Covid-19 Diary : Thursday 30 July, 2020

As predicted, we passed through 150,000 deaths in the US on Monday morning, and now, Thursday afternoon, are already up to 155,285.  Yes, that’s a rate of over 1,000 a day.

I am always puzzled by the people (and journalists) who express surprise at how virus rates are rising throughout the world again.

As you can see from these two charts of world new case counts per day and new deaths per day, the first reason I’m puzzled is because, world-wide, new case numbers have never stopped rising.

The second reason should be obvious.  Think of the virus like being in a boat with a leak.  You either patch it or bail the water out.  As long as you keep bailing, you can keep the boat afloat.  But if you stop bailing, the water coming in will start to flood the boat again.

It is the same with the virus.  You can “bail it out” by preventing the spread of infections, but “patching it” requires either a simple easy cure, herd immunity or a vaccine, neither of which are guaranteed.  Until we might get a vaccine, there’s a very simple equation :  More social distancing = fewer new virus cases, and equally, less social distancing = more new virus cases.  We will never win against the virus until we get the cure or vaccine, and every time we “stop bailing” – ie, start crowding into bars and restaurants and stop wearing masks – virus cases will rise again.

The virus doesn’t listen to political nonsense.  It ignores people congratulating themselves for having stopped its spread, and keeps right on spreading as soon as controls are relaxed.

Current Numbers

I remember when Vatican City had the highest proportion of cases of any country in the world.  In absolute numbers, it had less than ten cases, but due to its small size, it had the highest rate per million people.  It seemed like a statistical anomaly, and no-one ever thought that larger sized countries would get meaningful rates similar to this unique special case.

As Vatican City drops another two places in the list today, it is interesting to note that the world’s worst affected country, Qatar, with a case rate of almost 4% (39,340 per million) is a country of 2.8 million, compared to the tiny Vatican City with its currently 12 cases in a population of 801 people, and a case rate of 1.5% (14,981 per million).  Also ahead of Vatican City these days is now one of the major countries – Chile with a population of 19 million, and a case rate of 18,379 per million.

There’s one more major country that is likely to surpass the Vatican City within the coming week.  The United States.  That which was, a few months ago, unthinkable, is now becoming commonplace.

Belgium finally falls off the top ten case rate major countries (replaced by the Dominican Republic), but still is at the top of the death rate list.  The US has moved back up to eighth on the death rate list.

Top Case Rates Minor Countries

Top Case Rates Major Countries

Top Death Rate Major Countries

I Am Not a Doctor, But….

It is now abundantly clear to all who are willing to stare directly at reality that the virus can only be eliminated by a cure or vaccine/herd immunity.  Neither outcome is guaranteed, but that isn’t stopping more and more people from talking-up each new step by the 160 or so potential vaccine candidates as they move through their testing regimens.

But these resolutely optimistic commentators seldom pause for a moment of introspection, and to wonder, for example, what would happen if the virus adapts so as to avoid being neutralized by a vaccine.  That is of course an essential consideration, before we base almost literally the future of the world as we know it, and billions/trillions of dollars on global vaccination programs.  This paper looks at the issue, and its findings – while very far from conclusive – are not encouraging.

More hydroxychloroquine news, although you might not have seen all of it, because all the major social media services chose to censor this story.

As you know, I have an open mind on HCQ – I am not saying it works, because I of course have nowhere near enough certain data to establish that fact.  But I am saying there are credible reasons to believe that in some situations it may appreciably boost a person’s chances of not becoming severely afflicted by a Covid-19 infection and it deserves (and we deserve!) full and careful fair study.

I have also noticed how many of the supporters of HCQ do not seem to be in a position to benefit from the use and success of the drug at all (which is more than can be said for some of the people attacking HCQ and the big-pharma interests they represent).  They are ordinary normal doctors reporting on what they have observed among their patients. Individually, such observations are far from hard facts and conclusive proof, but they can’t be ignored, which raises the question of why there is such an orchestrated campaign of hate against this drug.

Yes, HCQ is controversial.  But since when has social media decided that controversy is a forbidden topic?  How is it that although eminent medical scientists can’t agree on a matter, Twitter and Facebook can unilaterally rule and decide the matter instead?

