Covid-19 Diary : Sunday 22 March 2020

 

I’ll start with a slightly amusing story, in a dark sort of way.  In the early days of this outbreak, I’d visit the excellent Worldometers site several times each day and refresh the page to see the change in total case numbers over the last period of time since my last visit.  I’d take a note of the last two or three digits of the total cases before the refresh, so I could get a sense for how many more cases had been added.

A while back, I needed to always remember the last three digits, because there were usually hundreds more cases added between refreshes.  And then – you can guess how this story is going – a day or two ago, I needed to start focusing on the last four digits, because there were sometimes even thousands of extra cases being added between refreshes.

I did that just now, and before the refresh I noted the last four digits as being 2625.  After the refresh, they had dropped to 2134.  I’ve occasionally seen declines in numbers due to a revision/correction during the day, but I was surprised to see an almost 500 decrease in the last hour or so.  I wondered where the correction happened, and looking at the individual country numbers showed only continued solid increases.

And then, suddenly, I realized.  The full number for the earlier count was 322,625.  And after the refresh, it became 332,134.  So, not a 500 case decrease, but a 9,500 case increase.  I’ve never seen that that large a change before.  It is the exponential thing at work again.

The most alarming part, for me selfishly, of the skyrocketing increase on Sunday is right here in the US.  Sunday saw a huge leap in new cases, with 8149 new cases reported as of now.  Compare that to Italy, with the second highest count, of “only” 5560 new cases.

Most of the new cases in the US were reported in New York state (5429 new cases).  This seems to primarily be because the state is conducting much more widespread testing than other states are (yesterday I reported how California has essentially abandoned general/generic testing entirely).  So we’re not necessarily comparing apples with apples.  In other words, there’s no need to feel even more set-upon by this huge one-day increase in cases in the US.

The understatement of the day goes to a quote on this page :

Giovanni Guaraldi, MD, of the University of Modena and Reggio Emilia, which is in the neighboring region of Emilia-Romagna, said at his hospital, physicians were thinking carefully about how to treat older patients, concerned that those 80 and over may never get off respiratory assistance once it’s started. “This is also difficult to communicate” to the family, Guaraldi told MedPage Today.

Well, there are actually at least two parts of this which could qualify – the “thinking carefully” as well as the “difficult to communicate” phrase.

I Am Not a Doctor, But…..

There is a veritable flood of “alternative medicines” being offered as ways to decrease your susceptibility to this virus, and/or to speed a cure if you are infected.  I occasionally glance at them and wince, but have refrained from commenting on any because I really don’t know enough to do so, and in some cases, on the basis of “Can’t hurt, might help” and possibly placebo affects if nothing else, there seems little good point in commenting.

On the other hand, just piling on with more and more folk remedies doesn’t scale infinitely.  There can be “too much of a good thing” and an increasing body of evidence suggests, for example, that some high-dose vitamin/mineral supplements actually become harmful rather than helpful.  For most of us, most of the time, just “eating well” and spending time outdoors is all we need.  If you’re not eating so well (fresh fruit and vegetables in particular), a case might be made for some type of supplement.

Now for the “but” part of the statement.  Two things to recommend you consider.

 – Propolis

I was speaking with a friend in Kazakhstan last night.  She has several businesses there, including one that focuses on honey and other bee-related products.  She urged me to do the same thing that she and her family is doing – start taking Propolis every day.  Maybe you’re more au fait these things than me, but I’d never heard of it before.  Manuka honey, yes.  Royal jelly, yes.  Regular honey, of course.

I did some research, and this seems to be one of the more trustworthy articles – even to the point of understated caution.  This second article is a bit more specific and enthusiastic.

My main takeaway is that propolis is a natural product made by bees.  It seems to have almost no negative downsides or side effects (assuming you’re not allergic to honey and bee products in general), and may have some positive impact in terms of fighting both bacterial and viral infections.  Note the FDA have not endorsed it as a medicine and there are no clear medical studies proving any claims about any beneficial effects.  But there are some persuasive reports as well as generations of folk-lore.

I did further “research” on Amazon and noticed a lot of propolis products for sale, in several different forms – drops, spray, and capsules.  There were some traps in how the products described themselves (most notable being one that seemed well priced until you found the obscured truth that to get the stated dose, you had to take four rather than one capsule, making it in truth four times more expensive than apparent).

Bottom line – I ended up ordering this product.  200 doses for $25 – seems like a reasonable amount of money to hazard on something that may or may not provide any value.  Delivery is promised between 1-8 April.

