Covid-19 Diary : Sunday 1 November, 2020

 

We are setting daily new records for the number of virus cases reported – both the daily count and the running weekly average.  This means the chances of meeting people in stores and elsewhere who are carrying and passing the virus are higher than ever before.  We all understand that – more daily cases means more virus prevalence in the community.  These are the riskiest times so far, for the US (and many other countries too).

And so, in this time of highest risk, what do the bright folk at the CDC say?  The CDC says it is safe to start cruising again.

Clearly the word “safe” has different meanings to the CDC than it does to regular people.

Decisions like this are why the US is and steadily remains the third most affected country in the entire world.  Other countries go up and down the rankings as they have major outbreaks and then develop appropriate responses; but the US refuses to implement any sensible or impactful measures.

Is there any hint of any lessons being learnt and improvements in how we manage this outbreak in the new case numbers shown in the table above?  Surely none that I can see.  Instead, there are bleating articles bemoaning the US doesn’t even know how/where people are catching the virus.

The failure of our “track and trace” program is another national disgrace.  The concept is so blindingly simple :

  • Test lots of people, whether they think they might have the virus or not (we failed at that).
  • Get results of the tests quickly (we failed at that).
  • If the results show the person to have the virus, work with the person to find out who they may have in turn infected, and urgently reach out to those people and ask them to self isolate and get tested too (we failed at that).

What part of this is rocket science?  It is all terribly – tragically – simple.  Meantime, our abject failure to institute simple public health measures sees 100,000 people a day getting infected, and now almost 1,000 people a day dying.

Yet the public debate isn’t about the unnecessary deaths, or tighter measures.  It is all about “re-opening” and relaxing restrictions.  This is not something you can blame President Trump for.  There’s a beyond-ridiculous “Great Barrington Declaration” that some 11,600 medical and public health scientists and 33,000 doctors have signed, calling for less restrictions and more relaxations of controls.

The Great Barrington declaration is terribly wrong.  But 44,000 “experts” – people who should know better – have signed it.

The BBC ran a couple of pieces a couple of days ago that were interesting.  One was all about a new lockdown in England to last four weeks.  Actually, senior cabinet ministers in the UK are already hinting the lockdown might be extended further.

The other was about a different approach in Slovakia – complete national testing of everyone in the country (over the age of 10), to be done on a single weekend.  The country’s defense minister made an interesting and very sensible point.  Facing criticism that the fast test they would be using could miss as many as 30% of people with infections, he said

It’s actually a fantastic number – if you take into account that you’re identifying 70% of sick or infected people across the country.  You then send them home so they don’t come into contact with other people and spread the infection further. There’s no better alternative if you want to find thousands and thousands of people who are currently infected but don’t know it.

I completely agree.  We shouldn’t let the excellent be the enemy of the good.  We shouldn’t worry about the 30% of infected people missed, and use that as a reason to do nothing.  Instead, we should be delighted at, in a single process, getting 70% of the infected people off the streets and into isolation.

If the testing could be repeated every week, that would surely quickly bring the virus under control.

Now consider this (please).  Which is less impactful on the country as a whole?  A four or more week national lockdown, or requiring everyone to be tested each weekend for a period of some weeks?

While the testing isn’t proven as a strategy, and it works best if coupled with tracing of the other people who the identified infected people may have passed the virus on to, it is clearly massively less impactful and with the unresolved ever-present question with lockdowns – what happens after the lockdown to stop the virus from spreading again – the testing option definitely needs to be trialed and might be shown to be by far the better approach.

Well done, Slovakia.  And as for the Great Barrington Declaration?  Oh, it is still advocating hand washing and doesn’t mention masks at all; and is totally silent on testing/tracing and against lockdowns.  43,000 “experts” and not a single one feels that masks are at least as important as hand-washing?  (Even worse, the cornerstone of this piece of dangerous nonsense is a reliance on herd immunity, something that seems less and less feasible with every passing week and new discovery.)

