Covid-19 Diary : Friday 1 May, 2020

 

I started off an email to a friend, earlier today, with these comments.  They express a new fundamental truth, and are worth repeating and amplifying.

Trying to keep ahead of all the developments on this virus is an astonishingly complex challenge.  Even now, many months into this struggle, we’re still discovering new things, New issues/concerns keep appearing, while old issues stay contentious and unresolved, like the never-ending debates on locking down and opening up.

Dismayingly, we’re even still debating fundamental things like “is the virus actually serious or is it a whole lot of nothing-burger”.  The lack of consensus, at all levels, about all things, is astonishing.

The only thing that hasn’t changed over the months is the consistently bad approach to everything taken by everyone.

We are spending trillions of dollars on compensatory aid for people and businesses harmed by this virus.  But how much are we spending to understand the virus and to be able to come up with answers to bring us back to normal?  Some companies, deserving or not, seem able to get tens of millions of dollars in aid just by asking for it.  But are similar amounts of money for research into the virus also freely on offer?

There is a multi-trillion dollar cost associated with each extra month we stay closed.  Shouldn’t we be willing to spend many billions of dollars, even on long-shots, any time there’s the possibility of bringing us closer to a solution that will allow us to return properly and completely to normal, with the virus fully vanquished and vanished?  In round figures, each extra day we’re closed is costing the country over $100 billion.

In addition to directed research to solve the present coronavirus crisis, shouldn’t we be spending extra billions of dollars to understand more about the truly weird and peculiar things that viruses are, and to come up with anticipatory knowledge and products for the next time a new virus suddenly attacks us?  Shouldn’t there be a worldwide effort to find the virus equivalent of penicillin?

Even while the government is throwing trillions of dollars with glee at all sorts of unlikely recipients, it is holding back on any type of investment in mastering an understanding of this virus and how to beat it.  That’s beyond crazy.

Here is an excellent article, written on 13 April (nearly three weeks ago) that posed 48 questions about the virus that had no answers.  A few of the questions are trivial, but many are vitally important and essential to be able to answer accurately.  Nearly the entire collection of 48 questions remain unanswered today.

Why are there not coordinated groups of researchers around the country and world focused on answering each and all these questions?

Here’s a new article that appeared a week ago, which points out an astonishing thing.  Although there have now been almost a quarter million deaths world-wide (and over 66,000 within the US alone), we still don’t know exactly why and how the virus kills its victims.

Sure, some types of vaccines can be developed without any need to understand and answer that question, but cures for infected people do need to know all about this process.  There is no clear pattern as to what/when/how/where the virus attacks, and no clear consensus as to the medical treatments best adopted in response.

For that matter, consider the much debated hydroxychloroquine, and the tens/hundreds of other similar off-the-shelf drugs that might be able to help people when they come down with the infection.  What is happening with testing any of these products?  All we know is there have been no “acceptable” tests with HCQ so far, and the “unacceptable” tests have given ambiguous results.  There have been two trials of remdesivir, one of which was negative and one of which was partially positive.  But is that the best we can do?  With these drugs, or with any of the other drugs!?

There’s no shortage of people to trial these things on.  Currently there are over two million active cases in the world, nearly one million of those being in the US alone.  We should be trying something on everyone.  Why aren’t we?

How about also trying to understand why some countries have so much higher rates of infections and deaths than others.  Why is the US near the top of both reported infections and also deaths?  If we knew that, we’d have some clear direction as to what we should do to move down that terrible list.

Another essential question – herd immunity.  Why has we not asked for volunteers from the hundreds of thousands of recovered patients and tested to see if they truly do have immunity against re-infection?  In the back of many people’s minds is a reliance on a “worst case scenario” that if all else fails, we’ll still end up with herd immunity.  What if that assumption is incorrect?

Where is the sense of urgency in any of this?  In the US, we’re suffering over 2,000 deaths every day, more than for any other type of disease.  We have as many as 30,000 newly infected people appearing every day – we’ve so many possibilities to trial any and every possible type of drug.  Why is this not happening?

