COVID-19 Update: Test Shortages, Possible Treatment Choices

August 12, 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: 

Test Shortages Might Last a While

The lack of supplies in the United States for conducting the appropriate amount of COVID-19 diagnostic testing within a useful turnaround time will likely last into the foreseeable future and will likely hamper the US response to the pandemic, say public health experts.

And this will probably delay diagnostic testing for other conditions, too, as schools and businesses scramble to try to reopen and hospitals begin to bring patients back in for elective procedures.

"We are increasingly concerned about the serious strains being placed on testing services for COVID-19, the impact those strains have on our ability to provide timely medical care to our patients, and ultimately on our ability to contain the spread of this dangerous virus," leaders from several medical groups write in a letter to US Health and Human Services Department Secretary Alex Azar.

Remdesivir Combo Treatment

On the treatment front for COVID-19, a new randomized, controlled clinical trial of the antiviral, remdesivir, plus interferon beta-1a in patients with the novel coronavirus is now underway.

Known as the Adaptive COVID-19 Treatment Trial 3 (ACTT 3), it is expected to enroll more than 1000 hospitalized adults with COVID-19 at as many as 100 sites in the United States and abroad. The National Institute of Allergy and Infectious Diseases (NIAID) is sponsoring the trial.

This is just one of hundreds of clinical trials ongoing the world over for COVID-19; treatment guidelines have evolved since the virus first appeared earlier in the year. Over the past few months, clinicians have learned more about the disease, and clinical trials have yielded information about what works — and what doesn't. Take this Medscape poll and tell us about how you treat your patients.

"Long-COVID" Affects Even Those With Mild Disease

Many patients are reporting long-term sequelae following COVID-19 infection, so called "Long-COVID," including those who only had very mild disease initially. A number of them are turning to the Internet for answers, often feeling dismissed when they have raised the issue with their healthcare provider.

Sachin Gupta, a pulmonologist and member of the CHEST Physician editorial advisory board who has treated numerous patients with COVID-19, tells Medscape how he believes physicians should respond to such concerns.

Most patients will not raise the topic until they have experienced prolonged symptoms, Gupta says, noting that acknowledgement and validation of the way they are feeling are important.

He advises: "Symptom management. I encourage such patients to build up slowly. I suggest they work first on their activities of daily living (bathing, grooming), then cooking, cleaning, checking the mail..," and lastly, "based on their tolerance of symptoms, to light purposeful exercise."

Ultimately, "I ask such...patients to expect a slow, gradual, and in most cases a complete recovery," Gupta said.

One British doctor, too, has noticed "Long-COVID" among recovering patients. Ramzi Khamis, MD, a cardiologist at Imperial College, London, tells Medscape UK: "One thing that surprises us now is to find that even with moderate COVID patients there is a number who find it difficult to recover. Their exercise tolerance takes a long time to return — 2 to 3 months or even longer."

Kidney Damage

Renal damage is another outcome of severe COVID-19 infection. A new study adds another piece to the confusing jigsaw that is COVID-19 and kidney injury; researchers now suspect any such damage is a by-product of SARS-CoV-2's effects elsewhere in the body, rather than a direct effect of the virus on the kidney.

The Many Ways School Openings Could Go Wrong

As a number of countries in the Northern Hemisphere debate whether to have remote or in-school learning, or a bit of both, in the wake of the COVID-19 pandemic, infectious disease expert Bill Hanage, PhD, of the Harvard T. H. Chan School of Public Health, discusses the many ways in which he believes opening schools in the US could go wrong.

Teen Tackles COVID With App

One teenager who may not be worrying as much as others about his future is Londoner Abubakar Buwe, 19, known as Abu ― a math whiz who has played a huge role building and running the COVID-19 symptom app developed by the company ZOE, in conjunction with Kings College Hospital.

Abu was on an internship with the health science company when the pandemic struck. He is now heading to Oxford University to study math and computer science.

The CEO of ZOE, Jonathan Wolf, said: "We have invited him back for his summer vacation and will try to convince him to come and work with us when he graduates ― if he hasn't offered me a job in his own world-conquering start-up by then."

Gaiter Bite

And last, but by no means least, a new study from Duke University, published in Science Advances  and highlighted in The Washington Post, finds that wearing a thin polyester spandex gaiter — well-liked by runners for their lightweight fabric — may be worse than going maskless when it comes to protection from COVID-19.

"It's not the case that any mask is better than nothing," says Martin Fischer, a chemist and physicist from Duke who participated in the study. "There are some masks that actually hurt rather than do good."

But as mentioned above, "may" is the operative word, because not everyone, according to an article in Slate, feels the study proves its case.

The study authors themselves issue a caveat, writing, "we want to note that the mask tests performed here (one speaker for all masks and four speakers for selected masks) should serve only as a demonstration. Inter-subject variations are to be expected, for example due to difference in physiology, mask fit, head position, speech pattern, and such."

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. 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.

Follow Lisa Nainggolan on Twitter: @lisanainggolan1. For more diabetes and endocrinology news, follow us on Twitter and on Facebook.

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