Covid-19 Diary : Thursday 24 September, 2020

 

“Those who don’t know history are destined to repeat it” is a saying attributed to Edmund Burke, an 18th century Irish statesman and philosopher, but often confused with a similar saying of George Santayana,  “Those who cannot remember the past are condemned to repeat it”, a statement he made in the early 1900s, and paraphrased still further by Winston Churchill in 1948 when he said “Those who fail to learn from history are condemned to repeat it”.

It is Churchill’s expression that is most apt today.  The rate of new coronavirus cases is again on the rise, through much of the US, and much of Europe.  The measures that countries variously put in place to reduce the virus spread have largely been abandoned, allowing the virus to surge back again to the level which had caused such alarm in March/April.

But this time, there seems no alarm.  European leaders are choosing not to reintroduce the controls that had successfully slowed the virus spread, instead apparently preferring to calmly watch virus rates and death rates rise, and then rise some more, and then – who only knows.

Is this a total abdication of leadership?  A total refusal to care for the welfare of their people?  What are they thinking of?  Or, why are they not thinking at all?

Current Numbers

Very little change in rankings today, other than Peru now taking the “top spot” in the major country cases rates, knocking Chile down a notch.

Note that just because there is little change in rankings does not mean that nothing much is happening.  All the listed countries are experiencing significant virus activity.

But, having said that, and with my earlier comments about Europe (and the US) above, world-wide, while daily new cases are increasing, this is nothing new.

As you can see from the chart above, the rate of increase in daily cases reported slowed down in August and has been much more gradual than it was in March and again in June and July.

That is of course not a victory of any sorts.  The virus is still accelerating its daily spread.  World-wide, in total, we are now averaging almost 300,000 new cases every day.  Even a flat line with no more increases would be a disaster – two million new cases every week.

When will we see that number start to significantly decline?  When will it drop below 100,000?  Or will it, ever, do so?  It surely won’t if the new European strategy is to do nothing, and the US strategy remains as fractured and disjoint as it has been so far.

Top Case Rates Minor Countries

Rank	One Week Ago	Today
1	Qatar	Qatar
2	Bahrain	Bahrain
3	French Guiana	Aruba
4	Aruba	French Guiana
5	Panama	Panama
6	Kuwait	Kuwait
7	San Marino	Israel
8	Andorra	Andorra
9	Israel	San Marino
10	Oman	Oman

 

Top Case Rates Major Countries

Rank	One Week Ago	Today
1	Chile	Peru
2	Peru	Chile
3	Brazil	Brazil
4	US	US
5	Colombia	Colombia
6	Spain	Spain
7	Argentina	Argentina
8	South Africa	Bolivia
9	Bolivia	South Africa
10	Dominican Republic	Dominican Republic

 

Top Death Rate Major Countries

Rank	One Week Ago	Today
1	Peru	Peru
2	Belgium	Belgium
3	Spain	Spain
4	Bolivia	Bolivia
5	Chile	Brazil
6	Brazil	Chile
7	Ecuador	Ecuador
8	UK	USA
9	USA	UK
10	Italy	Italy

 

I Am Not a Doctor, But….

Sorry for the negativity that follows.  But don’t blame me – I don’t make the news, I just dispassionately report on it!

You’d think by now that some of the very simple and basic issues to do with the virus and how it spreads would have been totally determined and resolved.  Think again.  Here’s an article that cites opposing studies about whether social distancing is good or bad.  If I had to choose between the probability of contracting Covid-19 and the possibility of having a weakened “human microbiome”, I know which I’d choose!

More than seven months into the virus spread, and WHO is still at loggerheads with most of the rest of the world when it comes to how the virus is passed on.  Seriously!?   Isn’t this a key fundamental issue to identify?  If we don’t know how it spreads, how can we ever devise ways to reduce its spread?

And here’s a shockingly error-ridden article that talks about a new strain of the virus which might be, it says, invalidating the efforts we’ve made in hand-washing and social distancing to control the virus.