Current Numbers

Armenia, not even on the minor country list last week, is now at the eighth position, and Luxembourg has reappeared after an extended absence, at number 10.  There’s a good chance both Armenia and Luxembourg will continue to go higher.

Lots of changes in the major country list over the last week.

The death rate list remains the same.

Top Case Rates Minor Countries

RankOne Week AgoToday
1AndorraAndorra
2QatarBahrain
3BahrainQatar
4ArubaAruba
5French GuianaFrench Guiana
6IsraelIsrael
7Vatican CityVatican City
8PanamaArmenia
9KuwaitPanama
10MontenegroLuxembourg

 

Top Case Rates Major Countries

RankOne Week AgoToday
1PeruBelgium
2USACzech Republic
3BelgiumUSA
4ChilePeru
5BrazilSpain
6Czech RepublicChile
7ArgentinaBrazil
8SpainArgentina
9ColombiaFrance
10FranceColombia
11NetherlandsNetherlands
12UKUK

 

Top Death Rate Major Countries

RankOne Week AgoToday
1PeruPeru
2BelgiumBelgium
3SpainSpain
4BrazilBrazil
5BoliviaBolivia
6ChileChile
7EcuadorEcuador
8USAUSA
9MexicoMexico
10UKUK

 

I Am Not a Doctor, But….

I truly believe there’s a well orchestrated campaign being played out in the media at present, trying to persuade us all that air travel is safe.  So far, it isn’t completely succeeding, but that is unlikely to see it stop, because the stakes are too high for the airlines, who have never seen public opinion as a stumbling block before.  If at first they don’t succeed, they’ll just double their PR budget to get more favorable press.

Here’s an interesting article that tries to cast some shade on some of the weaker element of this campaign.  The headline asks the question “Is the Covid-19 risk on airplanes really that low?”.  The answer is “No, the total risk of air travel (including unavoidable associated risks in airports, on shuttle buses, and every other part of an air journey, is much greater than the airlines want you to believe“.

Timings And Numbers

On Thursday, there were only two states with dropping rates of new cases (MS and OK).  Friday and Saturday saw just one state with dropping rates (MS) and today Florida joined Mississippi, making two cases with dropping numbers, and 48 with rising numbers.

As predicted on Thursday, the US did indeed exceed 100,000 cases – the very next day!  Worldometers reported 101,461 new cases on Friday – and 988 new deaths.  That’ll be the next new threshold to pass – the 1,000 deaths/day point, although that is not new – we have been suffering more than 1,000 deaths a day on and off since April.

I’ve been so quick to boast of my home country, New Zealand, and its success at vanquishing the virus that I’ve overlooked another country with equal or possibly even greater success – Taiwan.  This article talks about how Taiwan has now gone 200 days without a single local case of the virus.  Taiwan has a population of 23.8 million people, and in total, has had only 558 cases and 7 deaths.

There are lots of other island nations that should be able to do the same.  Sri Lanka, for example – population of 21.4 million but with 11,060 cases and at present, up to 500 new cases a day.  Australia, with 25.6 million people but 27,601 cases, although with a dropping number of daily new cases.  Or smaller islands – maybe easier to manage – such as Iceland or Cuba.  And, of course, closest to home, Hawaii – 1.4 million people and 15,154 cases, increasing at about 75 new cases every day.

The only reason these other places are failing where Taiwan and NZ have succeeded is lack of resolve to implement and comply with the necessary measures to first eliminate the virus from the island and second to keep it from returning.

The pre-election rhetoric is ramping up to fever pitch, with the latest anti-Trump message coming from the American Medical Association.  If we can ignore the unfortunateness that tens of thousands of their members chose to sign the Great Barrington nonsense, we should at least note they are now saying that President Trump is absolutely wrong to say doctors are inflating the number of Covid-19 deaths.

But, may I ask a small question to the AMA.  Who is it then, if not a doctor, that signs a death certificate?  Who is it then who decides to categorize a gunshot victim as a Covid-19 death, if not a doctor?

