Covid-19 Diary : Thursday 15 October, 2020

One of my common complaints about the entire virus debacle is the profusion of bad data – and tragically, much of it promulgated by the people we trust on and rely to give us excellent, not bad, data.

Before showing you the latest example, let me first provide an analogy so you can understand why the data is so bad.  Imagine someone (not you, of course!) is driving a car, and it “somehow” runs off the road.  The investigating policeman asks “Were you using your cell phone at the time?”.

How do you think most people answer that question?  Exactly – unless you really wanted a deluge of tickets for distracted driving, unsafe/dangerous driving, using your phone while driving, and additional cross words from your insurance company, you’ll say “No, of course not” to that question, won’t you.

So, is it really meaningful or surprising to find that when people who have come down with a Covid infection are asked if they had been wearing a mask most of the time prior to getting the infection, most people say “Oh, yes, of course I wear a mask all the time, it is totally not my fault that I caught the virus”.

The CDC are surprised to learn that most people who caught the virus say they were wearing a mask.

That data is beyond meaningless.  It doesn’t distinguish between different types of masks, some of which are known to work well, and many of which are known to be useless, and it relies on the unconfirmed answer of the person being asked the question.

There’s one more consideration, too.  Perhaps wearing a mask encourages people to adopt riskier behaviors – to spend more time indoors with larger groups of people and to abandon social distancing.  This would be identical to what was observed when cars first started being fitted with ABS.  Drivers started driving their cars harder and in more dangerous ways, thinking that ABS gave them some sort of magic protection.

Masks aren’t magic.  They improve your odds of avoiding the virus, but they don’t guarantee it.  The implication in this article, based on the CDC’s data, that maybe mask wearing is a waste of time is an offensive piece of idiocy, and shame on the CDC for being the underlying enabler for this.

Of course, the CDC has always had a love-hate relationship with masks, and perhaps they still secretly wish they could return to their earlier irresponsible and ridiculous advice that all we needed to do was obsessively wash our hands nonstop with plenty of soap, and no need to worry about masks at all.

The CDC have only distinguished themselves in a very negative way during this entire debacle, right from back in December when the first hints of the virus were appearing.  This is a very long read, but a great article about “The Fall of the CDC”.  Unsurprisingly, it is keen to place a lot of the blame for the CDC’s disastrous series of failings at the hands of its political masters, but even after those factors, it still paints a sorry picture.  I’m also not nearly so eager to allow “political interference” as an excuse.  “Just following orders” didn’t work well at the Nuremberg trials, and is expressly forbidden in the UCMJ these days, and while they’re not very strong, we do at least have some whistleblower protection provisions to encourage people to push back against such pressure.

High level staff at the CDC are presumably very employable elsewhere, and in the current climate, disagreeing with the government is something that many people would proudly feature on their resume, so there’s almost no downside and lots of upside for the people at CDC to justify the public’s trust and to be principled in their policy statements.

Some of the CDC’s bad public advice has clearly caused unnecessary extra lives to be lost and has harmed rather than helped our efforts to fight the virus.  The CDC leadership should have more backbone when confronted with bad political pressure, rather than just cave in.  They’re not paid generous six figure salaries to be “Yes men”.  They’re paid to be in command and control of their subject matter expertise, and to be a reliable and apolitical resource for the country (and world) to rely on.  Shame on them for allowing the credibility of their once great organization to now be zeroed out so thoroughly.

In what may be an orchestrated campaign, there’s a similar article in the Wall St Journal that appeared at the same time.  What I find particularly interesting is that it is Republicans who now have the least trust in the CDC, even though it is suggested to be Republican meddling that has caused some (but absolutely not all) of its public missteps.

Current Numbers

After several months with no new cases, The Vatican had a new outbreak of seven new cases all reported in one day, which saw it suddenly reappear in the minor country list, then after a couple of days, another 7 were added, so their total cases went from 12 this time a week ago to 26 at present, which caused them to dramatically reappear in the minor country list, and we see another “amusing battle” between them and Israel for prominence on that list.

I’ve added two more rows to the major country case rate table, because there’s such a lot happening at present.  The Czech Republic debuted, and went straight to ninth place, and France is back on the list at 10.  Our two new positions, 11 and 12, see the Netherlands also return, and Bolivia now at 12th, after being at 9th a week earlier.

Top Case Rates Minor Countries

Top Case Rates Major Countries

Top Death Rate Major Countries

I Am Not a Doctor, But….