That is so regrettably stupid as to be tragi-comic.  The “new” strain of the virus was identified in January and has been dominant for at least six months.

My sense is that the people who now seem to have been so spectacularly wrong when they told us all we needed to do was wash our hands are now desperately seeking excuses.  In reality, hand-washing – while always good – is an exceedingly minor threat vector for the coronavirus, and airborne contamination – preventable by the masks those same people told us we didn’t need to wear – is the most effective measure.  Hence their “discovery” of a “new” strain of the virus, perhaps.

Another example of inexplicable nonsense from WHO :  This article talks about WHO having a guideline that says there should be less than 5% of virus tests coming back positive for two weeks before it is safe for businesses to re-open.

Why is that nonsense?  Because the percentage of positive tests is dependent on who you allow to be tested.  With our present guidelines saying “You should only be tested if you are already believed to have the Covid-19 infection” of course our positive rates will be high.  If we truly had “anyone can be tested anytime they want, conveniently and for free” and if we had businesses and public gatherings testing everyone in their areas every day, the positive rates would drop way below 5%.

It is a bit like making an inference about the predominant religion in a country.  If you go and ask people their religion in a bar, very late on a Saturday night, you’ll find few people of any religious persuasion.  But if you survey outside a Roman Catholic Church on a Sunday, you’ll form the opinion that the country is almost 100% Catholic.

Because we don’t have a truly random base of who is being tested, it is meaningless to draw any inference at all from the percentage of people who are tested positive or negative.  Why doesn’t WHO understand this?

Still more nonsense, albeit not involving WHO this time.  This article says a rise in new virus cases in Sweden is “prompting concerns over whether Sweden has achieved any ‘herd immunity'”.

The thing is that, so far, Sweden has had a total of 0.9% of its population infected.  Herd immunity is generally believed to require over 60% of people to have been infected.  Sweden needs 70 times more people to be infected to bring about herd immunity, even assuming it exists with Covid-19 (which increasingly seems to be far from certain).

So who in their right mind ever thought that Sweden had achieved any measurable herd immunity at present?

Here’s a more upbeat article about Finland’s plans to deploy coronavirus-sniffing dogs at Helsinki Airport.  As a dog-lover myself, I’m a great believer in dogs and their ability to add value in many situations.  So I was of course predisposed to enthusiastically endorse this as a great idea.

But, alas, I can’t do that, and the article, while glowingly positive, is alarmingly light on specifics.  For example, this inspiring statement “dogs were able to identify the virus with nearly 100% accuracy, even days before a patient developed symptoms” begs the question “how near to 100%”?  Are we talking 90%, 99.9%, or what?  Is this accuracy for false-positives or false-negatives?  (Usually there are different measures for these two different types of error.)  What are we using to check the dog diagnoses?

And this statement “dogs are able to identify Covid-19 from a much smaller molecular sample than PCR tests” begs the question “How do we know this”?  How can a dog’s positive reaction be confirmed if the official “gold standard” test is unable to detect the presence of the virus?

Depending on your perspective, it is either good news or bad news that a fourth vaccine candidate has entered Stage Three testing.

Have you wondered how a vaccine will finally be selected and made the official vaccine?  I surely have.  Here’s an interesting article that says the process and the people involved are being kept a secret, so we’ll just have to trust the experts to do the right thing.  I do hope they’re not the same experts who told us we don’t need to wear masks…..

Amusingly, the reason for the secrecy is stated to be so there can’t be any coercion or pressure brought on the decision makers.  That is, of course, a totally naïve belief – naïve in the expectation that the members of the selection group will be anonymous (the head of the group has already been “outed”), and doubly naïve in thinking that secretive discussion is more likely to be honest than public discussion which holds everyone and their opinions accountable.

If secrecy guaranteed honesty and fairness, our courts and justice system would be all in secret.  The vaccine evaluation criteria and process and decision making should all be 100% in public.