These drug trials don’t have to take months.  You start getting meaningful data on measures such as viral load levels in less than a week of treatment, and longer term case resolution starts to become apparent in about two weeks.

Nothing – nothing at all – is more important than resolving this virus attack and getting our society and our economy back on an even keel.  While we’re obsessing over trivialities and indulging in fantasies about how we can live almost-normal lives (a nonsense concept to start with) and co-exist alongside the virus (another nonsense concept), we’ve totally taken our eye off the main game.

The main game is coming up with a treatment to quickly cure people who get the disease, and a vaccine so people can avoid the disease in the future.

Current Numbers

Here are the rankings for the eight states of any size with the highest infection rates.  There has been no change in rankings.

  • San Marino/580 cases/the equivalent of 17,094 cases per million people
  • Vatican City/11 cases/13,733 cases per million (unchanged)
  • Andorra/745/9,642 (unchanged)
  • Luxembourg/3,802/6,074
  • Iceland/1,798/5,269
  • Spain/242,988/5,197
  • Qatar/14,096/4,893
  • Gibraltar/144/4,274 (unchanged)

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

  • Belgium/7,703 deaths/665 deaths per million
  • Spain/24,824 deaths/531 deaths per million
  • Italy/28,236 deaths/467
  • United Kingdom/27,510/405
  • France/24,594/377
  • Netherlands/4,893/286

To put those numbers into context, the death rates per million in the US/Canada are 199/90.  The world average (not a very reliable number) is 30.7.

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

Same Day
Last Week
YesterdayToday
Total Cases2,829,8833,304,2203,398,473
Total Deaths197,243233,850239,448
Active Cases (ie not yet died or cured)1,834,0352,031,0172,078,924
US Cases/Deaths/Case rate per million925,038/52,185/27951,095,023/63,856/33081,131,030/65,753/3417
UK Cases/Deaths/Case rate per million143,464/19,506/2113171,253/26,771/2523177,454/27,510/2614
Canada Cases/Deaths/Case rate per million43,888/2,302/116353,236/3,184/141155,061/3,391/1459
Worst affected major country/case rateSpain/4,700Spain/5,125Spain/5,197
Second worst country affectedBelgium/3,822Belgium/4,186Belgium/4,231
Third worstIreland/3,683Ireland/4,174Ireland/4,219
FourthSwitzerland/3,313Switzerland/3,419Switzerland/3,432
FifthItaly/3,192Italy/3,398Italy/3,431

Today saw the US post its second highest number of new reported cases (36,007).  Are we really ready to start relaxing our social distancing?

I Am Not a Doctor, But….

This is an interesting concept – disinfection booths at airports.  But it strikes me as being totally wrong.  First, what is the point of disinfecting someone if they then sneeze a minute later?

More importantly, most disinfectant chemicals are very poisonous – that is almost an unavoidable requirement of such chemicals.  There’s no way in the world I’d want to be sprayed by them in a booth, nor would I want to be next to someone else who had been, either.

Timings And Numbers

Here’s an astonishing story about a possibly additional reason why China wanted to keep its virus outbreak secret for as long as possible – to give them time to buy up as much PPE as they could, all around the world.  The story is on a Canadian website and so primarily focused on Canada, but we believe it was happening elsewhere, too.

As you’ll see, this wasn’t so much a case of contacting wholesale suppliers and ordering container loads of bulk product (although was going on too).  It was deploying Chinese immigrants to go to retail shops and buy up all the masks they could find, one by one, on the shelves of the stores.

Be sure to notice the real “kicker” in the story, too.  The PPE that China bought up is now being sold back to the countries it bought it from.  But at 20 – 30 times the price it was originally bought for.

Some bad news.  A University of Minnesota Center for Infectious Disease Research and Policy report suggests it could take two years to finally tame the virus and get it under control.  I’ve not been able to find the report on their website but guess it assumes a slow move towards herd immunity rather than any type of vaccine or medical cure/treatment.

That two year timeline is in line with other similar studies, depending on how rapidly we allow case numbers to grow.  Can the country manage without an economy for two years?  Can you manage without an income?  Plus, there’s an enormous unproven and untested hypothesis in this – it assumes that recovered patients now have immunity.

