Covid-19 Diary : Wednesday 25 March 2020

 

I’d been reading late into the evening yesterday, seeking and sorting virus related articles for today’s diary entry, so my mind was – as it seems to always be – full of virus thoughts.  Suddenly, I realized I’d just semi-consciously coughed.  A dry cough.  Right at the top of the Covid-19 symptoms list.

I tried to ignore that cough, and so of course, by thinking about not coughing, I inevitably did.  Again.  And again.  Eventually I decided the best thing to do was urgently go to bed, sleep-off whatever it was, and hope to be all better in the morning, while trying also to shake off the little voice in my head pointing me to one possible exposure risk last Friday and telling me it was almost exactly the right amount of time from that contact to the present time (most common seems to be around 4 1/2 days from catching the disease to symptoms starting to appear).

I slept longer than usual, and woke feeling not entirely perfect, but I don’t think I’ve coughed today.  Eventually I decided to check my temperature and while the good news is isn’t elevated, it is actually almost at the point of being “too low”.  Possible explanations, I see from Googling, are alcohol and drug abuse.  I rush to assure you, neither is true!  What is true though is that it is usually the worst thing to do to Google one’s symptoms – you’ll end up being certain you’ve caught some rare and always fatal disease.

I remember one time going to see my doctor after having already consulted with Google.  I told him my symptoms, then to put him at ease, told him “It’s okay, I already know.  I’ve aggressive malignant skin cancer, and understand I’ll be dead before the year is out.”  The doc looked startled, then wrote something on a prescription form and said “Why don’t you try taking one of these once a day for a week first and see what happens”.  I did, and my “malignant skin cancer” disappeared.  It was apparently some sort of skin yeast. 🙂

Talking about drugs, I see that New York is now using, on a compassionate trial basis, the drug-combination that President Trump said seems promising.  Let’s hope the results from this will be positive.

Statistics

The top countries in terms of infection density are essentially unchanged in position from yesterday :

• San Marino/208 cases/the equivalent of 6,130 cases per million people
• Vatican City/4/4,994 (unchanged from yesterday)
• Faero Islands/132/2,701
• Andorra/188/2,433
• Iceland/737/2,160
• Luxembourg/1,333/2,129
• Liechtenstein/51/1,338 (no increase in cases for two days)

Here are the top six countries, showing death rates per million of population in the country :

• San Marino/21 total deaths/the equivalent of 619 deaths per million (no change from yesterday)
• Italy/7,503 deaths/124 per million
• Span/3,647/78
• Iran/2,077/25
• Netherlands/356/21 (new appearance on the list)
• France/1,331/20

To put those numbers into context, the death rates per million in US/UK/Canada are 3/7/1.0.

For major countries and/or outbreaks, and in general :

	Same Day Last Week	Yesterday	Today
Total Cases	218,953	417,676	468,499
Total Deaths/Percent of all Resolved Cases	8,943/9.6%	18,605/14.7%	21,185/15.7%
Active Cases (ie not yet died or cured)	125,394	290,759	333,497
US Cases/Deaths/Case rate per million	9,261/150/28	52,996/685/160	66,048/944/200
UK Cases/Deaths/Case rate per million	2,626/104/39	8,077/422/119	9,529/465/140
Canada Cases/Deaths/Case rate per million	727/9/19	2,590/25/69	3,409/36/90
Worst affected major country/case rate	Italy/591	Italy/1144	Switzerland/1259
Second worst country affected	Switzerland/360	Switzerland/1141	Italy/1230
Third worst	Spain/316	Spain/853	Spain/1059
Fourth	Norway/293	Austria/587	Austria/620
Fifth	Iran/207	Norway/513	Norway/569

It is a great surprise to see Switzerland now pull ahead of Italy in terms of the number of cases in relation to each country’s population.  This is not a one-off blip, either.  Switzerland has been steadily catching up with Italy, while avoiding the press attention that Italy has been receiving.

A prediction – in two days, China will have dropped from the country with the most cases in total to the third country, having been overtaken by both Italy and the US too.  And either in two or possibly three days, the US will have moved to the country with the most cases of anywhere in the world.  Ugh.

The big surprise today was Iran’s sudden surge in new cases.  They had a high new case count yesterday, but that looked as though it was just part of the random variation that is included in each day’s count, but now with 2,206 new cases today – 50% more than the previous highest new case count (which actually was yesterday) it seems there might be a significant surge in new cases there.  There was also a slight lift in deaths, so perhaps one province was playing “catch up” and lumped together a couple of days of numbers.  We’ll have to see what happens in the next few days.

The big puzzle continues to be the steady growth in closed case fatality rates.  As I’ve stated every day now for way too many days, this is entirely counter-intuitive and at variance with what experts predict and the known numbers imply.