No wonder only 39% of the population are willing to be vaccinated (see below).

There is a growing awareness that some people suffer the virus for a long time.  But there is another phenomenon as well, people who are released from hospital as being sufficiently recovered from the virus as to be discharged, but re-admitted again within a week.  A recent study found 10% of discharged virus sufferers were back in hospital within a week.

A couple of possibly good news items.  It seems possible that Favipiravir, touted by some as a virus cure, may be officially approved by the Japanese Health Ministry before the end of the year.  This is not a miracle drug that cures everyone, every time, but it is increasingly believed to help some people, some times.  So, good news, but not transformative.

And more good news for Ivermectin, this time in combination with the doxycycline antibiotic, also as a cure for mild to moderate Covid cases.

Inflation is a terrible thing.  Last week I was writing about Hawaii planning to introduce a virus test for potential visitors, with an estimated cost of $160.  Now we’re told that United Airlines will offer the tests, but at a cost of $250.

There’s so much wrong with their testing protocol for “mail-it-in-yourself” testing.  There’s no way of knowing who provided the sample, or when the sample was obtained.  That leaves a huge potential for “cheating”, and while cheating might be unlikely, it only takes one infected person to slip through the system to transform HI back into one of the highest new case rate states.

Timings And Numbers

There’s no good news in terms of our state-by-state battle against the virus.  We had 22 states with declining rates of new cases on Monday, 23 on Tuesday, then a drop to 19 on both Wednesday and Thursday.

To my horror, my state of WA suddenly shot to the top of the list of states with growing case counts, although I’m hoping this might be a statistical anomaly and quickly resolved.

CDC Director, Dr Robert Redfield, told the Senate that it will take until April, or May, or June, possibly even July, to get the entire American public vaccinated against the coronavirus.

It is easy to forgive him for the imprecision of the dates, with no vaccine candidate yet selected, but what is puzzling is his reference to vaccinating the entire American public.  The latest opinion survey shows that now a mere 39% of adults are willing to try any new vaccine when it is first released, and, as shown in this article, that percentage is rapidly dropping.

Surely Redfield should be talking about how long it will take for the 40% or fewer to be vaccinated, not how long it will take for everyone to be vaccinated?  Or was this a Freudian slip, and are there plans to “encourage” people to be vaccinated?

In case you think that would never happen, keep in mind that for all intents and purposes, vaccinations are mandatory for children in the US already, and there are lots of ways that adults could be encouraged but not forced to accept a vaccination – a tax rebate or surcharge, for example.  An extra amount added to our healthcare premiums each month, a bit like how smokers are penalized in some situations at present.

It seems that vaccines may be approved with as little as 2 – 3 weeks of observation of test subjects in the Stage Three trials, rather than the months or longer that is normally the case.  Absent some type of “encouragement”, even though I’m in two high risk categories – age and being male – I’m not planning on being vaccinated any time soon, myself.

Closings and Openings

We understand how gaspingly desperate the cruise lines must be to restart their cruising operations.  But don’t they understand that if they start cruising again, and then suffer another high-profile infected ship scenario or two, they’ll be closed down again, and not allowed to open any more, other than in ridiculously strict situations, and/or their market of eager cruisers will implode in on itself even more than it already has?

Currently, what we know of their plans suggests they might be inadequate.  Everyone will have to be tested prior to a cruise, but how long prior to a cruise?

If they follow what seems to be a common requirement – “you must be tested within 72 hours of the cruise” – that still leaves up to a week of risk.  Obviously, a test three days ago is obsolete on the day of the cruise, and in those last 72 hours, you’ve been doing higher-risk things like flying to the cruise port.  Not so obvious is that it can take more than four days between when a person is infected and when a test will detect their infection.  So there’s an entire week of potential risk that a test doesn’t pick up on.  People could walk on to their cruise while being highly infectious and waving a certificate showing that 72 hours earlier, a test failed to detect their infection.