As I said in my opening comments, we need to solve this problem, not give in to it and let it wash over us.

Who Should Pay

One of the stranger things about the money being spent by the government has always been the $10 billion set aside for airports.  Let’s first of all look at it from an overview and common-sense perspective.  Currently there are about 2 million fewer passengers traveling each day than was the case at the same time last year.  If we say that the $10 billion was planned to cover airports for three months of collapsed traffic numbers, that ends up with a payment of about $50 per lost passenger.

On the face of it, that looks insanely generous.  And when you adjust for the reduction in servicing costs the airports now enjoy due to having fewer people and planes, it seems even more generous.  Lastly, there’s the really big question – why should airports be so generously recompensed when so many other sectors of our economy are overlooked, entirely?

Now let’s move to the specifics.  How to allocate the money.  The easiest way would simply be to pay airports an amount per lost passenger.  It is exactly known how many passengers normally go through every US airport, and exactly known how many are now going through, so simply decide on an amount per lost passenger.

If you wanted to be more sophisticated, you could differentiate between tiny airports with free parking and just a basic ordinary small building as a terminal, and a single short runway, and major airports with massive investments and income streams from each person using their facilities, and adjust the per passenger amount to reflect that.  That is still a very simple approach.

But the actual process used for payouts seems to defy easy explanation, and has resulted in some airports, with major ongoing losses at present, getting almost no funding, and other tiny airports getting an unexpected cash bonus that represents up to 50 years of operating expenses.

Now to state the obvious.  Yet again.  There is no excuse for this level of idiocy.  We could put a kindergarten in charge of this program and come up with a better system.  What is the massive systemic malfunction that pervades every level of our goverment and prevents it from doing the right thing in the right way?

Logic?  What Logic?

Here’s something so strange as to defy explanation.  We truly can’t guess whether this is real or just public/political posturing.  But the Governor of Maryland has directly negotiated and secured the supply of some test kits from South Korea.  He arranged for them to be flown from South Korea direct to MD, and that much is sensible, although his stated reason “so as to avoid them crossing state lines” starts to hint at the really strange part.

He has now hidden these supplies and has them under National Guard protection.  The reason for this?  To stop the federal government stealing them from him.

We await the follow-up story of a pitched gun battle at some undisclosed MD location.

We’ve seen better organized banana republics.

Medical

I started today’s diary entry talking about how little we yet know about the virus.  Here’s an example of just one of the myriad of peculiarities of the virus.

We need to be throwing large teams of medical researchers at each of these strange behaviors, because maybe, in understanding one or more of them, we get a clue to a vulnerability and a way we can fight the virus and reduce the death rate.

A familiar story – in this case, British doctors are worrying that ventilators purchased from China are so unreliable they could kill their patients.

All joking aside, my perception is that these days, most products made in China are of reasonably high quality.  That’s just as well, because pretty much everything in our stores is from China.  So how is it that when it comes to medical equipment, where quality becomes literally life and death, their quality seems to plunge?

Here’s some good news about another possible test for viral infections.  I’d not realized that currently, most of the tests don’t detect people in the early stages of an infection.  That’s a massive limitation – remember, it is in the first few days of an infection that people are believed to be at their most infectious.

So a test that can detect infections sooner is clearly tremendously valuable.  Not stated in the article is how long it would take for the test to be processed and a result obtained.  There’s no point in a test that can detect an infection several days earlier than other tests if processing the test takes several days longer.

Money

The Dow disappointed again today, dropping another 622 points, a 2.6% drop, and closing the day and week at 23,724.  Last week it closed at 23,775, so there was the very slightest of drops for the entire week.

Rumors

In the early days, we heard a lot about the virus on cruise ships.  But now we don’t hear so much, because pretty much all ships are not operating cruises at present.  However, they still have crews on board, and we occasionally see items indicating some ships have active outbreaks on board.

But are the cruise lines “downplaying” (a polite way of putting it) these outbreaks?  Here’s an article suggesting they might be.

