Covid-19 Diary : Sunday 11 October, 2020

Early today, I typed the period key in the lower right of the keyboard, then looked at the screen and saw it saying “Page 348 of 348 126,194 words”.  I had just completed the last sentence of my virus book.

Well, actually, not really.  I now need to go through everything another time, editing, updating, adding, changing, and sometimes even deleting.  I’ll try and get that done by Thursday and have a version stable enough for the kind volunteers who have stepped forward to read through, critique, and review.  If you’d like to join this key team of “Beta Testers” and reviewers, please let me know.

The headlines are full of stories about Covid’s “second wave”; sometimes even referred to as a “third wave” – the first wave, the summer wave, and now the fall/winter wave – stories such as this one, for example, which seems to be expecting us to feel sympathy for Europe’s lack of preparation.

I object to this nomenclature.  The thing about talking about virus infection waves is that it removes the responsibility and causality of the events.  The growth of new cases is no longer primarily the result of stupid people acting stupidly; instead, it becomes some pre-ordained “law of nature” that we can fight valiantly against but can’t prevent, any more than we can stop waves at the beach from washing over our sand castles.

Most of all, it is not a second or a third wave, because the first wave never fully stopped.  What part of “zero cases” do the public health officials not understand as being a necessary precondition of announcing their success over the virus?

While the virus is a tough adversary and is not bound by rules of political correctness, it can be beaten.  My home country of New Zealand has shown that clearly, twice.  It would be lovely for the rest of the world to learn from NZ’s example rather than to weakly ask for pity as it is assailed by fresh waves of virus.

Current Numbers

Montenegro is now at ninth place in the minor country list.

Belgium is advancing up the major list, although it is a long way to get from its 13,524 cases/million to reach Colombia with 17,857/million.  But it added another 685 cases/million today alone, so that is maybe not impossible.  Its neighboring country of France is also racing to catch up South Africa.  France has 11,253 cases/million and added 246 cases on Sunday, with South Africa at 11,635 (and only 26 new cases/million today).

Top Case Rates Minor Countries

Top Case Rates Major Countries

Top Death Rate Major Countries

I Am Not a Doctor, But….

I read an interesting article that set me to wondering.  The article was yet another one about ivermectin, a low cost commonly available drug that is showing remarkable anti-viral properties, and how it is being approved as a Covid treatment in more and more countries.  The article noted wryly that the US has turned its back on it, and wondered why.

It might seem like a cheap shot to take, but it is interesting to note that the only two FDA approved Covid treatments – both under temporary Emergency Use Authorizations rather than in the form of full unqualified approvals – are very expensive.  Plasma from past sufferers, and Remdesivir.  Both are also only available in limited quantities.

The two new antibody drug treatments that are getting a lot of coverage since President Trump’s illness from Regeneron and Eli Lilly are also very expensive.  We don’t yet know for sure, but it seems a course of the Regeneron treatment may cost up to $6500, depending on the drug strength given, and currently Regeneron only have about 50,000 courses of the drug in stock – that’s little more than one day’s number of new Covid cases at present.

Why is the US so focused on ultra-expensive treatments in short supply, when much of the rest of the world is looking at ultra-low cost drugs in plentiful supply?  Are our public health officials acting like women who cheerfully pay $10,000 for a handbag, not because it is any better than the $100 handbag, but just to show off their wealth?

As I’ve ruefully observed repeatedly before, we are no longer a wealthy nation.  We can’t afford to adequately feed our hungry, house our homeless, or to provide quality education to our children.  We can’t afford adequate public transportation.  And we certainly can’t afford $6500 drug treatments when there is the possibility of equally good $6.50 treatments being overlooked and ignored.

If I should become infected with Covid, I don’t want to be told there’s an approved treatment but it is not available.  I don’t want to be told there’s a treatment but not covered by insurance and which would cost me $6500 plus related hospital care costs.  I want to be given a bottle of tablets and sent home with instructions to take one a day for a week, and possibly being asked for a $10 or $20 prescription co-pay.

Ivermectin, hydroxychloroquine, and some of the other low-cost treatments all might meet this scenario.  Remdesivir and the new treatments being developed do not.