While very many numbers in the entire evaluation and charting of this virus are ambiguous or uncertain, the two numbers that are probably most certain are the number of people who have died and, secondarily, the number of people who were infected and have now been declared as cured.

Here’s another chart for you.  It is an update of the US death rate chart, putting the daily death count from coronavirus into the context of other leading causes of death.

I include a conservative estimate for today’s total (it won’t be exactly known until this evening).  So what seems like a drop in deaths today is either my overly conservative guess or perhaps a random blip, rather than credible cause for rejoicing and relaxing.

As you can surely see, the last two days have both suffered more coronavirus deaths than the average annual ‘flu/pneumonia death rate (the green line).  People have loved to say “What is the big fuss, every year we have 25,000 or more people die of the ‘flu and no-one reacts, and this new virus has only killed (some very small number)”.

But – and keeping in mind the exponential thing too – that statement can no longer be credibly be made.  For the last two days, the rate from this virus is more than the combined rate from regular ‘flu and pneumonia too (probably half is ‘flu and half is pneumonia).

Who Should Pay?

Here’s a good summary of what the $2 trillion spending bill will do.  The quick headlines are $1200 per adult and $500 per child if you’re earning less than $75,000, no penalty on retirement fund early withdrawals, free virus testing, $100 billion given to hospitals, and a $500 billion fund to provide loans and guarantees and other forms of support to businesses.

Importantly, this $500 billion is not in the form of cash-grants.  The airlines will get $25 billion, which is half their $50 billion ask, and my sense is their initial ask was for a cash grant rather than loans or equity investments, so they’re probably going to be somewhat disappointed.

As mentioned in the article, four Republican senators and Bernie Sanders (however you describe him – an independent senator hoping to become the Democratic Presidential nominee?) are objecting to provisions of the bill. The four senators say the unemployment provisions would mean that low income workers get paid more if unemployed than employed, and not unreasonably suggest this might not be a good way to encourage/reward good behavior, and ask that the unemployment benefit be limited to no more than a person’s regular earnings.  They say the way it is written currently is a drafting error and was never meant to be policy.  Bernie Sanders describes this as “anti-worker objections” and says he won’t support fast-tracking the bill unless the Republicans back down from their demands.

Timings And Numbers

The latest estimate out of New York is that it may reach a new case peak sometime in the next 14 – 21 days.  We’d hope for the peak to come even sooner, due to the movement restrictions now in place, but we also know these restrictions are full of exceptions and are imperfectly observed.

It seems the title of “epicenter” is being passed from one city/county/state to the next to the next.  I’m very glad that where I live is no longer the epicenter.  And while yesterday New York (City) was claiming that title, today New Orleans is asking for it.

The beyond-obvious reason why cases are surging in and around New Orleans?  Mardi Gras, of course.

Possibly good news from China.  This is a good article but needs to be read very carefully – the article was obviously written so as not to annoy the Chinese.  It is important to understand that “easing” the travel restrictions is not the same as “ending” them.  You’ll still need to be able to prove you’re disease free (via an app on your phone) in order to be allowed to travel.

But even a successive series of easings of travel restrictions is a good thing.  The article also delicately touches on the possibility that cases in China were not only very undercounted in the early stages, but continue to be undercounted now, too.

Flowing directly from that article are these reported comments from Dr Fauci, who suggests the disease may become seasonal and return in our fall.  We’ll happy accept any respite during the summer months, of course, but we’re not entirely sure there is solid enough data to support his observation that the growth in southern hemisphere cases may be related to climate issues.

There’s really only been a month between the start of the virus and now, and temperatures haven’t changed that profoundly anywhere in that time.  We feel the growth in southern hemisphere cases might be a case of the virus simply taking more time to travel there, although we agree that in the modern jet age, and with travel to/from China being fairly ubiquitous everywhere in the world, that does feel like a bit of a stretch to put forward as the only explanation.

Of course, if the virus is indeed so very temperature sensitive, that is nice.  It is also a simple thing to test for, which has us wondering why there isn’t already a definitive study showing virus survival as a function of temperature and humidity.

Closings

If you do an internet search, you’ll see there have been predictions that the USPS will run out of money appearing regularly over the last ten years or so, maybe even longer.

So perhaps this latest invocation, saying the USPS may need to close in less than three months, needs to be taken with a grain of salt.  On the other hand, it is even more terrifying if we are increasingly relying on mail order, and if we both lose the Postal Service and continue to suffer more and more slowdowns from Amazon, what can we do to get products quickly and reliably (two words that the USPS are seldom credited with qualifying for, but which in truth they probably deserve)?

The reason for the latest prediction is due to “a critical fall-off in mail”, as a result of the coronavirus.