 – Vitamin Supplement

I’ve never taken multi-vitamin supplements before.  But I tuned in on this concept after reading the reports of one coronavirus sufferer who suggested that part of his hospital treatment included something akin to a standard multivitamin supplement as a general boost to his immune system.  So I bought a large 500 tablet bottle of them at Costco (Kirkland Daily Multi – currently showing as $12.50, which is a mere 2.5 cents per tablet).  Alternatively, something like the Centrum Adult on Amazon seems fine as well.

Vitamins are an enormously high markup product, so don’t automatically assume that because a brand is ten times as expensive and has lots of emotive adjectives used to describe it that it is necessarily any better than a generic like the Costco/Kirkland brand, or a regular branded product such as Centrum.

Different topic….  One final opening point.  Is this really the type of person we want leading a state’s fight against the virus?  I think I’d prefer someone who hasn’t already resigned herself to everyone in her state contracting the virus!

Warning – regrettably, I’ve allowed some politics to intrude today.  Hopefully there’ll be no further need in subsequent days.  But as part of my mission to tell the truth, the whole truth, and nothing but the truth, it is necessary not only to cite the good articles out there, but to rebut the bad ones.

Statistics

More movements in position among the countries jockeying for places in the top six list.

For the record, the new top countries in terms of infection density are

  • San Marino/175 cases/the equivalent of 5.158 cases per million people
  • Faero Islands/115/2.354
  • Iceland/568/1,665
  • Andorra/113/1,462
  • Luxembourg/798/1,275
  • Vatican City/1 case/the equivalent of 1248 cases per million people

Tomorrow I’ll be able to add a new column to show values for the same day last week as well.  That will be a fascinating comparison.  For major countries and/or outbreaks, and in general :

Yesterday Today
Total Cases 304,900 336,075
Total Deaths/Percent of all Resolved Cases 13,001/12.1% 14,613/13.0%
Active Cases (ie not yet died or cured) 197,106 223,826
US Cases/Deaths/Case rate per million 24,218/302/73 32,783/416/99
UK Cases/Deaths/Case rate per million 5,018/233/74 5,683/281/84
Canada Cases/Deaths/Case rate per million 1,328/19/35 1,470/20/39
Worst affected major country/case rate per million Italy/886 Italy/978
Second worst country affected Switzerland/793 Switzerland/864
Third worst Spain/545 Spain/612
Fourth Norway/399 Norway/417
Fifth Austria/332 Austria/397

This is another day where the death rate as a percentage of all closed cases has risen.  As both our time and data series extends with more values, one would expect this to become more accurate, but no-one is suggesting that a case fatality rate of 13% is to be expected.  It is way above every anticipated result, and staying at an elevated level.

We’d like to see some scientific commentary, at a level beyond that we can easily offer, on why this is happening, particularly because the serious/critical case level (which implies a future reduction in mortality rates) remains steady at around 5% (or slightly less) of all active cases.

How Bad is Covid-19?

This is a question I keep coming back to.  Is this Wuhan virus as terrible as it is treated as being, or is it all a storm in a teacup?  I read far and wide, trying to distill the truth out of articles on the far fringes of opinion as well as mainstream thought, and there are plenty of opinions, some quite convincing, at every part of the spectrum from “It is nothing” to “It is the end of the world”, from infection rates of less than 10% to – as quoted above – “everyone will get it”, and with death rates from under 0.1% to perhaps 3.4%.

The main point to keep in mind is one I’m referring to daily at present.  The exponential nature of the impacts of this disease.  It is certainly true that in most countries, and for most of us, a week or two ago, the coronavirus was something you abstractly read about, not something that intruded on your life in any way at all.  More recently, it is something that has caused many of us to rush to the stores to buy toilet paper, even if we’re not quite sure why we’re doing so!

The issue to consider, when trying to decide just how big the Covid-19 outbreak will be is not what it is like now, but what it will become in the future, and that’s of course a very speculative thing and related to the exponential growth that I necessarily keep referring to.

So the first part of the answer is “immeasurably worse than we currently expect”.

To get a second part, I thought it would be helpful to compare, within the US, the daily deaths from Covid-19 compared to the average daily deaths from major causes of death.

That provides, I hoped, a useful perspective about the relative magnitudes of these various different killers that we’ve come to take largely for granted.

You can see the result on the left.  Compared to the “big five” killers – heart disease, cancer, Alzheimer’s, emphysema and strokes – it is almost impossible to see the impacts of Covid-19, it is lost in with the crush of other less major causes of death at the very bottom of the page, there being such a huge bap between heart disease and cancer in particular, and everything else.