Now I certainly concede that by some measures, the latest Trump-endorsed supporter of HCQ would seem to be bat-shit crazy, but even crazy people have lucid moments.  If a crazy person votes Democrat, does that mean all Democrats are crazy?  If a mass-murderer drinks Diet Coke, does that mean Diet Coke should be banned?  No and no.  So why are some people seeking to attack the “eccentric” doctor rather than the actual evidence she offers of HCQ working for her patients?

One of the earliest advocates of HCQ was a doctor in upstate New York, who also looked, to be polite, a bit unkempt.  He is a working doctor, with a general practice, and treats ordinary people, all day, every day.  He noticed an astonishingly positive rate of Covid-19 avoidance by the people he treated, and dared to speak about this, wanting simply to help people everywhere.

Rather than express excited interest in this possible boost to Covid-19 treatments, medical researchers attacked his results, saying they weren’t scientific.  It is true, they weren’t “scientific”, but they were “persuasive” to anyone who was willing to believe that an ordinary everyday GP might come up with a game-changing treatment plan.  The appropriate response would have been to rush to duplicate his experiences in a more scientific setting, not to attack his findings and then pretend they didn’t exist.

The doctor has now got together with two medical researchers/statisticians and published a more formal scientific paper on his observations.  Critics still abound, unfortunately.

Meantime, plenty of air-time has been given to another “scientific study” that “proves” HCQ is useless.  But one has to point out that the most useless thing is the study and its findings, not the drug efficacy it is supposedly testing.

I say this for two reasons.  The first is that it does not replicate the three drug treatment used by Dr Zelenko (the good-guy doctor in NY).  It omits the zinc, which HCQ proponents claim to be an essential part of what makes HCQ so valuable.  That’s a bit like testing a new brand of gasoline, but without all the additives included, and concluding it is no good.  Or taste-testing KFC without the secret herbs and spices.

The second reason is because the results have no statistical value.  They are like a person who tosses a coin twice.  The coin comes up heads both times, and so the person then concludes that based upon his study, this is a magic coin that will always come up heads.  That’s a nonsense conclusion, because it is based on insufficient data.  It is the same with this study.  It concludes that using HCQ had very little affect on patient outcomes, but admits the range of possible outcomes is anywhere from “maybe it was twice as good as not using it at all” all the way through to “maybe using HCQ made patients twice as likely to die”.

That huge range of possible outcomes, including the extremely unlikely suggestion that HCQ could double your risk of death, shows the fundamental insufficiency of data on which the conclusion was based.  The study ended up with no valid findings whatsoever, and should never have been published, let alone used as another “study finds no value in HCQ” claim.

Disney’s cautious opening in Orlando continues to show some excellent best-practices.  We really liked that this week Disney issued new guidelines as to what types of masks are acceptable.  Too many people wear useless “face coverings” that provide little or no protection, either to themselves or the people around them, when it comes to Covid-19 infection avoidance.

All masks are not created equal.  Thank you Disney for recognizing this important point.  Most organizations are still struggling to be brave enough to require mask wearing at all, and going a step further to mandate some types of masks while not allowing other types is definitely a bridge too far for them.

Talking about masks, we’re interested to see a slow growth in coverage on the subject of face shields or at least eye goggles, with the godlike Dr Fauci himself now expressing cautious support for wearing this added element of protection, especially when in a situation where you’re at risk for an extended period (ie on a flight).

Here’s another commentary on how the first part of our body that is attacked by the virus is our nose or mouth.  This is something that now seems obvious, but which the health authorities have again been slow to acknowledge.

And another commentary on the risk of air-conditioning systems that recirculate air, especially if the system mixes air from several different offices or apartments as part of the recirculating.  Check what types of systems you have at home and at work, and don’t trust anyone who claims that “the filters get rid of it all”.  If that claim is made, ask what type of filter is used and check online to see how effective it is with aerosol sized viral particles, and further ask how often the filters are changed, and check what the recommended filter change interval is too.  If you were obsessive, you might ask for proof that the filters are indeed being changed at those intervals – I know I don’t change my filters as often as I should!

I see that Hawaii is considering creating “resort bubbles” – places where tourists can enjoy a vacation while simultaneously in a quarantine and safely away from the locals.  Sounds like a good idea for Hawaii and its desperately struggling tourism industry, but a really bad idea for the tourists.