I mentioned Amazon delivery problems.  My last attempt, yesterday, at ordering something from Amazon was very disappointing, with all the Prime featured products having long delivery times rather than one or two day delivery.  Amazon now has at least six of its warehouses affected by virus outbreaks.

The Olympics have now been officially delayed until 2021.

Here are some interesting statistics on airline schedule cutbacks, but we wonder why the article writer describes airlines as having “cut 100% of capacity” rather than simply saying “cancelled all flights”.

We continue to believe there are way too many remaining flights still operating in the US, ridiculously more than the loads can support.  Yesterday, per the TSA, saw about 275,000 people fly, compared to 2.1 million the same day last year.  Look for more cancellations.

Shortages

The argument if you should or shouldn’t build up an adequate/sufficient personal supply of food continues to rage.  Well, some “authorities” say we shouldn’t, but most people are ignoring them and doing what they feel sensible and prudent.  Here’s a new reason to worry about food supplies in the future – some countries that have formerly exported food are now starting to hoard their surplus food, themselves.

It does make it even harder to tell an ordinary man-in-the-street not to hoard food when entire countries are doing so now.

Logic?  What Logic?

Something that all epidemiologists are gaspingly desperate for at present is more data about the spread of the disease.  With more data, they can understand what is currently happening, and – most of all – start to come up with fact-based predictions for what to expect for the future.  The wild guesses about the percentage who might be infected, and the percentage of people who might die, and the time this will all take – these can cease being guesses and can start to become more probable expectations of likely future events.

As I said above, at present, there is only one statistic that we can place much confidence in – the number of people dying from the virus.  Even that isn’t 100% accurate – because how do you adjust for people who were almost dead already, but had their final passing slightly hastened by a slight nudge from the coronavirus, compared to a person in excellent health and with many decades of great life otherwise ahead of them?  Plus there’ll be some people just outright misdiagnosed.

However, flawed as it is, the death count is still the best number we have.  But it is totally insufficient to start to project any of the outcomes mentioned above.  What we need to know is how many people do not yet have the disease, have already had it and are now cured (especially including people who never were diagnosed with the disease), and how many people currently have the disease.  Those are the three numbers we desperately need.

There’s only one way to get those numbers, short of testing everyone in the population, regularly.  That is to do the same as opinion polls for elections, by doing random sampled testing.  We totally don’t have that at present.  We are only testing people who either are thought to probably have the disease already, or hypochondriacs who are pressuring to be tested.

Worse still – and now I get to my point – some of the US states aren’t reporting and sharing all that data.  So even the inadequate data we are obtaining isn’t being shared and can’t be used to improve our understanding and expectations.

That is sheer incompetence (or intransigence) of an almost criminal order.  And these are the same health authorities that some would suggest we should completely trust with our futures and leave all critical care decisions in their hands.  Not me.

Here is some good news about testing – an ambitious wide-spread testing program is about to be deployed in the UK.  It is still a biased “self selected” testing sample, and, crucially, there’s no mechanism to ensure that self-test-at-home results are then accurately and quickly reported to the central public health authorities.  But any testing is better than no testing.

Gov Cuomo has been getting a lot of airtime recently, but not all of it is to his benefit.  This article reports how he is thinking of closing some of New York’s streets because too many people are following each other too closely.  But closing some streets would funnel people into fewer streets, causing them to crush even more tightly together.  Bad idea.

He also complains that the federal government’s proposed $3.8 billion gift as part of its $2 trillion funding deal is not enough, saying that New York will incur as much as $15 billion in costs.  But unexplained is why he believes the federal government should pay 100% of NY’s costs, but not 100% of every state’s costs (and also not 100% of any business or person’s costs either).  Also unexplained is why he thinks struggling people and struggling businesses, in other struggling states, should have to struggle even more, so that NY alone can be made 100% whole again.

Here’s a store with a curious policy.  It won’t allow you in their store and will refuse to sell you anything unless you are wearing a mask and gloves.

Gloves in particular are a largely nonsensical item in terms of protecting the people around you.  A glove provides a great surface for viral particles to affix themselves to.  A glove is only clean the minute you put it on – and quite likely you might even contaminate it as you put it on.  It then very quickly becomes as dirty as the surroundings, and probably dirtier than your hands.

But perhaps there’s method in the store’s madness?  You see, directly outside the store, they have a stand selling overpriced masks.

Virus?  What Virus?

An airline known for its, ahem, “outside the box” marketing creativity has come up with a new campaign.  They are offering to pay fliers £7000 (about $8400) if the flier catches the virus on one of their flights.

Even assuming there was an easy way to prove where you caught the virus, and the airline truly did pay out, would you be willing to experience the virus, possibly time in the ICU and intubated, some weeks in hospital and a measurable chance of death, with a £7,000 compensation being offered?

Full marks to Vietjet for another headline grabbing promotion, but I think I’ll pass.