But let’s now zoom in to some of the lesser but still leading causes of death.  Let’s look at Covid-19 compared to regular ‘flu and pneumonia, and eleven other successively lesser causes of death.

As you can now much more clearly see, the Covid-19 numbers, after remaining low for a few weeks, are starting to rise, with today being the worst day ever, almost twice the next worst day.

If this trend continues (as seems inevitably will be the case) soon Covid-19 will be exceeding the daily ‘flu/pneumonia deaths, and, of course, probably continuing to rise still further on the chart.  We won’t need to keep zooming in to just the bottom part of the chart to observe its impacts.  I’ll keep tracking this every day and report back to you as and when appropriate.

So it seems fair to say that yes, the virus is bad.  As in, very bad indeed.  And getting worse.

Who Should Pay?

The airlines are going through their traditional song sheet when asking for money.  First they ask nicely, then they threaten “draconian measures” if they don’t get what they want, and quickly.

There’s an interesting extra point cited in the article.  Apparently, IATA estimates a total loss of $30 billion in revenues from all airlines, worldwide.

Now please keep in mind that a loss of revenues is not the same as a loss of profits.  Remember that fuel is one of the largest two or three costs for an airline, maintenance another, and clearly, with no flights, airlines are neither burning fuel nor needing to do scheduled “per so many hours of flying time” maintenance.  Labor is another of the big three costs, and with the layoffs and fewer flights, labor costs are plummeting too.  So if the gross loss of revenue is $30 billion, the net reduction in profit might be $10 billion, maybe a bit more, but certainly a huge amount less than the gross $30 billion.

How is it that the US carriers alone are asking for $50 billion, just for themselves, if the entire world’s airlines, as cited by the world’s airline organization, advocate and mouthpiece, IATA, expect to lose perhaps $10 billion?

I was sent an excellent article by reader Bill that starts by quoting NY Governor Andrew Cuomo, who said on Friday

This is about saving lives. If everything we do saves just one life, I’ll be happy.

That’s definitely a statement that demands some scrutiny.  Is it really valid to say that losing trillions of dollars in our economy, having who-yet-knows how many people jobless and companies destroyed, is worth it to save one single life?  If that is so, why don’t we all have unlimited infinite healthcare coverage (and fully for free)?

The ugly reality that politicians, particularly left-of-center, rarely acknowledge, is that a human life can indeed be valued.  There is a sensible cost to accept if it will save the oft-cited “just one life”, but there’s a nonsensical cost that can’t be justified as well.  That is why our cars have seat belts and air-bags, but aren’t built out of armor plating with six inches of interior foam padding and three foot collapsible bumpers front and rear.  That is why we don’t have to wear crash helmets in our cars.  Almost everything in our lives has design and cost compromises to make it acceptably and affordably safe, but not obsessively safe.  And, the ugly truth now exposed, that is generally true of healthcare solutions, too.

Here’s the article.  And lastly on this point, while Gov Cuomo forbids people from going to work, meaning these people lose their livelihoods and their employers potentially lose their businesses, might one enquire if he is still getting paid, himself?  Shouldn’t sacrifice start at the top?  For that matter, exactly how many state employees have been laid off so far?

Timings And Numbers

This article cites the best and worst case outcomes, and rightly avoids commenting on which is most likely.  As the article says, the outcome is entirely up to us.

A corona virus “exit strategy” (whatever that is) could be months or even years away, per this article.

Steve Mnuchin says that the very partial lockdown in some parts of the country might last 12 weeks; Andrew Cuomo says the crisis could last nine months.  And both might yet be proven to be too optimistic.  Details here.

Closings

We saw an interesting message on Twitter, reporting that there’s been a 64% rise in rental properties in Dublin.  The reason?  Thought to be property owners switching from renting their properties on Airbnb to now offering them as long term rentals instead – a combination of a fall-off of Airbnb type renting and also it being safer and easier to not have to clean/disinfect a property between every nightly rental.

Emirates said they are discontinuing all flights.  Not just some.  Not even most.  All flights.  But then it changed its mind, just a few hours later, and said it will operate limited flights to some countries if the demand is there and the countries’ borders remain open.

Noting that the list of countries Emirates cited includes countries with 100% closed borders, and noting further the proviso that it will only operate flights if the demand is present to justify them, we think this is merely a more politically correct way of saying the same thing as “we are cancelling all flights”.

Shortages

I went out shopping this afternoon.  I discovered that the local Trader Joe’s supermarket is now restricting the number of people allowed in the store at a time, with the result being a growing line of people waiting their turn to enter.  Ugh.

