Covid-19 Diary : Saturday 2 May, 2020

Here’s an amusing explanation of a serious problem – why there’s a shortage of virus tests at present.  In short, the answer is colossal and unnecessary regulation.

I keep reading about “a second wave” in articles at present.  I really dislike this phrase.  Embodied within it is a cop-out and an excuse and passively shifts the responsibility for such an event away from us and instead blames the virus.  It suggests there is an inevitability of the virus returning “just because it will”.  That is 100% wrong.

Sadly, there probably is an inevitability of the virus returning, but not due to any magic property of the virus, and also not due to any weather related issues (the virus has not shown itself to be unduly sensitive to weather issues).  The inevitability of the second wave is because of our current foolishness in opening up our states before we’ve beaten the first wave of the virus.  Yesterday had the second largest number of new cases of the virus reported – 36,007; today was barely under 30,000.

Maybe part of the reason for this large number is due to increased testing enabling us to find more cases than we would with less testing, but that’s an irrelevancy.  If there are 30,000 – 36,000 new cases in a day, no matter how they are found, that is too many to justify opening up the country again.

I’m not sure where I saw the suggestion that the target level of new cases should be one new case per million people per day.  But if it is valid, that means we could have up to 330 new cases per day.  We are 100 times higher than this target.  Who in their right minds can claim a victory over this virus with these huge numbers of new cases and declare it is time to now start opening up the country again?

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 (unchanged)
• Vatican City/11 cases/13,733 cases per million (unchanged)
• Andorra/747/9,668
• Luxembourg/3,812/6,090
• Iceland/1,798/5,269 (unchanged)
• Spain/245,567/5,252
• Qatar/14,872/5,162
• Gibraltar/144/4,274 (unchanged)

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

• Belgium/7,765 deaths/670 deaths per million
• Spain/25,100 deaths/537 deaths per million
• Italy/28,710 deaths/475
• United Kingdom/28,131/414
• France/24,760/379
• Netherlands/4,987/291

To put those numbers into context, the death rates per million in the US/Canada are 204/94.  The world average (not a very reliable number) is 31.4.

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

Ireland moved up to the second worst country affected, and the US suddenly appeared on the list, at fourth place, while Italy overtook Switzerland, so the double displacement pushed Switzerland off the “top five” list entirely.

There don’t seem to be any likely changes in these rankings for the next little while.

I Am Not a Doctor, But….

I wrote yesterday about how there is so much we don’t yet know about this virus, and an extraordinary lack of interest and commitment to finding out.

Here’s just one of the bazillion mysteries.  I’ve been reading regularly of people who had the virus, were supposedly cured and declared clear/free of the virus, and who then somehow became sick again.

At first my inclination was to ignore the reports as being sketchy, incomplete, and unpersuasive, and then as they continued, I thought maybe it was false testing results.  That may well still be the case, but the matter is extremely important and should be carefully examined.

There are only three ways we get through this virus pandemic (well, four if you include “everyone dies”).  The first is we find a cure to make the disease trivial and unimportant, the second is we find a vaccine so we are no longer at risk of being infected, and the third is that, over time, be build up “herd immunity” as a result of all the people who have had the virus and survived, and because of that, not at risk of being re-infected.

At present, there are no certain cures and no certainty we’ll ever find one.  There are no vaccines and again, no certainty we’ll ever develop one.  So our final ultimate defense has always been, worst case scenario, with each new case and hopefully recovery, we’re edging closer and closer to herd immunity – something it is believed requires about 60% or more of the population to have had the disease, so still probably a long way in the future.

But what if having the disease doesn’t give us immunity against getting it again?  What if we find ourselves with no cure and no vaccine?  What then is the ultimate outcome?  Will we live the rest of our lives in masks and gloves and goggles, socially distancing, and always anxious?

Timings And Numbers

This story about Britain opening a new super-morgue facility for dead bodies, and expanding morgue capacity in other parts of the country is puzzling.  Britain seems to be having about 700 deaths a day from the virus currently, a number that is believed to be gradually dropping.

