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May 4, 2020

New Covid-19 cases in US held steady last month—despite social distancing measures, data shows

Daily Briefing

    The rate of newly reported U.S. cases of Covid-19 held steady last month at about 30,000 cases per day, as providers are set to begin receiving Gilead Sciences' remdesivir to treat certain hospitalized Covid-19 patients.

    US Covid-19 cases surpass 1.1M, death toll tops 67K

    The news comes as the number of U.S. cases of Covid-19, the disease caused by the new coronavirus, and the number of U.S. deaths linked to the virus continue to grow. As of Monday morning, U.S. officials had reported 1,165,300 cases of Covid-19 in the country—up from 1,075,600 cases as of Friday morning.

    As of Monday morning, officials had reported a total of 67,785 U.S. deaths linked to the new coronavirus—up from 63,109 deaths reported as of Friday morning.

    Current projections raise new concerns around death toll, Covid-19 resurgence

    Despite over a month of social distancing in a majority of states, Axios' "Vitals" reports that the rate of newly reported U.S. cases of Covid-19 held steady last month at about 30,000 cases per day.

    According to "Vitals," the virus has continued to spread in part because many Americans—such as health care workers, emergency personnel, and grocery workers—have been unable to stay home. This, "Vitals" reports, presents a troubling picture, as many states are beginning to lift social distancing measures, which potentially could enable the new coronavirus to spread faster—and result in more deaths.

    The University of Washington's Institute for Health Metrics and Evaluation (IHME)—a predictive model that the White House has used for its Covid-19 case and death count projections—last week predicted the United States would see up to 70,000 deaths tied to the new coronavirus by August.

    However, the United States now appears likely to surpass that projection within a week, the New York Times reports. On Sunday, President Trump during a virtual town hall meeting hosted by Fox News said between 75,000 and 100,000 Americans could die from the new coronavirus.

    Separate modelling from CDC, which was obtained by the New York Times, suggests the United States could see about 200,000 new cases of Covid-19 by the end of May. According to the Times, the data also shows the number of daily U.S. deaths tied to the new coronavirus could reach 3,000 on June 1—nearly double the current daily death rate.

    Former FDA Commissioner Scott Gottlieb during an interview on CBS' "Face The Nation" on Sunday said he expects a "slow simmer" of new Covid-19 cases and deaths to persist throughout the summer and serve as a preview of larger outbreaks the country likely could see in the fall, when schools and college campuses reopen.

    "People are letting their guard down a little bit more, people are back at work after an August recess, and then you can see this slow simmer explode into a new epidemic or a large outbreak," Gottlieb said. "That's the concern, that if we don't snuff this out more, and you have this slow burn of infection, it can ignite at any time."

    And public health experts say robust testing is key to reducing the spread. Tom Inglesby, director of Johns Hopkins University's Center for Health Security, during an interview on NBC's "Meet The Press" on Sunday said access to testing for the new coronavirus continues to vary "like a patchwork across the country." He added, "Before we even get to the fall, I am worried that we will have small waves [of new Covid-19 outbreaks] in various places around the country for the coming months."

    FDA authorizes Gilead's remdesivir for emergency use to treat some Covid-19 patients

    As the nation continues to grapple with the Covid-19 epidemic, FDA on Friday issued an emergency use authorization (EUA) allowing providers to use Gilead's remdesivir to treat certain hospitalized patients with Covid-19.

    The move comes after NIH on Wednesday released preliminary data from a closely watched clinical trial suggesting the drug may help patients recover from the disease faster. An analysis of the trial's preliminary data showed that patients with severe cases of Covid-19 who received remdesivir had an average recovery time of 11 days, while patients with severe cases of Covid-19 who received a placebo had an average recovery time of 15 days. Put another way, patients who were treated with remdesivir had a 31% faster recovery time on average than patients who received the placebo.

    In addition, the preliminary results showed patients with severe cases of Covid-19 who were treated with remdesivir had lower mortality rates than those who received a placebo. According to the preliminary data, the mortality rate among patients who received remdesivir was 8%, compared with a mortality rate of 11.6% among those who received a placebo—though Anthony Fauci, director of NIH's National Institute of Allergy and Infectious Diseases, noted that difference was not statistically significant.

    FDA in the EUA recommends that providers using remdesivir to treat qualifying patients administer a five-day treatment course for patients who have not been intubated and a 10-day treatment course for patients who have been intubated.

    Gottlieb noted that the EUA includes language allowing providers to use remdesivir to treat patients who need supplemental oxygen but are not being treated with ventilators, which he said suggests providers could use the treatment in Covid-19 patients who have moderate cases of the disease. 

    "It can be used in moderate patients, as well as severe patients, and so I think this is a pretty broad indication, a pretty broad authorization, and it gives maximal flexibility to physicians. So, it's a very good development," he said.

    Under the EUA, Gilead will provide supplies of remdesivir directly to the federal government or authorized distributors. The federal government and authorized distributors will then distribute the drug to hospitals and health care facilities in collaboration with local and state governments.

    In addition, Gilead under the EUA is required to report all adverse reactions and medication errors tied to the drug's use. Health care facilities and providers also must report any adverse reactions tied to the drug to FDA.

    On Sunday, Gilead Chair and CEO Daniel O'Day during an interview with CNBC's "Face the Nation" said the company has donated its entire stockpile of remdesivir to the federal government.

    "We've donated the entire supply ... because we acknowledge and recognize the human suffering ... and want to make sure nothing gets in the way of this getting to patients," he said (Feuer, CNBC, 4/2; Johnson, The Hill, 5/2; Owens, "Vitals," Axios, 5/4; Baker, New York Times, 5/3; Perez/Cohen, Politico, 5/3; Lovelace/Feuer, CNBC, 5/1; Perrone/Marchione, Associated Press, 5/1; Wang, Inside Health Policy, 5/1 [subscription required]; Sternlicht, Forbes, 5/3; Azad, CNN, 5/3; New York Times, 5/4 [1]; New York Times, 5/4 [2]).

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