When I did get in, there was a notice limiting all shoppers to no more than two of any item, and no more than one cart’s worth of products in total.  The shelves were very thinly populated with products, many times with a front row of products but none behind them.  I bought the last remaining bottle of their tomato ketchup, and my dog was relieved to learn they still had adequate supplies of canned dogfood.  Their dogfood comes in three flavors, so I interpreted the “no more than two of anything” rule to mean I could get two cans of each flavor, and duly did.

Almost next door was a QFC (regional chain in the Pacific Northwest) supermarket.  They weren’t limiting shopper admission, nor were they limiting quantities purchased.  Indeed, they had a special on Campbell’s Soups encouraging larger sized purchases – three for $4.  I bought six.  Their shelves were patchily filled/not-filled, but in general seemed better stocked than TJs – they even had a very limited range of pasta whereas TJs had none.

You don’t even have to read more than a couple of lines in this article to spot the contradictions.  Can you reconcile these two statements, made at the same time by the same person

=>  There’s no risk of food running out

=>  stockpiling items could leave others without crucial supplies

and here’s yet another article trying to “reassure us” by illustrating the article with more empty shelve/aisle pictures.

For a change, here’s an article that expresses horror at discovering full shelves in a Seattle area Target store.  What is wrong with that, you might ask?  Well, when the stocks crammed onto the shelves are N95 masks that local hospitals are desperately short of, and even more so when the Target store then refuses to allow medical authorities to bulk-buy all their product, horror does seem a fair response.

The city mayor, county executive, and even state governor all got involved, with the bottom line Target has now donated the masks for free and promised not to sell any more at retail.  The amusing point here is that if the store manager had just allowed the hospital to buy them all at full retail, there’d have been no negative story and some profit in it for him instead.

Logic?  What Logic?

I wasn’t quite sure where to include an important item, and decided here would do rather than create a new heading for hopefully a single one-off item.

The one thing that has really truly dismayed me, more than anything else, is how some people are deliberately lying and distorting the truth about this virus pandemic, and in doing so, are harming our response and our perception of the reality of the events unfolding before us.

Some do so out of pig-ignorance and others out of venal self-interest.  These venal people deliberately lie, even though they know the truth, because they can use their lies and distortions to advocate other items on their thinly obscured agendas.

No part of the discussion and analysis of this virus and what to do and how to do it to minimize its impacts should be political, but sadly, right from the very first day, many people have framed it solely from a political perspective.  Here’s a resounding rebuttal of all the lies that have been spread by those people.

I will concede that President Trump wasn’t first out the gate to recognise the existential threat of the coronavirus.  I was a month ahead of him, myself.  But, to put his “failing” into perspective, which other national leaders in which other countries  were ahead of him and castigating him for not acting more strongly?  Most seemed more concerned that he was closing US borders without consulting them first.

Let’s also look outside the US for another example of where political correctness is killing people, quite literally.  Let’s look at the worst hit of all countries – Italy.  Italy is a country that maintained for way too long there was no virus, or if there was, it wasn’t a problem, and, most of all, it would be unacceptable to focus on limiting the movement of people visiting Italy from China, because that would be racist.

This article starkly lays out the extended idiocy of Italy’s early response that led to its now worst-in-the-world infection rates, with the tragic result being, so far, almost 5,500 deaths, another 3,000 people in serious/critical condition (most of whom seem likely to die), and an unknown number of people dying because their other urgent medical needs can not be responded to due to virus-overload in the hospitals.  And just as all cases originally trace back to China’s own deceitful early non-responses, many other countries have been infected not by people who have been to or are from China, but by people who have been to or are from Italy.

Talking about China’s deceit, the one thing I’ve received the most comments on in the 30,000 or so words of virus commentary I’ve written this last week is my referring to it as the Wuhan virus.  I’m told by some people that to use this phrase is being xenophobic or prejudiced.  When I ask them where the virus actually came from, and further ask if we’re to stop labeling things with reference to where they originate from, how we should now relabel, for example, Szechuan style cuisine, they don’t respond.

Here we are, looking at a virus that came from China, that China’s inaction allowed to escape into the wild and infect our communities and our countries (and theirs as well – 3261 Chinese people have died from it too), everywhere in the world, and the only thing some people can say/do in response is “don’t call the Wuhan/China virus by the name of its origin”.

Virus?  What Virus?

