Covid-19 Diary : Thursday 21 January, 2021

Happy “first birthday” – to the coronavirus.  It is one year since the first coronavirus case in the US, in Washington State – a man rumored to be a Boeing employee and recently returned from China.  A year later, and we are counting 25.2 million cases in the US with 420,028 deaths.  The last week or so has seen a slight drop in new cases and in deaths, but with today’s death count being 4,363, the third worst day ever, we’re still a long way from seeing any lights at the end of the tunnel that aren’t oncoming express trains.

On the other hand, a lot of people feel that a new President and administration will bring a welcome change in how the virus has been handled from a public health point of view.  I do not intend to defend anything done by the past administration, but my impression is the bulk of the mismanagement over the last year has been not just by political appointees but by career employees at the CDC and FDA and all the other agencies at federal, state, county and city level, and by political appointees at state/county/city levels.  The career appointees remain, and there has only been little turnover of political appointees at state and lower levels.

However, the “new broom” is already rushing to “sweep clean” and, as is always the case no matter which party succeeds the other, rushing even more to blame everything on the recently departed.  For example, and in particular, the claims of the vaccine distribution planning by the Trump administration to be “so much worse than we could have imagined“.

Although I’ve not hesitated to criticize our vaccine distribution, that’s a statement that demands some response, starting with dismay that the new coronavirus response coordinator is so apparently unaware of what had been done prior to taking over.  None of it was secret.  And much of the problem is at the state and county level – many states and counties are awash with vaccine, with less than 35% of their stocks dispensed.  Nationally, as of today, only 39% of our stocks have been dispensed.

But most of all, the interesting thing is that, while our response has been very much less than perfect in every imaginable way, astonishingly it has still been one of the very best responses in the entire world.  Only China and Russia started vaccinating prior to us, with unproven untested vaccines, and then Israel was next, starting one day before us.  In total, we have vaccinated more people than any other country in the world (we’ve dispensed 16.5 million doses, followed by China with 15 million then the UK with 5.4 million).

Expressed as a “per hundred people” rather than as an absolute number, the outstanding vaccination winner is Israel (35 doses per hundred people) followed by the UAE (21.9), then Bahrain (8.5) and the UK (8.0).  Those are all physically small countries with fewer logistic challenges, and coordinated healthcare systems, rather than the semi-anarchy that rules here.  The next nation is the US, with 5.0 doses per hundred people.  That is outstanding for the US with its much greater challenges in coordination and distribution.

Note – you should halve the number of doses to approximate the number of people with the two-dose complete vaccination.

That’s not a record to be embarrassed about at all.  Both Canada and Europe have achieved a much lower count of 1.8, barely one third our rate.

Meantime, actions such as this one “out of an extreme abundance of caution” and throwing away 330,000 vaccine shots as a result of the approach, are not anything that can be blamed on anyone other than the front-line people who decided to ditch the doses.

As you may know, I consider the statement “out of an abundance of caution” to always indicate that what follows will be indefensibly stupid.  Out of an extreme abundance of caution probably means “what we did is extremely indefensibly stupid”!

Talking about indefensibly stupid, the Brits are starting to have second thoughts about their plan to give more people one vaccine dose but no-one the two doses that are required for full vaccine effectiveness.  This was justified on the spurious grounds that one dose gives people appreciably more than 50% protection, so it is better to have twice as many people with “more than 50% protection” than it is to have a lower number with 95% protection.

That was always an incredibly weak claim, because it was never something that was tested for during the vaccine trials, merely something empirically guessed at from insufficient statistical data.  However, with the Israelis administering and monitoring a large number of doses, they are starting to build up a real-world understanding of how well protected people become after their first vaccine shot, and their analysis suggests the level of protection after one shot is insubstantial rather than substantial and less than earlier claimed.

British “experts” say they’ll look very carefully at the Israeli data.  That is good, but – wouldn’t you love to be living in a world where experts “looked carefully” at the data before making decisions, especially when the data to date and vaccine manufacturers recommended against their first decision….