It is simple, and the same as handbags.  Sometimes a new drug that costs 1,000 times more than an “old” drug isn’t actually any better at all.

There’s also the puzzlement – how is it that President Trump is so certain that it was the most expensive and scarce of all the different drugs he was given that is the one that cured him so miraculously?  There is no way he can know this.  The clinical studies published by Regeneron themselves give no hint of such amazing properties.

Most of all, how about an emergency use authorization for ivermectin, a well known widely prescribed drug for other purposes at present?  Actually, the good news is there’s no need for such a thing.  Any doctor can prescribe ivermectin for “off label” use to fight Covid-19 if he chooses to already.  Why is it not being widely prescribed?

I’ve written about a being-developed-in-the-US “breathalyzer” type test for Covid before.  Now there’s a new one being developed by a group in Israel, with a target for the test to give results in 30 seconds.

Wedo think the developers are a bit optimistic about getting a final product ready in days, and they are vague about its accuracy, but we eagerly await more news about this product.

There has been some discussion about the risk of catching Covid on an airplane flight, with some people suggesting the risk could be in the order of 1%, a number I’ve felt to be unrealistically high.

But now for a matchingly unrealistically low number – IATA claims to have found only 44 confirmed cases of Covid having been caught on flights between January – July, which works out to one per 27.3 million passengers.

Of course, there may be a huge difference between how detailed IATA’s search for infected passengers was and the reality of who catches the virus on flights.  It is truly very hard to be able to 100% confirm that an infected person caught the virus at one specific place.

Additionally, the risk of flying has to be seen as part of the totality of risk of traveling, starting with the minute you leave home, including any other public transportation unavoidably taken as part of the journey, and the time in airport terminals before and after the flight, too.  Maybe the risks on the plane are low, but the risks in the airport are high.  That doesn’t make the total experience of flying from one city to another any better, does it.

Air travel remains something I’d prefer to avoid at present if at all possible.

Timings And Numbers

Montana has been top of the list of naughty states for the last three days, and overall, there has been a further slight drop in the number of states with reducing daily case numbers.  13 states had reducing case numbers on Friday and Saturday, and today it was down to 12.

Why is MT doing so poorly?  There are various reasons, and two of them can be seen on the IHME website.  Currently Montana is rated at having about 60% mask use and zero social distancing as indicated by cell phone mobility data.  Better states, such as here in WA, have 75% mask use and a 20% social distancing score.

Closings and Openings

Hawaii is now starting to come up with a much better policy to minimize new introductions of the virus to their islands.  They are allowing people to fly to HI if they’ve had a no-result Covid test within 72 hours of travel, and then followed by a second test upon arrival to confirm the arriving person is still free of the virus.  Details here.

Will this work?  Well, the question is currently without meaning, because the state is still suffering elevated levels of new virus cases every day – about 60/million people, ie about 100 new cases every day.  But an important part of getting 60 down to zero is ensuring no new fresh introductions of the virus into the communities on the islands.  However, looking at New Zealand’s experience, it is clear that the virus struggles harder and harder to escape, the more that measures are put in place to keep it away.  Hawaii, which totally messed up its earlier opportunity in May to become fully virus-free, has shown no sign of any resolve to take the stringent measures needed now to achieve that.

Medical

I mentioned overlooked cheap solutions above.  Another case in point is the billions being spent on developing new vaccines.  So it is great to see some trialing of a vaccine that is already known to be completely safe, but not confirmed to be effective against Covid (although showing some potential promise).

Having an already-known-to-be-safe vaccine is a great leap ahead of most/all the other vaccine candidates at present, and it is disappointing it has taken so long to get this vaccine – the BCG TB vaccine – into a formal trial program.  The “problem” is that the BCG vaccine isn’t a profitable product, so there’s no big-pharma complex pushing it forward and keeping it in the headlines.

Oh, and the trial.  As you can see from the link, it isn’t in the US.  It is in the UK.  Our myopia and inability to “see” affordable easy solutions remains unchallenged.

Other

Here’s an interesting new product for the more anxious among us, soon to be improved in a new version complete with a hole for a straw.

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

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