November 4, 2020

In today's episode we discuss: —Understanding the Pathology: Should we be testing for more than SARS-CoV-2 antibodies? Microbiologists, pathologists, and public health experts associated with Mount Sinai Hospital analyzed 3277 blood specimens from recovered COVID-19 patients and found that neutralizing antibody level is the highest 31-35 days post symptom onset, even though general SARS-CoV-2 antibody levels had been high (well above the 160 titer range cutoff) long before this, suggesting the importance of also testing for neutralizing antibodies. —Transmission & Prevention: How do close contact and aerosol transmission risks compare? Swiss environmental engineers applied a Quantitative Microbial Risk Assessment (QMRA) to evaluate SARS-CoV-2 infection risk via aerosol transmission and close indoor contact using dose-response mice models and infection risk data from meta-analyses and found lower infection transmission risk via aerosol exposure within one hour (10^-6 to 10^-4) compared to close contact (10^-1; 12.8% risk within 1m) in a typically ventilated room (10-400 square-meters) with one infected person. Close contact may pose higher infection risk than aerosol transmission, but suggest real-life circumstances (i.e. prolonged exposure, higher density) could heighten risk of aerosol transmission not accounted for in this analysis. —R&D: Diagnosis & Treatments: Polyester or foam nasal swabs: which is better? A comparative analysis investigated sensitivity of polyester and foam nasal swabs stored in viral transport media (VTM), saline, or dry tubes from 126 convalescent COVID-19 patients and found polyester and foam swabs had sensitivities of 87.3% versus 94.5% in VTM, 87.5% versus 93.8% in saline, and 75.0% versus 90.6% in dry tubes, respectively. Polyester swabs had higher cycle threshold values and decreased performance compared to foam swabs when viral loads were near detection threshold, but because estimated sensitivity above 87% was deemed sufficient for times of public health emergency, polyester swabs stored in VTM or saline may suffice in settings where swab shortages exist. —Mental Health & Resilience Needs: How do science literacy and neurological mechanisms contribute to false beliefs? A Behavioral Neurologist from University of California, San Francisco describes that the neural mechanism behind false beliefs in COVID-19 conspiracy theories and science denial in healthy individuals is similar to those that have Lewy body dementia or Fronto-temporal dementia, concluding that “developing frontal circuitry to support the process of reasoning is part of education and science literacy and stands at the core of a healthy democracy.” Establishing this is the responsibility of the medical and scientific community through changes in the education system and working with political officials.