV-2 to a common strain of IAV that is transmitted through droplets and contact transmission. They recorded survival times for viral samples in human mucus and culture medium on a variety of surfaces (human skin, stainless steel, glass, and polystyrene plastic), and evaluated the effectiveness of 80% ethanol on viral survival on human skin.

The researchers found that both types of virus were inactivated faster on skin than on other surfaces, suggesting that human skin is a less hospitable environment for viruses. The study also found, however, that SARS-CoV-2 survived on skin significantly longer than IAV: 9.04 hours (95% confidence interval, 7.96 to 10.2 hours) versus 1.82 hours (1.65 to 2.00 hours), leading to the possibility of a higher risk of contact transmission for COVID-19.

Notably, the study authors also found that SARS-CoV-2 was completely inactivated within 15 seconds of exposure to 80% ethanol—the type of alcohol found in many over-the-counter alcohol-based hand sanitizers—highlighting the importance of proper hand hygiene for the prevention and spread of COVID-19. The US Centers for Disease Control and Prevention (CDC) recommends 60% to 95% alcohol in hand sanitizers for COVID-19.
Oct 3 Clin Infect Dis study


Summer family gathering leads to COVID-19 outbreak

An investigation today in Morbidity and Mortality Weekly Report (MMWR) concludes that a COVID-19 outbreak at a 3-week family gathering—which affected people across four states—likely originated from a 13-year-old girl who was exposed to a large outbreak in June 6 days before arriving.

Fourteen relatives (including the index patient) stayed in a four-bedroom, two-bathroom house from 8 to 25 days, and all but two were eventually infected. Six others visited outside in a physically distanced manner for 10 hours on day 3 and three hours on day 10, and while none of the 20 wore face masks, the more cautious relatives did not get COVID-19.

Of the infected relatives, one person sought hospitalization and another went to the emergency department for respiratory issues. Both have recovered.

Prior to the family gathering, the index patient received a SARS-CoV-2 rapid antigen test 4 days after her exposure, which came back negative. However, the authors of the report, who are from the CDC and state and local health departments, say this was probably because the test—the only type available to her at the time—was meant to be used within the first 5 days of symptoms, and she was asymptomatic. The only symptom she displayed was nasal congestion on the sixth day after exposure, which was also the start of the family gathering.

The authors note that this outbreak is yet another example showing that children and adolescents are viable COVID-19 vectors. The report also reiterates the importance of quarantining after any exposure, confirming negative rapid antigen tests with polymerase chain reaction tests, and following physical distancing and mask guidelines, pointing out that the relatives who practiced distancing were not infected.
Oct 5 MMWR report

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