Here’s a really good article about our current social distancing obligations which really should be essential reading for us all.

Medical

Here’s good news of another possible drug to fight the infection.  It worked well in China, and a clinical trial is about to start for 60 days in the US and elsewhere.

The following was taken from a Facebook post, and attributed to an Assistant Professor in Infectious Diseases at Johns Hopkins University. It is a great article and worth reading through.

• • The virus is not a living organism, but a protein molecule (DNA) covered by a protective layer of lipid (fat), which, when absorbed by the cells of the ocular, nasal or buccal mucosa, changes their genetic code. (mutation) and convert them into aggressor and multiplier cells.
  • Since the virus is not a living organism, but a protein molecule, it is not killed, but decays on its own. The disintegration time depends on the temperature, humidity and type of material where it lies.
  • The virus is very fragile; the only thing that protects it is a thin outer layer of fat. That is why any soap or detergent is the best remedy, because the foam CUTS the FAT (that is why you have to rub so much: for 20 seconds or more, to make a lot of foam). By dissolving the fat layer, the protein molecule disperses and breaks down on its own.
  • HEAT melts fat; this is why it is so good to use water above 25°C (77°F) for washing hands, clothes and everything. In addition, hot water makes more foam and that makes it even more useful.
  • Alcohol or any mixture with alcohol over 65% DISSOLVES ANY FAT, especially the external lipid layer of the virus.
  • Any mix with 1 part bleach and 5 parts water directly dissolves the protein, breaks it down from the inside.
  • Oxygenated water helps long after soap, alcohol and chlorine, because peroxide dissolves the virus protein, but you have to use it pure and it hurts your skin.
  • NO BACTERICIDE SERVES. The virus is not a living organism like bacteria; they cannot kill what is not alive with anthobiotics, but quickly disintegrate its structure with everything said.
  • NEVER shake used or unused clothing, sheets or cloth. While it is glued to a porous surface, it is very inert and disintegrates only between 3 hours (fabric and porous), 4 hours (copper, because it is naturally antiseptic; and wood, because it removes all the moisture and does not let it peel off and disintegrates), 24 hours (cardboard), 42 hours (metal) and 72 hours (plastic). But if you shake it or use a feather duster, the virus molecules float in the air for up to 3 hours, and can lodge in your nose.
  • The virus molecules remain very stable in external cold, or artificial as air conditioners in houses and cars. They also need moisture to stay stable, and especially darkness. Therefore, dehumidified, dry, warm and bright environments will degrade it faster.
  • UV LIGHT on any object that may contain it breaks down the virus protein. For example, to disinfect and reuse a mask is perfect. Be careful, it also breaks down collagen (which is protein) in the skin, eventually causing wrinkles and skin cancer.
  • The virus CANNOT go through healthy skin.
  • Vinegar is NOT useful because it does not break down the protective layer of fat.
  • NO SPIRITS, NOR VODKA, serve. The strongest vodka is 40% alcohol, and you need 65%.
  • LISTERINE IF IT SERVES! It is 65% alcohol.
  • The more confined the space, the more concentration of the virus there can be. The more open or naturally ventilated, the less.
  • You have to wash your hands before and after touching mucosa, food, locks, knobs, switches, remote controls, cell phones, watches, computers, desks, TV, etc. And when using the bathroom.
  • You have to HUMIDIFY HANDS DRY after washing them, because the molecules can hide in the micro cracks. The thicker the moisturizer, the better.
  • Also keep your NAILS SHORT so that the virus does not hide there.

Here is a very interesting but rather chilling timetable of what happens, day by day, if you get the virus.

It is interesting to note that almost half of New York City’s coronavirus cases are in people under 45.  Maybe their survival rates are better than for older folks, but they’re clearly every bit as much at risk as are older people.  They need to follow the same stringent social distancing rules as everyone else.

Money

The Dow continued to move gently upwards today.  Well, on any normal day a 2.4% uptick would be cause for rejoicing, but today it is merely reclaiming a bit more of the recently lost ground, and with no certainty of values holding into the future.  It closed at 21,201.

Rumors

Other

Here’s a fascinating bit of statistical trivia – the most searched for disinfectant terms by state. We hesitate to draw any conclusions.

We continue to be confronted with the conundrum – which freedom would we prefer?  Privacy, or being spared the virus?  While great privacy lovers, we feel the latter is currently the more valuable.  Here’s a great article about what Hong Kong is doing to enforce stay-at-home and self-quarantine orders.  It is clearly necessary, everywhere – this article suggests that over 100,000 Italians have been defying their travel bans.

Ooops.  I just coughed again.  Time to stop and see if some relaxation will help!

Please stay happy and healthy; all going well, I’ll be back again tomorrow.

 

Please click here for a listing of all our Covid-19 articles.