This article seeks to explain why you still need to wear a mask and avoid crowds after being vaccinated.  The main reason, to paraphrase, is because we really don’t know very much at all about what the vaccines may or may not do, because we didn’t take the time to trial and test for all these considerations.  One wonders what else was missed in the rush to get vaccines approved, and one also wonders just exactly how rigorous the approval process was.

On the positive side, we were delighted to see Joe Biden adding a federal mandate to wearing a mask when on public transport.  It was also good seeing him setting a goal – 100 million doses within 100 days.  It is great to have a number to be measured alongside.

On the other hand, if we do 100 million doses in 100 days, has anyone wondered how long it would take to get the entire country vaccinated?  Sure, it is very unlikely that everyone would want to be vaccinated, but at a rate of a million doses a day, and factoring in the 16.5 million doses dispensed already, that will see us triumphantly concluding the program in mid October.  Next year.  2022.

This is an inexplicably slow rate and a massively underachieving goal.  We’re pushing vaccinations into people’s arms at that rate already.  All Biden is striving for is to stay at our present rate.

We manage normal ‘flu vaccinations at a two-three times greater rate.  Why can’t we aim to at least vaccinate for Covid at the same speed as we do for annual influenza outbreaks?

The sainted Dr Fauci said that to achieve herd immunity, we’ll need as many as 280 million people vaccinated, which he might have predicted will happen by this fall.  The first day of fall is around 21 September.  At the target rate of 1 million doses a day, we’ll have vaccinated less than half the 280 million people needed for herd immunity by then.

Lastly in the introductory comments, it is amazing to see what a difference having a massive PR budget and lobbying group can do for a drug and drug maker.  This article touts a new expensive drug developed by Eli Lilly that can only be taken by IV as reducing a person’s risk of getting Covid.

Why the snark?  What’s not to like about that?  Nothing at all, but a quiet voice at the back says “isn’t that the same thing that ivermectin does, but by simply taking two tablets, for a dollar or less?”.  And whereas the Eli Lilly claim is backed by nothing more than biased research by Eli Lilly itself, the ivermectin benefits are supported by 53 different studies, 19 of which has been peer reviewed.

Sadly, our approach to treating Covid seems to be driven by PR and big budgets, not by common sense and medical science.  We eagerly await President Biden’s actions on ivermectin (and hydroxychloroquine).

Current Numbers

In the US, Rhode Island showed a massive growth in new cases, while worst state ND is easing in new cases and might in time be overtaken by SD and possibly other states.  In the death rates, Mississippi displaced Connecticut.

In the minor country list, French Polynesia dropped off the list, as did Georgia, being replaced by Israel and Lithuania.  In the major country list, the UK eased back a place.

Very little obvious change in the death list, but the UK has caught up to both the second and third countries and if its very high casualty rate continues much longer, may overtake them both and move into second place.  The encouraging news for the UK is their new case rate is sharply falling, but it may take a few more days before the lagging death rate starts to fall as well.

US Best and Worst States

Top Case Rates Minor Countries (cases per million)

Top Case Rates Major Countries (cases per million)

Top Death Rate Major Countries (deaths per million)

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Items below include an amazing new smart-watch app for detecting the virus, with only one problem; mask questions but not answers; a possibly harmful new approach to making restaurant dining safer, and an earlier approach to making restaurant dining “safer” which did quite the opposite; experts simultaneously say ‘yes’ and ‘no’ yet again; why are we spending $20 billion more on vaccines when we’ve already bought and paid for 700 million doses; not all vaccines are equally effective; some great new charts and data sources; and a really strange place to shelter from the virus for three months.

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One final item today.  Reader Linda advises of a new major side effect being experienced by many people when they finally get their second dose, particularly if they’ve been worrying for the three weeks prior to then if they’ll get it or not.

The side effect?  Relief.

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

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