Closings and Openings

New York’s governor, Mario Cuomo, is one of those amazing “Teflon politicians” who seems to avoid accountability for his mistakes.  Quite the opposite, he’s managed to earn praise for “his handling” of the severe NY outbreak of virus cases back in March/April.

As you can see, New York’s daily case numbers have been slowly but steadily rising again.  Cuomo has been busy blaming other states for this, saying that visitors from other states are bringing the virus in to NY with them.  That’s quite possibly so, but what goes around comes around, and visitors from NY are also taking cases to other states, and bringing the infection back with them too.

The only real answer to that problem is to seal NY’s borders, 100%, not allowing other people in and not allowing New Yorkers back in either, other than with state controlled 14 day quarantines in special quarantine facilities upon return.

That’s of course politically unacceptable, so instead Cuomo continues vaguely blaming other states, and announcing restrictions on visitors from some states – ones he deems to be too dangerous.

His latest stunt is to require visitors from all other states (except NJ, CT and PA – three states he deems “safe”) to quarantine for three days and prove they are free of the virus before being released from quarantine.

The decision to exempt CT NJ and PA is purely political.  New York is averaging 107 new cases per million people every day.  Pennsylvania is averaging 176, New Jersey is averaging 189, and Connecticut is running at 206 – almost twice the NY average.

If NJ is safe with 189 cases and PA with 176, why not MD with 139 new cases a day?  Or, going north, if CT is safe with 206 new cases a day, why not NH with 81 cases a day? And so on, extending out from NY to other nearby states.

We wonder how this will be enforced.

And we also wonder if he’d not be better advised protecting his citizens from each other – the average person in New York encounters many other locals every day, but vastly fewer out-of-staters.  That is where the biggest risk is, and controlling that risk will also happily control the risk from other people, no matter where they come from.  Shouldn’t that be his highest priority?

Like many politicians, he is confusing actions with outcomes; and trying to shift the blame and inconvenience from voters to non-voters).  It is crazy to allow people from states with twice the rate of new infections come into NY, but to restrict people from states with half the rate of new infections.  And all types of travel restrictions in/out of the state are unhelpful when the state can’t control its “in the community” transmission of infections currently.

Medical

Some people, in supporting their call for fewer restrictions and suggesting we just give in to the virus, erroneously claim that very few people are dying of the virus.  While, for sure, the actual count of deaths is far from exact, our guess (and it is only a guess) is that there might be close to a balance between over reporting and under reporting, with each set of errors cancelling out the other.  Whatever the number truly is, surely no-one can pretend that the official count of 237,000 deaths in the US alone – just over four times the deaths in the eight years of the Vietnam war, but in a mere eight months of the virus war – is low.

Call 237,000 whatever you like.  High, low, or anything else.  The thing is that just focusing on deaths is greatly missing a very important issue.  The “survivors” (just like in Vietnam) are often “wounded” – with brain damage, lung damage, and other organ damage – all is quite common in people when emerging from a Covid infection.  This article, while not statistically significant, gives you some feeling for the impacts the virus has had on some people who are “cured”.

The problems with the virus go way beyond “merely” the people who die from it.  As is also true of any war and its “survivors”.

Other

Reader Fred has an interesting question.  He asks

Let’s suppose Biden wins.  Trump is still in charge until the inauguration.  And let’s also suppose Trump blames his loss on Covid-19, which is probably accurate at least in part if not in whole.

What will the Trump administration do about the pandemic between 4 November and the Inauguration on 20 January 2021?? Continue to claim it’s going away?

It will be interesting to see – win or lose – if there’s a shift in the administration’s position shortly after the election.  Even if Trump wins, he’s know a “lame dog” – but also unaccountable – for the next four years.

It will be fascinating to see what happens, in all respects, this coming week.  As the Chinese wish their non-friends, we are indeed living in interesting times.

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.

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