The AstraZeneca vaccine test remains paused, for now five weeks, and now the Johnson & Johnson trial has paused too, after one participant developed an unexpected illness.  We don’t know enough yet to understand if this is significant or “just one of those things”.

Then the next day, the trial of an antibody therapy also needed to be paused.  This article worries that the pauses in these trials show that things are moving too quickly.  I disagree.  This is what trials are for – to uncover problems.  The trials are working exactly as expected.  And when you have tens of thousands of people participating, there are bound to be “false alarms” when someone randomly develops some unrelated illness, but which has to be investigated in case it is related to the vaccine or drug being trialed.  It is  good to see the trials being very responsive to potential problems.

We are not only now having previously infected patients coming down with new second infections, but one of them has died.  This puts a focus on the growing but perhaps unrealistic eagerness for us to obtain herd immunity – a phenomenon that relies on people who have been previously infected, developing immunity from future infection.  That expectation is being increasingly challenged, and this quote in the article has to be considered as a major understatement

the possibility of reinfections could have significant implications for our understanding of Covid-19 immunity

Talking about good quotes, one of the best we’ve seen during the entire virus problem was offered up this week.  There’s been a tendency to not place blame for the virus spread directly where the blame lies – at the feet of the careless people who are not observing “best practice” social distancing, quarantining, and mask wearing.  Instead we mumble about “second waves of course being worse than the first” (a nonsense concept) and make other indistinct comments.

Not so Dr Steven Woolf, the director emeritus of the Center on Society and Health at Virginia Commonwealth University, who is quoted in this article as saying

The virus didn’t get to all those counties by hopping on a bus.  This is being transmitted by humans.  The policies we’ve relaxed have allowed people to transmit the virus because they’re not wearing masks, they’re not social distancing, they’re gathering in large groups, they’re going to football games, they’re attending political rallies and creating superspreader events that carry the virus on to a new destination.

Bravo.  We need to hear more from Dr Woolf.

The weight of evidence in support of ivermectin as an effective early treatment against the virus continues to grow (there are also suggestions it might have some prophylactic properties as well, but let’s not get too far ahead of ourselves).

There has now been a peer reviewed study published supporting its efficacy.  When will the CDC/FDA/NIH/WHO/etc wake up and acknowledge this?

Timings And Numbers

Things continue to get worse in the US.  After Sunday’s count of a mere 12 states with declining new case rates, we moved up to 13 on Monday, then 11 on Tuesday, 12 on Wednesday, and today sees us down to only 10.

Montana continues to be the worst or second worst state every day when it comes to new case numbers.

Here’s another perspective on the state by state trends, even worse than the rt.live numbers I report.

Some studies suggest Covid deaths are overcounted – there was the famous case in the Seattle area of a person who died from a gunshot wound being counted as a Covid death, for example.  But here’s a balancing view, suggesting that we’re not counting enough deaths as Covid related.

Which is correct?  It is impossible to say.  Maybe the overcounting and undercounting balance each other out?  But with approximately 222,717 deaths reported in the US and 1,102,844 worldwide, and any sort of adjustment up or down from that as you may choose, surely no-one can say that the virus is unimportant and not worth bothering about.

Closings and Openings

Hawaii continues to over/under engineer its rather confusing approach to re-opening to tourism.  Different islands in the Hawaiian group have different policies now.  This article has a helpful table part-way down, but then, if you keep reading, it all gets complicated again.

An unexpected and terrible casualty of the virus caught my eye earlier this week.  Scotland’s whisky industry.  In particular, there’s now the ridiculous-seeming situation where on the fabled Isle of Islay, the brightest shining star in the whisky-drinker’s firmament, it is impossible to buy a single bottle of some of the magnificent whiskies that are distilled on the island itself!  That’s because the whisky is shipped off the island in bulk and bottled just out of Glasgow, and due to quarantine and travel restrictions, is not able to be shipped back to its island home.

Islay always features in our very popular Scotland’s Islands and Highlands tours; and I increasingly find myself wanting to return there – even if there’s no local whisky to be sipped.  People who have enjoyed those tours already will enjoy reading a quote in the linked article from Linda at the Bowmore Hotel, and will doubtless have vivid memories of her very eccentric husband, Peter, too.

Medical

Thank goodness this outcome is very rare – another terrible outcome of this scourge – a man who, it is said, went deaf as a result of the virus.

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

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