As you can see in the chart, according to one of the more widely accepted models, Britain is now 22 days past its peak death day.  Why is the government now – three weeks after the peak – expanding morgue capacity from the earlier “normal” count of 20,000 bodies up to a new 50,000 capacity.

Being able to handle 30,000 more bodies (in addition to the 20,000 morgue spaces already) represents about six weeks of virus deaths.  To put this number in a different context, it is additional capacity greater than every virus related death so far – in total Britain has had 28,131 virus related deaths.

So what does the UK government know that it is not sharing with us?

Here’s an excellent article and with lovely graphics that talks about the reality of how long it might take for a vaccine to appear.  It starts off by looking at and explaining why normally we would not expect to see a vaccine prior to May 2036.  To compress that timeframe down to “real soon now” surely does seem impossibly difficult.  You can set your own assumptions and see how the lead times change.

Not so carefully considered is the huge assumption – will a vaccine ever be found?

Even if it can, you’ve got to be a huge optimist and able to ignore things like our inability to make test kits at any sort of measurable rate, and all the failures to meet promised dates for when bulk testing will be readily available, before you can will yourself to believe that a vaccine any time next year is a possibility.

Closings and Openings

When might we be able to start traveling internationally again?  Not all foreign countries are as eager to re-open as we are in the US.  In France, there are increasing suggestions that the country might remain essentially closed through their summer and perhaps for the entire year.

This is not definite, but it isn’t looking good.

Shortages

About the only thing that is reliably constant about this virus is that everything to do with it is always worse than expected.  So it is unsurprising to read this headline “Why The Meat Shortages Are Going To Be Much Worse Than Most Americans Are Anticipating“.  We are not wired to embrace worst case scenarios (but that doesn’t mean they won’t happen).

When we’ve lived our entire lives being guaranteed full meat cases in the supermarkets, the thought they might become as empty as the toilet paper and disinfectant aisles is almost impossible to comprehend.

Logic?  What Logic?

I wrote a few days back about how the thrill of seeing both the US Navy Blue Angels and the US Air Force Thunderbirds performing overhead at the same time, and on a nice day, unsurprisingly brought New Yorkers out of their apartments and onto the streets and parks to watch the show.

This was of course a totally predictable response to a great aerial spectacle.  But it surely was not a textbook example of best social-distancing practice.  It was, to be blunt, a gratuitously stupid thing to do, and will probably end up costing unnecessary lives.

You might think that after the obvious happened in NYC, the two display teams would cancel their planned tour around major cities putting on air shows.  But, alas, you’d be wrong.  They’ve now done the same thing over Washington, DC, with the same result.

Why are they doing this?  Do they have no sense at all?  Our own government is doing things designed to encourage the spread of the virus.

Our good friends at the airlines are eager to sell tickets, of course, but we do feel it is a bit over-zealous to be selling tickets to destinations that people can’t currently travel to.

Medical

We continue to be astonished at the difference in treatment accorded the remdesivir drug made by the multi-billion dollar big-pharma company, Gilead, and the treatment given to common ordinary 80 year old hydroxychloroquine.

It has now been realized that the government changed the parameters for what would constitute a successful test halfway through the remdesivir test that is now being lauded as being successful.  Originally the success measure was whether patients lived or died.  But when that looked to be not very promising, they changed the test to “how much sooner do people who are going to live anyway get pronounced better”.

On the basis that surviving patients were deemed in some way cured in 11 days rather than 15 days, the drug was therefore hailed as a success, even though there was no statistically significant difference in the number of people who did not die as a result of taking the drug.

Don’t get me wrong.  I’d be highly delighted to be discharged from hospital in 11 days rather than 15.  But I’d be willing to be patient for four more days if necessary.  On the other hand, when faced with a choice between living or dying, I’ve a much stronger preference.  Get me a drug that ensures I live and keeps me off a ventilator, please.

Here’s an unusually fair treatment of the issue that manages to get out from under the barrage of hype surrounding this drug.

Other

We don’t agree with the pilot’s sentiment, but we love the way he expressed it.

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

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