COVID-19 Update: Trump’s New Adviser,
Plasma Potential

Ellie Kincaid

August 17, 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: 

Trump's New Adviser

President Trump last week added a new medical adviser to the White House's coronavirus response: Scott Atlas, MD, a senior fellow at Stanford University's Hoover Institution, a conservative think tank. His views are aligned closely with Trump's views on the virus, particularly with regard to reopening schools, avoiding lockdowns, and resuming some sports.

Atlas is board-certified in diagnostic radiology and served as a professor and chief of neuroradiology at Stanford University Medical Center in California from 1998 to 2012. He has also worked as a medical adviser for Republican presidential candidates including Mitt Romney.

Plasma Potential

Researchers from the Mayo Clinic recently reported the outcomes for 35,000 COVID-19 patients who received convalescent plasma through the US Food and Drug Administration (FDA) expanded access program. The results "provide signatures of efficacy," they write in the report posted to the preprint server medRxiv.org, though the study was observational and did not have a control group. 

More than 64,000 COVID-19 patients in the US have already received convalescent plasma as a potential treatment, but experts worry it will be difficult to learn whether the intervention works through clinical trials. "There's concern about when there will be a clear answer," one infectious disease specialist told the Associated Press.

Skin Lesions From Infection or Treatment? 

SARS-CoV-2 infection has been associated with a range of skin conditions, but the drugs used to treat COVID-19 can also have cutaneous side effects, dermatologists write in a review

Diagnosing skin manifestations in patients with COVID-19 remains a challenge, because it is unclear whether the skin lesions are related to the virus, the authors write. They recommend that dermatologists consider adverse drug reactions in the differential diagnosis as well. 

PPE Shortage Could Last Years 

Officials from healthcare and manufacturing industries predict that shortages of personal protective equipment (PPE) and medical supplies could persist for years without strategic government intervention, Kaiser Health News reports

Manufacturers in the National Council of Textile Organizations, which make reusable cloth gowns, have made "hundreds of millions of products," said CEO Kim Glas, but without long-term government contracts, many are apprehensive to invest in the equipment needed to scale up the business and eventually lower prices. 

"If there continues to be an upward trajectory of COVID-19 cases, not just in the US but globally, you can see those supply chains breaking down again," Glas said. "It is a healthcare security issue."

US to Make Coronavirus Strain for Possible Human Challenge Trials

US government scientists have begun efforts to manufacture a strain of SARS-CoV-2 that could be used in human challenge trials of vaccines, in which healthy volunteers would be vaccinated and then intentionally infected with the virus, Reuters reports.

The work is preliminary and such trials would not replace phase 3 trials such as those now under way testing experimental COVID-19 vaccines from Moderna and Pfizer, according to a statement from the National Institute of Allergy and Infectious Diseases (NIAID).

"Should there be a need for human challenge studies to fully assess candidate vaccines or therapeutics for SARS-CoV-2, NIAID has begun investigations of the technical and ethical considerations of conducting human challenge studies," the agency's statement said.

FDA Authorizes New Saliva Test 

The FDA authorized a new type of saliva-based COVID-19 test on Saturday, which could cut down on the cost of testing and the time it takes to process results. 

The diagnostic test, created by the Yale School of Public Health and called SalivaDirect, doesn't require a special type of swab or collection tube, and also doesn't require a special type of extractor, which is helpful because the extraction kits used to process other tests have faced shortages during the pandemic. 

Yale will provide the instructions to labs as an open source protocol. The test doesn't require any proprietary equipment or testing components, so labs across the country can assemble and use it based on the FDA guidelines. The testing method is available immediately and could be scaled up quickly in the next few weeks, according to a statement from Yale.

Experimental Botanical Discussed

President Trump met with the vice chairman and director of a biotech company, along with secretary of Housing and Urban Development Ben Carson, MD, and MyPillow founder/CEO Mike Lindell, an investor in the company, to hear about its experimental botanical extract oleandrin that the vice chairman says is a "cure" for COVID-19, Axios reported

In a preprint posted to the server bioRxiv.org last month, scientists from the University of Texas Medical Branch at Galveston and Phoenix Biotechnology, the company developing oleandrin, said the compound demonstrated "potent prophylactic and therapeutic antiviral activities" in cultures of Vero cells. Further clinical studies have not been published. 

According to Axios, Phoenix Biotechnology vice chairman Andrew Whitney said the company is pursuing FDA authorization for oleandrin as a drug for COVID-19, or permission to sell it as a dietary supplement, and Trump has reportedly "expressed enthusiasm" about the extract.

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 .

For more news, follow Medscape on Facebook, Twitter, Instagram, and YouTube, and follow Ellie Kincaid on Twitter @ellie_kincaid.

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