Perhaps continuing on the threat of politically correct but fatal and fateful decisions, WHO was warned, way back in December, about the potential risks of the new Wuhan virus and its potential to be transferred from human to human.  But because the warning came from Taiwan, a country WHO refuses to allow to participate in its activities (at the behest of China) and because the warning was about China, WHO just ignored the warning entirely.  Not only did it ignore the warning, but WHO subsequently lied about the matter – on 14 January they were still maintaining the virus could not be transmitted from person to person.

This does beg the question.  What is the best name for this virus?  The Wuhan Virus?  The China Virus?  The Italian Virus?  Or, perhaps, to make the people who don’t like the thought of tying the virus to a specific region, the WHO Virus?

On Thursday, 2,647 passengers were allowed to disembark the Ruby Princess cruise ship in Sydney without being questioned about their health.  A day later, four passengers tested positive for coronavirus.

The cruise was deemed “low risk” by the New South Wales state government (because it was mainly Australians, New Zealanders and Americans, and only went from Sydney to New Zealand and back again), but clearly, after the positive result, some of the 2647 passengers have been exposed to the onboard COVID-19 and are now scattered across Australia, including into retirement homes and/or back to New Zealand or the US.

There is no such thing as “low risk” at present, and any time you get a group of people together, there’s a possibility that one (or more) people are already infected.  If the group is kept closely together, especially at meals, for a number of days, there’s a huge potential for the infected people to spread the disease on to others.

Medical

Here’s another recounting of a patient’s experience fighting the Wuhan/China/Italian/WHO virus.  Keep in mind, as you read the horrifying account of her struggles, that while we’re told the virus really only affects old people over 60 (when did “over 60” become old….) and those with other medical problems; this woman is fit and 39.

This is an interesting suggestion – one of the first indications you could be coming down with Covid-19 might be a loss of smell.

There has been some controversy about the potential value of chloroquine as a treatment for virus sufferers.  Sadly, it seems the largest part of the controversy is because President Trump weakly pointed out its potential/possible benefit, and the people who’d prefer to see us all die rather than admit he might be right about anything rushed to point out and restate what Trump had already acknowledged, that there have been no formal clinical studies to 100% confirm the drug works, 100% of the time.

Although there may not have been any current clinical tests on this exact coronavirus, chloroquine has been proven effective against other similar viruses such as SARS and indeed there were some positive trials back in 2005, and other hospital experiences have suggested benefits in up to 75% of people treated with the drug.

I’m going to try and find a mail-order “no prescription required” pharmacy and try to get some for myself.  Not to use as a preventative measure, but in case I get infected.  If anyone is aware of any such pharmacies, please let me know.  They used to be prolific on the internet, but Google decided “for our own good” to delist them all – the companies still exist, but are now impossible to find.

Yet again, Google claims to know better than we do ourselves what is best for us, and yet again, the internet which was supposed to be the ultimate level playing field and democratization of information ends up being effectively controlled by a handful of unaccountable organizations and their murky priorities.

This article has a great table of potential symptoms for the virus.  Noting that testing remains hard to obtain for much/most of the country, it might be helpful.

This article says the costs and impacts of our fight to control the spread of the coronavirus might be worse than the costs of the virus directly.  It is advocating for a case by case identification of patients and the people they come in contact with.  This is a process used successfully in some closely monitored Asian countries that also have relatively low numbers of new cases each day (such as Singapore).

We don’t disagree that this approach would be best, but it is already too late now – for example, this article tells how in Los Angeles County, doctors are being advised to give up on testing patients unless the test results would change how the patient is to be treated.  We no longer have the capacity and resources for the “surgical strike” approach.

That is unfortunate, and if we’d locked down our borders more strongly sooner, and responded ultra-aggressively to identify and isolate every possible infected person, maybe (but only maybe) it would have worked.  But we had those people – the ones who would prefer to kill us than to admit President Trump is correct – protesting our early border closures and labeling any measures targeted at the virus source – China – as being prejudiced against China.

We’re now too late for alternate approaches.  We need to do everything possible, or else the consequences threaten to be very much worse than any of the containment/mitigation strategies currently employed or being considered.

Money

With the markets closed over the weekend, we’ll wait and see what happens tomorrow.

Rumors

Other

We understand that strong measures may be needed to respond to scofflaws who flout movement restrictions and quarantine requirements at times like now.  But the current laws and justice system have all the tools needed, assuming the authorities choose to use them.  We find proposals like this (indefinite detention without trial) unnecessary and worrying in the extreme.

Here’s another adulatory article that seems to support my “Fauci for President” call.

Lastly, are these daily updates useful?  If they are, please pass them on to your friends and others.

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.

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