We also suspect such “bubbles” will be porous.  For example, what about the staff working in a resort – will they have to be quarantined, too?  How will tourists get between the airport and their “bubble”?  What happens if one person in a bubble develops an infection – will all other people in the bubble then have to reset their 14 day counters and re-quarantine?

There’s also the point that most people go to Hawaii for about a week, so you’d never get out of your bubble during your entire “vacation”.

One possible way out of this problem, and it is a problem that applies everywhere, to everyone, is fast testing.  While we struggle to turn around tests in under ten days in the US, the Japanese are rolling out new tests at their two Tokyo airports that will give results in one hour.

When can we expect one hour rather than ten day results for our testing?

Timings And Numbers

The excellent rt.live site is showing some progress in the US.  14 states were showing shrinking daily rates of new infections on Monday, 17 on Tuesday, and 20 on Wednesday and again today.

But don’t go too overboard at celebrating this.  That still leaves 2/3rds of all states suffering growing daily rates of infections.

It does show that if you wear a mask and keep away from others, the virus will recede.  Not so obvious though is that you need to continue those behaviors to keep the virus at bay.

Here’s a terrible set of charts showing how very poorly the UK has done in terms of virus fatality rates.  But beware of the double-log charts below the main chart – they compress a huge amount and range of data into narrow ranges, and may perhaps imply more meaning than actually exists.

Closings and Openings

What do you think about cruising starting up again?  Good idea or bad idea?  If a bad idea, when do you think it will be okay for cruising?

The CDC has said it won’t lift its current no-sail order until after it has received public submissions on the concept.  That seems like a great idea, although I’m not sure how many disease/epidemiological experts there are among people interested in cruising, and the cynical part of me wonders if this isn’t a bit of subterfuge by the CDC so when it does lift the ban, it can defend its decision by saying it based its decision on feedback from the general public.

If you’ve some thoughts on the matter, you should share them with the CDC.  More details here.

The huge annual CES (Consumer Electronics Show) event, usually held every early January in Las Vegas, has now been cancelled for 2021.  Well, the official description doesn’t say cancelled, it says that it will be “all digital” instead.  It is interesting that people are cancelling events that far out.

Planning to go to Europe any time soon?  Better keep those plans on hold for a bit longer.  Europe doesn’t plan to allow Americans in to visit any time soon.  We can’t say we blame them!

Who Should Pay

Kodak has decided to continue their “pivot” to becoming a pharmaceutical manufacturer, with a little help from the US Government.  They’re getting a $765 million loan, with the expectation that Kodak will start supplying some of the ingredients used in many different drugs, reducing our dependence on foreign suppliers (especially the country that starts with the letter C and ends with the letter A).  This has wildly enthused the stock market.

The virus, the “social unrest”, and the increasing likelihood there may be a change of administration after the next election has seen gun sales running at the highest levels ever for many months in a row.  Many gun stores have desperate shortages of both firearms and ammunition at present.

You’d have to be a special kind of stupid, if you were a gun manufacturer, not to be making massive profits currently.  Or, you’d have to be Remington, now back in Chapter 11 for the second time in two years.

Logic?  What Logic?

We totally don’t understand how it is that some organizations are requiring a virus test as early as four days prior to allowing the person to board a plane or enter a country or whatever else.  That’s way too far in the past – it is a bit like feeling totally safe doing some “bareback riding” with a hardworking “lady of the night” who had been tested for STDs four days earlier.

The latest example of this is Emirates Airline.  But if you have a disability or are under 12, you don’t need to be tested at all – an equally strange exemption.

Virus?  What Virus?

We read about stores boasting how they are now requiring all customers to wear masks.  That is half right, but also half wrong.  Yes, they may post signs saying masks are required, but as this article points out, the stores are too timid to actually insist people must comply.

Stores have no problems limiting their sale of alcohol and tobacco products to people over whatever age applies, of enforcing the restrictions on coupons, and in many other ways imposing order on their customers.  What is the problem with mask wearing.

Rumors

After refusing to acknowledge the virus as being present in the country for months, North Korea has now conceded that it does have some cases, although is quick to point out that this is all the fault of a specific very bad individual.

Other

Here’s a suggestion if you’re wondering how to vacation this summer.

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

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