As I’ve said before, how good would you feel visiting a “lady of the night” who specializes in not requiring protection from her customers, and learning that her last test results were a week ago?

Other vague concepts to be adopted by the cruise lines, as cited in this article, refer to “increase the amount of fresh air in their ventilation systems” and “use advanced filtration methods where feasible”.  How much of an increase of fresh air?  What does it mean “where feasible” and exactly how “advanced” should the filtration be?

Not very confidence-building, is it.  And that’s before we start to understand how these voluntary guidelines would be policed and enforced, and what the penalties for non-compliance would be.

Who Should Pay

Still talking about cruise lines, maybe there’s a reason they seem to be so lackadaisical.  They’re expecting not to be found liable for much more than pocket change if any passengers should actually become infected and die from the disease.

A 1920 law limits the liability of cruise lines for “deaths on the high seas” – ie, more than three miles from shore.  Could we suggest it might be time to revise this legislation?

And talking about the consequences of virus outbreaks, we do understand that Iowa’s economy has a large dependency on ranchers and meat processing.  But this article, which tells how the Iowa Premium Beef Plant was fined $957 after a virus outbreak infected 338 of the plant’s 850 workers – not quite $3 per infected worker – surprises us.

Could we suggest there needs to be some type of equitable trade-off between trivial inconsequential outcomes when companies don’t do enough to protect their workers’ health, and company-killing draconian penalties at the other extreme.  Wherever that equitable middle ground might be, can we also agree that $3 per infected employee is laughably low and needs a bunch of zeroes added to it?

Logic?  What Logic?

At first glance, this seems like just another of the regrettable examples of uncontrolled stupidity being expressed in the form of a mass public concert, with many people attending without masks and no social distancing.

But there’s a twist.  Proving that there’s nothing too strange for South Dakota, freshly recovered from the impacts of its Sturgis biker rally, it is now putting on an indoor concert for 5,000 people, and sponsored by the enormous Sanford Health company – a company that advocates people avoid social gatherings in groups of more than 10 people, and urges everyone to keep at least 6′ from everyone else.

Sanford Health isn’t just some little podunk clinic in a small town in rural SD.  It employs 1,446 doctors.  And it wasn’t a decision made by some low-level person.  Its CEO said the company is honored to play a role in the concert.

Unbelievable.

Virus?  What Virus?

Still thinking of SD’s upcoming concert, we hope they’ll both require masks and also enforce that requirement with as much enthusiasm as was the case at this eighth grade football event in Marietta GA.

We also ponder the life lesson expressed in this case, where a man who dismissed Covid-19 as a “socialist hoax” has now died of – yes, you guessed it, Covid-19.

Medical

Bad news if you’re a man.  You’re 62% more likely to die from Covid-19 than women.

Bad news for everyone not yet bald.  Losing your hair is another outcome of the virus, and of worrying about the virus, too.

Rumors

It is being suggested that the front-runner AstraZeneca vaccine might now have a second test subject suffering from unexpected neurological problems.

One such event might be random chance.  Two such events, each unusual, start to be significant.  If there’s a third, what happens then?

Unfortunately, we might never know the answer to that question.  It might be kept secret (see item above).

Other

One of the fiercest critics of the US government’s response to Covid-19 actually works for – yes, the US government.  His day job is as a PR official for the National Institutes of Health.  His “other job” is criticizing it every which way.  We wonder if he feels at all conflicted….

So, should we believe him when he says NIH is doing an excellent job, or when he says they’re doing a dreadful job?

New virus cases are starting to rise in the UK again.  And so, in preparation for possible problems in the foreseeable future, one of their supermarket chains has started rationing toilet paper again.

That is surprising for several reasons.  First, it is surprising that manufacturers haven’t caught up with demand.  And secondly, ahem, most of the people I know are still well-stocked after their March buying spree!

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

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