COVID-19 Update: Chronic Fatigue, Preventing Next 5M Cases

Ellie Kincaid

August 10, 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:

Chronic Fatigue

More than a third of people with COVID-19 symptoms said they were not feeling back to their normal state of health when researchers called them a couple weeks after testing, according to a recent CDC report.

Scientists are beginning to study whether the SARS-CoV-2 infection may create post-viral issues such as myalgic encephalomyelitis, also known as chronic fatigue syndrome.

Several lawmakers created a bill called the "Understanding COVID-19 Subsets and ME/CFS Act," which would allot $60 million of federal funding to research projects about the long-term effects of COVID-19.

Preventing the Next 5 Million Cases

The US has officially tallied more than 5 million confirmed cases of COVID-19, 1.5% of the country's population. If the true number is 10 times higher, as research suggests, that still leaves plenty of room for the virus to spread. Experts have outlined recommendations to address the pandemic at this stage — and prevent the current case count from doubling.

"My best hope is for a vaccine," William Schaffner, MD, an infectious disease specialist at Vanderbilt University, told WebMD Chief Medical Officer John Whyte, MD, in a video interview, "a vaccine that's safe and effective, and for which we can create a delivery mechanism that is efficient, clear, transparent, and equitable, getting to all of the populations here in the United States and then around the world."

If the country's current trajectory continues until December 1, scientists from the University of Washington's Institute for Health Metrics and Evaluation predict nearly 300,000 Americans could die from COVID-19 by then, though they estimated 70,000 fewer lives would be lost with universal mask-wearing.

Operation Warp Speed Plans Clarified

Moncef Slaoui, PhD, the chief of the federal government's effort to develop COVID-19 vaccines and therapeutics quickly, dubbed "Operation Warp Speed," said the program's previously stated goal to deliver 300 million vaccine doses by January 2021 would likely not fully occur until the middle of the year, depending on the data from clinical trials.

The program aims to deliver 300 million courses of therapy, not individual doses, as some vaccines will likely require two doses, he clarified, speaking to a National Academies of Sciences, Engineering, and Medicine committee that will issue recommendations on COVID-19 vaccine allocation in September.

Slaoui also said that every vaccine candidate would seek full approval from the US Food and Drug Administration (FDA), as opposed to an emergency use authorization, which has been used for most of the COVID-19 diagnostics and therapeutics that have been brought to the US market so far. Slaoui said that Operation Warp Speed had an agreement with the FDA to quickly review data, but that approval criteria "will be the same as those used for any regular vaccine."

Antibody Testing in NYC HCPs

Voluntary testing for SARS-CoV-2 antibodies at a large healthcare system in New York found that 13.7% of healthcare personnel (HCPs) tested positive for the antibodies, only slightly higher than the prevalence other studies have found for the state's general adult population.

The researchers found very little difference in antibody seroprevalence when sex, race, ethnicity, and age were factored in, as well as whether a person worked in an area such as an intensive care unit or behind the reception desk, the researchers write.

Glycemia in Dexamethasone-Treated COVID-19

Although there are already guidelines that address inpatient management of steroid-induced hyperglycemia, the UK National Diabetes COVID-19 Response Group has put out new guidance addressing glucose management particularly for COVID-19 patients receiving dexamethasone therapy.

The authors say that this new guidance was needed "given the 'triple insult' of dexamethasone-induced impaired glucose metabolism, COVID-19–induced insulin resistance, and COVID-19–impaired insulin production."

In Memoriam

As front-line healthcare workers care for patients with COVID-19, they commit themselves to difficult, draining work and also put themselves at risk of 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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