Other

Elon Musk has been raising a few eyebrows again.  Today he tweeted that he thought Tesla’s share price was too high – it quickly and obligingly dropped 11%.  That’s a peculiar thing for any CEO to say about his stock (although in the case of TSLA we do agree about its too-high valuation).

And the previous day, he had some words to share about the coronavirus outbreak.  While his perspective may have been slightly tinged because it has impacted on his Fremont factory, they were none the less “fighting words”.

Lastly today, here’s an innovative way of helping people to practice appropriate social distancing.

 

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.

 

3 thoughts on “Covid-19 Diary : Friday 1 May, 2020”

  1. Fred Harrison

    “Why are there not coordinated groups of researchers around the country and world focused on answering each and all these questions?”

    I couldn’t agree more. It is beyond frustrating to note the alphabet soup of agencies and committees and offices and task forces both in the US and the UK tasked by their governments ostensibly to plan and prepare for biological emergencies such as this, but which have obviously failed in that task. With a few honorable exceptions, mostly in Asia, I think the same can be said about the rest of the world.

    My apologies for the extended rant that follows.

    Formally, the World Health Organization is supposed to be in the lead internationally. But WHO’s authority and credibility have been badly damaged by early missteps, and by a US decision to defund and investigate it.

    Informally, in the past, the US has taken the lead. When a swine flu epidemic threatened in 1976, the US threw all its resources at the problem and came up with a vaccine within seven months. There were dire problems with the vaccine and, luckily, the threat subsided anyway. But concerted action was taken.

    Today, there are five potential vaccines in clinical trials around the world and 71 others at a pre-trial stage. Fortunately, WHO seems to be co-ordinating much of this activity, despite the US disengagement. And the US itself has initiated “Operation Warp Speed”, intended to produce a working vaccine by January.

    But what should we do in the meantime, and what should we do if none of the 76 candidate vaccines work? No-one knows, but everyone appears to have an opinion. This is the frustrating bit.

    In times of crisis, we have come to expect there to be leadership. Where is it?

    The UN, it almost goes without saying, is useless on this vital issue, the Security Council hopelessly compromised by the likelihhod of either US or Chinese vetoes for whatever others might wish to do.

    WHO, while at least recording the various efforts to develop a vaccine, has proved powerless to co-ordinate anything else. The procurement of essential medical goods has fallen into chaos and anarchy, with profiteers exploiting the leadership vacuum.

    The US president’s mind appears to be focused on the November election and is torn between supporting national guidelines and inspiring resistance to them. (It might be remembered that 1976 was also an election year, but President Gerald Ford opted in favor of the national effort to find that year’s vaccine. He lost the election.) In any event, President Trump has made it plain that global partnerships are not his “thing”.

    Which leaves everything to local leadership and the unappetizing picture we see everywhere of governors and mayors out-bidding one another for medical supplies — and (as you report) even stashing them out of reach of other jurisdictions — or recklessly easing stay-at-home strictures, placing their own and other people at greater risk.

    And what of the alphabet soup of experts? What are they doing? This morning, in the UK where I am, we’re being told that the Department of Transport is considering requiring temperature checks of commuters forced by circumstance to travel to vital jobs. This is despite all sorts of evidence that asymptomatic people can spread the virus. But, as ever, the excuse is that the department is being “guided by science.” Which science? In the absence of leadership and co-ordination, it appears we can pick and choose whichever “science” we like.

    So, like you, I wonder why, 4-5 months in, do we know so little about this virus, about how to cure its multiple effects and how to stop it. But, most of all, I wonder how our governance systems have proven so dysfunctional that we can’t even get ourselves organized sufficiently to develop the answers.

  2. It was widely reported (so google and pick your preferred news source) that the trade deal with China had a ‘force majeure’ type clause (below). So by not announcing the virus until after the agreement was signed, China has a get out of jail free on the trade agreement. Money over lives …

    Article 7.6, which stipulates that the parties shall ‘consult with each other’ in the event of a ‘natural disaster or other unforeseeable event’ outside of their control.

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