COVID-19 Update: New Tx Guidelines, More Infections

Victoria Giardina

June 26, 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:

US Guidelines Add Dexamethasone Recommendations

The National Institutes of Health COVID-19 Treatment Guidelines Panel has added a recommendation to prescribe dexamethasone for COVID-19 patients who are mechanically ventilated or require supplemental oxygen. Citing the RECOVERY trial for hospitalized patients in the United Kingdom, the panel advises using the drug at a dose of 6 mg per day for up to 10 days, with a strong recommendation for patients who are mechanically ventilated and a moderate recommendation for patients who require supplemental oxygen but are not mechanically ventilated. The panel says that the drug shouldn't be offered to COVID-19 patients who do not require supplemental oxygen. 

The Infectious Diseases Society of America also added dexamethasone recommendations to its treatment guidelines for COVID-19 patients this week. 

10x Reported COVID-19 Infections

Officials from the Centers for Disease Control and Prevention (CDC) estimate that more than 20 million Americans may have been infected with SARS-CoV-2, Reuters reports, while only one tenth of those cases have been recorded. They based this estimate on serology testing, which identified SARS-CoV-2 antibodies in an average of 10 people for every single known case of COVID-19. More than 120,000 Americans have died from the disease so far.

Texas Pauses Reopening

The governor of Texas temporarily paused the state's reopening on Thursday as COVID-19 infections and hospitalizations in the state continued to increase. Texas recorded 6000 new cases on Monday and has experienced record-breaking hospitalizations for 13 days straight. 

"At this time, it is clear that the rise in cases is largely driven by certain types of activities, including Texans congregating in bars," the Texas governor said in a press release. "The actions in this executive order are essential to our mission to swiftly contain this virus and enhance public health."

The new executive order mandated that bars and similar establishments close, as well as rafting and tubing businesses, and set a 50% maximum capacity for indoor restaurant dining. 

Why Is the Median Age of COVID-19 Cases Decreasing?

The median age of new COVID-19 cases is dropping in some areas, but what does that mean? Biostatistician Natalie E. Dean, PhD, explains three things that might be going on: more testing, better protection for older individuals, and more infections in younger adults. 

"The reality is almost certainly some mixture of all three explanations," she writes, "and will vary from location to location." 

Vaccine Distribution Planning 

Developing a SARS-CoV-2 vaccine and distributing it to all Americans will be a difficult feat, but experts from the CDC's Advisory Committee on Immunization Practices are already beginning to plan, using lessons learned from the 2009 H1N1 influenza pandemic. One example: prioritizing for initial vaccination those at increased risk for severe illness and healthcare personnel. 

Remdesivir Endorsed in Europe

The European Medicines Agency has recommended the conditional approval of remdesivir for COVID-19 patients over 12 years of age with pneumonia who require oxygen support. It is the first treatment on track for approval in Europe. Remdesivir is endorsed for severely ill COVID-19 patients in the United States, India, and South Korea, and it's approved in Japan.

The Week That Wasn't in COVID-19

This week in COVID-19 news, researchers announced a study of how coronaviruses infect bats, tech companies introduced products to promote careful handwashing, and scientists described the prevalence of SARS-CoV-2 antibodies in four different populations in Wuhan, China. But you didn't see these headlines on Medscape. Here's why.

Oral COVID-19 Vaccine in Development

The US government will fund a nonhuman primate study of an investigational oral COVID-19 vaccine as part of Operation Warp Speed, its program to accelerate the development of vaccines for the disease. Vaxart, the company developing the tablet vaccine, announced the news today. 

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 1500 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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