COVID-19 Update: 'Breakthrough' Drug, Mask Sterilization

Victoria Giardina

June 16, 2020

Editor's note: Find the latest COVID-19 news and guidance in Medscape's Coronavirus Resource Center.

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

Dexamethasone Deemed 'Breakthrough' in UK Trial

The inexpensive and widely used steroid dexamethasone reduced death rates by about a third for severely ill COVID-19 patients in a clinical trial conducted in the United Kingdom, researchers from Oxford University announced

"It is a major breakthrough," said one of the colead investigators. Dexamethasone was "the only drug that's so far shown to reduce mortality — and it reduces it significantly," he said. 

The RECOVERY trial compared outcomes of around 2100 patients who were randomly assigned to get the steroid with those of around 4300 patients who did not get it. The full results of the trial have not yet been peer-reviewed or published as a preprint. 

Mask Sterilization

When sterilizing face masks, the type of face mask and the method of sterilization have a bearing on subsequent filtration efficiency, according to researchers who tested two sterilization techniques on the pressure drop and filtration efficiency of N95, KN95, and surgical face masks. The greatest reduction in filtration efficiency after sterilization occurred with surgical face masks, they found.

Researchers suggest that individual facilities test all masks intended for healthcare worker use before and after sanitization procedures take place, especially with the high demand for effective face masks and the risk for counterfeit, ineffective products.

As for mask use outside of healthcare settings, Paul Auwaerter, MD, clinical director of the division of infectious diseases at Johns Hopkins University Hospital in Baltimore, Maryland, encourages physicians to "try to convince your patients to make wearing masks out in public a routine if they can't keep social distancing." In a commentary for Medscape, he explains common misconceptions about masks and how he addresses them. 

Remaining Federal Remdesivir Supply

The federal government will distribute nearly all of its remaining supply of remdesivir to states by June 29, while holding back less than 2% of the original donation "in the event 'hotspots' emerge in the coming weeks," a spokesperson for the Department of Health and Human Services (HHS) has told Medscape Medical News

Gilead, Remdesivir's manufacturer, has said it is rapidly scaling up a complicated supply chain to produce a drug that wasn't being manufactured at all as of January in order to meet demand. Gilead may be able to stretch supplies further than initially thought, however, and is actively experimenting with new formulations that would make remdesivir more accessible outside the hospital.

Physicians across the country report their hospitals currently have sufficient access to remdesivir. But because the future supply of the drug is uncertain, administrators and doctors worry that there won't be enough for everyone who may need it. Experts seem to accept that they may need to adjust their existing treatment protocols if supplies run low to prioritize the patients with the most need. 

"That's the problem. That's the most difficult part — how much more you're getting and when you're getting it," says Onisis Stefas, PharmD, MBA, vice president of pharmacy at Northwell Health in New York. 

How America's Hospitals Survived the First Pandemic Wave 

In late March, as the number of COVID-19 cases was growing exponentially in New York state, Governor Andrew Cuomo said hospitals in the state might need twice as many beds as they normally have. Hospitals scrambled to increase their capacity, and the state worked with the federal government to open field hospitals across New York City. 

But when New York hit its peak in early April, fewer than 19,000 people were hospitalized with COVID-19, and, overall, the healthcare system didn't run out of beds. ProPublica reports on how early projections of the COVID-19 surge were wrong, and how political leaders and hospitals can learn from the experience to prepare for a potential second wave of the pandemic later this year. 

Rise in Cases in Arizona Linked to End of Stay-at-Home Order

With new daily coronavirus cases rising in states across the United States, an explosion of new infections in Arizona is stretching some hospitals and alarming public health experts who link the surge in cases to the state's lifting of a stay-at-home order a month ago, Kaiser Health News reports. Over the past week, Arizona has seen, on average, more than 1300 new COVID-19 cases each day.

"Perhaps, Arizona will be a warning sign to other areas," said Katherine Ellingson, an epidemiologist at the University of Arizona. "We never had that consistent downward trend that would signal it's time to reopen and we have everything in place to do it safely."

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. More than 1000 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.

Victoria Giardina is Medscape's editorial intern. She has previously written for "The Dr. Oz Show" and is currently a National Lifestyle Writer for Her Campus. She can be reached at vgiardina@webmd.net or on Twitter @VickyRGiardina.

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